Performance Audit

of the

Nevada State Board of Medical Examiners

Report to the Legislative Commission

Federation of State Medical Boards

Year Ending June 30, 2003

December 1, 2003

 

 


Table of Contents

I. Objectives

II. Summary

III. Principal Recommendations

IV. Other Findings and Recommendations

V. Comparative Data

VI. Attachments

 

The Federation of State Medical Boards of the United States, Inc.

P. 0. Box 619850

Dallas, Texas 75261-9850

(817) 868-4000

 

 


Objectives

The Federation of State Medical Boards of the United States, Inc., (“the FSMB”) conducted this audit of the Nevada State Board of Medical Examiners (“the Board”) pursuant to the terms of Section 41 of Chapter 508, Statutes of Nevada 2003; the Request for Proposal ("RFP") of the Legislative Commission, dated August 15, 2003 (Attachment 1); and the FSMB Response to the RFP, dated September 12, 2003 (Attachment 2). The Legislative Commission directed that the performance audit include, without limitation, a comprehensive review and evaluation of:

 

a) The methodology and efficiency of the Board in responding to complaints filed by the public against a licensee.

b) The methodology and efficiency of the Board in responding to complaints filed by a licensee against another licensee.

c) The methodology and efficiency of the Board in conducting investigations of licensees who have had two or more malpractice claims filed against them within a period of 12 months.

d) The methodology and efficiency of the Board in conducting investigations of licensees who have been the subject of one or more peer review actions at a medical facility that resulted in the licensee losing his/her professional privileges at the medical facility for more than 30 days within a period of 12 months.

e) The methodology and efficiency of the Board in taking preventative steps or progressive actions to remedy or deter any unprofessional conduct by a licensee before such conduct results in a violation under NRS Chapter 630 that warrants disciplinary action.

f) The managerial and administrative efficiency of the Board in using the fees that it collects pursuant to NRS Chapter 630.1

 

This audit included an examination of the records described in the Response to the RFP; a site visit on November 3 and 4, 2003, including interviews with four Board members, six staff, and two external financial auditors; and a review of materials listed in Attachment 3.

 

1 RFP, Attachment 1

 

 


Summary

 

The audit indicates that the Board meets or exceeds its statutory responsibility described in NRS 630.003, entitled "Legislative declaration." As is the case with any medical board, this Board could improve its effectiveness in protecting the public in certain ways, but some changes will require legislation. The report contains recommendations within the precise enumerated objectives of the RFP as well as other recommendations that are presented in the spirit of the stipulation in the RFP that the review and evaluation be without limitation. 2

 

The following is a summary of findings and basic recommendations relating specifically to the objectives. Specific methodologies and efficiencies of the Board and principal recommendations for improvement are covered later in the report.

 

a) The methodology and efficiency of the Board in responding to complaints filed by the public against a licensee.

b) The methodology and efficiency of the Board in responding to complaints filed by a licensee against another licensee.

 

The Board does not distinguish between how it responds to complaints filed by the public and complaints filed by licensees. All allegations of violations within the Board's jurisdiction are investigated, regardless of source. Furthermore, the Board has a process for taking immediate action in emergency situations involving imminent risk to the public. An informal system exists for investigators and legal staff to discuss cases and priorities. With the volume of investigations increasing dramatically, for reasons discussed later, a more systematic approach is needed to assign resources more efficiently and to prioritize those matters with higher potential impact on citizens.

 

The Board should implement a system through its database management software for assigning and tracking high, medium or low priority to investigative cases that suggest risk to the public. The Chief Investigator, Medical Reviewer, and General Counsel now meet on an ad hoc basis to discuss cases and ensure that those involving higher public risk get proportionally higher priority. These staff members or their representatives, along with the Executive Secretary when appropriate, should meet on a regular basis to discuss open cases and to allocate investigative and legal resources.

 

While a citizen who files a complaint ("the source") receives immediate acknowledgment of the complaint being reviewed and, if a case is closed, a closure letter, the lines of communication should be improved between the Board and the source, especially when the source is a member of the public. Sources should be sent regular communications regarding where the complaint is in; the process and periodic updates on status if the Board enters a lengthy disciplinary process. Sources should testify in hearings unless the

 

2 RFP, Section V, Paragraph B, Objectives

 

 


Board's General Counsel determines such testimony would hinder the Board's ability to prosecute.

 

c) The methodology and efficiency of the Board in conducting investigations of licensees who have had two or more malpractice claims filed against them within

a period of 12 months.

 

The Board reviews all reported claims, adjudications and settlements regardless of time period; therefore, all malpractice claims filed against a licensee within a period of 12 months are examined. Furthermore, the Board considers all prior claims each time a new case is reviewed. Malpractice insurers and licensees must report to the Board any claim for malpractice or negligence and the settlement, award, judgment or other disposition thereof. 3 The Board has a thorough screening process for sifting through malpractice information reported to it from numerous sources, obtaining outside expertise when indicated, and deciding whether underlying events constitute a basis for prosecutable disciplinary action under the Nevada Revised Statutes.

 

The Board recently, on its own initiative, began reviewing county records online and in courthouses to identify malpractice lawsuits that have been filed. Since medical malpractice insurance companies and licensees are required by law to report these same claims to the Board, reviewing courthouse records appears to be redundant and an inefficient use of the Board's investigative resources. The Board's review of such records, however, indicates that many individuals and entities are not fulfilling their statutory obligation to report. To address these problems, the Board should seek legislative authority to review courthouse records and develop a consolidated reporting system or fall back on existing reporting with an emphasis on punitive action for failure to report. .

 

d) The methodology and efficiency of the Board in conducting investigations of licensees who have been the subject of one or more peer review actions at a medical facility that resulted in the licensee losing his/her professional privileges at the medical facility for more than 30 days within a period of 12 months.

 

The Board reviews all reports required by statute4 of changes in privileges and outcome of disciplinary action by a licensed hospital, clinic or medical facility or medical society. Thus, where there is statutory compliance with reporting requirements, actions resulting in loss of privileges for more than 30 days within a period of 12 months are always investigated by the Board. ; As with all matters under investigation, an accounting of all prior Board investigations pertinent to . a licensee are is provided to the appropriate Investigative Committee of the Board when a current report is considered.

 

The Board should take steps to ensure accurate, timely reporting by those entities outside of its jurisdiction and periodically remind medical societies of their reporting requirements.

 

3 NRS 630.3067, NRS 690B.045

4 NRS 630.307

 

 


e) The methodology and efficiency of the Board in taking preventative steps or progressive actions to remedy or deter any unprofessional conduct by a licensee before such conduct results in a violation under NRS Chapter 630 that warrants disciplinary action.

 

While the board takes steps to deter unprofessional conduct, such as checking malpractice claims filed in county courthouses and posting recent disciplinary actions, "unprofessional conduct" per se is not grounds for initiating discipline or denying licenure as delineated in Chapter 630 of Nevada Revised Statutes. Additionally, the statute was recently revised to require that, in order for the Board to take an action on a felony conviction, it must relate to the practice of medicine, effectively removing Board discretion in such matters.

 

Unprofessional conduct should be added to the statute as grounds for discipline or license denial, and the Board should be authorized to define unprofessional conduct by regulation. Furthermore, NRS 630.301 should be revised to restore the statute to its earlier status by including conviction of a felony and any offense involving moral turpitude as basis for discipline or denial of a license.

 

f) The managerial and administrative efficiency of the Board in using the fees that it collects pursuant to NRS Chapter 630.

 

The Board uses its fees efficiently; however, safeguards could be improved. The auditors conducting the annual financial audit do not present the annual audit directly to the entire Board. The Board should create an audit committee to whom each audit would be presented in person by the auditors. Additionally, the auditors should be required to indicate in writing to the Board whether or not a management letter has been prepared. The auditors should be required to submit the management letter at the same time they submit the audit, and each recommendation contained in the management letter should be discussed and accepted or rejected in a public session of the Board.

 

 


Principal Recommendations

 

The following section details the Board's methodologies and the audit findings for each of the points specified for review by the Legislative Commission.  Comments on the Board's efficiencies and principal recommendations for improvement are also provided. A review of other processes and recommendations for improvement are presented later in the report in the spirit of the stipulation in the RFP that the review and evaluation be without limitation.

 

a) The methodology and efficiency of the Board in responding to complaints filed by the public against a licensee.

b) The methodology and efficiency of the Board in responding to complaints filed by a licensee against another licensee.

 

The process for resolving complaints is the same for reports filed by the public or a licensee. All are identified and categorized by source for later analysis. Except in emergency cases, all input sources (citizen complaints, malpractice claims reported, questionable drug prescribing identified in the prescription monitoring system, hospital actions, complaints filed by a peer, etc.) are treated as complaints, and investigations are initiated to explore and monitor these matters through to disposition. (A flowchart and detailed written overview of the Board's complaint and investigative process are provided as Attachment 4.) The method of investigation was described consistently by all those interviewed and especially thoroughly by those integrally involved in the process. The methodology followed due process and good practices and provided for a fair hearing and for appropriate sanction when indicated.

 

If the Chief Investigator determines an emergency exists involving public risk, he immediately meets with the General Counsel and the Medical Reviewer to discuss the case.If these staff members concur that an emergency exists and the evidentiary standard has been met, the Board is summoned for an emergency teleconference to consider a summary suspension. Otherwise, the case is routinely assigned to an investigator for review and case preparation.

 

An informal system exists for investigators and legal staff to discuss cases and priorities. The volume of investigations is increasing dramatically, for reasons described later; therefore, a more systematic approach is needed to assign resources efficiently and to prioritize those matters with higher potential impact on citizens.

 

Complaints need to be triaged systematically for prioritization when cases are opened. The Board should implement a system for assigning priority to investigative cases that suggest risk to the public. A simple system of priority can be implemented with high, medium or low priority assigned and tracked through the Board's database management software. While this is not a scientific nor wholly objective system, it will improve patient protection and in broad terms allocate resources intelligently. This is also important for accountability purposes:

 

 


The Chief Investigator, Medical. Reviewer, and General Counsel now meet on an ad hoc basis to discuss cases. Open cases should be reviewed at regular intervals in a structured process including the Executive Secretary and/or the Deputy Executive Secretary, the Chief Investigator, the Medical Reviewer, and the General Counsel. The purpose of this meeting is to discuss priorities of new cases opened since the last meeting, cases where risk of further public harm is identified in the investigative process and investigative priorities. The General Counsel can also advise investigators in order to manage investigative resources. Investigators should not, for example, spend time on cases the General Counsel feels lack prosecution potential, and they should maximize resources on cases that require more, intensive effort.

 

Currently, there is one Investigative Committee (IC)5 for the Board; a second is being formed due to the increasing workload of the investigative process. A third committee has been formed to handle license application cases involving malpractice. The IC meets eight times a year: the day before each quarterly Board meeting and a few weeks prior to each Board meeting. Since Board members who have served on the IC of a particular case are precluded from voting on the outcome of that case, having two ICs still allows a quorum of eligible board members to vote on the discipline in each case that is investigated. Barring board members who have investigative knowledge of a case from voting on that discipline is consistent with standard practices in administrative law.

 

The Board also has recently increased its investigative staff. A reasonable portion of this resource should go to timely communication with those who file complaints with the Board. While citizens who file complaints receive immediate acknowledgment of the complaint and, if a case is closed, a closure letter, they receive no other correspondence in the form of periodic updates or progress of the case if charges are filed. The lines of communication should be improved between the Board and the source through use of regular communications about where the complaint is in the process. (See Attachment 5 for sample form letters currently used in the complaint process.) Such communication is especially important when the source is a member of the public. It is less important if the source is an organization or reporting entity such as an insurance company.

 

The Board should interview, call or write every complaint source to give them an opportunity to supplement the complaint letter, even though the current standard letter to the source acknowledging the complaint invites the source to send additional information. Thereafter, investigators should be encouraged to periodically update sources on progress and disposition. A letter should go to the source when the investigation is complete and the report has gone for review by the Medical Reviewer and the IC. Additionally, sources should be sent periodic updates on status if the Board enters a lengthy disciplinary process.

 

Sources should testify in hearings unless the Board's General Counsel determines such testimony would hinder the Board's ability to prosecute. A letter should be sent to the source when formal charges are brought, with a copy of the charges and notice of the date, time and place of the hearing and communicate the right to be present at the public

 

5 NRS 630.311

 

 


proceeding. The letter should also list a contact name at the Board office for questions. Finally, the Board should provide a copy of its decision to the source after the hearing.

 

c) The methodology and efficiency of the Board in conducting investigations of licensees who have had two or more malpractice claims filed against them within a period of 12 months.

 

The Board reviews all reported claims, adjudications and settlements regardless of time. period and reviews a chronicle of all prior claims each time a new case is reviewed. Consequently, all malpractice claims filed against a licensee within a period of 12 months are examined. The Board thus has a perspective on all prior claims reported each time it examines a new claim. Malpractice insurers and licensees must report to the Board any claim for malpractice or negligence and the settlement, award, judgment or other disposition thereof.6

 

The Board has a thorough screening process for sifting through malpractice information reported to it from numerous sources, obtaining outside expertise when indicated, and deciding whether underlying events constitute prosecutable disciplinary actions under the Nevada Revised Statutes. A review and discussion of the Board's time lines for investigations is provided as Attachment 6.

 

In reviewing a sample of malpractice cases in Board files, input sources for malpractice almost never include the plaintiff who filed the claim, or someone on their behalf. These cases are reported pursuant to statute as follows:

  • Insurance companies: Any breach of professional duty toward a patient involving a settlement, judgment, or award to a patient for more than $5,000 must be reported to the Board within 30 days of the settlement.7
  • Insurance companies: Any action filed or claim submitted to arbitration or mediation for malpractice or negligence must be reported to the Board within 30 days after the action is filed. The Board must also be advised of any disposition within 30 days. There is no minimum threshold.8
  • Clerk of the Court: Must notify the Board and report any physician, PA or practitioner of respiratory care who has a finding, judgment, or other determination of liability for malpractice or negligence.9
  • Physician: Must self-report any claim and subsequent disposition within 90 days after the claim is filed or disposed of.10
  • Medical Dental Screening Panel (MDSP): Reviewed malpractice claims before they were filed in state court and reported their findings to the Board.11

 

6 NRS 630.3067, NRS 690B.045

7 NRS 690B.045

8 Section 54 and 63 of Assembly Bill 1 of the l8th Special Session of the Nevada State Legislature.

9 NRS 630.307 (1) (e

10 NRS 630.3062

11 Note: the MDSP was abolished in October 2002 by legislation but was allowed to complete cases already filed. Per AB 1, 18th Special Session of the Nevada Legislature, claimants may either proceed with the panel review or remove the case and file an action in state court for complaints filed before October 1; 2002. Therefore, the Board may still receive some reports from the MDSP until all of its cases are cleared.

 

 


  • Since August 2003, he Board has commenced, on its own initiative, a review of courthouse records in principal population centers looking for malpractice filings. In an effort to determine if physicians are failing to self-report, the Board has determined that there :is a lag between filings and service of notice upon the physician that accounts for many of the cases where there is a court filing but no physician self-report.

 

The FSMB reviewers identified 200 cases involving malpractice reported by insurance companies, the MDSP, county clerks of the court, and licensees for the year ending June 30, 2003. Some of these cases are duplicates of the same event reported by different sources. Of these cases, 12 individual physicians had two or more separate malpractice reports within a 12-month period. Of these, four had all cases closed when the MDSP found no malpractice. Outside peer review was ordered five times, with no finding of malpractice returned two times. Outside peer reviews remain pending in two cases. The Board's Investigative Committee forwarded two cases to legal counsel for potential charges. In one case an outside peer reviewer found malpractice; the IC interviewed the physician and subsequently closed the case.

 

For the period January 1, 2002, until November 3, 2003, the Board opened 1,154 investigations. Of these, 605 are reported malpractice cases from all the sources noted above. Many investigations are duplicates of the same event. A physician report, insurance company report and county court record report could result in as many as six cases involving the same claim and settlement being reviewed by the Board.

 

Further review of the 1,154 investigations opened by the Board for the period January 1, 2002, until November 3, 2003, revealed that 22 cases, or fewer than 2% of investigations, came from hospital sources. Hospitals, clinics, and other medical facilities licensed in Nevada are required to report changes in privileges.12 For most of the cases of malpractice that were sampled, the alleged malpractice occurred in hospitals. This presents three possible scenarios: hospitals are not reacting to these malpractice cases with limitations on privileges, there is underreporting of hospital actions, or both. The Board should obtain a list of hospitals, clinics, and other medical facilities licensed in the state from the Bureau of Licensing, Nevada State Health Division. The Board should periodically remind hospital administrators and the chiefs of medical staffs of the facility reporting requirements, and the Board should publicly demand that the State Health Division enforce its sanction for non-reporting.

 

Three cases of malpractice were sampled and reviewed.. One of these cases was widely reported in the media as an example of a physician ho had a serious problem with malpractice and who appeared to flee to another state. The following was observed:

  • He applied for a license in February 1993. There was nothing in his application to forewarn the Board that he was a malpractice risk. He was appropriately trained, passed minimum competency exams, had no derogatory information information reported by himself or other licensing boards, and had five years of approved postgraduate in a United States hospital He had been certified as a specialist by a

 

12 NRS 630.307

 

 


specialty board approved by the American Board of Medical Specialties, thereby demonstrating sufficient training after he received his M.D. to practice a specialty.

  • The Board's biennial registration forms ask for malpractice information. In many, if not most cases, years pass between alleged malpractice and lawsuit pleadings that reach a licensee. This licensee first reported malpractice claims on his 1999 registration form. At that time; through dual reporting systems noted above, the MDSP also reported these events to the Board. However, at that time, there was a four-year lag in cases reported by the MDSP. The MDSP would reach one of three conclusions: reasonable probability of medical malpractice, no reasonable probability of medical malpractice, or unable to reach a decision on the issue of medical malpractice. Initial reports on this licensee were in the latter category. As cases progressed involving this licensee, the MDSP changed its determination on some of the earlier cases. The following was reported by the licensee in 1999: a $17,500 settlement in May 1998; a non-monetary settlement in February 1999 of a case involving allegations from 1995; and pending cases involving allegations from 1994 and 1996, including a lawsuit filed in December 1998. The Board conducted an investigation and obtained peer expert testimony, which determined that the records it had thus far did not demonstrate practice below minimum standards.
  • More cases were reported through the MDSP in 2001. Some of these had malpractice allegations going back to 1995. In 2001 the Board had 15 cases open, and peer reviews were coming back negative. The Board issued charges alleging ten counts of malpractice and then indicated its intent to hold a hearing, which would start the disciplinary process. Rather than face these charges, the doctor surrendered his Nevada medical license.
  • The Board's public record included a document describing all the charges, and this record was immediately sent to the state to which this licensee fled, as well as all other states and all other entities that are notified through the FSMB Board Action Database. In all of these malpractice allegations, dating back to 1995 in some cases, not once did the patient complain to the Board. Had that occurred, the Board could have intervened much sooner.

 

Two other cases involving malpractice were sampled and examined as to time line. In one case, the initial report came to the Board in August 2001. Medical records were twice subpoenaed from two hospitals and reviewed by an expert. The case was presented to the Board's Investigative Committee in May 2002. The case then went to legal counsel with records received from the MDSP and went back to the IC in September. The IC authorized issuance of a formal complaint, and a hearing was scheduled in December 2002. The Board issued a public disciplinary order in April 2003, imposing a continuing education requirement, a fine, and a public reprimand. The case was reported to all appropriate entities in a timely manner and appeared in the Board's Summer 2003 Newsletter.

 

Board investigators recently began reviewing county records online and in courthouses to identify malpractice lawsuits that have been filed. A case is opened each time a lawsuit is found, creating another layer of redundancy, because both medical malpractice

 

 


insurance companies and licensees bylaw must report these same claims to the Board. While results are preliminary, there appears to be a lack of reporting by both licensees and insurance companies. It is interesting to note that physician self-reports rarely appear in the file until August 2003, when the Board started reviewing county records. Concurrently, physician self-reports started cascading into the investigative system, presenting several problems for the Board.

 

First, a significant burden was added to investigative resources to follow up on the claims in county courthouse records. No centralized system for consolidating these cases is in place; therefore, any resource dedicated to this effort is pulled away from investigating complaints from the public and other sources. Second, reviewing courthouse records is redundant. Assuming statutory compliance with reporting requirements, this check .should be unnecessary.

 

The Board should abandon the review of county court records. While periodic sampling of county records would help ensure self-reporting, as noted above, the Board should periodically remind licensees of their responsibilities to report via the Board's Newsletter, the Board's website, and registration notices. Concurrently, the Board should pursue failure to report by its own licensees and mount an aggressive enforcement effort to impose discipline on those licensees who fail to report claims.

 

The Board also should identify and refer to the Division of Insurance, Department of Business and Industry, all cases in which an insurance company fails to report to the Board. The Board should obtain from the Commissioner of Insurance a list of insurance companies writing malpractice insurance in Nevada and periodically remind these companies of reporting requirements and penalties for failure to report. The existing penalties for insurance companies and physicians who fail to report malpractice claims, settlements, and judgments are adequate and significant and should be pursued.

 

Once the Board has identified a good sample of failed reporting in its review of courthouse records, it should either seek legislative authority to review courthouse records, seek a consolidated reporting system for that purpose, or fall back on existing reporting with an emphasis on punitive action for failure to report. One approach to simplify the process would be to modify NRS 630.307 by adding to those items that are reported by clerks of court a provision to report malpractice claims as well as liability judgments to. the Board. Another more cost effective approach would be to rely on the Commissioner of Insurance to enforce newly enacted penalties on insurance companies

for failure to report.13

 

The Board receives malpractice information, both claims and settlements, from so many sources that there ore often duplicates of the. same case migrating through the system. These cases need to e consolidated through the computer system when initially entered to eliminate opening multiple investigations. The reporting requirements detailed earlier demonstrate the potential for several reports of the same event to come to the Board. All

 

13 Nevada Medical Professional Liability, Department of Business and Industry, Division of Insurance, Bulletin 02-011, (October 1, 2002).

 

 

 


of these cases present a distorted picture of backlog and complaints in the state and distract resources from other priorities.

 

For malpractice cases particularly, one case should be opened for the initial event reported (claim, settlement, etc.). All subsequent reports should then be included as update material in the chronological record, rather than as new cases. Furthermore, each case reported by the clerk of the court or an insurance company should be checked to see if the licensee self-reported. The Investigative Committee should be informed of a failure to self-report and discipline should be levied as a matter of routine. By focusing on penalties for those who fail to report, some of the redundancy and its associated overhead can be eliminated.

 

A review of all the malpractice cases in the Board files noted above reflects a paucity of patient complaints. In samples of malpractice claims involving one licensee with numerous claims, there was no example of a patient plaintiff who concurrently filed a complaint with the Board when alleged malpractice occurred. The Board should find ways to motivate victims of alleged malpractice to notify the Board of these matters. Additionally, the legislature should consider incentives to motivate plaintiff's attorneys and victims of malpractice to file complaints with the Board earlier in the process, such as isolating Board action or lack of Board action from having any impact on outcome in a civil tort case.

 

The premise of the malpractice system is tort, to compensate a patient for damages caused by the negligent or intentional conduct of a physician. The premise of the regulatory system, however, is to enforce compliance with the standards of conduct set forth by the legislature to protect the public health and welfare through appropriate action against the license to practice. The Board may act against a physician for violation of the medical practice act even though no harm to the patient occurred. The Board may likewise find that, even though a patient was harmed, the medical practice act was not violated. Happy outcomes in medicine are not guaranteed, and an unhappy outcome does not mean the medicine was faulty or the medical practice act was violated.

 

There may be concern about jeopardizing a legal case if the Board intervenes, as well as reticence to alert the Board to a claim because if the Board closes a case it may be perceived to negatively affect the civil case. One remedy may be statutory language that lowers perceived barriers to Board involvement, such as language providing that the presence or absence of Board action or involvement has no bearing on a civil case and may not be used as evidence.

 

With all of the reporting mechanisms in place, some of them overlapping, in sample cases the greatest amount of time passes between the alleged malpractice and the notice from the MDSP to the Board of the existence of a complaint that triggered reporting. In the sample noted previously, one malpractice case reported by the licensee on registration in 1999 showed the date of suit as "12/16/98" and the date of act "12/21/96."

 

 


The legislature should consider reestablishing a properly funded organization to perform the functions of the Medical Dental Screening Panel. There were often significant delays between the date of the malpractice claim and the report to the Board by the MDSP, which medical Board staff attributes to a lack of funding for the MDSP. Although there is a distinct difference between what constitutes a basis for a malpractice judgment and grounds for a prosecutable disciplinary action, the MDSP findings were useful to the Board as a prescreening tool. Malpractice claims have increased dramatically since the . MDSP .was disbanded by legislation in October 2002. Unless there is a direct correlation between the occurrence of malpractice and the existence of the MDSP, this recent increase in claims can be at least partially attributable to frivolous claims. This benefit is now lost to the Board, and it must now scour many more claims to identify those that should be prosecuted. The legislature should restore a properly funded successor to the MDSP, while insisting that its procedures facilitate the process of dealing with complaints, rather than hindering that process unnecessarily.

 

Finally, the Board should periodically ask the entire in-state licensee population, via its newsletter, for physician volunteers for peer review. Peer review by a qualified expert is usually necessary to meet the Board's evidence standard in a hearing. A peer review establishes prevailing medical practices and is necessary to identify practices falling below those standards. Peer review is therefore a necessary part of Board operations.

 

Due to the geographic distribution of the population, it has become increasingly difficult to find medical experts to conduct these reviews who come from a part of Nevada different from the practice area of the physician under investigation. Doing so is important to avoid conflicts of interest. Physician licensees should be encouraged to participate in the process as part of their professional responsibility. While the Board offers an incentive to licensees for doing peer reviews by offering Continuing Medical Education credit, wider solicitation could yield more volunteers. Based on experience of similar recruitment efforts in other states, the volunteer list needs to be screened to remove volunteers who would be easily impeachable as prosecution experts, such as physicians with a significant malpractice or disciplinary history.

 

d) The methodology and efficiency of the Board in conducting investigations of licensees who have been the subject of one or more peer review actions at a medical facility that resulted in the licensee losing his/her professional privileges at the medical facility for. more than 30 days within a period of 12 months

 

The Board reviews all reports required by statutel4 of changes in privileges and outcome of disciplinary action by a licensed hospital, clinic or medical facility or medical society. As with all matters under investigation, all prior investigations are reported to the IC when.a report is made on a current matter. Thus, always complying with statutory reporting requirements would result in a report to the Board of actions resulting in loss of privileges for more than 30 days within a period of 12 months.

 

14 NRS 630.307

 

 


The reviewers identified eleven (11) cases meeting these criteria in a review of all cases for the year ending June 30, 2003. Two cases were closed; one in which the physician was reinstated. These two cases took an average of 233 days from the date opened until closed. A sampling of case files demonstrates thorough presentation of information to the IC, including internal medical review. In all cases the Board's Medical Reviewer requested medical records from the respective medical facility.  The process thus provides for thorough information to be presented to the IC when it considers the case. These cases naturally take longer to complete and present to the Board due to this step in the process.

 

The Board has made no enforcement effort to ensure accurate reporting by those entities outside of its jurisdiction. The Board should obtain current mailing addresses of all hospitals and other treatment facilities from the Bureau of Licensing, Nevada State Health Division, and periodically remind all hospital administrators and chiefs of medical staffs of reporting requirements of NRS 630.307. The Board should also periodically remind medical societies of their reporting requirements.

 

e) The methodology and efficiency of the Board in taking preventative steps or progressive actions to remedy or deter any unprofessional conduct by a licensee before such conduct results in a violation under NRS Chapter 630 that warrants disciplinary action.

 

The Board takes periodic steps to deter "unprofessional conduct."15 Examples include:

  • checking malpractice claims filed in county courthouses;
  • publishing and mailing a newsletter of disciplinary actions to all licensees;
  • posting recent discipline cases to media, hospitals, and medical societies after such actions become public;
  • asking the legislature for improvements to its statutory authority; and
  • tightening licensing standards to mirror prevailing minimum standards in other jurisdictions.

 

"Unprofessional conduct" per se, however, is not grounds for initiating discipline or denying licensure under current Nevada law. Instead, Chapter 630 of Nevada Revised Statutes define such grounds in particular detail. If the Board finds a need to define public protection in an area not covered by the statute, it must wait for the legislative cycle to do so. Defining disciplinary grounds too narrowly in law has drawbacks. For example, the statute was recently revised to require that, in order for the Board to take an action on a felony conviction, it must relate to the practice of medicine. It is logical to assume that most citizens in Nevada would want the Board to take action on the license of a physician convicted of murder or a serious sexual offense, whether or not the crime directly related to the practice of medicine. However, the effect of the recent statutory change is to remove the Board's ability to act on a license in such matters. NRS 630.301 should be revised to restore the statute to its earlier status by including conviction of a

 

15 RFP, Section V, Objectives, B 5, page 10.

 

 


felony and any offense involving moral turpitude as basis for discipline or denial of a license.

 

Unprofessional conduct should be added to Chapter 630 of Nevada Revised Statutes as grounds for discipline or license denial. The Board should be authorized to define unprofessional conduct by regulation so that it may act to protect the public when the legislature is not in session.  The administrative process for adopting regulations provides the public, interest groups, and the legislature with a process of oversight to ensure appropriate use of this delegated authority. If the Board, for example, determines from surveillance of investigations that anorectic drugs are being prescribed injudiciously for treatment of obesity, it could create boundaries by regulation under the definition of unprofessional conduct, imposing a timely public protection solution. This arrangement enables and encourages the Board to deter unprofessional conduct more preemptively.

 

f) The managerial and administrative efficiency of the Board in using the fees that it collects pursuant to NRS Chapter 630.

 

The Board uses its fees efficiently; however, safeguards could be improved. The auditors conducting the annual financial audit do not currently present the annual audit directly to the entire Board. The report is instead presented to the Board's Secretary/Treasurer. In accordance with law, a copy of the audit is sent to the Legislature.

 

Some findings in prior audits have not been resolved; therefore, they recur in subsequent audit cycles. These findings were listed in the management letter, which has not been presented to the Board in person and concurrent with the audit.

 

The Board should create an audit committee to whom each audit would be presented in person by the auditors. Additionally, the auditors should be required to indicate in writing to the Board whether or not a management letter has been prepared. The auditors should be required to submit the management letter at the same time they submit the audit, and each recommendation contained in the management letter should be explained, discussed, and accepted or rejected in a public session of the Board.

 

 


Other Findings and Recommendations

 

Public Records of Disciplinary Cases

Public records of disciplinary cases are made available through a manual system consisting of request and prepayment from the customer, processing the request by staff at the Board's office, depositing the funds, retrieving and photocopying the public document, and mailing the photocopy to the customer. The Board thus has the overhead of an order/billing/shipping system. Even though this system provides a revenue source, the net profit to the Board is marginal. The costs include tying up staff and photocopy equipment, the attendant error whenever staff must summarize a complex legal document, and delay to the customer.'

 

Recommendation: Make public Board orders and statements of charges available to the public at no cost, electronically. The customer looks up the licensee on the web page, and once identified, is presented with options to select any public records. The customer clicks on the record, and it is displayed on the customer's computer screen via Adobe Acrobat software, an industry standard in use for such common applications as income tax forms in all states and the federal government. The Adobe Acrobat reader software is free. This process makes public records immediately available to the customer where they can be downloaded and printed with user resources. The overhead of manual photocopying and processing remittances is all but eliminated for the Board. Furthermore, since Board summaries of these documents can be subjective, allowing the public to access these files directly eliminates the need to summarize them. The document thus “speaks for itself” and interpretation is left to the reader.

 

Only those customers who have no access to a computer need request a copy  of the Board's order. Experience at other Boards suggests that the charge for providing paper copies of records may be dropped, as the number of requests will be minimal. The process of posting these documents electronically on the web is simple for the Board. Purchased Adobe software provides a utility to create Adobe files using the word processing soflware used to create the document in the first place. The Board simply mounts the file in secure file space on the Internet server it uses and provides a link to the public record from the physician lookup software.

 

Educating Licensees About the Board

The FSMB reviewers noted the Board's efforts at physician education and noted the publication of a quarterly newsletter, which includes summaries of disciplinary actions taken by the board, including letters of public reprimand. The board members and staff interviewed recognized that the board's role is primarily driven by the complaint process. As laid out in the statute, “For the benefit and protection of the public, the Legislature delegates to the Board of Medical Examiners the power and duty to determine the initial and continued competence of physicians... who ,are subject to the .provisions of this chapter.” 16 The Board carries out this responsibility by having rigorous initial licensure

 

16 NRS 630.003, as amended by Section 42 of Senate Bill 250 of the 72nd Session of the Nevada Legislature.

 

 


requirements that ensure all licensed physicians have three years of continuous successful training and have taken a recent examination to show competence. Plans are underway to strengthen the continued competence requirements of physicians, which will distinguish Nevada as having the highest and most rigorous initial licensure and continued competence requirements for licensure of any of the 69 medical licensing jurisdictions in the United States and its territories.

 

Recommendation:. Even though the newsletter is an excellent publication, minor changes could be made to enhance its value as an education tool to inform physicians of the duties of the Board and its role in protecting the public.The newsletter also serves the important role of reminding physicians of their professional responsibilities. The newsletter would be more effective if professionally redesigned to enhance readability.

 

Members of the Board or staff should arrange speaking engagements before physician and specialty groups and hospital medical staffs to inform the physician population of issues facing the medical disciplinary and licensing community and to explain how the Board works. Board members and staff should also regularly address community groups (e.g., Rotary, seniors, citizen advocacy groups) throughout the state.

 

Public Information

Public information is disseminated through many sources such as a website, a newsletter, a process for copying public files, public service announcements, media contacts with the Executive Secretary and Board President, and correspondence with sources. When the media reports referred to in the appendix were reviewed, a distorted picture of the Board emerged. With all the attention on a few sensational malpractice cases, the physician workforce shortage, and the malpractice climate that precipitated a special legislative session, the Board was painted as an almost reluctant participant by the media and by legislative sources. Our view is not that the Board is falling short in its responsibilities or its sense of mission, but rather that the message is simply not getting out. Steps have been described above to make the Board more consumer-friendly, e.g., more correspondence with sources and dissemination of public records at no charge. More can be done through a dedicated Public Information Office (PIO) for 1) disseminating information to the public and 2) transmitting public needs, expectations and feedback to the Board on a regular basis.

 

Recommendation: Hire a full-time public information/media/communications specialist and implement a proactive communications program that explains the Board, its mission, and what it does to all of the Board's publics on an ongoing and regular basis. Additionally, there is opportunity to provide this function with little or no budgetary impact. The Board currently funds Public Service Announcements (PSAs) at $60,000 annually. The benefits of these PSAs are at best anecdotal. They did nothing to address or deflect criticism of the Board throughout the malpractice reform deliberations in the Special Session: The funds for these PSAs could be redirected to fund the PIO.

 

A Public Information Office could assemble key information needed on short notice by representatives of the media, legislature, and interest groups. Among the ingredients in

 

 


these messages should be explaining and emphasizing the due process and statutory constraints on the board, as well as what by law must be kept confidential and what everyone is entitled to know and ask. The newsletter and the basic consumer brochure are good pieces but should be redesigned so that they cry out to be read. By statute or regulation, the board should make it a condition of licensure that every physician have a supply of the consumer brochures prominently available in his/her waiting room.

 

Physician Workforce Statistics

The PIO could develop useful statistics that serve a public purpose. There was a special session of the state legislature to address tort reform. 17 The session was sparked by rising medical malpractice insurance costs that led to the temporary closure of the Trauma Center at the University Medical Center and decisions by an estimated 150 Southern Nevada doctors to close their practices, retire early, or apply for licenses in other states. 18  A charged media environment resulted, and in the process there was a need for useful, reliable information about the availability of physicians in the state.

 

One media report described legislation to use two million dollars of Board reserve funds to set up a fund to help physicians who have difficulty in paying their malpractice insurance.19 This would have had the effect of removing funds from the regulatory process to augment the malpractice premiums of those with highest risk. Another report said "Some reports of physicians relocating to other states, retiring or closing practices were not accurate or involved relatively few physicians."20 The Government Accounting Office (GAO), a federal agency, conducted a survey of OB/GYN specialists and found that, of 30 OB/GYN practices in Clark County, 28 were accepting new patients with waiting times for an appointment of three weeks or less. 21 The GAO report has been seized by consumer groups and trial lawyers, who say the report backs their contention that medical groups have doctored tales of physicians quitting in order to persuade policy-makers to curb jury awards and place fee limits on attorneys.22

 

Recommendation: More reliable information about the physician workforce in Nevada is needed. The Board can provide useful data from within the state that is needed by the legislature and others to make workforce decisions. The physician registration form is the ideal survey instrument. It generates 100% response from active licensees, and accuracy is encouraged by virtue of penalties for false reporting.

 

The Board can ask simple workforce questions, such as are you accepting new patients, do you accept Medicare and/or Medicaid, how many hours a week do you see patients, do you accept new patients, and do you deliver babies. Once the Board collects the data,

 

17 Joelle Babula, "System sought for reporting medical errors," Las Vegas Review Journal, July 23, 2002, Section B, page 1B.

18 Ibid.

19 "Dividends or subsidies for Nevada Doctors?" The Associated Press State & Local Wire, Reno, December 9, 2002.

20 Steve Tetreault, "Medical Malpractice Insurance: GAO: Crisis exaggerated," Las Vegas Review-Journal, September 6, 2003, Section B Page 1B.

21 Ibid.

22 lbid

 

 


medical school statisticians and researchers could analyze and present the data in a cogent format.  Other medical boards engage in such activity with little additional overhead for the board. An example of a cooperative relationship involving a health services research center and health care regulatory boards may be found at the Cecil B. Sheps Center of the University. of North Carolina at Chapel Hill.23

 

Relations Between the Board and the Medical Association

There are strained relations between the Board and the Nevada State Medical Association. A review of media reports indicates that the medical association is often a critic of the Board. It even proposed legislation to direct part of the Board's surplus in funds to pay malpractice premiums of a narrow specialty. A competitive, non-cozy relationship with the state or any county medical society is acceptable, perhaps even preferable, given the contrasting missions of the board and the professional societies, but neither should be antagonistic to the other, appreciating the distinctive role and responsibilities of each. A medical society is an interest group. The Board is a regulatory agency with specific statutory authority and limitations. There are plenty of opportunities for these interests to clash.

 

Recommendation: The board should undertake a continuous and ambitious program to make presentations describing what the board does and why and how it operates to every local and county medical association and large hospital medical staff. Similar presentations should be scheduled with Rotary clubs, Lions, Kiwanis, chambers of commerce, citizen groups, etc. The presentation needs to be repeated every two or three years to each group. The members change, people forget and repetition will help ensure most people really know what the Board does. A Public Information Office can approach this task as a mission.

 

Recent Statutory Changes (Grounds for Disciplinary Action)

Some recent statutory changes diluted consumer protections provided by the Board. In the 72nd Session of the Nevada Legislature, Senate Bill 250 altered the law24 regarding the Board's ability to take discipline for conviction of a felony as follows (language stricken by this Senate Bill is marked through): "...grounds for initiating disciplinary action or denying licensure: 1. Conviction of a felony, any offense involving moral terpitude or any offense relating to the practice of medicine or the ability to practice medicine."25

 

Under this new language, the Board is greatly disadvantaged in its ability to protect the public. The Board now has the difficult burden of establishing a nexus between the felony that served as the basis for the conviction and the practice of medicine, and the potential for losing a case is greatly increased. A June 24, 2002, newspaper report states that a Carson City doctor was accused of drugging his ex-wife and kidnapping her from Utah, and his medical license in Nevada “...is active and in good standing, according to

 

24 NRS 630.301(1)

25 Ibid.

 

 


the Nevada Board of Medical Examiners.”26 If this crime were one of pure kidnapping, upon conviction this physician's license likely would remain unencumbered, as the Board would be precluded from acting under the new legislation. An average citizen in Nevada would reasonably expect that the Board would and could take action swiftly, based solely on the conviction of a felony in the appropriate circumstance.

 

Recommendation: Restore NRS 630.301 (1) to its earlier status to reverse the recent statutory limitation on felonies and moral turpitude offenses as grounds for discipline or denial of licensure. Most felonies are inconsistent with the character required of a healer, and one should not condone or appear to condone improper sexual activities, which is what the elimination of "moral turpitude" implies. The state-granted privilege of licensure as a physician demands a higher level of character. Additionally, the Board should drop "good standing" from its description of license status. This is a subjective statement and is not necessary when describing license status.

 

Recent Statutory Changes (Exception to Core Licensing Requirements)

A recent legislative change creates a substantial exception to the core licensing requirements contained in NRS 630.131 for physicians who have been issued a license by another state, territory, or the District of Columbia. 27 This process is referred to as "endorsement."28 This concept, however, departs from the concept of endorsement used by other states. Most states, when referring to endorsement, still require core competencies and credentials, such as graduation from medical school and completion of post-graduate training or residency training. Endorsement is generally a process for recognizing different examinations, reflecting that the state of the art for licensing examinations is a dynamic process changing over time. Few, if any, states issue a medical license solely on the basis of a license from another jurisdiction. This is generally known as the concept of reciprocity. Of the more than 600,000 physicians licensed in this country, some were licensed without what other states or territories regard as appropriate core credentials.

 

A Board that opens the door to automatically licensing a physician based on a licensing credential from another state exposes itself to the lowest common denominator, or licensing standard, of any other state used at any other time. The provisions that exempt an applicant from meeting the requirements of NRS 630.160 can have that effect if the Board elects to create an exemption for any of those requirements. Under the provisions of this Nevada statute, the following core credentials can be excepted:

  • Citizen of the U.S. or is lawfully entitled to work in the U.S.;
  • Has received the degree of Doctor of Medicine from an approved medical school;
  • Has passed an approved licensing examination (which tests for minimum competence);

 

26 Sandra Chereb, "Probe widens in arrest of Carson City doctor," The Associated Press State and Local Wire, June 24, 2002, State and Regional.

27 Section 6 of Senate Bill 332 of the 72nd Session of the Nevada Legislature

28 Ibid.

29 The Federation of State Medical Boards of the United States, Inc., A Guide to the Essentials of a Modern Medical Practice Act, (Dallas, 2003), p. 12

 

 


  • Has completed approved postgraduate (residency) training.

 

The Board is in a difficult position by having an expression of legislative intent to lower these requirements on a subjective, case-by-case basis. The Board functions in a legal environment. If it creates exemptions for a postgraduate training requirement in one case, it creates a precedent, thus rendering that minimum standard moot. All subsequent applicants have a basis for demanding similar consideration. Subjectivity is induced into a system that should be objective. Perhaps worst of all, the physicians who minimum standards are designed to screen out have leverage to get licensed in Nevada. Less costly and less potentially dangerous ways to attract physicians to the state are available.

 

Recommendation: The exception provision for core credentials should be repealed. While we would not expect the current board membership to exercise this waiver authority, a future board may not be as tough, and this toughness is to the advantage of Nevada's citizens, who currently enjoy a medical licensing climate that is among the most consumer/patient-protective in the entire nation.

 

License Registration

Currently license registration is on a biennial cycle. All 4,400+ active status physician licensees register at the same time – prior to July 1 of odd-numbered years. As a consequence, answers to important registration questions become dated, and addresses often become stale because of failure to notify the Board of changes. Licensee statistics become unreliable, licensees are purged, and it appears that more physicians are leaving the state than are coming in.

 

Recommendation: Move to an annual process of registration based on birth month. This would purge inactive licensees and outdated addresses sooner, provide critical self-reported information on the registration form in a more timely fashion, and make for more efficient processing of transactions. In addition, if earlier recommendations are implemented regarding collection of physician workforce data, these data will be more accurate and timely when collected and updated on a monthly basis. A change in the registration interval requires a statutory change. 30

 

The Board should also implement a system of electronic registration for licensees via the Internet. Accepting credit card payments would provide significant convenience to physician licensees, lower manual overhead for the Board, and provide prompt, accurate registration information to the Board electronically.

 

Background Checks of Licensure Applicants

The Board relies on applicant information on license applications to determine whether the applicant has a criminal history.  There is no primary source verification of these responses. Instead, the Board validates these answers with the applicant through a registration form that is mailed to the applicant shortly after licensure. The form asks the same yes/no questions appearing on the application form. The Board checks responses forinconsistencies and occasionally detects them.

 

30 NRS 630.267

 

 


Recommendation: The Board should do primary source verification of criminal history. It may contract with a private vendor for such criminal record checks, but there are disadvantages to this approach. Private vendors generally check records state by state and this can lead to omissions. These private companies do not have access to the consolidated records used by law enforcement agencies.

 

The best system currently available to a qualified agency such as a medical licensing board is the federal law enforcement system (National Crime Information Center) maintained by the US Department of Justice (USDOJ) through the Federal Bureau of Investigation (FBI). To gain access to this system, the Board needs specific statutory authorization from the legislature. The USDOJ can furnish template language for this purpose. With fingerprint cards that meet FBI standards, the Board can check the criminal records of all applicants. States that adopt this process usually get two sets of prints, one for the state law enforcement check, in this case Nevada, and one for the FBI. Usually a state law enforcement agency approved by the FBI acts as a broker for these record checks.


Comparative Data

 

1) FSMB Composite Action Index3l, attached. This index is a weighted averaging of statistics that allows a board to compare its level of disciplinary activity to itself over time. However, it does not take into account variables such as:

  • Cohort differences in licensee population, such as training, experience, rural/urban distribution, number of in-state medical schools and training opportunities, etc.
  • Preventive measures, such as early intervention in treating impaired physicians, peer review, and use of early intervention assessment/remediation programs before complaints and malpractice suits arise.
  • Limitations inherent in different statutory schemes that enable licensing boards to take disciplinary actions.
  • Board resources, funding and staffing.
  • Economies of scale, differences between large and small boards.

 

This index is, however, one indicator of performance as qualified above.

 

2) The Nevada State Board of Medical Examiners is in the forefront nationally among medical boards that have sought improvement to their licensing statutes. The FSMB publishes model guidelines for such efforts, 32 and this Board has embraced most of them. Minimum licensing requirements have been adopted, including training and examination requirements. Grounds for disciplinary action incorporate the latest thinking of medical boards. Finally, there is a national dialogue in the area of medical licenure to implement continuing competence requirements for physicians, and this Board is proposing such standards. A recommendation was made above regarding checking for criminal history, one of the few areas in which Nevada falls below the national model act, in addition to the recently enacted statutory deficiencies noted above.

 

31 See http://www.fsmb.or, Media room, For immediate release April 9, 2002.

32 The Federation of State Medical Boards of the United States, Inc., A Guide to the Essentials of a Modern Medical Practice Act. (Dallas, 2003).

 

 


Composite Action Indices*

Nevada State Board of Medical Examiners

1993- 2002

 

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

Composite

Composite

Composite

Composite

Composite

Composite

Composite

Composite

Composite

Composite

Action

Action

Action

Action

Action

Action

Action

Action

Action

Action

Index

Index

Index

Index

Index

Index

Index

Index

Index

Index

4.64

4.00

7.78

5.10

4.32

4.99

3.94

4.16

4.89

4.33

 

*The Composite Action Index (CAI) is the arithmetic mean of four ratios provided in the Federation's Summary of Board Actions: Total Actions/Total Licensed Physicians, Total Actions/Practicing In-State Physicians, Total Prejudicial Actions/Total Licensed Physicians; and Total Prejudicial Actions/Practicing In-State Physicians. Each of the four ratios offers a useful and interesting measure of activity within a jurisdiction. However, to depend on any one as a definite measure would be to ignore significant; variables represented in the others. Therefore, the Federation has created the CAI to combine the four ratios into a single composite ratio for each board. This simple device, the CAI, permits relevant variables to contribute in a balanced way to a final figure that can be useful in measuring an individual board's disciplinary activity over time.