State regulators rarely discipline physicians

Ga. medical board cited for failing to protect public from harm.

Chances are slim that any Georgia physician accused of mistreating or abusing patients will face serious consequences from state regulators. And even if the allegations are substantiated, the doctor’s future patients may never fifind out about them.

Investigations by The Atlanta Journal- Constitution have revealed that to be the case when it comes to physicians reported to the state medical board for sexually abusing their patients or over- prescribing addictive medications. But in an excoriating report released this week, the state Department of Audits and Accounts measured the lack of accountability in raw numbers, raising anew concerns that Georgia regulators are failing their mission of protecting the public from dangerous doctors.

“In a state like Georgia, where our health care system is really insuficient and not meeting the needs of the population already, t hi s j ust f urther breaks down what should be a very close rela

tionship between individuals and communities and their health care system,” said Laura Colbert, executive director of Georgians for a Healthy Future.

The state audit examined the Georgia Composite Medical Board’s structure, how its staff investigates complaints and how board members make decisions. It portrays a slow- moving bureaucracy, dominated by doctors who allow colleagues to continue practicing even after being credibly accused of harming patients. Sometimes, auditors found, the board takes so long to reach decisions that licenses lapse and the doctors escape public discipline altogether.

The state audit found that less than 2% of cases opened against physicians during the last fiscal year resulted in any public disciplinary actions.

Auditors also found gaps in state laws that can shield abusive doctors. Among t he weaknesses, Georgia doesn’t require hospitals, law enforcement or courts to report doctor violations to the board, nor are physicians required to report dangerous colleagues.

Of the 68 other state medical boards ,65 have stronger mandatory reporting requirements, according to the audit.

Members of the medical board will talk about the audit at their meeting next week, Executive Director Lasharn Hughes said, and look for areas to make improvements to best serve Georgia citizens.

But parts of the report weren’t fair, she said, such as its portrayal of the high proportion of non- discipline cases as a shortcoming.

“It doesn’t mean that those cases warranted public sanctions,” she said. “They may not have been to that level … It could be anything, like, ‘ I didn’t get my records in a timely manner.’ It’s stuff like that. All of them aren’t sexual misconduct cases or egregious cases.”

State auditors, however, found Georgia’s rate of discipline stacks up poorly to that of other state regulatory boards they examined. Maryland, Virginia, Tennessee, Florida, North Carolina and Ohio all had higher rates of discipline for doctors, ranging from three to nearly six times higher.

Th eA J Ch as reported extensively on the medical board’ s habit of for giving doctors, a practice that continues. In a national investigation four years ago of doctors who sexually violate patients, the AJC found that two-thirds of Georgia doctors found to have sexually violated patients still were permitted to practice.

In a 2017 national investigation into the opioid crisis, the AJC found that the Georgia board had taken public action against only a handful of doctors per year for improper opioid prescribing. Even doctors who recklessly prescribed painkillers or had been arrested on drug charges were able to keep practicing.

Other findings in the audit also echo AJC findings.

The audit noted that consumers are underrepresented on the medical board. State law stipulates that two of the board’s 16 members represent the public. Like the AJC, the auditors reported that the public members are more likely than physician members to act when violations occur.

Colbert, of Georgians for a Healthy Future, pointed out that one of the board’s current consumer members is a pharmacist. “Not to pick on that individual, but I don’t know that that qualifies as a consumer,” she said.

The state Audit sand Accounts department also noted the board closes some cases with confidential actions.

In the last fiscal year, the medical board closed 17% of cases by sending doctors a confidential “letter of concern,” which is not considered disciplinary action.

Only 18 cases last year resulted in actual discipline, including sus pending or revoking medical licenses. The board took minor actions in four of those cases, such as imposing fines, reprimands, license restrictions or educational requirements.

Two other cases resulted in private actions, state auditors found, meaning the complaints were settled quietly between the board and accused doctors, with the records closed to the public.

The board took no public action against Dr. James Lanier Heaton after he was indicted in 2018 in a federal drug- trafficking case. It still didn’t act in October 2019, when Heaton was convicted on multiple counts. This past March, five months after his conviction, the board allowed the former nursing home medical director and family medicine doctor to voluntarily surrender his license.

There is no hint in the 2020 document that the surrender was anything but his desire, and no information about the reasons. Heaton’s attorney in the federal case did not i mmediately return a call for comment.

The state audit explores why discipline may be so rare, attributing a culture of leniency to both internal and external f actors. The board may be hamstrung by a state Legislature that seizes licensing revenues each year that could go toward more investigative resources, the audit says.

In examining the board’s i nvestigative process, the auditors found that its guidance to staff is more limited compared with other states and management can’t easily track the progress due to data system limitations. That can result in some lengthy delays.

The audit said that prescribing complaints can take one month to eight years to close.

Such delays can pose risks to the public, the audit says. It described one case where the board received a sexual misconduct complaint in 2016 against a doctor with a history of complaints and prior discipline, yet the board took a year to issue a summary license suspension.

In a recent case reviewed by the AJC, the board did discipline Dr. Basil Lamont Anderson, a family medicine doctor in Oakwood — three years after he was first reported to police for sexually harassing and improperly touching an employee.

After her December 2015 report to police, investigators unearthed a series of other complaints. He was arrested in February 2016 and in January 2017 pleaded no contest to one count of misdemeanor sexual battery.

The board in July 2017 issued a confidential order for Anderson to get a mental and physical examination after it said it had received information that he had engaged in “acts of sexual intimacy, misconduct, assault, battery and other boundary violations with his patients, former patients and employees.”

The board revoked his license in July 2018 — one year after it ordered the examination — saying Anderson had offered no indication he would comply with recommendations from the examination.

Anderson could not be reached for comment.

Leslie Mcguire, the director of Audits and Accounts’ performance audits division, said the review of the medical board was prompted by reporting by t he AJC and other national news outlets, as well as a recent review of the Department of Community Health, which the medical board falls under.

There will be a follow- up audit within the next two years, Mcguire said.

Among the recommendations for reforms, the audit said the medical board should engage in more public outreach so the public knows how to complain about an offending physician, and how to go about it.

The board should consider issuing press releases about disciplined doctors and having a presence on social media. Hughes, the executive director, said the board’s public outreach committee has been working on that, as well as a sign for doctors to post in offices about the complaint process.

“Some things, we were already working on before,” Hughes said.