Nevada medical board seeks to update discipline, licensing systems

The Nevada Board of Medical Examiners is proposing legislation to increase transparency and efficiency, and include patients in the disciplinary process.

The plan would allow patients or others who file complaints against physicians to voice their concerns by making a statement or testifying as a witness at a hearing. They also could address the board when discipline is imposed. At present, patients are not allowed a voice in the hearing or punishment phases of the process.

Under the proposal, complaints would be made public when they are filed, with case numbers assigned to each, as well as a brief description. Doctors and patients would be unnamed unless the case goes to a hearing.

"Right now, the public doesn't get any of that information," said Louis Ling, the board's chief executive. "This way, one way or another [the public] will know why a case was dismissed [or accepted]."

Ling proposed the changes to the medical board in December 2008. He is crafting a bill to put before the Nevada Legislature in February. Nevada's legislators meet every two years.

The state board has been criticized over its handling of some high-profile cases in the past year, including a charge that it moved too slowly on liability claims against an endoscopy center in Las Vegas that was accused of unsafe syringe use that infected eight patients with hepatitis C.

"There are probably three or four, maybe five other bill drafts out there from legislators to fix various elements of our practice," Ling said. "What we're hoping is [that] our bill addresses all of those criticisms."

Public distrust of the board is the chief reason the Nevada State Medical Assn. agrees with the move to propose changes, said NSMA Executive Director Lawrence P. Matheis.

"We're in favor of them doing it, [but] we have to see what actual steps will be proposed in the end," Matheis said, noting that caution must be taken to guard against damaging doctors' reputations unfairly. "It is always a problem of due process vs. public confidence, but there's no doubt that in Nevada the last couple of years, there's been an erosion of public confidence in the health care system, in the profession of medicine and in the board."

The proposal also calls for establishing a time frame for resolving complaints. Determinations would have to be made within 90 days, and if a case goes to a hearing, then it must be resolved within nine months. Ling said some cases have dragged on for two years or more.

"That's too long for the patient who had something bad happen," he said.

In addition, a time line would be added to the license application process. The new goal would be to issue physician licenses within 60 days. Most now take anywhere from 30 to 90 days, but Ling said some take much longer.

Ling sees the proposed changes as necessary, since the last time the board's disciplinary statutes were overhauled was 1977.

"The licensing system had some changes in 1985, but you're still looking at law that's 20 or 30 years old in some cases," he said. "We simply had to come up with a modern approach to the practice of medicine, and that's really what this bill does."