No medical training. No external scrutiny.

In fairness to the investigators, if any were hired who are motivated and intelligent, for how long could they continue to invest themselves in their investigations knowing that their work is for naught? The state medical board of Ohio doesn’t discipline anyone on the basis of complaints filed by patients, so why would an investigator stick out his or her neck?

If one did, the first person the investigator talks to is the patient. After that the investigator is accountable only to supervisors and the people about whom the patient has complained. The investigator does not have to go back and face the patient again to explain why the complaint is being dismissed. The only people the investigator has to please after the interview with the patient are people whose interests are the opposite of the patient’s.

There is a nonprofit organization called Acorn that wages voter registration campaigns. Registering voters is a benevolent activity. No one gets rich doing that. Yet the workers there submitted fraudulent submissions for the 2008 presidential election in effort to please their supervisors. This happens in every walk of life. An investigator at a state medical board doesn’t have to submit anything fraudulent. He/she only has to be efficient and quick rather than probing and thorough, to make everyone but the patient happy. Justice is difficult under good circumstances. Under these it doesn’t really exist.

How often can an investigator arrive on the scene before the trail is too cold anyway? A patient reporting a problem to the state medical board of Ohio is told to gather a wealth of documents. By the time the state medical board of Ohio receives it and sorts through it, the witnesses have done a thousand more medical procedures and have trouble recollecting anything.

If they do recollect enough to indict a health care professional and there is no other way for the state medical board of Ohio to avoid disciplining a physician, the Ohio State Medical Board has been known to sit on a case until the physician finally retired. It also has been known to get out of disciplining a physician by concluding that the long-held case has been outside of their purview all this time since the state medical board of Ohio has no authority to enforce criminal law. That would be the province of the police. Their obligation at that point is to deliver the matter to the correct authority for pursuing it, but they don’t. There is no one holding them accountable. So they just don’t.

One way or the other, the Ohio State Medical Board rarely finds anyone guilty as a result of their own investigations. Investigators will be aware of that. What motivation can they have for ruffling feathers and making enemies by actually uncovering problems? The investigators have to face patients first and everyone else last. They don’t have to sit down face to face with the patient whose life has been ruined and explain why no one believes him or her. They should have to do that.

Whether or not investigators at the state medical board of Ohio make honest efforts to discover anything must remain confidential under Section 4731.22(F)(5) of the Ohio Revised Code. So they cannot even get credit for trying from the one constituency that would want them to, the patients. For sheer sanity anyone would have to become an automaton filling in blanks and moving on to the next case without making a serious attempt to discover anything.

I am told that there are 22 investigators at the state medical board of Ohio. Almost every question I ask about those investigators cannot be answered because of confidentiality. However, I do know the name of the one investigator. I was able to find out that he is a retired police officer. When he was a police officer he wasn’t smart enough to be an investigator. He tried for years to become one. When they finally relented and gave him a chance, he screwed it up so badly that he was demoted. That is is not done lightly. That demotion reduced his pay and reduced his retirement benefits (so he needed to work during retirement for the state medical board). A former colleague of his told me that the word of mouth on my investigator was that he couldn’t write a parking ticket without screwing it up. I’m also told that back at police headquarters when they learned he had become an investigator with the state medical board of Ohio, in the office there was spontaneous, collective laughter. Would an organization that honestly wanted serious investigations hire this person?

This particular investigator was assigned to my case. He has only a high school degree and no medical training. It was up to me, a patient, to explain the medical aspects of the case to him. At the time I still was figuring it out myself. When he went to investigate the case, he asked the questions I asked him to ask (or so he told me) and no others. So I was conducting the Ohio State Medical Board’s investigation through him. And I didn’t know what to ask at that time. What patient would? More details (that I wasn’t supposed to be able to find out) will be covered here eventually.

By the way, when he told me that he had asked exactly what I had asked him to ask, I asked him what questions those were. He told me that he could not tell me because of confidentiality. He could not quote back to me what I had said to him because of confidentiality? They are so used to hiding behind “confidentiality.”

The whole process seemed design to placate if not defeat me, not find problems, seek justice or protect patients. He did not even find the paper trail that I told him about. So I got the documents myself and sent them to him. Months later when I telephoned his superior I was told, with exasperation, that I’d buried them in a stack of documents. It was twenty pages, but apparently that was too much for them because they later said they were closing the case. So I reduced the 20 pages to a graph that in one page visually summarized what the documents showed. With that they continued reviewing the case for a while longer (before closing it).

In other words, not only is it necessary for the patient to find the evidence and run the investigation, but it also is necessary for the patient to digest the matter for the state medical board of Ohio and make it into a presentation that can get their attention. But even after that, why would they stick their necks out and pursue justice?

What patient other than me other can take the time to stay on top of them like this to try to get them to do their job? I am dubious about whether there is anything that could be done to get them to do it. Monitoring by a external group I suppose might help some, but I doubt any group run by health care professionals ever will have the perspective and motivation necessary to protect patients.

I am doing this not merely for my need for justice, but also as a test case. The citizens of Ohio need someone to figure out how to get justice and then explain to them how. The citizens of the country need someone to explain why mandatory reporting laws are useless (see mandatory reporting). The State and Federal Government need someone to show examples of why current systems don’t function. Ohio courts need someone to point out the inequity of liability limitations that make it so that someone with an MD can commit blatant violence against a patient and be protected by statutory liability limits, while the victim of the violence is not protected from being silenced by the unlimited liabilities incurred merely for speaking about it.

It’s biting off a lot. It is my new unremunerative career. I’ve succeeded at more of it than I ever thought I would. But they keep finding ways to silence me. They even tried to put me in jail, and nearly succeeded. So that future patients are not so silenced, next we need to pass laws and fight for court precedents that allow patients to speak about their health care (see freedom of speech for patients) so that we will be able to learn what we need to know to manage our health care and make medicine less dangerous for patients and less safe for operators who cannot be trusted. Somewhere in all this there needs to be someone on the side of patients. Right now there is not. There isn’t even a phone number to call to get help, or just to ask questions, when you have become the victim of an adverse event. There needs to be an Ohio State Patients Board. There needs to be a National Patients Board. There needs to be advocates on the side of patients.

Ohio State Medical Board

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Yes, the state medical board of Ohio has a few citizens who are not MDs on their board of directors, and I suppose that is supposed to be scrutiny. But they are not patients who have been injured and they do not understand how the state medical board of Ohio really works, or fails to work. They are loaded down with reams of papers they are supposed to review. They are not scrutinizing the organization. They are dealing with paperwork that is assigned to them.

I asked people at the board several times “What constitutes sufficient evidence” without getting answers better than “It depends” or “It’s different for different cases,” which means either that the state medical board of Ohio acts arbitrarily in the absence of standards or the state medical board of Ohio never bothered to figure out what their standards are. When I ask questions like “What percentage of cases result in discipline” they don’t know. Most of the questions I asked had answers that the Ohio State Medical Board deemed confidential under law. So I’d re-asked them in different ways until, in some cases, I hit on answers that are not confidential but the state medical board of Ohio still didn’t know the answers. The state medical board of Ohio does not appear to want to know those answers. They were not organized in a way that would allow them to figure out the answers. In one case I was told to call back in a couple of years when a new computer system “might” make it possible to figure out the answer. When I did that, they began to ignore me so that they wouldn’t have to produce the answer.

These were answers that should have been understood and articulated already just for their own internal functioning. The state medical board of Ohio is an organization operating with insufficient self-awareness and woefully inadequate oversight from any external authority. Unaccountable government authority – doesn’t that run counter to the very nature of what the USA is supposed to be about?