Years after an investigation by The Atlanta Journal-Constitution and a state auditor’s report found inadequate oversight of problem doctors left Georgia patients unprotected, few of the recommended fixes have been fully implemented, a new state report has found.
The Georgia Composite Medical Board is the state’s body that licenses doctors, disciplines them for abuse, misconduct or incompetence, and can limit or revoke their licenses in order to protect patients. The report, released Friday, was a follow up to a 2020 audit that depicted a slow-moving bureaucracy, dominated by doctors who allow colleagues to continue practicing even after being credibly accused of harming patients.
In apparent disregard of new legal requirements put into place following the first audit, the report said the board still does not mandate background checks for newly licensed doctors, leaving the potential for a doctor to bury a record of misconduct by relocating. The board also still has no official conflict of interest policy, leaving the potential for doctors on the board to vote on whether to discipline doctors they’re connected to. And when a doctor is being investigated, the board still has no formal timeline for when the board should take action.
The board has argued that it has been hamstrung by staff departures, the death of its respected staff director, and inadequate funding from the state Legislature.
Indeed, the board could more than fund a robust investigative operation with the physician licensure fees it collects, but the majority of the $8.5 million is siphoned off by the state Legislature. The Legislature takes all the fees, then gives the board its budget separately: $2.6 million for all its functions overseeing the state’s approximately 25,000 working doctors.
Among other gaps the report identified is the missed opportunity for the 16-member board to more strongly represent patients, as opposed to doctors. The state Legislature has made the board up mostly of doctors, but research has shown that boards that lack a strong mix of consumer and doctor members can result in more permissive decisions that favor problem doctors.
In the AJC’s 2016 investigation Doctors & Sex Abuse, a nationwide review of disciplinary actions against doctors who were accused of sexual misconduct with patients found that the boards tended to focus on the doctor: whether or not the doctor had learned from their mistake, or perhaps gone to therapy and been rehabilitated. In the thousands of board orders the AJC reviewed, it was rare to see any mention of the harm suffered by abused patients or whether they received treatment or had an opinion on reinstating the doctor.
On Georgia’s board, by law, only two of 15 voting members may be “consumer members.” AJC reporters found that even those two consumer members, appointed by Gov. Brian Kemp, actually represent the health care industry.
One of Georgia’s “consumer members,” Judy Gardner, is Director of Pharmacy Services at Northside Hospital. The other, Charles Harris, founded a healthcare staffing company.
The board’s executive director, Daniel Dorsey, said in an interview that the staff has made some progress toward the recommendations. They hope to have criminal background checks in process at the end of this year or beginning of next year. Some of the policies like triaging the caseload are already practiced but yet to be written out in the procedures manual, though he said that too will happen in coming months.
“We’ve got our foot back on the gas and we’re moving forward with trying to get these recommendations implemented, because at the end of the day, it’s about protecting patients and that’s what we’re going to do,” Dorsey said.
All of the gaps, from funding to lack of clear procedures to lack of patient voices, have consequences.
The earlier Georgia report found only 2% of investigations against doctors resulted in public discipline. An AJC review of disciplinary cases in recent years finds marginal change, a finding echoed by the updated auditor’s review.
The review acknowledged that the board had made progress in some areas, but called for action in the others.
“These actions are critical to furthering GCMB’s mission to protect the public and ensuring that unsafe physicians are not allowed to practice medicine,” the review said.
State Sen. Ben Watson, R-Savannah, who chairs the Senate Health and Human Services Committee, said he had tried to get adequate funding this year for the board to meet its obligations, but that the budget negotiations had been a “roadblock.”
It’s clear the board needs to do more and needs more funding in order to do it, Watson said.
“And I think that would be an understatement. And I think it needs to be addressed.”
AJC investigative editor Lois Norder contributed to this story.