State medical board is soft on physicians, compared to other states and professions, and seems to be getting more lax

Though the state has a serious problem with abuse of prescription drugs, the Kentucky Board of Medical Licensure has a history of being soft on physicians with problematic prescription pill-writing practices, reinstating licenses after doctors have been convicted of felonies within Kentucky and granting licenses to doctors who have had them taken away in other states. So reports R.G. Dunlop of The Courier-Journal, whose three-day package that began yesterday highlights many instances of doctors whose medical privileges have been restored after serious run-ins with the law.

He starts with Tufan Senler, who ran a weight-loss clinic in Jefferson County and pleaded guilty to felony drug trafficking and money-laundering charges. "But in March 2010, after Senlar had been sentenced to two years' probation, the Kentucky Board of Medical Licensure restored his medical privileges — even though he still had more than six months of court-imposed home incarceration to serve," Dunlop reports.

In October, the C-J submitted questions to the board, asking it to provide information about 30 disciplinary cases, as well as its policies. "The board's written responses, received a month later, did not address most of the questions about specific cases, and ignored cases entirely," Dunlop reports.

Legislators have expressed their disapproval, with House Speaker Greg Stumbo and Attorney General Jack Conway both asking the board to make use of the state's prescription drug-monitoring system known as KASPER. Until last week, the board was against requiring doctors to use KASPER, though on Thursday agreed to support mandatory registration.

Not only has the board has been lax in tracking doctors, it has allowed physicians to practice in Kentucky when they've ran into trouble in other states. Again, Dunlop lists several examples, one of which involves Ali Sawaf. His medical privileges had been taken away at a Michigan hospital and he was convicted of tax evasion and domestic violence. In 1998, the Kentucky board granted him a license, and three years later, he was "facing a multitude of federal and state criminal charges, including the illegal prescribing of controlled substances," Dunlop reports. He was given a 20-year prison term.

Frank Rapier, who recently retired as the head of Appalachian High Intensity Drug Trafficking Areas program, said it was "ridiculous" that the board would allow doctors who were convicted or disciplined in other states to practice in Kentucky. "Why would we allow that?" he said. "An arsonist gets kicked out of one state, and you're gonna let him in yours?" In Florida, the state medical board often tells doctors who have been asked to surrender their licenses to "never" reapply. In Virginia and Ohio, a doctor can have his or her license permanently revoked. In Kentucky, they can reapply after two years in most cases.

And though Kentucky's board is lax compared to other states, it seems to be getting more lenient. "According to data compiled by a federation of licensure boards nationwide, the Kentucky board's total 'prejudicial actions,' which include the most serious sanctions it imposed, dropped from 95 in 2009 to 52 last year," Dunlop reports. "That was the fewest such actions by the board since at least 1999."

For more than 10 years, Kentucky's board has consistently been ranked by Public Citizen, a national nonprofit consumer-advocacy organization, as one of the country's best. But in 2010, it dropped to 12 place, down from third the year before. Dr. Sidney Wolfe, director of Public Citizen's Health Research Group, called the drop "very worrisome."

Kentucky's licensing board is also more lax than other professional boards in the state. After a felony conviction, Kentucky lawyers and pharmacists can lose their licenses permanently. The pharmacy board "can also revoke a license for five years and a day, which requires the pharmacist to seek reinstatement and, at least in some instances, to retake required tests," Dunlop reports. Attorney Kent Westberry, a former federal prosecutor and president of the Kentucky Bar Association in 2004-05, said he could only remember one instance of an attorney who had been disbarred for a felony conviction getting his license reinstated.

Gov. Steve Beshear said the board has pledged "to take swifter, more decisive action against these drug-dealing doctors who are no longer practicing medicines but who are instead enabling devastating additions." Conway said he is "hopeful" the board will become part of a solution in combatting prescription drug abuse. Stumbo said he plans to propose legislation that will improve the use of KASPER and make the board take "prompt action to curtail the prescribing privileges of anyone convicted of inappropriate prescribing."

Board attorney Lloyd Vest said changes must come from the legislative level, saying that the options of permanent license revocation and longer periods before reinstatement is considered would have to be made law and "the board would certainly respond to those legislative statements." (Read more)