Thursday, June 23, 2005
By Dr. Anthony Policastro
Nanticoke Memorial Hospital

I've been a member of the State Board of Medical Practice for almost two years. I have a variety of duties as part of that role. These include things like interviewing new candidates for licenses. These include things like looking at suggested changes to the rules and regulations that govern the board. These include things like reviewing complaints from patients. Most states have a method for patients to provide complaints. Delaware is no exception. The Board of Medical Practice does a formal investigation on any legitimate complaint. One member of the board is appointed as a co-investigator. Once the investigation has been completed, the board member reviews the information to see if there is a violation of the Medical Practices Act. If there is no violation, then the complaint is closed. A letter is sent to the person who lodged the complaint to explain this. If there is a clear-cut violation, then the board member refers the case to the state attorney general's office for potential legal action against the physician. This is the part of the process that most people do not understand. The board cannot take action against a physician's license without the attorney general having a violation to prosecute. The board cannot give a written reprimand to a physician without the attorney general having a violation to prosecute. There has to be proven unprofessional conduct. The law defines unprofessional conduct. It includes things like committing Medicare fraud. It includes things like conviction of a felony. It includes practicing medicine under a false name. It includes practicing medicine without a license. It includes illegal drug dealing. It includes unethical advertising. It includes taking money for treating a disease that cannot be cured. It includes allowing an unlicensed person to practice medicine. It includes failure to make mandatory reports to the board. It includes price gouging. It includes failure to obey a subpoena by the board. It includes losing a medical license in another state. It includes charges of misconduct. As you might expect, it is unlikely that patients will file any of these kinds of complaints about physicians. For that reason, these kinds of complaints are relatively few in number. Most complaints fall into one of four categories. The first of those is related to "willful" violation of patient confidentiality. The emphasis here is on the word willful. This carries with it the implication that the violation was done with the intent to harm the patient. Most violations of confidentiality are accidental and unintended. The second category is unethical behavior. There are clear instances of unethical behavior. These include things like a physician having an affair with a patient. However, in most cases whether something is truly unethical is a judgment call. A patient might think a physician is being unethical if his/her after hours office phone message tells them to go to the emergency room. That is really not the case. Therefore, most of these complaints are opinions and there is clearly not enough evidence for the attorney general to prosecute the individual. The third category is "gross" negligence. Again the emphasis here is on the word gross. Simple negligence can occur. It is not a violation of the state law. When the patient gets a bad result, the assumption is that it must be due to negligence. That is why malpractice suits are filed. Even in those suits there is a lot of testimony about whether any kind of negligence occurred. Gross negligence requires obvious evidence that the physician strayed very far from the standard of care. The fourth category is incompetence. This is similar to the area of allegations of unethical behavior. The investigation has to show that there was such obvious incompetence that the attorney general would have a strong enough case to prosecute the physician for it. The laws for the Boards of Medical Practice differ in each state. The way the rules work for Delaware is that action by the state board requires an offense significant enough for the state attorney general's office to be able to prove the charge in court. Gathering enough evidence to do so is often difficult. The main reason for that is that there has to be more objective evidence than what is put in the original complaint. The investigation must find that evidence. The attorney general's office must be able to line up the testimony to support the results of the investigation. The perception of many individuals is that a letter about a physician is enough to have the State Board of Medical Practice take some kind of action against the physician. However, the way the process works in Delaware, the board must be able to find that the individual physician has violated the law enough to be prosecuted by the attorney general's office. That is not something that can be done just based upon a letter of complaint. Despite the fact that this is a difficult process, the board still encourages individuals who have a concern to voice that concern so that it can be investigated. Of course, the first thing to do when you are upset with a physician is to go to the physician directly. He/she may not realize that you are upset and you may very well get the apology you are seeking right from the start.

Dr. Anthony Policastro is medical director at Nanticok Memorial Hospital.
New Zion Diabetes Health Expo a success
New Zion United Methodist Church held a Diabetes health Expo Saturday at the church and it drew a large audience including speakers , Dr. Dawn Gradison, Judge Roslind Toulson and Mrs. Connie Green Johnson, a former Laurel resident and an employee of Quality Insights. Johnson is a Community Outreach Health Specialist. The theme of the seminar was "Your Body Is Your Temple." There were many vendors present to answer diabetes concerns as well as free Glucose testing and pre-test which was done throughout the day. Toulson, a New Castle County judge gave a personal testimony. Toulson said some have a C.D.L. license, I have a "C.T.L. license, choose to live," said Toulson. Telling the audience in a warm personal message, to get a "Choose to live license" eat healthy exercise and eliminate those people who do not help in your campaign to change your lifestyle. Toulson's life changing event happened several years ago when she suffered heart problems that put her in a hospital and a heart catheterization. Further testing revealed she had diabetes. "You are perfectly normal one day. That put me in shock," said Toulson. That night she cried herself to sleep, "putting the blame in all the wrong places." Toulson told of a free-will talk with God that helped her to get on the right path towards a healthful lifestyle. Toulson held up a pair of her old slacks to show the audience the difference in her life and told of how much healthier and better she felt including her overall outlook on life. "Choose to live, pray for me and I will pray for you," finished Toulson. Present at the Expo was Mrs. Delaware 2005 Mrs. Sheniqua Parker-Arendall and Little Miss Laurel 2005 Tyanna Handy. Deborah Waller, a nurse at Laurel Intermediate School organized the event.

Safe Sitter classes offered at Nanticoke Memorial Hospital
Safe Sitter classes for girls and boys aged 11 to 13 will be offered at Nanticoke Memorial Hospital. The two part course will be held from 9 a.m. till 3 p.m. on July 22 and 23. The Safe Sitter program is a medically-accurate instructional series that teaches youngsters how to handle emergencies when caring for younger children. The cost is $35. Participants are to bring a bag lunch. To register your son or daughter or your child's babysitter, call 629-6611 ext. 2540. The goal of Safe Sitter is to reduce the number of accidental and preventable deaths among children being cared for by babysitters. Thousands of young adolescents across the country have been trained by Safe Sitter to handle life-threatening emergencies. All medical information will be taught by a certified professional. During the course, students get hands-on practice in basic life-saving techniques so they are prepared to act in a crisis.

Instructors also provide tips to make sitters more confident caregivers. They teach safety and security precautions, such as what to do if a stranger comes to the door and when and how to call for help. They give information on child development and suggest age-appropriate activities. Participants will learn about the business aspects of babysitting. For more information about Safe Sitter, contact Nanticoke Memorial Hospital at 629-6611 extension 2540.