Ohio State Medical Board
as a model of medical boards in general

It is run by people who share the same conflict of interest that made patient safety an issue in the first place

As the American Iatrogenic Association says, "Keep in mind that state medical boards are generally comprised of physicians. As with all such agencies that regulate occupations, members of these boards feel a personal and professional kinship with those who they regulate. In other words, doctors do not regulate doctors effectively. Claims to the contrary notwithstanding, a state medical board does not operate in your interest."

An analysis of the disciplinary actions of the OSMB complies with that. No disciplinary actions could be found that definitely resulted from complaints filed by patients. This suggests a bias toward physicians and away from patients, unless one believes that complaints filed by patients never have merit.

Naively thinking that a board of directors charged with running a bureaucracy would want data on how they are doing, I contacted them to report my findings. Their response was that they have good procedures. That may be so, but according to the numbers, they are not getting good results from them. An organization can be no better than the people in it.

At the state medical board of Ohio we see bureaucrats behind closed doors with no real accountability and with disinclinations to find truth or arrive at discipline. After all, this is the organization that lobbied the government to pass liability limitation laws to protect physicians. It is run by physicians who share the perspective of the people they are supposed to discipline, not the perspective of the patients who need to be protected. 

Patient Complaints

When a patient begins the complaint process with the Ohio State Medical Board, figuring out who they are is only the beginning of the obstacles faced by patients. There also is an Ohio State Medical Association that represents doctors. There also are other boards for various other disciplines in medicine. The task of figuring out to whom to complain will eliminate many legitimate complaints at the outset without their ever being filed. I have discussed that with people at the medical board and they don't want to receive anymore complaints. They believe they receive too many already. An organization honestly interested in solving the problems of patients would want to elicit complaints, not eliminate them before they are heard.

When a patient telephones the Ohio State Medical Board, the patient encounters a phone matrix at the end of which is a message that doesn't mention filing complaints, but is the correct place to leave a message if that is why the patient is calling. (By clicking phone matrix you can listen to a recording of the process of going through the maze. How many senior citizens could make it to the end of that phone matrix? And that recording was made with the benefit of already knowing all the correct options to choose.)

No one ever answers that line. The patient always is directed to leave a message. When the patient does that and waits for the return call, the patient always will wait for the rest of the day without receiving a call. The call comes the next day. A normal patient won't know that and likely will have given up waiting and might not be at the phone the next day. If no one answers, the medical board leaves a message that says that they tried to contact the patient, and that is the last the patient will hear from them. The patient must call them again, go through the matrix, and leave another message that once again will not be returned that day. One can lose a week going through this process before figuring out that one needs to camp out by the phone on the day after leaving them a message.

When a patient finally gets them on the phone, the patient is told that a form will be mailed. Evidence is disappearing. The trail is getting colder. Witnesses are becoming less and less valuable as the time passes before anyone even attempts to identify who they are.

The form sent to the patient says for the patient to gather the diagnostic evidence. This puts the patient in the position of having to schedule appointments with doctors in order to create that diagnostic evidence (in our experiences and conversations with the Ohio State Medical Board, they appear to be unaware of the near impossibility of getting physicians to create diagnoses that indict a colleague - see white wall of silence). If the patient ever manages to accomplish this task, months if not years easily can have passed as the trail grows colder and colder.

The evidence that patients are supposed to gather is supposed to be "reliable, probative, and substantial," but the Ohio State Medial Board will not say what is reliable, probative and substantial. They will list things to send, like x-rays, but the Ohio State Medical Board does not move toward justice as a result of those things, as their disciplinary actions show.

If the patient manages to gather and send what has been requested, the state medical board of Ohio then often sends an investigator to speak to the patient. But to read how that works, read my section on Ohio State Medical Board investigators. In our experience they don't even find witnesses. They don't know what questions to ask or what documents to look for. The don't show an interest in doing their job. They don't even find existing paper trails and, if the paper trail presented to them is too long, in our experience they never read it. When the victim points this out to an investigator's superiors, they are unresponsive. Does this sound like a civil bureaucracy operating behind closed doors with no meaningful scrutiny?

There are more wrinkles. They are covered at the other links on this page.

The OSMB is one of the most respected state medical boards in the country. The Health Research Group at Public Citizen did a study (http://www.citizen.org/publications/release.cfm?ID=7166) of state medical boards in which it ranked the OSMB as the only one of the USA's fifteen largest states to be represented among those with the highest disciplinary rates. But even though it disciplines a higher percentage of physicians than other large states, it manages to avoid doing it in response to complaints filed by patients. It is hard to regard this as anything other than one more example of the antipathy that medicine holds for the experience of patients.

Healthcare professionals report adverse events less than 2% of the time. For the other 98% of the times patients are the only source for that information. And the OSMB dismisses it as though it were frivolous in almost all cases.

It is time to stop imagining that the well being of health care professionals is not the top priority of health care professionals when things go wrong in medicine. It is time to stop imagining that having patients go back to the same group of people who injured them is a reasonable response to the worst problems harming patients.