'Trust system' allows Georgia doctors to omit black marks on records

The public profile for Dr. Rose Horne posted online by the Georgia Composite Medical Board shows she has been convicted of a felony. It also includes a brief description of the crime — or at least the version Horne remembers.

“Offense associated with my spouse nearly annihilating me,” her description says in its entirety.

The reference is to abuse Horne experienced at the hands of her husband more than 30 years ago in Tennessee. It doesn’t mention that she was convicted of second-degree murder and sentenced to 15 years in prison for paying two men $10,000 to kill him.

Horne’s online profile illustrates how a medical board program that’s supposed to give the public crucial facts about Georgia doctors is instead an unpredictable honor system. Too often, it yields incomplete, deceptive or even false information.

Under Georgia law, physicians are required to complete a detailed questionnaire when they are licensed. The board then uses the answers to compile profiles for each physician that can be accessed on its web site.

Some of the questions deal with basic background information such as education and training. Others delve into more critical areas, including felony convictions, board disciplinary histories, malpractice judgments and settlements and restrictions on hospital privileges.

But the board does not check the information, leaving the public with what the physicians themselves see as the truth, sometimes a dicey proposition.

Physicians are also required to report certain changes within 10 days, including criminal actions and malpractice judgments and settlements. The board doesn’t check those, either.

Spot checks by the Atlanta Journal-Constitution found five malpractice verdicts that do not appear on the physicians’ profiles, including two that date to 2011 and one to 2009. All are over the $100,000 reporting threshold.

LaSharn Hughes, the board’s executive director, acknowledged that the profiles are based largely on a “trust system” that puts the onus on physicians to be honest in their answers. Although some answers may be insufficient, the the program is still valuable, she said.

“It may not capture everything, but at least it opens the door for me, as a consumer, to say, `I have concerns,’” Hughes said. Even partially correct answers, she said, can lead patients to search further through Google and other means for more information.

Patients’ right to know

The profiles were mandated by the Legislature when it passed the Patient Right to Know Act in 2001. According to the law’s sponsors, some of whom were among the state’s most powerful Democrats, more information about physicians was needed because managed care programs had narrowed patients’ options.

“That information is virtually impossible to find now,” then-House Majority Leader Larry Walker told The Associated Press at the time.

In signing the questionnaires, physicians acknowledge that their statements are “true and correct” and that the forms “may be selected for verification.” They also acknowledge that false or incomplete answers may result in the board taking disciplinary action against them.

When the law went into effect, Hughes said, the board made an attempt to check some of the information. But it quickly backed off, realizing it didn’t have the personnel to handle the job, she said.

“Like everything else in state government, you can’t have a person dedicated to reading 33,000 (questionnaires),” she said.

The board does update the profiles when it disciplines physicians and adds information reported by malpractice insurers, she said.

But gaps in reporting by physicians “sort of renders the web page irrelevant,” said Richard Mitchell, an Atlanta attorney who handles malpractice cases.

On Sept. 24, Mitchell wrote the board to complain that three malpractice verdicts he had obtained had yet to appear on the physicians’ profiles. Since then, one of profiles has been amended to include the verdict, although the amount is incorrect. The other two profiles remain unchanged.

Betsy Cohen, the board’s legal counsel, said the board will investigate if it learns of false information on a profile, but she was unaware of any physicians being sanctioned for such a violation.

“No particular cases come to mind as to discipline imposed for erroneous responses on a profile,” she wrote in an email.

Dr. Michael Carome, director of health research at Public Citizen, the nonprofit consumer advocacy group, said states that offer physician profiles are providing an important service. But when medical boards don’t check verifiable information such as criminal records or malpractice judgments, some of the value is lost.

“The information is only as good as the person entering the data and the quality checks the board engages in to determine whether the information is accurate,” Carome said. “To the extent that some physicians may choose to slant the information, well, then it’s not very useful.”

A 1982 conviction

Horne’s description of her murder conviction from 1982 gives her view of a saga that made headlines in both Nashville, where the crime occurred, as well as her home state of Georgia.

Horne, then known as Rose-Horne Leaphart, was charged with hiring the two men who beat her husband, a dental student, with a baseball bat and left his body stuffed in the trunk of a car.

When the case went to trial, she told the jury that her husband had beaten her, broken her arm, blackened her eyes and forced her to submit to drug injections.

According to a published account, the jury was moved by Horne’s story, but it still found her guilty and imposed a minimal prison sentence. She served three years before being released on parole, according to the Tennessee Department of Correction.

Efforts to contact Horne, whose profile lists a Valdosta address, were unsuccessful. A woman who answered the phone at a home of a relative promised to pass along a message from an AJC reporter to the physician, but the call was not returned.

Horne was issued a Georgia medical license in June 1981, just a month after she was indicted. At the time, the prosecutor handling her case called the board’s decision “one of the most irresponsible I have ever seen.” She surrendered the license after she was convicted and wasn’t reinstated until 2009, records show.

Hughes said she looked into Horne’s profile after the AJC inquired about it. She said Horne’s description of her offense, while clearly one-sided, is probably sufficient under the law.

“My argument would be that she disclosed (what was required),” Hughes said. “Should it be better? Yes. … She didn’t hide it, but the description probably should be better.”

Several other online profiles examined by the AJC for physicians with criminal records include similarly vague descriptions.

One is the profile for Dr. Andrew Dekle, a Cairo physician who was convicted in federal court in Albany in 1997 of writing at least 129 drug prescriptions for women in exchange for their willingness to have sex with him or allow him to take nude photographs. His conviction required that he surrender his medical license, but he was reinstated in Georgia in 2003.

Dekle’s online profile shows a criminal offense that occurred in the middle district of Georgia in 1997. But it describes the offense only by what appears to be a criminal code: “18USC941.” Moreover, court records show that Dekle actually violated a different statute, 21U.S.C.841(a)(1).

Dekle also was convicted of conspiracy to distribute controlled substances without a legitimate medical reason, but the conviction was reversed on appeal.

He did not respond to phone and email messages from the AJC.

The profile created for Dr. Armando Sanchez, who pleaded no contest to solicitation of capital murder in Texas 12 years ago, also accurately shows a felony conviction, but it makes no mention of what he did.

“Charged with felony, pled nolo contendere,” the profile reads, making no mention of the actual charge or that it involved his attempt to hire a hit man to kill a disgruntled patient.

The profile also notes that his deferred adjudication was terminated in 2009, again without any mention of the underlying facts.

Sanchez, who was licensed by the Georgia board in 2010 and now operates a clinic in Smyrna, declined to be interviewed by the AJC.

When asked about the Dekle and Sanchez profiles, Horne again cited her belief that some information is better than nothing.

“To me, as a lay person, if I were concerned, I’d at least have this information to make a decision,” she said. “There is something for you as a consumer to make a better informed decision.”