Doctors seeking refuge from true punishment in malpractice cases need only move to Missouri, if the findings of a St. Louis Post-Dispatch investigation are any indication. Ironically enough, repeated confidential reprimand letters appear to be the punishment of choice doled out by the "Show Me State's" Board of Registration for the Healing Arts, which, according to the newspaper, is assigned to "protect the public."
A case in point is the board's handling of multiple malpractice offenses by ophthalmologist Dr. David E. Braverman, whose most recent offense in 2003 involved accidentally operating on the wrong eye of a 5-year-old girl who needed a muscle fixed in her left eye. Braverman tried to pass the mistake off as simply bleeding in the right eye that also required surgery, and even edited the patient's charts to match his claims, reports the Post-Dispatch, but only received a "letter of concern" that allowed him to continue to see his patients.
Several other malpractice cases against Braverman were noted by the newspaper, including one where a patient lost an eye due to failure to treat a post-surgical infection, and another in which a patient lost his vision because of undiagnosed glaucoma. In neither of those cases did the board take any public punitive actions.
"I was under the assumption that [Braverman] didn't work anymore," Nathan Wessley, the undiagnosed glaucoma patient, told the Post-Dispatch. "Maybe if people [knew what happened to me] they wouldn't go there anymore."
Overall, the newspaper found that the board, which can suspend the licenses of doctors deemed dangerous, rarely ever does. With two serious actions taken per 1,000 licenses, Missouri's boards ranks as one of the least active in the U.S.
That may, however, be due to the arduous process required to take any action in such cases. If a punishment cannot be agreed upon by the Healing Arts board, the board is required to appeal to the state's Administrative Hearing Commission, which then decides on a punishment--if deemed necessary--after a lengthy process that often takes years to complete. In the meantime, the doctors under investigation continue practicing.
What's frustrating is that the board feels that this physician should be disciplined, Tina Steinman, the board's executive director, told the Post-Dispatch. But the long drawn-out process and the possibility that the board could lose its case means the physician is let off the hook and allowed to practice without any added monitoring.
Travis Ford, a spokesman for the board, feels that it's up to the state's lawmakers to change such a setup.
"It seems like a cop-out, but our position is that we enforce the laws that are on the books," he told the newspaper. "[T]he policymakers need to look at the quality of those laws to see if any changes are needed."