Disciplinary Double Standard?

I like to uncover evidence of hubris and hypocrisy in state medical boards, so when I came across patient records of Robert Thilo, MD, a psychiatrist to whom the Washington Physicians Health Program (WPHP) apparently refers impaired physicians for “treatment,” I felt a little like James Stewart must have felt after he stepped on Donna Reed’s robe in “It’s a Wonderful Life.”

A couple of years ago the Washington board (MQAC) disciplined Dr. Al Bunin for giving the entire chart to the patient, and they recently sanctioned him again for “illegible” records. Dr. Thilo’s record was not just illegible. It was practically nonexistent, consisting of essentially blank pages with the patient’s name and maybe a date of service. I reported my discovery to MQAC along with copies of the “records.”

This looks like a win-win in my hunt for hypocrisy. If MQAC approves of Dr. Thilo’s blank records I can accuse them of according special treatment to a physician who may have drunk the Kool-Aid, supporting the growing industry of brainwashing “disruptive” physicians in order to keep a full practice of “patients” so desperate to keep their medical license they will cooperate with almost anything. If, on the other hand, MQAC disciplines Dr. Thilo, they will discredit WPHP.

Several months ago MQAC assigned Lisa Noonan to investigate two complaints against me. (More on that later.) Not long before they notified me they had closed those cases Ms. Noonan, who MQAC assigned to investigate Dr. Thilo as well, asked me to reveal the identity of the patient whose name I had carefully removed from Dr. Thilo’s records. I responded by challenging MQAC’s need for that information while suggesting that she might obtain the name from Dr. Thilo. Of course if all your patient records are blank I can see the difficulty in telling one from the other. Does Ms. Noonan just want an excuse to divert attention from one of WPHP’s favorite physicians? Has Dr. Thilo refused to provide the name? Does MQAC want to fine or get rid of us both, a little double-dipping by the State of Washington?

I offered to provide Ms. Noonan with the name if she would just offer some explanation of how the patient’s name would help the investigation. She refused. Perhaps the wording of the initial threat to open “an investigation against” me provides a clue. Investigations usually begin without prejudice as indicated by a word like “into,” rather than “against.” She also failed to provide me with information about the process of such an investigation. Not exactly a paragon of neutrality.

According to one statute failure to provide the name will lead to a subpoena. Should I wait for the subpoena? I have a few more days to decide whether to accede to the bullies. Meanwhile, I will contact Dr. Thilo.

Stay tuned. I have another complaint pending with MQAC for hospital records that include nonsense apparently produced by word processing error. One can usually identify nonsense for what it is, but imagine how many medical records contain errors that look sensible. Those are the most dangerous, possibly lethal. After all, a record that contains no information contains no MISinformation. Will MQAC act to insure patient safety or just sweep it under the carpet, appying a different standard to a hospital physician than they apply to Drs. Thilo or Bunin.

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