Lane - Fundamentals of medical practice investigation

Fundamentals of

Medical Practice Investigation

Fundamentals of

Medical Practice Investigation

Jeffrey D. Lane

CRC Press

Taylor & Francis Group

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2017 by Taylor & Francis Group, LLC

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Version Date: 20160205

International Standard Book Number-13: 978-1-4987-5628-0 (Hardback)

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Library of Congress Cataloging-in-Publication Data

Names: Lane, Jeffrey D., author.

Title: Fundamentals of medical practice investigation / Jeffrey D. Lane.

Description: Boca Raton, FL : CRC Press, 2017. | Includes bibliographical references and index.

Identifiers: LCCN 2016004702 | ISBN 9781498756280 (alk. paper)

Subjects: LCSH: Medical laws and legislation--United States. | Physicians--Malpractice--United States. | Medical care--Law and legislation--United States. | Medical care--United States--Evaluation.

Classification: LCC KF2905 .L357 2017 | DDC 344.7304/11--dc23

LC record available at http://lccn.loc.gov/2016004702

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This work is dedicated to my mother, Sally G. Lane and to the memory of my father, the late Chester C. Lane, Jr. Thank you for raising me right.

Contents

The state agencies that are charged with regulating the practice of medicine, commonly referred to as state medical boards, are faced with a daunting task. Their mandate is to protect the public by enforcing the laws and rules related to the practice of medicine. These laws are commonly referred to as medical practice acts. State medical boards must ensure that a physician is properly educated, trained, and competent to practice medicine safely prior to issuing a license to practice as well as to discipline a physician when laws and rules are violated.

The boards would not be able to adequately carry out this mission without benefit of thorough, quality investigations. A thorough and quality investigation begins and ends with the investigator. A well trained, knowledgeable, and experienced investigator is perhaps one of the most important members of the medical board team in terms of the boards ability to regulate the practice of medicine.

Medical practice investigation occupies a very specialized niche in criminal justice and regulatory arenas. These investigations can be extremely tedious, complex, and often deal with a plethora of esoteric terms and concepts. The education and training required to be a successful medical investigator will not come exclusively from the basic law enforcement police academy or from courses provided in college curricula.

During my tenure as the Director of Investigations for the Georgia Composite Medical Board, specialized training in medical investigations was difficult to find. As a Georgia Peace Officer Standards and Training Council (POST) certified instructor, I often found myself having to develop training courses for the boards investigators attempting to focus more on the specific medical-related aspects of investigation.

These comments are certainly not meant to disparage any training agency or its programs. The majority of investigative training programs are designed to reach a much broader audience and the programs I have encountered over the years have been excellent. Training agencies often lack resources to develop such topic-specific programs designed for the relatively small specialized medical investigation entities. In light of the sparsity of specific medical investigation training, I seek to develop this text as a resource for medical investigators. The investigative fundamentals presented in the text may also be applied to investigations concerning an array of other healthcare practitioners to include physician assistants, nurses, dentists, physical therapists, psychologists, etc.

This book is in no way intended to be the absolute final authority on medical investigation. Even though medical investigators share a common goal, that is to find the truth, we often get there via different routes. Each board in every state has a similar mandate as described above, and each state has its own laws and regulations, many similar to other states and many not so similar, all affecting the course of investigation. The book is designed to be a guide assisting the investigator along the way.

It is fully respected and appreciated that the investigative principles and methods contained in the book may or may not apply to all state boards and it is fully understood that each state board has its own way of carrying out its duties as they must comply with the laws and procedures of their state. It is hoped that the information contained herein will benefit new, inexperienced investigators, experienced investigators as a refresher, and perhaps benefit law enforcement officers, as they encounter medical investigators in joint investigations or find themselves confronted with a medical practice issue in their jurisdiction.

A final thought before forging ahead. When I was appointed as an investigator for the Georgia Secretary of States Office in 1981, I had no concept of medical investigation. The only knowledge I had regarding medicine and medical practice was from an occasional visit to the doctor. Shortly after my appointment, I and my fellow investigators attended an agency-wide meeting to hear a presentation given by G. Douglas Talbott, MD. The late Dr. Talbott was the founder of Talbott Recovery Campus (TRC) in Atlanta, Georgia. TRC is an addiction/substance abuse treatment facility and developed one of the early treatment programs focusing on medical professionals. He and some of his staff came to the Georgia Medical Board to discuss the programs offered by TRC and develop a relationship with the board as the board dealt with practitioners suffering from substance abuse issues.