Board of Licensure Complaint Panel Trends in Complaints Process for Response amp What Drives a Consumer to Complain Attorney Panel Kelly Hoffman Norman Hanson amp DeTroy in Maine ID: 772727
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Board of Licensure Complaint Panel:Trends in Complaints, Process for Response, & What Drives a Consumer to Complain Attorney Panel: Kelly Hoffman – Norman, Hanson & DeTroy in Maine Melissa M. Hanlon – Sulloway & Hollis in New Hampshire Beth Catenza – Sulloway & Hollis in New Hampshire Mark F. Werle – Ryan Smith & Carbine in Vermont
Maine Board of Licensure in Medicine Kelly M. Hoffman , Esq Norman Hanson & DeTroy , LLC 207-774-7000 www.nhdlaw.com khoffman@nhdlaw.com
New Hampshire Board of MedicineMelissa M. Hanlon, Esq.Beth G. Catenza, Esq.Sulloway & Hollis, PLLC9 Capitol St.Concord, NH 03301mhanlon@sulloway.com bcatenza@sulloway.com603.224.2341
Vermont Board of Medical PracticeMark F. Werle, Esq. Mead Building 98 Merchants Row P.O. Box 310 Rutland, Vermont 05702-0310 Phone: 802-786-1000Fax: 802-786-1100Website: www.rsclaw.com
What is the structure of each Board in Maine, New Hampshire, and Vermont?
Maine Board of Licensure in Medicine Members of the Board are appointed by the Governor The Board employs its own administrative and investigative staff, which is the largest of all professional boards, whether part of the stand-alone boards or otherwise. All volunteer Board with six physician members and three lay members Six year renewable terms
Maine Board of Licensure in Medicine Board Member Name Specialty Expiration of Term Maroulla S. Gleaton, M.D., ChairmanOphthalmology06/30/19Louisa Barnhart, M.D., SecretaryPsychiatry/Family Practice06/30/21 Vacant Public Member 06/30/21 Susan Dench Public Member 06/30/22 David H. Dumont , M.D. Emergency Medicine/Family Practice 06/30/20 Christopher R. Ross, P.A.-C Physician Assistant/ Family Practice 06/30/19 Peter J. Sacchetti, M.D. Internal Medicine 06/30/19 Michael P. Sullivan, M.D. Emergency Medicine/Family Practice 06/30/21 Brad E. Waddell, M.D. General Surgery 06/30/23 Lynne M. Weinstein Public Member 06/30/22
THE NEW HAMPSHIRE BOARD OF MEDICINEEstablished in 189711 MembersDelegates to MRSCAlso 11 MembersAll appointed by Governor and Executive Counsel
Structure of the Vermont Board of Medical Practice
What are the Recent Trends in Maine, New Hampshire, and Vermont?
Maine Board of Licensure in Medicine Concerns Opioid/Chronic Narcotic/Controlled Substance Prescriptions Communication “Fraud, Deceit, or Misrepresentation” Paperwork Errors Patient Transition
2018 Maine Board of Licensure in Medicine Reported Adverse Actions 9 Medical Doctors 4 Consent Agreements Inaccurate information EHR Urination outside building in sight of an exam room; seen by patient Misuse of alcohol, drugs, or other substances Mental or Physical Condition that Impairs ability to provide safe patient care 4 Amendments to Consent Agreements Allowing a practice monitor Removing a practice monitor Conditions on license related to writing prescriptions 1 Withdrawal of License Request Pending Investigation 1 Physician Assistant Sexual Harassment of a medical assistant
2017 DISPOSITIONS
2014 DISPOSITIONS
2012
Prescription/Opioids
Other
2013
Prescription/Opioids
2014
Prescription/Opioids
2015
Prescription/Opioids
2016
2017
Prescription/Opioids
2018 as of June 1st
Prescription/Opioids Complaints 2012-2018
2012-2018
“Over the five years [2011-2015], the average of investigations opened each year is about 197, and the average number of cases resulting in discipline or surrender of license was just under 9. Among all those investigated, that yields a rate of roughly one in 22 cases that resulted in an adverse outcome for the licensee.”http://www.healthvermont.gov/sites/default/files/documents/2016/12/BMP_Complaints_Investigation%20Stats.pdf
Range of Discipline Boards May Impose
Maine Board of Licensure in MedicineDismissalDismissed with a Letter of GuidanceFurther InvestigationMedical Records Interviews Written Questions Informal Conference Adjudicatory Hearing
Discipline the Board of Licensure in Medicine can impose on Licensees Condition, limit, suspend, or revoke the license, certificate, or practice Take such other action relating to discipline or practice as the board determines is properImpose an administrative penalty not to exceed $1,000.00https://legislature.vermont.gov/statutes/chapter/26/023
What Drives A Complainant or the Complaint Process
What Drives the Complaint Process?Who is likely to report? - Employers - Patients - Law Enforcement - Comes up in checks Frequent Types of Reports: - Record Keeping - Unprofessional Conduct - Misconduct in Another State - Prescribing Practices - Medical Negligence - Licensing Issues
Maine Board of Licensure in Medicine
ANECDOTAL OBSERVATIONSIncrease in follow-up questions after initial response submittedIncreased level of scrutinyMore consumer complaints
Examples of Complaints from 2012-2018
Record KeepingDid not maintain adequately Did not do timely maintenanceNot legible enough for a non-medically trained person to read them Not clear, concise, complete, unambiguous, and arranged in chronological orderNon-standard abbreviations and symbols Creating false medical records to obtain prescriptionsLacks the patient’s name
Unprofessional Conduct DUIsCharges from the StateCriminal Investigations Breaking court conditions Sharing information without a consent form
Misconduct in another stateReviews from a different medical boardCessation in a different stateLitigation in another stateMedical fraud in another state
Medical NegligenceFailure to properly review an EKG printout Failure to confirm a dosage to a nurse Failure to order appropriate testing Failure to conform to the essential standards of acceptable and prevailing practice
Prescribing practices Over prescriptions of opioidsTerminated opioid dependency treatment without warning Did not document comprehensive history and physical exam before treatingDid not utilize screening and assessment instruments Did not obtain written consent to treat/agreementDid not use tool to adjust doses Did not refer to a counselor Did not administer regular urine testing Did not do random counts of pills to monitor treatment Did not test for pregnancy Refilling medication when patient said it was lost or missing (multiple times) Continue to prescribe despite evidence of patients ongoing abuse of drugs Purchasing medications for personal usePrescribing medication for an inappropriate physician-family relationship Despite positive drug tests not changing prescription plan Not recording reason for change in medication Mailing friends a medication
Fact Pattern to Address the Request for "Case Study" of Recent Complaints
Board of Licensure Complaint Panel Kelly Hoffman – Norman, Hanson & DeTroy in Maine Melissa M. Hanlon – Sulloway & Hollis in New Hampshire Beth Catenza – Sulloway & Hollis in New Hampshire Mark F. Werle – Ryan Smith & Carbine in Vermont