Article from May 12, 2003 edition of the South Sound Business Examiner (Tacoma, Washington).
VICTIMS OF THE SYSTEM
Whether you agree with their motives, their methods or the way they reacted to dicey situations, you'll probably admit it might not be paranoia that makes this trio wonder if they're Victims of the System.
[Jump to the story about lawyer Schafer.]
By Steve Dunkleberger & Paul Schrag
Business Examiner staff
It has been said that no good deed goes unpunished. And there's plenty of evidence to support that contention, especially when the government gets involved.
South Sound residents who believe their careers and livelihoods have been altered by government and their own good intentions include a former medical doctor, an office-supply store owner and a lawyer who can't practice for six months. Here are their stories:
Physician Sarah Reade says she had no reservations about alerting the Medical Quality Assurance Commission (MQAC) to the possibility a colleague's illness might be endangering patients. She now wishes she had kept her mouth shut.
"Sometimes, I still can't believe what happened," Reade says of her encounter with MQAC, an arm of the state Health Department that enforces standards of competence for a variety of health-related fields and agencies.
The physician couldn't heal herself
The Olympia residents recalls that it began in 1997. The internal medicine specialist was practicing at Stevens Hospital in Edmonds at the time and growing increasingly concerned by comments from patients. They described odd, sometimes-disturbing behavior on the part of a colleague, she says. When she looked into their allegations, she says, she discovered a disturbing series of misdiagnoses, including one in which her colleague treated a patient with congestive heart failure for pneumonia.
"Patients were coming to me and asking if there was something wrong," says Reade.
She points out that her colleague was suffering from Parkinsons Disease, which can manifest itself in abnormal gait, stiffness, tremors, loss of muscular control and, of most concern to her at the time, a form of dementia related to neurological degeneration.
Reade says she consulted with the MQAC, hoping for help in resolving patient concerns and to resolve issues of liability since the two physicians shared patients and space. MQAC responded by sending investigator Virginia Renz to conduct an informal interview with Reade's colleague, his attorney and staff at the clinic where Reade and her colleague practiced.
After concluding Reade's concerns were unfounded, Renz scheduled an interview with Reade, who was unaware that the physician she'd raised concerns about, some members of their staff and her ex-husband had turned the tables on her. They described having smelled alcohol on her breath in the medical office on at least two occasions and claimed it was she who'd been exhibiting strange behavior, including late night phone calls in which she allegedly slurred her words.
Renz concluded Reade had a drinking problem that warranted further action. Her report was forwarded to to the Washington Physicians Health Program (WPHP), which specializes in intervention and treatment of physicians with substance abuse problems or mental illness. The WPHP has counterparts nationwide that collectively claim success rates of 85 to 90 percent -- success being defined as returning the healthcare professional to a healthy, chemical-free lifestyle. WPHP says its primary role is to protect patients from impaired physicians -- that helping physicians clean themselves is a bonus.
Most physicians avoid suspension of their medical license by cooperating with WPHP, says Director Lynn Hankes.
"The program really does work," he says. "If a physician works with us, they can usually get back on track without jeopardizing their career."
Most physicians are eager to do exactly that. In fact, in the vast majority of cases WPHP handles, the physician whose career is at stake is self-referred. They recognize that they have a problem and turn to WPHP for the cure.
Reade was among just 14 percent of the cases that are dropped in MPHP's lap by state agencies or the courts. Hankes concedes that some of these cases turn out to have been based on false reports. It's a fact of life that would do little to mitigate the impact on Reade's practice.
According to official MPHP files made available by Reade, MPHP's inquiries included calls to her father, her ex-husband and colleagues in Edmonds. The files portray Reade as unstable and mentally ill and refer repeatedly to strong suspicions, sometimes even certainty on the part of those who were interviewed and interviewers, that Reade was abusing alcohol. The first entry is typical: "Ms. Renz feels strongly that there is a chemical dependency."
"The investigations were a joke," says Reade.
She admits that shortly after the death of her mother, which coincided with what she describes as a nasty divorce and legal battles over her mother's estate, she occasionally drank more than she should have in the evening.
"It was one of the hardest times of my life," says Reade.
But she denies ever drinking before work, while on duty or while on call. She is convinced that this fact was never considered by MPHP, which she says had drawn its conclusions before even interviewing her. During the interview, she says, she was told it was clear she needed treatment and that arrangements were being for her to get it.
Hankes refers to the meeting as benevolent coercion.
"It has to have a coercive element because these individuals are suffering from a disease e that tells them that they are not sick," he says. "We use a loving, compassionate but totally honest approach. It's a tough-love mentality."
A letter from Hankes to MQAC Lead Attorney Gerald Kelly claims Reade broke down and admitted to having a drinking problem. Reade flatly denies such allegations and claims that she was warned that if she didn't cooperate she faced suspension of her medical license.
"I was just so intimidated," says Reade. "Their methods were draconian."
For his part, Hankes denies his agents make such threats. In fact, he says, they are required to emphasize that involvement is strictly voluntary and that the agency has no jurisdiction over licensing.
Reade says she warily consented to visit treatment facilities for an evaluation, if for no other reason than to assure MPHP the charges against her were groundless and that she was competent to continue practicing medicine.
Reade was sent to Springbrook Northwest in Newberg, Ore., one of several centers used by WPHP for evaluations and treatment of physicians. There, she says, she was prescribed drug withdrawal therapy despite the fact the discharge summary she eventually obtained from Springbrook clearly states that all medical tests administered there to identify physical effects of alcohol abuse were negative. That did not discourage the center from subjecting her to treatment she deemed unnecessary and unwarranted, she says.
"As soon as I stepped through the doors, I was considered an addict," says Reade. "Any contradictions or anything I said in my own defense just reinforced that I was in denial."
Springbrook interpreted her intractability as evidence that she needed intensive care and recommended that she spend three months there if she really wanted to get well. Her three-month stay would cost her $35,000, she was told. Reade says she left Springbrook that day.
She returned to Edmonds, hired an attorney and arranged for private evaluations in hopes of obtaining evidence that would contradict the damning reports from Springbrook.
In May 1998 Hankes informed Washington Department of Health Staff Attorney Gerald Kelly that his agency believed Reade had a drinking problem and had refused treatment. Evidence of her denial that she had a problem was the fact that she'd hung up on Hankes when he called to offer help, the letter said. Hankes said it was his opinion that Reade was unsafe to practice medicine.
On May 12, 1998, Sarah Reade's medical license was suspended by the Medical Quality Assurance Commission under the authority of the Washington State Health Department.
"I was in shock," says Reade.
Despite assurances by Hankes and MQAC Program Director Lisa Noonan that the WPHP is not the investigatory arm of any state agency, court documents related to the suspension suggest WPHP interviews and notes were the principle evidence in the Health Department's case against Reade.
"If they felt there was someone else they needed to talk to," Noonan says, "they would have."
Yet Noonan also observes that Reade's suspension was uncharacteristic, according to MQAC protocol. Most suspensions require more serious violations, such as sexual misconduct, she says.
The type of sexual misconduct, for example, that Reade's colleague at the Stevens clinic had been found guilty of in 1990. He was on his final year of probation when Reade expressed her concerns about whether Parkinsons was affecting his ability to practice. That doctors license of practice was intact until he suffered a skiing accident in 2002 and voluntarily retired from practice.
"Unless there is a clear danger presented, a substance-abuse case will not usually result in suspension," says Noonan.
Reade underwent yet another evaluation -- this one ordered by the MQAC -- at McLean Hospital in Massachusetts. There, physician Alan S. Barry conducted a five-day examination before concluding that despite Reade's appearing to have experienced a brief period of difficulty, there was no evidence at all of chronic alcohol abuse. A little more than a year later, Reade included Barry's report in the evidence she presented to a State Medical Board commission and Assistant Atty. Gen. Sharon Eckholm, who had taken over the case from MQAC. They, in turn, concluded that there were no grounds to justify suspension of Reade's medical license. All charges against her were finally dismissed.
But her ordeal wasn't over.
Earlier this year, Reade gave up medicine and says this time it's probably for good. She launched a practice in Olympia in 2000, she explains, but was forced to shut it down a few months ago when she was informed by her malpractice insurance provider that the cost of her premiums was going up -- from $5,000 a year to $30,000. The insurer had just discovered her license had been suspended, she says. Never mind that she later was exonerated, she adds.
"I'm just not going to subsidize a broken system anymore," she says. "I just can't afford it."
She she's still paying off the $200,000 in bills that accumulated as a result of lost income, attorney fees and other expenses she accumulated fighting the battle with the state, she explains.
Hankes defends his program saying he helps 30 to 40 physicians a year avoid losing their licenses. He remains convinced that there was no impropriety in the handling of Reade's case.
"We really don't rush to judgement," he says.
Noonan concedes that regardless how judgements are reached, they typically have long-range implications -- even if a physician is exonerated.
"I will admit that the impact on someone's practice can be devastating," says Noonan. "There is really no recourse, though, because reports to our agencies are made in good faith."
That comes as little consolation to Reade, who has placed all her patient records and medical equipment in storage and accepted a job with Western Institutional Review Board, an agency that reviews human medical experiment practices and research