***MINUTES***
OPEN SESSION BOARD MEETING
Held in the Conference Room of the
videoconferenced to
the
2295 B
Renaissance Drive,
and
Board Members Present
Cheryl A. Hug-English, M.D., President
Jaculine C. Jones, Ed.D., Vice President
Donald H. Baepler, Ph.D., D.Sc., Secretary-Treasurer
• Joel
N. Lubritz, M.D.
Robin L. Titus, M.D.
Marlene J. Kirch
Stephen K. Montoya, M.D.
Javaid Anwar, M.D.
Staff Present
Larry D. Lessly, J.D.,
Executive Secretary/Special Counsel
Drennan A. Clark, J.D., Deputy Executive Secretary/Special
Counsel
Laurie L. Munson, Deputy Executive Secretary
Richard J. Legarza, J.D.,
General Counsel
Stephen D. Quinn, Deputy General Counsel
Lynnette L. Krotke, Chief
License Specialist
Douglas C. Cooper, Chief Investigator
Trent S. Hiett,
Investigator (present in
Also Present
Charlotte M. Bible, J.D., Chief Deputy Attorney
General
Timothy D. Coughlin, President,
Arne D. Rosencrantz,
Director, Board of Directors,
Professionals Assistance Foundation
Roger Belcourt, M.D.,
John B. Lanzillotta,
P.A.-C, Physician Assistant Advisory Committee Member
• Michael
J. Garcia, R.R.T., Practitioner of Respiratory Care Advisory Committee Member
Robert D. Fisher, President &
CEO,
Mailing Address:
Physical Address:
(775) 688-2559 - Fax
(775) 688-2321
E-mail:
nsbme®medboard.nv.gov - Website: www.medboard.nv.gov
(NSPO Rev. 1-03) (0) 1934
Open Session Minutes
March 12 & 13, 2004
Board Meeting
Page 2 of 23
FRIDAY.
Agenda Item 1
CALL TO ORDER AND ANNOUNCEMENTS - Cheryl A. Hug-English, M.D., President
The meeting was called to
order by Cheryl A. Hug-English, M.D., President, at
Agenda Item 2
APPROVAL OF MINUTES
- December 5 & 6,
2003 Board Meeting - Open/Closed Sessions
Dr. Lubritz
moved to accept the minutes of the December 5 & 6, 2003 Board Meeting -
Open/Closed Sessions. Mrs. Kirch seconded the motion,
and it passed unanimously, with the Chair voting in favor of the motion.
Agenda Item 3
PERSONNEL
Open Session
- Consider and Discuss
Additional Staff Requirements:
-
Deputy General Counsel
- Investigator(s)
-
License Specialist
Mr. Lessly
explained that both the General Counsel and Deputy General Counsel continue to
be extremely busy and it appears the Board will need another attorney when Mr. Legarza retires. He requested authority to immediately hire
a new Deputy General Counsel to begin the training process before Mr. Legarza retires.
Mr. Clark told the Board
that due to an increasing number of applications and renewals, one License
Specialist currently has 52 new application files she is unable to open and
others have 40 or more, and it is clear they need an additional License
Specialist to handle the increased workload. He recommended the Board hire the new
License Specialist at entry-level wage, with a review and possible salary
increase after six months. He stated no additional office space would be
required to house this additional employee.
Mr. Clark then explained
that there has been an increase in complaints and administrative work in the
Investigations Division, due in part to the Legislature abolishing the
Medical-Legal Screening Panel, and this increase warrants hiring two additional
Investigators. In
Dr. Baepler
stated there is enough money in the budget for the additional salaries,
equipment and office space, and that he felt if there is office space available
we should acquire it. He commented that the need for an additional License
Specialist is good news because it shows more health professionals want to move
to
Open Session Minutes
March 12 & 13, 2004
Board Meeting
Page 3 of 23
Dr. Baepler
made a motion to authorize the hiring of a new Deputy General General, an additional License Specialist and two
additional Investigators. Dr. Jones seconded the motion, and it passed
unanimously, with the Chair voting in favor of the motion.
Agenda Item 7
COMMITTEE
Dr. Montoya stated the
Committee met with Nevada Broadcasters Association concerning a comprehensive
campaign to get the word out about what the Nevada State Board of Medical
Examiners is and what it does. The Nevada Broadcasters Association listened to
what the Committee had to offer and came up with several ideas. The Committee
will review the proposals and present them to the Board. The current ads will
be phased out and new ads substituted in their place.
Mr. Clark told the Board
one idea was to have people such as Senator Bryan, Senator Raggio,
and other well-known people do advertising spots, and also to have a doctor,
possibly Dr. Tony Alamo, do a spot in Spanish.
Dr. Hug-English stated
that consideration of continuation of the contract with
• Broadcasters
Association is also on the agenda and there are two questions the Board needs
to decide when considering that item: (1) whether to continue the contract; and
(2) whether these new scripts are what the Board wants.
Agenda Item 15
REPORTS
- Diversion Program:
Quarterly Report - Timothy D. Coughlin, M.D., President;
Bradley
J. Thompson, M,D., Medical Director; Arne D. Rosencrantz, Director,
- Physician Assistant
Advisory Committee - John B. Lanzillotta, P.A.-C, and
Dan Hickey, P.A.-C, Advisory Committee Members
- Practitioner of
Respiratory Care Advisory Committee - Michael J. Garcia, R.R.T., Advisory
Committee Member
- Investigative
Committees - Donald H. Baepler, Ph.D., D.Sc., Secretary-Treasurer, Chairperson
Joel
N. Lubritz, M.D., Chairperson
Richard
J. Legarza, J.D., General Counsel
Stephen
D. Quinn, J.D., Deputy General Counsel
Douglas
C. Cooper, Chief Investigator
- Consideration of Cases
Recommended for Closure by the Committees
- Status of Investigative
Case Load
- Status of Recruitment
of Peer Reviewers
Secretary-Treasurer
- Donald H. Baepler, Ph.D., D.Sc.,
Secretary-Treasurer
- Status of Finances
Open Session Minutes
March 12 & 13, 2004
Board Meeting
Page 4 of 23
- Diversion Program: Quarterly Report – Timothy D.
Coughlin, M.D.
President; Bradley J. Thompson, Medical Director;
Arne D. Rosencrantz, Director;
Arne D. Rosencrantz, member of the Nevada Health Professionals
Assistance Foundation's Board of Directors, stated the Foundation has made
strides since the December meeting of the Nevada State Board of Medical
Examiners. He introduced Timothy D. Coughlin, President; Roger Belcourt, M.D., Director; Bradley J. Thomson, M.D., Interim
Executive Director/Medical Director; and Peter Mansky,
M.D.
Dr. Thompson stated the
Diversion Program is in its ninth year. Victor Rueckl,
M.D. resigned due to a personality conflict with
• reserves;
they have increased client fees slightly and are working on reducing balances
owed to the program. They also have a verbal commitment from the Board of
Osteopathy and may get support from the medical societies. They may also
approach the Dental Board and may consider formalized contracts with hospitals.
In his brief tenure since Carol Bowers left, he has been happy with the
relationship between the board and staff. They have strong Diversion Committees
in both the north and south.
Dr. Mansky
thanked the Board for the opportunity to speak to the Board and stated he has
watched the Diversion Program and thinks by using outreach and education, they can identify physicians with problems before
they reach the level of problems with patient care.
Dr. Hug-English welcomed
Dr. Mansky and stated the Board looks forward to
working with him. She stated the Board appreciates the work the Diversion
Program has done in the past and appreciates Dr. Mansky
stepping in at a tough time. The Board supports, and will continue to support
and appreciate, the program
- Physician Assistant Advisory Committee – John B. Lanzillotta, P.A.-C; Dan Hickey, P.A.-C
John B. Lanzillotta, P.A.-C told the Board Physician Assistants are
constantly working in situations involving end-of-life care, where a delay in
pronouncement of death can be traumatic for families, and currently R.N.s are legally authorized to pronounce death but
Physician Assistants are not. He feels it would be helpful if Physician
Assistants were also authorized to pronounce death and he would appreciate the
Board's input on changing the statute accordingly.
Mr. Legarza
explained that he and Mr. Lanzillotta have talked
about this in the past and if this is something the Board thinks Physician
Assistants should do, a member could propose a BDR at the next Legislative
session.
Open Session Minutes
March 12 & 13, 2004
Board Meeting
Page 5 of 23
Mr. Lanzillotta
explained the idea came from one Physician Assistant who works with other
Physician Assistants in Hospice.
Mr. Lessly
stated the Board will be considering a legislative package at the June meeting
and suggested Mr. Lanzillotta refer the matter to Mr.
Legarza for inclusion in the legislative package at
that time.
Mr. Lanzillotta
stated that pronouncement of death is written into the Model Physician
Assistant legislation, but it has been considered state by state and he doesn't
know the number of states which have included it in their legislation.
Edwin Kingsley, M.D.
stated the Clark County Medical Society is not against a change in legislation
to allow Physician Assistants to pronounce death, but as a member of Hospice he
was never aware of a problem with pronouncement of death by R.N.s
who have been delegated that authority by physicians.
Dr. Anwar
stated he sees no reason why Physician Assistants should not be authorized to
pronounce death in addition to R.N.s, and Dr. Lubritz agreed.
Dr. Hug-English
instructed the Board's legal team to include the proposal in the Board's
legislative packet for discussion at the June meeting.
- Practitioner of Respiratory Care Advisory Committee
— Michael J. Garcia, R.R.T.
Mr. Garcia stated the
Practitioner of Respiratory Care Advisory Committee will be requesting a BDR
from the Board to revise the Nevada Revised Statutes to reflect that
Practitioners of Respiratory Care do not have to have separate licenses to draw
arterial blood gases, as it is part of their scope of practice. Additionally,
it has come to the attention of practitioners that EMTs
are providing patient respirator monitoring care, and he has received concerns
from practitioners related to the qualifications of those who perform these
services. Therefore, they have approached the Department of Health for a
determination as to who is qualified to perform these services. He then
inquired as to how renewal of licenses for practitioners of respiratory care
was proceeding.
Dr. Hug-English stated
she thinks licensure for blood gases preceded practitioners of respiratory care
and that is why it has been licensed separately.
Mr. Legarza
explained he had tried informally to change it, but the Bureau of Licensure
& Certification was opposed to it because it is revenue for them.
Dr. Hug-English stated
the Committee could request a BDR with no objection from the Board.
Open Session Minutes
March 12 & 13, 2004
Board Meeting
Page 6 of 23
- Secretary-Treasurer - Donald H. Baepler,
Ph.D., D.Sc., Secretary-Treasurer - Status of Finances
Dr. Baepler
reviewed the distributed Board Balance Sheet as of
Dr. Anwar
moved to approve the financial documents. Dr. Montoya seconded the motion, and
it passed unanimously, with the Chair voting in favor of the motion.
Agenda Item 4
CONSIDERATION OF ADOPTION OF PROPOSED AMENDMENTS TO
- Donald H. Baepler, Ph.D., D.Sc., Secretary-Treasurer
- Richard J. Legarza, J.D., General Counsel
- Stephen D. Quinn, J.D.,
Deputy General Counsel
Dr. Hug-English stated
the continuing competency of physicians is an issue the Board thought was
important to look at. The committee, chaired by Dr. Baepler,
has done a lot of work on the issue and held workshops to receive public
comment, and the purpose of this meeting is to receive additional comments and
then allow for Board discussion.
Sidney Zimmet, M.D. told the Board he has been a practicing
physician in
Edwin Kingsley, M.D., on
behalf of Joe Hardy, M.D., asked how the amended regulation would affect urban
and rural family practitioners, who are already required to take exams every
six years, as he does not know if the exam would meet the requirements of the
proposed regulation amendments.
Dr. Baepler
stated he believed the exam would likely qualify.
Don Bunch, M.D. told the
Board he has practiced cardiovascular surgery in
Dr. Hug-English stated
the Board appreciated the public comments and she thanked the Committee for its
hard work on a very complex, important issue.
Discussion by the Board
members ensued concerning the proposed amendments to the regulation.
Open Session Minutes
March 12 & 13, 2004
Board Meeting
Page 7 of 23
Motion
by Dr. Montoya to table the proposed amendments to the regulation for the time
being. Dr. Anjum
seconded the motion, and it passed unanimously, with the Chair voting in favor
of the motion.
Agenda Item 5
CONSIDERATION OF AUDIT PERFORMED BY THE FEDERATION OF
STATE MEDICAL BOARDS OF THE UNITED STATES. INC. AS
MANDATED BY THE
- Drennan
A. Clark, J.D., Deputy Executive Secretary/Special Counsel
Mr. Lessly
stated he had reviewed the audit by the Federation of State Medical Boards and
the "white paper" by the Clark County Medical Society. Some of the
suggestions made in the audit would be advantageous to implement, others would
do nothing, and some would require legislation to implement.
Mr. Clark provided the
Board with a detailed outline of the recommendations contained in the audit
report and the recommendations of staff with regard thereto.
Dr. Anwar
moved to approve the changes already implemented and to table discussion of the
remainder of the recommendations in the audit until the June meeting. Mrs. Kirch seconded the motion, and it passed unanimously, with
the Chair voting in favor of the motion.
Dr. Hug-English stated
the audit was a very favorable report of the Board and it reinforces the fact
that the Board is doing a good job. There is always room for improvement, but
she appreciates every member and the work they do.
Agenda Item 6
CONSIDERATION OF POSITION PAPER PREPARED BY THE
- Edwin Kingsley, M.D.,
President,
Edwin Kingsley, M.D.
stated the Board strives to protect the interests of the citizens of
Open Session Minutes
March 12 & 13, 2004
Board Meeting
Page 8 of 23
Discussion ensued
concerning how and which physicians were polled by the Clark County Medical
Society in preparation of its position paper. Dr. Lubritz
challenged the name of the position paper of the Clark County Medical Society, as he had discussed the position paper with many of
the previous officers and current members of the board of trustees, and they
had not even had an opportunity to read the Federation of State Medical Boards'
audit, much less have an opinion on it. Therefore, it was an opinion letter of
Dr. Don Havins and Dr. Kingsley and not that of the Clark County Medical
Society.
Dr. Kingsley stated the
changes the Clark County Medical Society is suggesting are not adversarial;
many have already been addressed by Board staff and they only disagree with a
few.
Agenda Item 8
CONSIDERATION OF CONTINUATION OF CONTRACT WITH
- Robert D. Fisher,
President and CEO -
Robert D. Fisher,
President and CEO of Nevada Broadcasters Association, appeared before the
Board. He stated a public information officer has nothing to do with public
service announcements or NCSAs; those are two totally
different types of functions. What his company wants to address is the Board's
public awareness campaign, and he would make the same presentation today as he
did in December, adding that he has met with Tony Clark three times now and has
submitted scripts for the Board's review. He thinks a 12-month contract is
necessary for consistency and continuity. He stated there are three messages
that need to be delivered: the mission of the Board, the quality of doctors in
the state and directing people to the website for information. He stated that
once the Board approves scripts, they could be on the radio in ten days and on
television within two weeks. He feels the increase in the monthly cost to the
Board for the Nevada Broadcasters Association's services from $5,000 to $6,000
is still a discount, as the usual charge is $7,500 per month.
Dr. Hug-English suggested
the matter be tabled until Saturday to give the Board members an opportunity to
review the scripts and think about it.
Mr. Legarza
stated an annual contract in this amount ($72,000) would require going to the
Board of Examiners and justifying a sole-source contract, which will take time
and can't be done right away, but the Board could extend the contract for three
months now and enter into an annual contract at a later date.
Agenda Item 9
CONSIDERATION OF REQUEST BY WASHOE MEDICAL CENTER FOR
APPROVAL OF PRACTITIONER OF RESPIRATORY CARE TRAINING PROGRAMS PER NRS
630.047(1)(E) AND (F)(1)
Dr. Anjum
moved to grant the request of
Open Session Minutes
March 12 & 13, 2004
Board Meeting
Page 9 of 23
Agenda Item 10
DISCUSSION OF REGULATION AMENDMENT TO ALLOW
RECERTIFICATION BY ABMS SUBBOARDS TO SATISFY THE REQUIREMENTS OF
- Lynnette L. Krotke, Chief License Specialist
Ms. Krotke
told the Board that from January 2004 to March 2004 the Licensing Division has
received around 400 applications for physician licensure. Many of these
physicians do not meet the requirements because the Board currently does not
recognize recertification in subspecialties. She
suggested that amending NAC 630.080(1)(B)(5) to allow
ABMS subboard recertification
would be a good way to enable additional qualified physicians to obtain
licensure in the state.
Dr. Anjum
stated he thought it was always the intent of the regulation to recognize
subspecialties as a valid entry point.
Ms. Krotke
explained that currently they are only accepting recertification
in the primary specialty to meet the 10-year examination requirement.
Dr. Baepler
moved to approve recertification by subspecialty
boards approved by the American Board of Medical Specialties. Dr. Lubritz seconded the motion, and it passed unanimously,
with the Chair voting in favor of the motion.
Dr. Hug-English stated
this is just a clarification of the intent of the regulation and since subboard recertification exams
are so thorough, the Board should accept them.
Agenda Item 15 (CONTINUED)
REPORTS
- Diversion Program:
Quarterly Report - Timothy D. Coughlin, M.D., President;
Bradley
J. Thompson, M.D., Medical Director; Arne D. Rosencrantz,
Director,
- Physician Assistant
Advisory Committee - John B. Lanzillotta, P.A.-C, and
Dan Hickey, P.A.-C, Advisory Committee Members
- Practitioner of
Respiratory Care Advisory Committee - Michael J. Garcia, R.R.T., Advisory
Committee Member
- Investigative
Committees - Donald H. Baepler, Ph.D., D.Sc., Secretary-Treasurer, Chairperson
Joel N. Lubritz, M.D.,
Chairperson
Richard
J. Legarza, J.D., General Counsel
Stephen
D. Quinn, J.D., Deputy General Counsel
Douglas
C. Cooper, Chief Investigator
-
Consideration of Cases Recommended for Closure by the Committees
-
Status of Investigative Case Load
-
Status of Recruitment of Peer Reviewers
- Secretary-Treasurer -
Donald H. Baepler, Ph.D., D.Sc.,
Secretary-Treasurer
-
Status of Finances
Open Session Minutes
March 12 & 13, 2004
Board Meeting
Page 10 of 23
INVESTIGATIVE COMMITTEES – Donald H. Baepler, Ph.D., D.Sc.,
Secretary-Treasurer, Chairperson
Joel N. Lubritz, M.D., Chairperson
Richard Legarza, General Counsel; Stephen D. Quinn, Deputy General Counsel;
Douglas C. Cooper, Chief Investigator
-
Consideration of Cases Recommended for Closure by the Committees
-
Status of Investigative Case Load
-
Status of Recruitment of Peer Reviewers
Dr. Baepler
stated that Investigative Committee A authorized filing formal complaints in 13
cases, although many do not appear to rise to the level of license suspensions
or revocations. Two cases were sent out for peer review, appearances were
requested in 2 cases, 5 cases were referred back to investigative staff for
further investigation and 48 cases were closed.
Dr. Lubritz
stated that Investigative Committee B authorized filing formal complaints in 2
cases, 5 cases were sent out for peer review, appearances were requested in 3
cases, 7 cases were referred back to Investigations and 112 cases were closed.
Agenda Item 11
DISCUSSION OF AMERICAN PSYCHIATRIC INSTITUTE
SELF-ASSESSMENT EXAMINATION INSOFAR AS IT SATISFIES THE REQUIREMENTS FOR
LICENSURE BY ENDORSEMENT UNDER
- Donald H. Baepler, Ph.D., D.Sc.,
Secretary-Treasurer
Dr. Baepler
stated the American Psychiatric Institute Self-Assessment Examination has been
accepted by the Board only with applications by endorsement. The statute states
the requirements, but it is difficult to tell whether all requirements are
specifically met by the examination. However, since it has been recommended for
use, he would be inclined to approve it due to the nature of the specialty.
Ms. Krotke
stated the License Specialists wanted to ensure the Board was comfortable with
it, as applications for licensure by endorsement are being received more
frequently now. There are a number of other examinations they can take and peer
review is an option, so this would be one more alternative.
Dr. Baepler
moved to accept the American Psychiatric Institute Self-Assessment Examination
as a means for Psychiatrists to qualify for regular licensure when the
application is by endorsement.
Dr. Titus stated she was
uncomfortable with it.
Dr. Lubritz
suggested writing to the ABMS and ask its opinion
whether the American Psychiatric Institute Self-Assessment Examination is
appropriate to examine their physicians.
Dr. Baepler
stated he agreed and withdrew his motion.
Open Session Minutes
March 12 & 13, 2004
Board Meeting
Page 11 of 23
Dr. Lubritz
moved that Board staff correspond with the ABMS and ask the status of the
American Psychiatric Institute Self-Assessment Examination, and that the Board
refuse to accept the examination until receiving a response from the ABMS. Dr.
Titus seconded the motion, and it passed unanimously, with the Chair voting in
favor of the motion.
Agenda Item 15 (CONTINUED)
REPORTS
Diversion Program:
Quarterly Report - Timothy D. Coughlin, M.D., President;
Bradley
J. Thompson, M.D., Medical Director; Arne D. Rosencrantz,
Director,
- Physician Assistant
Advisory Committee - John B. Lanzillotta, P.A.-C, and
Dan Hickey, P.A.-C, Advisory Committee Members
- Practitioner of
Respiratory Care Advisory Committee - Michael J. Garcia, R.R.T., Advisory
Committee Member
- Investigative
Committees - Donald H. Baepler, Ph.D., D.Sc., Secretary-Treasurer, Chairperson Joel N. Lubritz, M.D., Chairperson
Richard
J. Legarza, J.D., General Counsel
Stephen
D. Quinn, J.D., Deputy General Counsel
Douglas
C. Cooper, Chief Investigator
-
Consideration of Cases Recommended for Closure by the Committees
-
Status of Investigative Case Load
-
Status of Recruitment of Peer Reviewers
- Secretary-Treasurer -
Donald H. Baepler, Ph.D., D.Sc.,
Secretary-Treasurer
-
Status of Finances
INVESTIGATIVE COMMITTEES – Donald H. Baepler, Ph.D., D.Sc.,
Secretary-Treasurer, Chairperson
Joel N. Lubritz, M.D., Chairperson
Richard Legarza, General Counsel; Stephen D. Quinn, Deputy General
Counsel; Douglas C. Cooper, Chief Investigator
-
Consideration of Cases Recommended for Closure by the Committees
-
Status of Investigative Case Load
-
Status of Recruitment of Peer Reviewers
Douglas C. Cooper, Chief
Investigator, told the Board the Investigations Division currently has 636 open
cases. Ninety-seven cases, which all appear to be minor, have
been held in abeyance because they cannot handle them all with the current
staff. The current workload is approximately 108 cases per Investigator.
With the addition of two additional Investigators, that will drop to 72 cases
per Investigator, which will be manageable. Many cases are easily resolved
because they are duplicates, ie., an Investigator investigates a citizen complaint and then
receives the same case through a court filing.
Mr. Cooper stated
preparation for peer reviews is the next largest time-consuming project. In
2002, there were 40 peer reviews; there were 49 as of
Open Session Minutes
March 12 & 13, 2004
Board Meeting
Page 12 of 23
Mr. Cooper explained that
in 2003 there were 61 civil court filings and out of those 61, 50 to 60%
included multiple physicians. Investigations has to
open a file on each physician involved. He believes the court cases are
leveling off, so with the new staff, each Investigator should have a caseload
of 40 or 50 cases by this time next year.
A discussion ensued
concerning peer reviews and the procedure for same.
Mr. Quinn explained it is
difficult to find peer reviewers. Generally, the Board uses in-state
physicians, and there can be a fear of professional ostracision.
Staff will continue to encourage in-state physicians to act as peer reviewers,
but there may be instances when it will be necessary to look outside the state.
Dr. Montoya moved to
approve the Investigative Committee Reports. Dr. Jones seconded the motion, and
it passed unanimously, with the Chair voting in favor of the motion.
RECESS
Dr. Hug-English recessed
the meeting for lunch at
RECONVENE
Dr. Hug-English
reconvened the meeting at
Agenda Item 22
APPEARANCES FOR CONSIDERATION OF ACCEPTANCE OF
APPLICATIONS FOR LICENSURE
CLOSED SESSION
22(a) William Torch, M.D.
Upon returning to open
session, Dr. Titus moved to accept Dr. Torch's application as supervising
physician for APN Monette Martin. Mrs. Kirch seconded the motion, and it passed unanimously, with
the Chair voting in favor of the motion.
Agenda Item 18
CONSIDERATION OF PROPOSAL FOR SETTLEMENT IN THE
MATTER OF THE ELLIOTT D. SCHMERLER. M.D. VS.
Adjudicating Board Members: Cheryl A. Hug-English, M.D., President; Jaculine C. Jones, Ed.D., Vice President; Joel N. Lubritz,
M.D.; Robin L. Titus, M.D.; Marlene J. Kirch;
All of the adjudicating
Board members were present.
Mr. Clark summarized the
mediation of this case. He told the Board that during the mediation, Dr. Schmerler made an offer to surrender his license while
under investigation, with prejudice, meaning he would never again apply for a
license in the state of
Open Session Minutes
March 12 & 13, 2004
Board Meeting
Page 13 of 23
would present it to the Board. They are concerned that
acceptance of the offer could lead to another D'Ambrosio-type
situation.
Mr. Quinn recapped the
circumstances surrounding the revocation of Dr. Schmerler's
license by the Board.
A discussion of Dr. Schmerler's offer and the possible ramifications of
acceptance ensued.
Dr. Schmerler's
attorney spoke on behalf of Dr. Schmerler, and Dr. Schmerler explained what he has done to keep current in the
medical profession.
Dr. Lubritz
moved to reject Dr. Schmerler's settlement offer in
the mediation of the case. Mrs. Kirch seconded the
motion, and Dr. Hug-English took a roll call vote, with the adjudicating Board
members voting as follows:
Dr. Jones: yea
Dr. Lubritz: yea
Dr. Titus: yea
Mrs. Kirch: yea
Dr. Anjum nay
Dr. Anwar: yea
Dr. Hug-English yea
The settlement offer in
the matter of Elliott D. Schmerler, M.D. vs. Nevada
State Board of Medical Examiners, Case No. 42363, Nevada Supreme Court, was
rejected.
Agenda Item 12
DISCUSSION OF CONVERSION FROM RESTRICTED LICENSE
STATUS TO UNRESTRICTED LICENSE STATUS (
- Lynnette L. Krotke, Chief License Specialist
Ms. Krotke
explained that this agenda item was prompted by a letter received from Robert
Platt, M.D., requesting conversion of his license from restricted status to
unrestricted status. He is currently county-restricted in Elko because he only
had one year of post-graduate training, but we are in a position today that he
could possibly be licensed under the new statute. He has completed four years
of part-time practice in Elko, which would not normally meet the requirement to
obtain an unrestricted license, i.e., three years full-time practice. However,
under the new statute, he meets the requirements because he is Board certified
in Emergency Medicine.
Dr. Titus moved to grant
an unrestricted license to Dr. Platt. Dr. Lubritz
seconded the motion, and it passed unanimously, with the Chair voting in favor
of the motion.
Open Session Minutes
March 12 & 13, 2004
Board Meeting
Page 14 of 23
Agenda Item 13
DISCUSSION OF QUESTIONABLE EDUCATIONAL STANDARDS OF
CARIBBEAN (FOREIGN) MEDICAL SCHOOLS, PURSUANT TO NEVADA REVISED STATUTES
CHAPTER 630.130 AND NEVADA ADMINISTRATIVE CODE SECTION 630.050
- Lynnette L. Krotke, Chief License Specialist
Ms. Krotke
explained that the License Specialists have been receiving a lot of information
on the foreign medical schools included in the information provided to the
Board in their meeting packets, as well as Mexican medical schools, and they
want to confirm whether the Board wants to license applicants from these
schools. These applicants typically have had problems passing USMLE. The number
of attempts is remarkable and scores are low. The schools in question are in
the World Health Organization book, but some other states already do not accept
these schools.
Mr. Lessly
added that the Board cannot license someone unless he/she graduated from a
medical school with the same standards as American medical schools.
Dr. Hug-English directed
Ms. Krotke to continue to bring these applicants
before the full Board. Additionally, the Board would like the License
Specialists to note in bold type questionable schools, as well as any other
problematic areas they see when reviewing applications.
Agenda Item 14
BOARD WEBSITE: www.medboard.nv.gov REPORT
- Laurie L. Munson,
Deputy Executive Secretary
-
Status of Website Update Project
-
Status of Addition of Licensees' Educational History and Other Enhancements to
Licensee Search Module
- Status of Website Update Project
Ms. Munson advised the
Board that the Board's website is now in full compliance with all statutory
requirements, and she is working to make the website more user-friendly for the
public and the Board's licensees. She summarized recent additions to the site,
which include: addition of an FAQs section, addition
of a link to the Inspector General's Office and other agencies, addition of
forms sections for both licensees and consumers, addition of a listing of
licensees, in alphabetical order, who have received disciplinary action from
the Board, and a section which includes some of the Board's financial
documents. A hit counter has also been added to the website, to allow the Board
to track the number of visits to its website. She told the Board that staff has
plans to upgrade the search module so that a search can be made by geographical
area or scope of practice, as well as by physician name, and that she has some other
ideas for improvements to the website which she will bring to the Board at a
later date.
- Status of Addition of Licensees' Educational
History
Ms. Munson told the Board
that pursuant to its direction, a full-time temporary employee was hired
through Kelly Services in late December to review the Board's licensee files
and compare the educational information contained therein to that in the
Board's database to verify the accuracy of the information and correct any
errors in the database. The temporary
Open Session Minutes
March 12 & 13, 2004
Board Meeting
Page 15 of 23
employee has currently completed approximately 30% of the
work, and staff anticipates completion of that work in approximately 4 months,
at which time the information will be added to the website.
Agenda Item 16
EXECUTIVE STAFF REPORTS - Larry
D. Lessly, J.D., Executive Secretary/Special Counsel
Drennan
A. Clark, J.D., Deputy Executive Secretary/ Special Counsel
Laurie
L. Munson, Deputy Executive Secretary
Lynnette
L. Krotke, Chief License Specialist
- Consideration of
Request for Staff Attendance at Educational Meetings
-
Federation of State Medical Boards New Executives' Orientation,
(Drennan A. Clark, Deputy Executive Secretary/Special
Counsel & Laurie L. Munson, Deputy Executive Secretary)
-
Washoe County Medical Society Spring Mini Internship
Program,
(Trent
Hiett, Investigator; & Jennifer Sloan,
Investigator)
- Update on
Video-Conferencing Equipment and Training
- Report on Status of
Renewal Registration of Practitioners of Respiratory Care
- Consideration of
Physicians' Use of Credentialing Entities Regarding Licensure Applications -
Informational Items
- Informational Items
Mr. Clark requested the
Board members provide him with any additional items they would like included in
a proposed legislation packet for discussion at the June meeting.
- Consideration of Request for Staff Attendance at
Educational Meetings
Mr. Clark requested
authority for Investigators Trent S. Hiett and
Jennifer K. Sloan to attend the Washoe County Medical
Society Spring Mini Internship Program in
Mr. Clark requested
authority for Financial Support Assistant Deborah E. Swartz to attend a State
Personnel Training Session in May.
Mr. Clark requested
authority for he and Ms. Munson to attend the
Federation of State Medical Boards New Executives Orientation in
Motion
by Dr. Baepler to authorize attendance at the
aforementioned educational meetings as discussed. Mrs. Kirch seconded the
motion, and it passed unanimously, with the Chair voting in favor of the
motion.
- Report on Status of Renewal Registration of
Practitioners of Respiratory Care
Ms. Krotke
stated the Licensing Division received no response to the first mailing in
October 2003. The second mailing went out in January 2004 and to date 794
Practitioners of Respiratory Care have renewed, 10 have requested non-renewal,
144 have been suspended for non-payment and 5 have reinstated. She thinks most
of the 144 are travelers, as the License Specialists have made numerous
unsuccessful attempts to reach them.
Open Session Minutes
March 12 & 13, 2004
Board Meeting
Page 16 of 23
- Consideration of Physicians' Use of Credentialing
Entities Regarding Licensure Applications
Ms. Krotke
told the Board the Licensing Division has issues with other credentialing
entities that are not as serious as those with U.S. Medical Licensing, but they
want to make the Board aware of these issues and request the Board's direction.
She stated that some credentialing entities are doing a good job and may be
helpful about 10 percent of the time, but 90 percent of time they only
complicate the process.
Dr. Hug-English directed
Ms. Krotke to bring any other credentialing entities
with problems that rise to the level of U.S. Medical Licensing to the Board's
attention for a determination as to whether the Board wants to accept
applications from those entities.
Agenda Item 17
LEGAL REPORTS - Richard J. Legarza,
J.D., General Counsel
Stephen
D. Quinn, J.D., Deputy General Counsel
Charlotte
M. Bible, J.D., Chief Deputy Attorney General
-
Board Ordered Terms, Conditions and Probation Status
-
Board Litigation Status
Mr. Quinn stated the
Board currently has four cases pending in court. In the Alan Mishler case, the Ninth Circuit Court of Appeals affirmed
the District Court's decision to grant summary judgment to the Board. Dr. Mishler has until March 20 to file a petition for
Certiorari or request a rehearing.
In the Robert Rutledge
case, Dr. Rutledge filed a petition for judicial relief on
The Kenneth Mower case is
on appeal with the Nevada Supreme Court. It is currently scheduled for
mediation, but Mr. Quinn thinks it will be taken off the mediation calendar and
move forward.
John H. DeTar, M.D. has filed an action against the Board to
mandate the Board to investigate a hospital credentialing committee that
conducted a review against him concerning a statement regarding quality of
care. Mr. Quinn has taken the position that the Board has no jurisdiction, and
has filed a response.
Agenda Item 19
CONSIDERATION OF REQUEST BY
- Cheryl A. Hug-English,
M.D., President
Open Session Minutes
March 12 & 13, 2004
Board Meeting
Page 17 of 23
Dr. Montoya volunteered
to act as liaison between the Board and the NSMA. Dr. Hug-English stated it may
be a rotating position.
Agenda Item 21
LICENSURE RATIFICATION
-
Ratification of Licenses Issued, and Reinstatements of Licensure and Changes ofLicensure Status Approved, Since the December 5 & 6,
2003 Board Meeting
-
License Application and Malpractice Review Committee Licenses Issued Since theDecember 5 & 6, 2003 Board Meeting
Dr. Baepler
moved to ratify the licenses issued, and reinstatements of licensure and
changes of licensure status approved, since the December 5 & 6, 2003 Board
meeting. Dr. Jones seconded the motion, and it passed unanimously, with the
Chair voting in favor of the motion.
Agenda Item 20
CONSIDERATION OF REQUEST TO RESCHEDULE DECEMBER 2004
BOARD MEETING DATES
- Joel N. Lubritz, M.D.
Dr. Lubritz
requested the Board consider rescheduling the December 2004 Board meeting, but
after brief discussion withdrew his request.
Agenda Item 23
MATTERS FOR FUTURE AGENDA
Mr. Clark mentioned three
items that would be on the June meeting agenda: (1) proposed legislative
initiatives packet; (2) staff evaluations and compensation; and (3) election of
officers and appointment to committees.
Agenda Item 22 (Continued)
APPEARANCES FOR CONSIDERATION OF ACCEPTANCE OF
APPLICATIONS FOR LICENSURE
Dr. Jones moved to go
into Closed Session to discuss the character and professional competence of
applicants for licensure approval. Mrs. Kirch
seconded the motion, and it passed unanimously, with the Chair voting in favor
of the motion.
22(b) Armin Vishteh, M.D.
Upon returning to Open
Session, Dr. Baepler moved to allow Armin Vishteh, M.D. to withdraw
his application without prejudice. Dr. Montoya seconded the motion, and it
passed unanimously, with the Chair voting in favor of the motion.
Dr. Anjum
moved to return to Closed Session for the same purposes stated before. Dr.
Montoya seconded the motion, and it passed unanimously.
Open Session Minutes
March 12 & 13, 2004
Board Meeting
Page 18 of 23
22(c) Frank Toppo, M.D.
Upon returning to Open
Session, Dr. Anjum moved to approve Frank Toppo, M.D.'s application for an
unrestricted license. Dr. Montoya seconded the motion, and it carried
unanimously, with the Chair voting in favor of the motion.
Mrs. Kirch
moved to return to Closed Session for the same purposes stated before. Dr.
Jones seconded the motion, and it passed unanimously.
22(d) Frank Stile, M.D.
Upon returning to Open
Session, Dr. Lubritz moved that the Board accept
Frank Stile, M.D.'s application for unrestricted
licensure due to his successful passage of a peer review. Dr. Anwar seconded the motion, and it passed unanimously, with
the Chair voting in favor.
Mrs. Kirch
moved to return to Closed Session for the same purposes stated before. Dr.
Jones seconded the motion, and it passed unanimously.
22(e) William Summers, M.D.
Upon returning to Open
Session, Dr. Anjum moved that the Board decline to
exercise its discretion to issue a license to William Summers M.D. by
endorsement at this time because of new information provided by Dr. Summers
that requires investigation, and that Dr. Summers can sit for a peer review in
the meantime and the Board can consider an application for unrestricted
licensure at the June Board meeting. Dr. Titus seconded the motion, and it
passed unanimously, with the Chair voting in favor of the motion.
22(f) Brian Heiter, R.R.T.
Upon returning to Open
Session, Dr. Montoya moved to accept Brian Heiter, R.R.T.'s application for licensure. Dr. Baepler
seconded the motion, and it passed unanimously, with the Chair voting in favor.
Mrs. Kirch
moved to return to Closed Session for the same purposes stated before. Dr.
Titus seconded the motion, and it passed unanimously.
22(g) Joseph Teichgraeber,
M.D.
Upon returning to Open
Session, Dr. Titus moved that the Board grant Joseph Teichgraeber,
M.D.'s application for licensure. Dr. Baepler seconded the motion, and it passed unanimously,
with the Chair voting in favor.
Dr. Titus moved to return
to Closed Session for the same purposes stated before. Dr. Baepler
seconded the motion, and it passed unanimously.
Open Session Minutes
March 12 & 13, 2004
Board Meeting
Page 19 of 23
22(h) Jeffrey Tennant. M.D.
Upon returning to Open
Session, Dr. Lubritz moved that the Board grant
Jeffrey Tennant, M.D.'s application for unrestricted
licensure subject to his successful passage of a peer review, at his own
expense. Dr. Montoya seconded the motion, and it passed unanimously, with the
Chair voting in favor.
Dr. Titus moved to return
to Closed Session for the same purposes stated before. Dr. Jones seconded the
motion, and it passed unanimously.
22(i) Edward Gray, M.D.
Upon returning to Open
Session, Dr. Montoya moved that the Board grant Edward Gray, M.D.'s application for licensure. Dr. Titus seconded the
motion, and it passed, with Dr. Baepler and Dr. Lubritz abstaining and the Chair voting in favor.
Mrs. Kirch
moved to return to Closed Session for the same purposes stated before. Dr.
Montoya seconded the motion, and it passed unanimously.
22(j) Lillian Cavin, M.D.
Upon returning to Open
Session, Mrs. Kirch moved that the Board grant
Lillian Cavin, M.D.'s
application for Special Purpose licensure. Dr. Titus seconded the motion, and
it passed unanimously, with the Chair voting in favor.
Dr. Jones moved to return
to Closed Session for the same purposes stated before. Mrs. Kirch
seconded the motion, and it passed unanimously.
22(k) Edgar Clark, M.D.
Upon returning to Open Session, Dr. Baepler moved that the Board approve Edgar Cla