Health Letter, September 2023
By Robert Steinbrook, M.D.
If you’re not outraged,
you’re not paying attention!
Read what Public Citizen has to say about the biggest blunders and outrageous offenses in the world of public health, published monthly in Health Letter.
In August 2023, a ProPublica investigative report called attention to a Pennsylvania radiologist with a “national empire of vascular clinics” who has been “disciplined by medical boards in over a dozen states, lost privileges in multiple hospitals and settled federal allegations of fraud, admitting that his company had performed procedures without any documented need.” The issues have included an experimental and unproven treatment for multiple sclerosis, involving the use of balloons and stents in veins to improve blood flow, and the performance of vascular procedures on hemodialysis patients without evidence of need. According to ProPublica, “two [patients] lost their legs and several nearly lost their lives” after invasive vascular procedures. Yet despite myriad sanctions, fines and lawsuits, the physician is seeing patients and “still adding to the nearly $50 million he has earned in the past decade in federal insurance reimbursements.”
The story of Dr. James McGuckin, and his ability to continue to practice, illustrates much of what is wrong with the patchwork of regulations and state and federal regulatory agencies that are ostensibly protecting the public from dangerous doctors. If regulators are unable or unwilling to stop physicians from practicing even in egregious situations, to what extent are they able to protect the public in the less extreme and more common situations of doctor misconduct that lead to patient harm?
The state medical boards that license physicians can take disciplinary actions against licensees who injure, endanger or behave inappropriately or illegally towards patients. In August 2023, we released a new report on state medical boards’ disciplinary actions. The report showed a decline in state rates of serious disciplinary actions (per 1,000 physicians per year) in 2019-2021, as compared with 2017-2019 (the time period covered in our previous report). The new report also showed continued major differences among states in the rates of serious physician disciplinary actions. For 2019-2021, Michigan, with an average of 1.74 serious disciplinary actions per 1,000 physicians per year, had the strongest record, and the District of Columbia, with an average of 0.19 serious disciplinary actions per year, had the weakest. The report could not account for the effects, if any, of the COVID-19 pandemic on serious disciplinary actions in 2020 and 2021.
Michigan’s rate of serious actions reflects a better level of performance, not an optimal level. The story of James McGuckin is a timely reminder that all state medical boards can — and must — do a far better job of protecting the public from dangerous doctors.