Thousands of doctors across the U.S. are on medical probation for reasons including drug abuse, sexual misconduct, and making careless—sometimes deadly—mistakes. But they’re still out there practicing. And good luck figuring out who they are.
The state medical board’s report on Leonard Kurian, an obstetrician-gynecologist in Southern California, tells in stark clinical detail what it says happened to several patients in his care. And it’s not easy to read.
The report describes the time Kurian surgically removed the wrong ovary from a 37-year-old woman, a mistake the patient only learned about weeks later when, still in pain, she went for more tests. The good ovary was missing, and the cystic one was still inside her.
Kurian’s record gets worse from there. The report makes the case of how his errors of medical knowledge, judgment, protocol, and attentiveness contributed to the deaths of two patients. Both were young mothers who had recently given birth to healthy babies.
You might think a doctor with that type of record would be barred from practicing medicine, but that didn’t happen in this case.
Thousands of working physicians are currently being disciplined by their respective state medical boards for findings that patients may want to know about–things such as sexual misconduct, their own addiction problems, overprescribing controlled substances, and all sorts of other documented examples of unprofessional or dangerous doctoring.
Though the odds are quite good that your doctor isn’t one of them, it’s important to know for sure.
Changing the System
Here’s the problem: Even in a time when vast amounts of information sit at the end of our fingertips, it’s still too difficult for consumers to find a doctor’s disciplinary record and its causes.
Through our Safe Patient Project, Consumer Reports is working to change the way the system works around the country. “The onus shouldn’t be on patients to investigate their physicians,” says Lisa McGiffert, who directs the effort. “Doctors on probation should be required to tell their patients of their status.”
Last fall in California, the state with the most doctors, Consumer Reports petitioned the medical board to do just that. The board rejected the idea, saying it would put too much of a burden on doctors and damage the doctor-patient relationship.
We also filed a public records request and were able to obtain California’s entire database of doctors on probation as of late September, information that is now searchable on our Safe Patient Project website.
Consumer Reports’ deep dive into California’s records brings this important issue into sharp focus. Read some of the probationary settlements, all signed by the doctors and their lawyers, and it becomes clear why this matters:
There’s the orthopedic surgeon whose inattention to a man’s fractured thighbone resulted in a leg amputation. And the family practice physician, who, along with her cardiologist husband, ordered more than 4 million doses of hydrocodone in 15 months but when pressed by investigators could account for only a small fraction of it. You’ll find examples of doctors practicing under the influence–a psychiatrist drinking midshift and the urologist arrested for DUI while on call, his blood alcohol reading almost twice the legal limit.
And what about the highly regarded surgeon with a seizure disorder? Is his condition something patients need to know about?
Some of the most egregious cases raise the question: What does it take for a doctor to have his or her license suspended or revoked? And if those sorts of transgressions are regularly tolerated with only modest and discreet sanctions, the system of disciplining physicians needs to be made more transparent, reliable, and accessible than it is today.
State medical boards are really hybrid regulatory agencies, combining government oversight with professional peer review. Their main purpose is to license and discipline physicians and to investigate complaints, whether they are filed directly by patients or come from other medical personnel, hospitals, the courts, or law enforcement. It’s important work often performed by volunteers–doctors and also some outside the profession.
“One of the core defining points of what a profession is, is that it takes responsibility for regulating itself,” says Jim E. Sabin, M.D., director of the ethics program at Harvard Pilgrim Health Care, an insurance company in Boston, and a clinical professor of psychiatry and population medicine at Harvard Medical School.
Board findings and sanctions should be public, Sabin says. “Can that be uncomfortable for the medical profession? Yes, it can. That’s unfortunate–the discomfort–but the responsibility of an agency like a board of registration is to the public.”
In the case of Kurian, the California board placed him on probation from 2015 until 2022, citing 40 instances of his negligence and incompetence, yet allowed him to keep practicing on the condition that he completes courses in clinical training, ethics, and medical record-keeping. And he doesn’t have to tell new or existing patients he’s on probation or what’s in the board’s 25-page investigative report that details his mistakes. Kurian did not respond to messages left with his office staff. Two of his lawyers declined to comment.