Doctors and other medical professionals in Nevada would be free to refer to an investigation by a licensing board as a ‘review and evaluation’ as long as no formal investigation is approved by the board, avoiding the potential downfall of revealing a probe that fizzles.
“Justice delayed is justice denied for those who are eventually cleared of wrongdoing,” Sen. Joe Hardy, a physician who sponsored the bill, testified before the Assembly Commerce and Labor Committee on Wednesday.
The measure is intended to prevent medical professionals from having to disclose some investigations to potential employers, insurers, or credentialing authorities.
“It just has a negative stigma in general, no matter what the outcome was, even if it was completely dropped,” Dallin Hilton, a medical student at Touro University in Las Vegas who testified in favor of the measure told the Current. “You wouldn’t have to state you’ve been reviewed and evaluated.”
But Keith Lee, representing the Nevada State Board of Medical Examiners, which regulates physicians, said licensees are currently under no obligation to “check that box” if the findings of a confidential informal investigation do not merit a formal probe.
He noted that unsubstantiated allegations or complaints that lack enough evidence to proceed are not available to the public under current law.
“Is there a distinction between a claim that is without merit and a claim that has insufficient information?” asked Speaker Jason Frierson, an attorney.
“There is no distinguishing between a claim that is without merit and one that has insufficient evidence to proceed to a formal case,” Dr. Weldon Havins, a member of the medical board who testified in favor of the bill, responded. “They’re closed.”
Frierson also inquired whether investigators have access to previous, unsustained complaints against a licensee who is the subject of a new allegation.
“The answer is yes,” Havins said.
Sen. Maggie Carlton raised concerns about the lack of input on the measure from other boards that would be affected by the legislation.
“There’s a lot of different citations in here for a lot of different boards. Have the other boards weighed in on this?” she asked.
Hardy suggested the fiscal note of zero attached to the bill is “tacit admission” that other boards had seen the legislation.
“State boards are self-funding, so there wouldn’t be a fiscal note,” Carlton retorted.
“We need more good physicians providing quality care for Nevada residents,” said Hardy, who contends the measure would allow boards to address serious violations sooner.
But a report from Public Citizen says what Nevada needs is to reprimand more doctors.
Medical errors were responsible for the deaths of 98,000 Americans in 2020, according to the Institute of Medicine, and according to a 2017 survey from the University of Chicago, go unreported about two-thirds of the time. Even when errors are reported, regulatory boards are hesitant to take action.
Nevada ranked 45th in the nation for the number of serious disciplinary actions against doctors in 2017-2019, according to Public Citizen, with the Board of Medical Examiners meting out sanctions to .47 per 1,000 physicians.
Annually, the state averages 4.33 sanctions a year against more than 9,000 doctors.
By contrast, Kentucky’s rate of serious actions issued against doctors was 2.29 per 1,000 licensees — more than any other state. On an annual basis, Kentucky takes serious disciplinary actions against an average of 44.67 of its more than 19,500 doctors.
According to Public Citizen, Nevada would need to discipline an additional 16.6 doctors a year — a 382.4 percent increase — to keep pace with sanctions issued in Kentucky.
Only Nebraska, Minnesota, South Dakota, Georgia, New Hampshire and the District of Columbia disciplined a smaller percentage of physicians than Nevada.
In 2011, Public Citizen wrote letters to 33 states’ medical boards that failed to discipline fifty percent or more of the doctors whose privileges had been suspended or revoked by hospitals, according to the National Practitioner Data Bank. Nevada was one of them.