Tuesday, December 24, 2013

What Can Law Do

WHAT CAN LAW DO
===============
Congress declared; 'Pizza is a Vegetable'. Yes!!! You heard it.

COMMENTS
----------------
Such tasks could previously be accomplished ONLY ;
1) by the Power of Magic or
2) by the Declaration of a King
Now we have Law to accomplish such tasks.

STORY
---------
At any rate, you may still be wondering how it came to pass that Congress arrived at the conclusion that pizza could count as a serving of vegetables. Wonder no more! Congress was guided along this path by lobbyists. And lobbyists can do all sorts of things, by magic! (Except provide nutritious lunches for children.)

"School meals that are subsidized by the federal government must include a certain amount of vegetables," the AP reports, "and USDA's proposal could have pushed pizza-makers and potato growers out of the school lunch business." It would have pushed vegetable growers into the business, but their lobbyists aren't as powerful, it seems.

A Thought for Physicians
---------------------------
Can we lobby for a Rational Law to eliminate the Medical Board?

LINK
http://www.huffingtonpost.com/2011/11/16/pizza-vegetable-school-lunches-lobbyists_n_1098029.html

‘Standard of Care’ is without any Standard

There is no medical definition for (the imaginary) Standard of care, although the term is firmly established in law…

Thus with no clear medical definition for standard of care, it remains unclear how this mainly legal concept of standard of care weighs up and compares in status to consensus statements or clinical guidelines that are secured in evidence-based medicine and produced by a representative organization or authoritative medical body.

At this time, any physician in California can be disciplined for correctly diagnosing and treating a patient. In such matters, the Medical Board can find the accused physician guilty for not complying with a “Standard of Care”, an imaginary standard unknown to Medical Professionals.

Primary Use
===============
This Standard is primarily used by the Medical Board(s) and the ‘litigation community’ to inflict Financial and Emotional harm (aka Disciplinary Actions) on Physicians and other Healthcare providers. The Board establishes "Negligence" of a Doctors and other Healthcare providers by claiming that the doctor did not comply with the Standard of Care (an imaginary and bogus standard).

Principal Criticism
===============
The principal criticism is that the ‘Standard of Care’ has extended beyond its intended limits, and allows the standard in law to be set subjectively by expert witnesses.

For example:
This Standard is primarily used to prove Negligence of a physician but this is clearly against the intent of such imaginary standard.
In the case of Maynard, Lord Scarman stated that:

“For the realm of diagnosis and treatment, negligence is NOT established by preferring one respectable body of professional opinion to another.”


 Who are Expert Witness
===============
Despite, the Supreme Court has set some conditions to determine who can be an expert witness, as a matter of practice, Expert Witness are doctors ‘paid’ by the Medical Board and the office of Attorney General. Generally, expert witness has same or very similar qualification as any other doctor. In some cases, the expert witness had even lesser qualification (than the doctor whom the expert witness will judge).

An expert witness does not see a patient, nonetheless, the witness doctor is ‘assumed’ to be expert merely by reviewing medical records of a patient. A ‘victim physician’ is ‘conveniently’ disciplined by relying on the report of such expert witness.


Wrongful Disciplinary Conviction(s)
 ===============

The imaginary ‘Standard of Care’ is a primary mechanism of wrongful disciplinary conviction(s) of qualified physicians.

Medical Board has set of physicians (expert witness) who get money from the Medical Board and write a report to ‘conveniently’ discipline physicians.

Since the expert witness is working for the Medical Board, the opinion of the expert witness is deemed as Standard and the victim doctor is disciplined for NOT complying with the imaginary ‘Standard of Care’.
That is how it is done in California.


 Deputy Attorney General’s Question to the Expert Witness
===============
In some of the cases when the 'paid’ expert witness CANNOT even accuse the doctor of violation of the bogus Standard of Care, the Deputy Attorney General would ask the expert witness,

“How about we discipline the doctor for Protection of Public”?





 References;
===============
1) What does the Medical Community Mean by “Standard of Care”
http://jco.ascopubs.org/content/27/32/e192

2) Modern Era of Discipline of Physicians
(http://www.scribd.com/doc/140078140/Modern-Era-of-Discipline-of-Physicians-in-California)

3) Meeting of Defense Attorney(s) of Northern California, Deputy Attorney General & Expert Witness; Walnut Creek, California (2011)



Rehan Sheikh
=================
More on Selective Regulation of Healthcare & Healthcare Professionals;
https://www.facebook.com/PhysiciansForFairness


 

Friday, January 25, 2013

Unequal Justice for Physicians of California

The Constitution of the United States stands for Equal Justice for all. 
Remember  'Pledge of Allegiance'!Equal Justice for all ...

Unfortunately, Equal Justice is NOT available to the physicians of California.

A Comparison of Discipline --- Dr. Mishler  and Dr. Sheikh

In the discipline of Dr. Mishler:
  Dr. Mishler suffered disciplinary action by the State Medical Board where the action was taken without producing relevant records. The State Medical Board, further, attempted to shift the burden of preservation of records on the physician.

In the discipline of Dr. Sheikh:
  1. Medical Board of California and County of San Joaquin denied compliance with the written orders of the Administrative Law Judge to release Dr. Sheikh's records (including correspondence between the Medical Board of California and the Residency Programs) to Dr. Sheikh.

  2. When Dr. Sheikh requested defendant's (Medical Board of California and County of San Joaquin) compliance with the Judge’s orders, Defendants took further adverse actions including but not limited to evicting Dr. Sheikh from her fully paid home without a hearing and without a written order from the Court at a five day notice.

  3. The Board brought accusation of Dishonesty for wrongly answering question 14 of the application form and then the Board (very) disturbingly claimed that the Board didn't have a "Burden of Proof" to bring accusations against Dr. Sheikh. (No Civilized Nation, whether Modern or ancient, has claimed to bring accusations against anyone without evidence).
The accusations of Dishonesty were brought without any ethical opinion or expert.

  4. The Board refused to grant hearing on over 76 objections that Dr. Sheikh had submitted in her Demurrer/Notice of Defense on the accusations the Board.

  5. The Hearing Officer of the Medical Board did NOT find Dr. Sheikh guilty of accusation of Dishonesty, nonetheless the Board denied Dr. Sheikh's application for license.

  6. The final decision of the Board denying Dr. Sheikh's application for Physicians and Surgeons license was delivered in violation of 28 U.S.C. § 1341 (Mail Fraud). A crime that comes with up to many years in prison if committed by a commoner.

==================
 Justice for Dr. Mishler
==================
 The Mishler Court, Alan Mishler v. The State of Nevada Board of Medical Examiner, 849 P.2d 291 (Supreme Court of Nevada 1993); was clear and concluded;
In short, we conclude that the Board's actions and the proceedings against Dr. Mishler constituted a disturbing abuse of its power. Therefore, we reverse the disciplinary order of the Board in its entirety and dismiss all proceedings against Dr. Mishler with prejudice.
==================
 Justice for Dr. Sheikh 
==================
The Ninth Circuit Court of Appeals in California dismissed Dr. Sheikh's Petition without hearing and without giving any relief to her.  Sheikh v. Medical Board of California:

======================================================
 Below is the complete text of decision from the Ninth Circuit Court of Appeals
======================================================

UNITED STATES COURT OF APPEALS
FOR THE NINTH CIRCUIT
FILED
FEB 11 2011
MOLLY C. DWYER, CLERK
U.S. COURT OF APPEALS
ORDER
Before: CANBY and LEAVY, Circuit Judges.
Appellant’s motion for injunctive relief is denied.
The previously established briefing schedule remains in effect.

========================================================
 An exact copy of the Court's decision can be downloaded from the following link.
========================================================
http://www.physicianforfairness.com/#!__disciplinaryprocess/unequal.justice

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Tuesday, January 15, 2013

Composition of the Medical Board of California & Modern Era of Discipline of Physicians:

(How Medical Board of California can Discipline every Physician as a Matter of Law)

The Practice of Medicine is a specialized field and this is not unreasonable to assume that the licensing Board is run by individuals with intimate knowledge of the medical profession. This is not unreasonable to assume that the licensing board will grant license to all qualified applicants. This is not unreasonable to assume that Physicians may be disciplined for legitimate reasons for their actions relevant to their profession.

Unfortunately, the reality cannot be farther from perception. Whether Medical Profession has any bearing on the Medical Board or Discipline of Physicians, can be obvious from the composition of the Board. Because Mission of the Board is “Protection of Public” (not necessarily to improve access to health care Services), the percentage of the physician members in the Medical Board of California is lowest in several decades.

The Board employs an army of investigators under its Chief investigator who work in tandem with the Office of State Attorney General. All investigators of the Medical Board have a title of “Peace Officer”. The Peace Officers/ Investigators are assigned to interview physicians on all matters including matters relevant to health care and patient care. This is understood that none of the investigators has any qualification in the medical field.

Now after recent changes; an experienced Chief of Licensing resigned and the Board has appointed a new Chief of Licensing. The most relevant experience of the new Chief of Licensing is that he worked in licensing of Automotive Vehicle Repair. In his previous assignment current Chief of Licensing , had relied on smog certification to assert fitness of licensees.

“Prior to accepting this position, [Chief of Licensing] was a program manager at the Bureau of Automotive Repair for two years where he managed complaint intake, the toll-free call center, statistical unit staff , and case settlements, citations and license denials.”

“[Chief of Licensing] is technical advisor to the Board members and the primary liaison between the Board, public, consumers, and licensees regarding all issues relating to the license of physicians and affiliated healing arts professions overseen by the Board.” (Quarterly Newsletter of Medical Board of California (October 2010) at page 7 ).

Considering the above, this is understandable that the Medical Board of California is confused on setting a standard for fitness of physicians.

The effects of such composition of the Board are obvious from the following;
a.Dr. Sheikh completed Family Medicine Residency Training and received a certificate of Residency Completion from University of California at Davis.

b.Before starting residency, Dr. Sheikh participated in Research along with faculty at Stanford and was named a co-author on a number of topics published in professional journals.

c. Dr. Sheikh received excellent recommendations from VA Palo Alto, University of Texas Medical Branch and from Stanford School of Medicine.

d. Two senior Residency Program Directors wrote letters in her support rating her as an excellent and intelligent physician. Three different Residency Program Directors on several occasions testified under Penalty of Perjury (by completing L3 form) that Dr. Sheikh is competent to practice Medicine.

e. Nonetheless, the Board accused Dr. Sheikh of incompetence.

f. The Board claims that Dr. Sheikh is not fit for license after she has reliably practiced as a Resident Physician in the State for over two years.
Unfortunately, during recent decades, License of Physicians and Surgeons is based on the State’s mistaken belief that a Physician’s license is a privilege arbitrarily available at its grace.

A physician can be disciplined for matters relevant to health care and a physician can also be disciplined for matters not relevant to health care. Then the Board provides physicians a disciplinary process and a physician can also be disciplined by the Disciplinary Process itself;

a. Generally, all citizens can contest a subpoena according to rules but a physician can be found guilty of unprofessional conduct for contesting a subpoena issued by the Board.

b. Physicians are guilty of unprofessional conduct if they do not submit themselves to be interviewed by peace officers of the Board though every citizen can claim Fifth Amendment Right (against self incrimination).

c. A physician may be found guilty of unprofessional conduct for any reason as determined at the discretion of the hearing officer.

d. Merely contesting the disciplinary accusation of the Board is likely to result in the conclusion that a physician cannot be rehabilitated.

 At this time any physician in the State of California can be accused and can be reliably found guilty of unprofessional conduct for not maintaining accurate records (Bus. & Prof. Code § 2266) (for lack of any standards). 

 At this time, a physician can be disciplined for correctly diagnosing and treating a patient. In such matters, the Board can find the accused physician guilty for not complying with a “Standard of Care”, an imaginary standard unknown to Medical Professionals.

 A physician who opposes illegal discrimination is likely to be disciplined by the Board. A woman physician who opposes any Harassment is likely to be disciplined by the Board.  A physician is likely to be disciplined for demanding reimbursement for his services form an insurance company. A physician can be disciplined on request from a company not relevant to health care. A physician is likely to suffer professional harm for supporting a physician’s license with the Board. Some physicians have relied on their ignorance of the problem; more informed physicians have relied upon retaliation of the Board for keeping quite.

 The Courts have begun to recognize the possibility of such prejudicial circumstances and recently the Fifth Circuit Court of Appeals noted, “AAPS’s complaint alleged, among other things, abuses perpetrated on physicians by means of anonymous complaints, harassment of doctors who complained about the Board, and conflicts of interest by decision-makers. If practiced systemically, such abuses may have violated or chilled AAPS members’ constitutional rights”. AAPS v Texas Medical Board, (5th Cir. 2010).

 An experienced woman physician, when explained abuse of the Board, had tears in her eyes. Physicians of California are in shock and perhaps that is a consequence of “Protection of Public”.

 The article was originally published on this website.  http://www.physicianforfairness.com/  

Author: Rehan Sheikh



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Medicare Fraud: $ 424 Million Over Billing by a California Hospital --- No Disciplinary Action---- No Criminal Prosecution


On Medicare Fraud --- According to a Government Report [A California Hospital] overbills $424 Million to Medicare
 ======================================
[1] The inspector general found that [Hospital] submitted a diagnosis code for a genetic disorder characterized by abnormal brain function in a patient whose records only discussed a fever and a cough. 

[2] Another patient was reported to have prostate cancer when medical records discussed a shoulder suture removal.

[3] For a third patient, [Hospital] submitted a diagnosis code for “unspecified septicemia,” a lethal infection of the bloodstream, when medical records discussed a knee surgery and did not mention a bloodstream infection, the report says.

STRICT ACTION ON MEDICARE FRAUD?
==========================
A Centers for Medicare & Medicaid Services representative said the agency, which administers the Medicare program, is aware of the report and is willing to work on the matter with [Hospital].

NO CRIMINAL ACTION ANNOUNCED against the Hospital.
BTW, average jail time is many years when a physician is accused of negligent over billing of a few hundred dollars even when a billing mistake is done by an employee.....

NOTE;for my readers, Medicare pays about 40% or more to hospital for the same services as provided by physician practitioners. That is because of a law passed by the Congress. 

About Repeated Acts of Negligence
 =======================

[Hospital] disputed the inspector general’s findings, saying the review of 100 cases could not be generalized to hundreds of other claims.

NOTE;It is customary for the Medical Board of California to revoke a physician's licenses for two or more MINOR repeated acts of Negligence. 

==============
............QUIZ ..........
.==============

Is the Medical Board of California empowered to take actions against Dishonest and undesirable Medical Providers? ..................

[ or ] 

Is the Medical Board of California empowered only to take Disciplinary Actions against Physicians of California?

Protection of Public or Violation of Rights? Really....

http://californiawatch.org/dailyreport/report-estimates-health-plan-overbilled-medicare-424m-18752




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