Medical disciplinary actions increasing in South Dakota

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Medical professionals are being disciplined at an increasing rate by the South Dakota Board of Medical and Osteopathic Examiners.

In 2010 alone, the board disciplined 39 medical professionals. Twenty-two were disciplined in 2009. From 2005 to 2008, the board disciplined no more than 15 medical professionals each year.

The board became separate from the South Dakota State Medical Association in 2005 and became an arm of state government in the Department of Health. Not all disciplinary actions from 1993 until 2004 — the year prior to the switch — are on the organization’s website, said Margaret Hansen, the board’s executive director. Among the records that are posted for those years, no more than 15 actions are posted in any year. Hansen said the board is working to post the missing records as time allows.

So far this year, 18 medical professionals have been disciplined.

Neither the recent upswing nor the specific actions are well-known, in part because the board does not always notify the public and typically does not alert the media when an action is taken. Hansen said lists of media contacts are “difficult to maintain.”

Hansen said the rise in actions taken by the board doesn’t necessarily indicate a trend toward unethical behavior in the medical field.

“It would be hard to say there are more board actions going on. It could be there are more licensees,” Hansen said.

The number of licenses issued has fluctuated within a small range in the last five years. The board issued 256 licenses in 2006, 231 in 2007, 276 in 2008, 265 in 2009, and 229 in 2010. Currently, there are 3,325 medical licenses in South Dakota, but a member of the board’s staff said it’s difficult to say how many licenses there were in any other year, because the board only tracks the number issued per year and the current total.

Multi-state actions

Hansen said the increasing number of disciplinary actions could also be due to an increasing number of licensees obtaining licenses in multiple states. When such professionals are disciplined elsewhere, they’re typically also disciplined in South Dakota.

Hansen said other factors in increased disciplinary actions could include the board overseeing the discipline of 13 medical professions, and ever-evolving national, regional and state standards. Over the years, the number of regulated professions and types of licenses within the medical field has increased, Hansen said. There are now 35 licenses, registrations and certifications within the 13 regulated professions.

Former doctor Joshua W. Payer, who practiced in Platte, Geddes and Chamberlain, is one of the medical professionals in the Mitchell area who was recently disciplined. He surrendered his South Dakota license after he came under investigation for “alleged unprofessional conduct and violations of the South Dakota Medical Practices Act.” After he was indicted for federal charges in South Dakota, Payer agreed not to practice medicine in Iowa and shortly thereafter surrendered his Iowa license as a part of a settlement with that board.

He was indicted in South Dakota for illegally distributing Oxycontin and engaging in sex trafficking of a minor, with the indictment coming just a few days after surrendering his South Dakota license. He pleaded guilty to two federal charges of sex trafficking on Nov. 1 and was sentenced to 22 months in prison on March 1. On April 8, Payer surrendered his Iowa medical license.

The majority of the information regarding his actions was not published on the South Dakota board’s website. The only actions found there were Payer’s agreement to surrender his license and the board’s action to cancel it. The board did not publish any other information, because it did not conduct an investigation after Payer surrendered his license prior to the conviction. Hansen said the Iowa Board of Medicine had to conduct an investigation because Payer did not agree until April to refrain from practicing medicine in that state.

Most recently, the Minnesota Board of Medical Practice disciplined Payer on May 14 by revoking his license, which means he can no longer practice medicine or surgery in Minnesota. He has the option of seeking re-licensure, and the board could re-open the investigation, according to the board’s website.

Notification efforts

Hansen said the South Dakota board does not operate quietly — it has all disciplinary information on its website and does not hide anything from the public. She added that the board is constantly trying to improve the website by adding items like a licensee profile of each medical professional. Prior to its website, anyone who needed information had to request a hard copy.

Because the board does not notify the media when a medical professional is disciplined, the only sure way for the media or public to know about disciplinary actions is to monitor the website for new postings. Many other state government agencies routinely notify the media about happenings in a specific geographic area. The Daily Republic, for example, receives notifications about road projects in the Mitchell area from the state Department of Transportation, and notifications about water and sewer projects in the Mitchell area from the state Department of Environment and Natural Resources.

“I’m open to suggestions on how to get information to the public,” Hansen said. “We also kind of rely on the media.”

States surrounding South Dakota have similar boards. Nebraska formerly notified the media of board actions but found it to be too time-consuming.

“We made the media aware of the information online,” said Marla Augustine, public information officer for the Nebraska Department of Health and Human Services. “We had a call from an Omaha World Herald reporter about a dentist, so we told him what date the hearing was, which could be found on our hearing schedule.”

Iowa offers a media kit, a news stream with press releases and more direct access to agendas, minutes and reports.

As far as notifying patients, Hansen said if a doctor’s license is revoked and the board knows the clinic at which he or she practices, the board will post notices. For example, a physician in Rapid City lost his license and the board posted a notice at one clinic he served, but wasn’t sure of other clinics he served.

“We don’t always know all the clinics,” she said.

Recent examples

The board disciplined or monitored six other medical professionals in The Daily Republic’s coverage area over the last two years. Besides Payer, two doctors were being monitored by the board in 2010, a medical assistant and physical therapist assistant are being disciplined for not holding current licenses, a doctor recently received an unconditional license, and an emergency medical technician received a probationary license.

Dr. Gregg Tobin, Mitchell, submitted an application Dec. 9, 2009, to renew his medical license. He failed to truthfully answer that he’d been charged with driving under the influence just four days prior to his application submission. He admitted to the board in January this year that he lied on his application and it was actually his third DUI arrest.

Pursuant to Tobin’s agreement with the board, Acumen Institute of Lawrence, Kan., evaluated him and recommended Tobin abstain from the consumption of alcohol and controlled substances while holding a medical license. He must participate in daily call-ins per an alcohol monitoring contract he signed with the South Dakota Health Professionals Assistance Program. He was also ordered to attend Alcoholics Anonymous meetings at least three times a week. Tobin continues to practice, and his license expires in March 2012, according to the board’s website.

In 2010, the board disciplined Dr. Jerome K. Howe, Mitchell, after he made “derogatory, threatening and inflammatory comments … to a news reporter” in 2009. Those statements included racial slurs and a threat to “firebomb” The Daily Republic’s building over an editorial that upset Howe. He was also disciplined by Avera Queen of Peace, the facility at which he worked. The state board directed Howe to get an assessment for “anger management issues, unprofessional conduct and disruptive behavior,” according to the board’s agreement with Howe. His license expires in March 2012, according to the board’s website.

‘Public information’

In 2010, the board reprimanded Valerie Henglefelt-Wantoch, Mitchell, for representing herself as a medical assistant without having proper registration. In a consent agreement with the board, Wantoch said she wanted to obtain and had submitted an application for a medical assistant registration. The agreement states, “The board considers practicing as a medical assistant without a registration a serious matter.” Wantoch has obtained her license, which expires in December, according to the board’s website.

Another Mitchell woman was reprimanded in February for not renewing her physical therapist assistant license. Amber Hockett received a license Jan. 22, 2010, but did not renew it Jan. 1, 2011, and continued to work at University Physical Therapy in Mitchell. She also admitted she didn’t practice with “a valid and board-approved supervision agreement since July 2010,” according to Hockett’s consent agreement with the board. Hockett has obtained a current license that expires in 2012, according to the board’s website.

A Chamberlain physician recently regained his full license privileges after complying with orders throughout a five-year probationary period, which started in December 2005. According to the state board’s record on Dr. Travis Sanger, he was to abstain from substance abuse and alcohol, practice medicine under a mentor who is a licensed physician, be evaluated for substance abuse and self-report any future substance abuse. He was also required to attend a refresher course on family medicine during his probation.

According to the state board’s records, Sanger successfully completed all requirements during his probation and was granted an unconditional license in March.

A Lower Brule man was recently granted a temporary EMT license. Benjamin Estes is required to enroll in the South Dakota Health Professionals Assistance Program and comply with any requirements in the program while he holds the license. No other information is currently available, and the board will review Estes’ case at its next regularly scheduled meeting in September.

Despite the board’s relatively low profile, the South Dakota State Medical Association president said the board is doing its job according to state law. Dr. Karla Murphy, Sioux Falls, said the board’s website is available to the public and includes all final actions on cases.

“Obviously it is public information that anyone has access to,” she said. “I don’t think it’s ever been hidden. It exists for the media and anyone who wants access to it.”

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