Q&A with Courtney Perkes, Part 2: Truth-checking a medical board’s claims of one-bad-apple syndrome
The Medical Board of California told Orange County Register health reporter Courtney Perkes that it was rare for a doctor to be disciplined, allowed to return to practice and then disciplined again. She wanted to see if that was actually true, and so she asked the board for every record of a doctor who had petitioned for a license reinstatement. Her investigation uncovered the fact that about a quarter of all doctors who get their licenses back reoffend. The first part of my interview with Perkes appeared last week. The second part is below. It has been edited for space and clarity.
Q: How did you decide who you wanted to consult as outside sources?
A: The first interview I did was with Peter Osinoff, the attorney who represents so many of these doctors who face medical board discipline. I wanted to bounce off him what I had found and just give him descriptions of what some of the situations were: the crimes, the cases, and also the rate of recidivism, for lack of a better term. He was extremely helpful. He talked to me for well over an hour, and he was just very thorough in explaining things. He has certainly represented his share of doctors who had gotten their licenses back, and he wanted to explain fully where he was coming from. I also knew I wanted to talk to Julie Fellmeth, who had been the board monitor. The first time I called her she was attending a medical board meeting. She was actually the one who steered me to Rudy Bermudez and said he had written this law to try to make it harder for doctors to get their licenses back. And so I contacted our Sacramento reporter and asked him if he knew how to get a hold of Rudy, and he did. I also tried to track down nearly all of the doctors. I approached many more doctors than actually made it into the story.
Q: How did you track most of them down?
A: If they had returned to practice, I would just call their office and leave a message.
Q: When you're leaving a message about a doctor who has been disciplined with an office manager or secretary, what did you say you were calling about?
A: I said I was writing about the medical board and writing about doctors who regained their licenses after being disciplined. I said I was including this doctor so needed to talk to them or their attorney about their case.
Q: Were you worried that you would be telling this person for the first time that the doctor had a disciplinary history?
A: No. I felt like my only shot at reaching this doctor was through this medical receptionist, and I didn't want them to miss the importance of making sure the doctor got the message. Also, I was calling a lot of doctors from other parts of the state who I knew would find it strange that a newspaper from Orange County was calling them, so I wanted to be clear about why they should call me back. I always had the receptionist repeat back the message to me, too, so that I knew they took everything down correctly.
Q: Did that work?
A: No. Nobody called me back. But I knew that I had given it my best shot. One doctor had a Facebook picture of him holding up the LA Times and reading it, so I thought he at least was friendly toward newspapers. But he never responded to my messages on Facebook. And then I got lucky with Dr. Kaplan, the psychiatrist. I Googled him and found an office number for him in LA. I called him up at 5 p.m. thinking it was the end of the day and he might pick up. He did. He pretty much refused to talk, but I did get one comment from him.
Q: And have any of them contacted you since?
Q: And why do you think that Peter Osinoff talked when he has spent so much time telling his clients not to talk?
A: When I told him what the results were, he thought it was fascinating. Julie Fellmeth thought it was fascinating. Both of them, in spite of their quibbles with the medical board for different reasons, had similar reactions. Peter Osinoff thinks that sometimes they are too tough, and Julie Fellmeth thinks that sometimes they were way too lenient. But they had common ground on what they thought the data showed. That surprised me a little bit. They both thought that this was an objective analysis of how effective it is to give someone a second chance, and that, for the most part, the medical board's system is working.
Q: Let's talk a little bit about the numbers. You wrote about 123 doctors, and 66 of them were reinstated. Of those, only 16 messed up again. That's about one out of four, but it's also a small number. Why not just bail on the investigation when you see that you're only talking about 16 doctors?
A: I think the story then became about the process. And that it wasn't this smoking gun per se. We already knew about Dr. Andrew Rutland, who was, of course, the most serious example of a doctor getting in trouble again, because a patient died. A lot of those doctors getting in trouble again were not meeting the terms of probation but weren't being accused of harming patients. What became really interesting was how doctors would get up there on the stand and describe their most vulnerable moments in life and describe how broken down they were and this betrayal that they had committed. There was just a lot of drama.
Q: That's what I was thinking when I was reading this, that you could almost have a TV series that every week takes you through one of these doctor's cases because they have these incredible life journeys.
A: And even more interesting was then reading how these decisions were weighed and what was considered important. A question my editor would frequently ask was, "Is there anything so bad that a doctor could do that he will never be allowed to treat patients again?"
Q: What was the answer?
A: There were only a handful of cases where the judge talked about the heinousness of the original crime, and usually it involved sexual abuse.
Q: You mentioned your editor. I presume it was Chris Knap, the Register's investigations editor. What was it like working with him on this story?
A: I learned a lot from Chris about how to approach an investigation. He asked a lot of good questions that helped me know where to go next. And I was very grateful that I was given the time to work on the project at all. As you know, it's harder and harder to find time to do something bigger than a daily.
Q: Why do you think the medical board decided to respond to you only in writing?
A: My experience has been that they don't want to talk to reporters, at least to me. And I don't know why that is.
Q: You contrast doctors who lost their licenses to lawyers who are disbarred. Did you consider going the distance and examining all the lawyers who have returned to practice after disbarment?
A: I didn't look at that. I just didn't have the time. Also, I think that lawyers can do a lot of really bad things, but the role that doctors play in our society is unique. The intimacy they have with patients and the access they have to tax dollars when we're talking about Medicare and Medi-Cal billing and the ability they have to prescribe these powerful drugs puts doctors in a class all their own. There is no other role in our society where a person has access to so much public trust, and, because of that, they deserve special scrutiny.