Shoddy care by doctors. Sexual misconduct. Malpractice cases that led to $1 million settlements. Violations involving prescription drugs. Those are among the serious allegations made against Georgia doctors last year in formal complaints.

But the public will never know the details of how the Georgia Composite Medical Board handled the vast majority of these complaints. That's because almost everything the medical board does related to doctor discipline is kept top secret.

The board's secrecy came to light again recently in the case of Dr. Paul Harnetty. The board had investigated the former Georgia doctor, a criminal case revealed, but he was never publicly disciplined. Harnetty was convicted last month of sexually assaulting patients in a Wyoming. The AJC investigated the doctor's Georgia history in a story published Sunday. 

If the Georgia board issued Harnetty a private order, or dismissed the case, that would be the usual order of business, judging by the board's latest data.

The board got 1,787 new complaints in the 2017 fiscal year that it determined were within its jurisdiction, according to the board's annual report for the 2017 fiscal year, which runs from July 2016 through June 2017.

During that year, the board issued only 36 disciplinary actions, the report says. Among them, one doctor had his license revoked, and two had their licenses suspended. The most common public actions the board took were 23 public reprimands, according to the report.

The medical board staff did not respond to the AJC's request for more information about confidential letters and orders and the disciplinary actions summarized in its annual report.

 Dr. Paul Harnetty

Credit: Lois Norder

icon to expand image

Credit: Lois Norder

The board dismissed a lot of cases, and it will never have to justify why. In fact, Georgia law bars the board from discussing any case, even a case in which it has imposed public discipline.

The board's meeting minutes reveal that the doctor-dominated board takes many more private actions than public ones.

In just one month last year, for example, the board accepted two "private consent orders" and amended another one. The only information the board provided about those doctors was the case number. No names. No description of the case. No public information at all.

At the same meeting, the board also accepted one of its committee's recommendations to "require a private consent order as a condition of licensing" a pain clinic. The owner of the clinic had been interviewed by the committee, the minutes show. Pain clinics need special licenses because their focus on treating pain generally leads to lots of prescriptions for highly-addictive opioid pain pills.

The same month -- May of 2017 -- the board closed 14 cases with "Letters of Concern," according to the meeting minutes. What were the concerns? That's something the public simply has no right to know. It's between the doctor and the board.

Not every state handles so much of its doctor discipline privately. Georgia is among 21 states where the law allows secret actions in physician discipline, according to a 2016 AJC national investigation.

 When Dr. Paul Ruble surrendered his license last April, the medical board didn't reveal that he was on his way to federal prison after a 2015 indictment in a pill mill case.

Credit: Lois Norder

icon to expand image

Credit: Lois Norder

The Georgia board also usually provides no details if a doctor gives up a license. The AJC found some 30 cases in Georgia where physicians who were facing criminal charges involving controlled substances, or who were facing sanctions in other states, surrendered their licenses without the medical board noting any reason.

If the doctor instead keeps practicing after being arrested, the board often remains silent,  routinely letting a case play out in court before taking any action against a doctor's license.

The AJC investigated the board's handling of doctors who improperly prescribe opioids in a series published in December. The AJC also studied improper prescribing in all 50 states in its 2017 national investigation, Healers or Dealers?

The AJC discovered in its 2016 Doctors & Sex Abuse national investigation that the Georgia board has handled even serious allegations in private.  The board placed Dr. Jacob Ward on probation after he pleaded guilty in a criminal sexual misconduct case. But that criminal case revealed a back story. Two other patients had made similar charges against Ward four years earlier and the board did nothing other than write a "personal and confidential" letter to the doctor expressing its "concern regarding exams and patients of the opposite sex."

The Georgia Composite Medical Board is a 16-member board made up of 13 physicians, two consumer members and one nonvoting Physician Assistant member. All voting members are appointed by the Governor and confirmed by the State Senate.