Sunday, August 21, 2005
Letter to Charleston Gazette reporter Morgan Kelly explaining corrupt, arbitrary, and capricious Texas Medical Board
Dear Morgan Kelly, July 8,’05
I read your article about Dr. Chalifoux. I know him very well and he is a good, competent and conscientious neurosurgeon. It is a shame that you didn’t show more respect and deference to Dr. Julian Bailes a nationally recognized neurosurgeon and his staff plus the Dean and university hospital administrator. They would hardly let a neurosurgeon practice there unless he met accepted standards and was not a danger to patients as implied by the biased opinion of Dr. Kalafut. What a big surprise that a representative for the state board didn’t apologize for their devious treatment of this doctor and congratulate the West Virginia board for their courage in righting a wrong in spite of possible future criticism. The larger question is how a good surgeon could lose his license in one state but receive a license in another state. I was present during his travails with the state board.
Part of the problem was one of timing in that the TSBME had received significant complaints and notoriety in the newspapers for leniency towards some incompetent and troubled doctors. The politicians and new director had strongly stated that with increased funds they would go after the “bad” doctors. There was incredible pressure to produce immediate results that the politicians could take credit for and loudly proclaim the advancement of quality care throughout Texas. Unfortunately, in attaining a more active investigative and prosecutorial character, there were numerous violations of due process and fairness which was recently exposed and studied by the legislative sunset committee that was evaluating the TSBME in order to make recommendations for appropriate and desirous changes if deemed necessary. Both the Texas Medical Association and Texas Osteopathic Medical Assoc. testified before the committee due to the multiple complaints they had received from many of their physicians. Thanks to the Sunset committee the board is being forced to follow the existing guidelines that any doctor being investigated for standard of care issues is reviewed by at least 3 doctors. Another essential component is that a different set of doctors will be used for each separate complaint occurring during a physician’s period of practice in Texas.
When Dr. Chalifoux did not accept the board’s offer of 1 year probation, the TSBME became mean-spirited, churlish and overzealous in its efforts to get this doctor. In order to achieve their ends, the board used the same 2 retired neurosurgeons to review almost all of his cases a violation of fairness and their own guidelines. Interestingly, cases from one hospital examined by another neurosurgeon were found to be within the standard of care. These neurosurgeons were biased, unprofessional in their evaluations, picayune and possibly anti-osteopathic. Many of there opinions were just incorrect and blatantly imprecise reflecting the fact that many of the cases involved fusions which neither surgeon performed. One of the neurosurgeons, a Dr. Barrash, is being sued by another neurosurgeon in state district court for making false statements concerning patient review. That case will shortly begin. The fact that of the 18 complaints, Dr Chalifoux effectively defended 17 of them should be considered a blistering condemnation against the board. The sad fact is that even after defending his treatment, the “experts” who were over 90% wrong in there reviews were never reprimanded or censured and Dr. Chalifoux must persevere with a revoked license. Many neurosurgeons in Tarrant County have at least one major malpractice case with a patient death but have their license. The West Virginia board relied on multiple sources for professional opinions to include 3 professors of neurosurgery. There was a real effort to obtain a broad, fair and balanced comprehensive review of these cases not followed by the Texas board. No individual would want to be repeatedly judged by the same persons due to the probability of a clouded, sophistic and distorted perception developing from familiarity and prior erroneous assumptions. Who in his right mind would want previous jurors to judge him if a new trial was necessary?
The real tragedy of a Dr. Chalifoux is that the public will think this expose is protecting them but in reality many problems still exist in the hospitals because of anti-competitive, political and inconsistent peer review which is what started this physician’s troubles. Such an individual as Dr. Chalifoux since coming to this area has been under continuous intense scrutiny and review not normally reserved for most physicians. There is a story, here, concerning the TSBME ranging from preferential reviews and minor punishments for well connected doctors or lack there of to abusive treatment and prosecution of some doctors. Dr J. Oswalt MD took out the wrong lung but only received a $2500 fine because his partner, T. Kurksey, MD sits on the board. As an example, at Columbia Plaza Medical center were he was viewed as a competitor by the dominant and influential neurosurgical group, there, an anti-competitive peer review action was imitated which resulted in his interaction with the TSBME. One of the members of that neurosurgical group has multiple malpractice cases to include death and paralysis and numerous patient complaints much more threatening and serious than Dr Chalifoux but because one of the doctors in the group of Lee Anderson, MD, the head of the board, is friendly with the chief neurosurgeon of that group nothing was done other than a whitewash review. But they sure went after Dr. Chalifoux.
Most reporters do not have the desire and commitment to do a story that goes beyond the mere superficiality of this present article. Why is there still serious quality of care problems in hospitals throughout the country? Is it the mere failure to remove the licenses of some doctors or is it the more pervasive failure of hospital peer review to really do its job and get beyond hospital politics and favoritism. All of Dr. Chalifoux’s problems stem directly from illegitimate and biased peer review. But hospitals have absolute immunity without any true accountability. The HCA healthcare hospitals paid out nearly $1.7 billion dollars in fines for kickbacks, overcharging and various other dishonorable actions. How many patients had unnecessary and harmful surgeries and procedures to increase the bottom line? Why did it take so long for whistleblowers to report these transgressions? Recently, The Tenet hospital in Redding, Ca was fined for doing many inappropriate CABG surgeries. No doctor came forth to report this terrible situation and the administrator and his crony surgeons were protected by ineffective peer review and the many doctors not willing to confront more powerful elements within the hospital. In many hospitals, the doctors with the ultimate decision making on the medical executive committee and board of trustees owe their allegiance to the administrator. This is just the tip of the iceberg. A cardiologist in Dallas at Presbyterian hospital just won over a $600 million dollar award for anti-competitive peer review. But the newspapers here are scared to investigate this phenomenon. Mitch Mitchell who wrote that piece on Dr. Chalifoux in the Ft. Worth Star Telegram admitted that the newspaper leadership does not want any investigation. This was also echoed by Doug Swanson a reporter for the Dallas paper. This is but one of many reasons why reporters are held in poor esteem. Other reasons include making false reports and not fully presenting all the information leading to incorrect assumptions and recriminations.
Your article is a slap in the face of Dr Bailes who has developed an outstanding neurosurgical program at the University and is well respected throughout the community and country. You have inadvertently supported the decision of the Texas board and given credence to 2 neurosurgeons with questionable reputations in Texas who violated their code of ethics by twisting the data to help the board destroy this individual. This can be easily proven with an unbiased and professional review of the cases. One can also review the “proposal for decision”, on the SOAH web site which includes the opinion of the 3 judges a far different conclusion then the state board.
On the Texas medical board bulletin a Herbert L. Fred, MD wrote an article about “...sagging medical professionalism”. He said, “...the most common, and yet most subtle expression of betrayed professionalism is serving ourselves before serving our patients. By doing so, we sacrifice the very core of doctoring—humanism. And as a result, the patient-physician bond becomes weakened—or never even forms. Additional manifestations include abuse of power, arrogance, lack of conscientiousness, and conflicts of interest”. This doctor failed to also mention that these failings also affect doctor-doctor relationships. Too many physicians due to greed and pursuit of power will destroy another doctor utilizing a vast array of dishonorable attributes such as lies, exaggerations, silence, prevarications and dishonesty, to name a few, in order to advance themselves in the present environment of decreasing reimbursements.
I was one of 19 doctors that reviewed these cases and am well aware of the present ethical climate in Texas which is echoed by many other physicians.
John B. Payne, DO
I read your article about Dr. Chalifoux. I know him very well and he is a good, competent and conscientious neurosurgeon. It is a shame that you didn’t show more respect and deference to Dr. Julian Bailes a nationally recognized neurosurgeon and his staff plus the Dean and university hospital administrator. They would hardly let a neurosurgeon practice there unless he met accepted standards and was not a danger to patients as implied by the biased opinion of Dr. Kalafut. What a big surprise that a representative for the state board didn’t apologize for their devious treatment of this doctor and congratulate the West Virginia board for their courage in righting a wrong in spite of possible future criticism. The larger question is how a good surgeon could lose his license in one state but receive a license in another state. I was present during his travails with the state board.
Part of the problem was one of timing in that the TSBME had received significant complaints and notoriety in the newspapers for leniency towards some incompetent and troubled doctors. The politicians and new director had strongly stated that with increased funds they would go after the “bad” doctors. There was incredible pressure to produce immediate results that the politicians could take credit for and loudly proclaim the advancement of quality care throughout Texas. Unfortunately, in attaining a more active investigative and prosecutorial character, there were numerous violations of due process and fairness which was recently exposed and studied by the legislative sunset committee that was evaluating the TSBME in order to make recommendations for appropriate and desirous changes if deemed necessary. Both the Texas Medical Association and Texas Osteopathic Medical Assoc. testified before the committee due to the multiple complaints they had received from many of their physicians. Thanks to the Sunset committee the board is being forced to follow the existing guidelines that any doctor being investigated for standard of care issues is reviewed by at least 3 doctors. Another essential component is that a different set of doctors will be used for each separate complaint occurring during a physician’s period of practice in Texas.
When Dr. Chalifoux did not accept the board’s offer of 1 year probation, the TSBME became mean-spirited, churlish and overzealous in its efforts to get this doctor. In order to achieve their ends, the board used the same 2 retired neurosurgeons to review almost all of his cases a violation of fairness and their own guidelines. Interestingly, cases from one hospital examined by another neurosurgeon were found to be within the standard of care. These neurosurgeons were biased, unprofessional in their evaluations, picayune and possibly anti-osteopathic. Many of there opinions were just incorrect and blatantly imprecise reflecting the fact that many of the cases involved fusions which neither surgeon performed. One of the neurosurgeons, a Dr. Barrash, is being sued by another neurosurgeon in state district court for making false statements concerning patient review. That case will shortly begin. The fact that of the 18 complaints, Dr Chalifoux effectively defended 17 of them should be considered a blistering condemnation against the board. The sad fact is that even after defending his treatment, the “experts” who were over 90% wrong in there reviews were never reprimanded or censured and Dr. Chalifoux must persevere with a revoked license. Many neurosurgeons in Tarrant County have at least one major malpractice case with a patient death but have their license. The West Virginia board relied on multiple sources for professional opinions to include 3 professors of neurosurgery. There was a real effort to obtain a broad, fair and balanced comprehensive review of these cases not followed by the Texas board. No individual would want to be repeatedly judged by the same persons due to the probability of a clouded, sophistic and distorted perception developing from familiarity and prior erroneous assumptions. Who in his right mind would want previous jurors to judge him if a new trial was necessary?
The real tragedy of a Dr. Chalifoux is that the public will think this expose is protecting them but in reality many problems still exist in the hospitals because of anti-competitive, political and inconsistent peer review which is what started this physician’s troubles. Such an individual as Dr. Chalifoux since coming to this area has been under continuous intense scrutiny and review not normally reserved for most physicians. There is a story, here, concerning the TSBME ranging from preferential reviews and minor punishments for well connected doctors or lack there of to abusive treatment and prosecution of some doctors. Dr J. Oswalt MD took out the wrong lung but only received a $2500 fine because his partner, T. Kurksey, MD sits on the board. As an example, at Columbia Plaza Medical center were he was viewed as a competitor by the dominant and influential neurosurgical group, there, an anti-competitive peer review action was imitated which resulted in his interaction with the TSBME. One of the members of that neurosurgical group has multiple malpractice cases to include death and paralysis and numerous patient complaints much more threatening and serious than Dr Chalifoux but because one of the doctors in the group of Lee Anderson, MD, the head of the board, is friendly with the chief neurosurgeon of that group nothing was done other than a whitewash review. But they sure went after Dr. Chalifoux.
Most reporters do not have the desire and commitment to do a story that goes beyond the mere superficiality of this present article. Why is there still serious quality of care problems in hospitals throughout the country? Is it the mere failure to remove the licenses of some doctors or is it the more pervasive failure of hospital peer review to really do its job and get beyond hospital politics and favoritism. All of Dr. Chalifoux’s problems stem directly from illegitimate and biased peer review. But hospitals have absolute immunity without any true accountability. The HCA healthcare hospitals paid out nearly $1.7 billion dollars in fines for kickbacks, overcharging and various other dishonorable actions. How many patients had unnecessary and harmful surgeries and procedures to increase the bottom line? Why did it take so long for whistleblowers to report these transgressions? Recently, The Tenet hospital in Redding, Ca was fined for doing many inappropriate CABG surgeries. No doctor came forth to report this terrible situation and the administrator and his crony surgeons were protected by ineffective peer review and the many doctors not willing to confront more powerful elements within the hospital. In many hospitals, the doctors with the ultimate decision making on the medical executive committee and board of trustees owe their allegiance to the administrator. This is just the tip of the iceberg. A cardiologist in Dallas at Presbyterian hospital just won over a $600 million dollar award for anti-competitive peer review. But the newspapers here are scared to investigate this phenomenon. Mitch Mitchell who wrote that piece on Dr. Chalifoux in the Ft. Worth Star Telegram admitted that the newspaper leadership does not want any investigation. This was also echoed by Doug Swanson a reporter for the Dallas paper. This is but one of many reasons why reporters are held in poor esteem. Other reasons include making false reports and not fully presenting all the information leading to incorrect assumptions and recriminations.
Your article is a slap in the face of Dr Bailes who has developed an outstanding neurosurgical program at the University and is well respected throughout the community and country. You have inadvertently supported the decision of the Texas board and given credence to 2 neurosurgeons with questionable reputations in Texas who violated their code of ethics by twisting the data to help the board destroy this individual. This can be easily proven with an unbiased and professional review of the cases. One can also review the “proposal for decision”, on the SOAH web site which includes the opinion of the 3 judges a far different conclusion then the state board.
On the Texas medical board bulletin a Herbert L. Fred, MD wrote an article about “...sagging medical professionalism”. He said, “...the most common, and yet most subtle expression of betrayed professionalism is serving ourselves before serving our patients. By doing so, we sacrifice the very core of doctoring—humanism. And as a result, the patient-physician bond becomes weakened—or never even forms. Additional manifestations include abuse of power, arrogance, lack of conscientiousness, and conflicts of interest”. This doctor failed to also mention that these failings also affect doctor-doctor relationships. Too many physicians due to greed and pursuit of power will destroy another doctor utilizing a vast array of dishonorable attributes such as lies, exaggerations, silence, prevarications and dishonesty, to name a few, in order to advance themselves in the present environment of decreasing reimbursements.
I was one of 19 doctors that reviewed these cases and am well aware of the present ethical climate in Texas which is echoed by many other physicians.
John B. Payne, DO
// posted by texas shammed @ 12:22 PM 
