Suggestions for fixing medical disciplinary system should be welcomed

When the hepatitis outbreak story broke in February, calls poured in from anesthesiologists who wanted me to know that a nurse anesthetist doesn’t have the training of an anesthesiologist. An anesthesiologist would NEVER reuse a syringe and the same vial of anesthesia on a patient and spread hepatitis from patient to patient. Never. Never. Never. The doctors are so much better trained than the nurses that such a practice was inconceivable.

The calls stopped abruptly when health officials said state health inspectors observed a Las Vegas anesthesiologist reusing syringes on four different patients at the Gastrointestinal Diagnostic Clinic, where he worked. He has been identified as Dr. Scott Young and was fired from the clinic but still works in the valley.

According to the state report (and this is disputed), Young said he would change the needle but use the same syringe to dip into the anesthesia vial for multiple patients.

This is precisely what health officials say occurred at Dr. Dipak Desai’s two endoscopy clinics, where nine patients were infected with hepatitis.

So it seemed odd that Dr. Larry Tarno, the executive director of the Board of Osteopathic Medicine, said he doesn’t believe Young needs to face discipline that would stop Young from working.

The details of the osteopathy board’s proposed settlement with Young are not public. In fact, the settlement is so hush-hush not even Young or his attorney John Cotton had seen it Tuesday when the settlement was on the board’s agenda. Young and Cotton didn’t know they were on the agenda.

Clerical mix-up, Tarno said.

But how does any doctor agree to a settlement agreement his lawyer hasn’t seen? Must be one of those failures to communicate.

It has been suggested to me that Young may not have done what the first report said he did.

(Southern Nevada Health District spokeswoman Stephanie Bethel said that report was an interim report, and a final version is due in a few weeks.)

One of Young’s patients believes his patients should be notified because people remember the doctor who did the procedure, but not the anesthesiologist. The patient worries whether Young put another batch of patients in harm’s way.

Bethel said Young’s patients have not been notified “because there’s no evidence of the same types of long-term problems we had at the endoscopy centers.”

If Young didn’t do what is alleged, health officials owe him more than “sorry, man.” But his past and future patients deserve to know the facts. And the board that disciplines Young, a doctor of osteopathy, should use the same standards as the board that disciplines Desai, a medical doctor.

I was derided last March when I suggested the Board of Medical Examiners and the Board of Osteopathic Medicine should be merged so that the same set of standards applied to the state’s 6,000 medical doctors and the 500 doctors of osteopathy.

Tarno opposes combining the boards and said I was “ill-informed” and had “a political agenda.” (If wanting bad doctors, whether MDs or DOs, to be disciplined is a “political agenda,” then Tarno is right.)

Last week, Larry Matheis, executive director of the Nevada State Medical Association, went much further than my suggestion. He proposed the Legislature should create a State Department of Professions and not leave licensing and investigations in the hands of 42 different boards.

Matheis asked the Legislative Committee on Health Care to consider combining the 22 boards dealing with health professionals, including nurses, doctors, dentists, opticians, optometrists, podiatrists, psychiatrists and alternative medicine. Each one has its one fiefdom, most with executive directors not eager to lose their jobs.

Combining administrative duties could mean a potential savings in staff, rents and salaries if at least some of the boards were combined or responsibilities were more centralized.

The downside: It centralizes a lot of power.

Perhaps Matheis, like me, is ill-informed and has a political agenda when he suggested a Department of Professions.

I doubt it. Like many who care, he’s trying to come up with ideas to fix a broken disciplinary system and make sure health professionals, as well as their patients, are treated fairly.

Jane Ann Morrison’s column appears Monday, Thursday and Saturday. E-mail her at Jane@reviewjournal.com or call (702) 383-0275.