April 7, 2008
State Disciplines 2 Valley Doctors: Medical Board Officials Don’t Say That Patients Suffered Under the Physicians’ Care. If the Men Fail to Stay Clean and Sober, They Could Lose Their Licenses.
By Colleen Lamay, The Idaho Statesman, Boise
Apr. 7--State medical watchdogs have taken disciplinary action against two family physicians with drug problems.
The physicians are Dr. David A. Smith, who works under a contract with Omega Health Services in Boise, and Dr. Raymond P. Hooft of Idaho Minor Emergency and Family Practice in Meridian.
Each physician in the unrelated cases agreed in writing to a long list of rules, including drug tests and workplace monitoring, to make sure they stay clean and sober. The state Board of Medicine could yank their licenses to practice medicine if they fail.
"The board's primary concern is the public's safety," said Nancy Kerr, executive director of the board, which licenses and regulates the more than 4,000 physicians who work in Idaho.
The two cases are complex and underscore patients' responsibilities to look around before they choose physicians. The investigations centered on whether the doctors relapsed after past abuse of drugs, alcohol or both, according to the state Board of Medicine.
In 2005, Smith was accused of using controlled substances and abusing his prescription writing privileges. He was disciplined then, but it was tightened in January after pseudoephedrine, an ingredient in some cold remedies, was detected in his body. Hooft, 54, who has a history of depression, slit his wrists and attempted suicide in 2006 after binge drinking, the board alleges in its complaint.
In neither case did the board mention that any patients suffered because of the doctors' care. In both cases, the board sought to stop the potential for patients to get hurt, Kerr said.
Discipline of doctors nationwide is unusual. Less than 5 percent of physicians have restrictions on their licenses due to drug abuse, insurance fraud or other problems. Idaho numbers are similar, Kerr said.
The Idaho board took 47 actions, from revoking licenses to issuing simple reprimands, in 2006, up from 42 a year earlier, according to board statistics.
Quarterly newsletters from 2007 name 14 disciplined Idaho doctors in a variety of specialties. Documents relating to their cases are posted online.
Most were accused of abusing prescription drugs or of writing unnecessary prescriptions for patients. A few were accused of abusing street drugs or patients, either sexually or by providing substandard care.
Other cases, especially if they are isolated incidents, may or may not become public, according to the board's Web site.
Smith and Hooft are the only two Treasure Valley doctors named in the board's most recent newsletter.
Disciplined physicians who sign monitoring agreements with the board do not admit guilt but agree to get help through a program for impaired physicians.
Some doctors with impairments never get to the point where the Board of Medicine forces them into treatment and their troubles become public. Such doctors may volunteer for help, or their families or colleagues may encourage them to seek help from a program called Physician Recovery Network, funded in part by the Idaho Medical Association and the Board of Medicine.
The program can provide intensive treatment at specialized centers nationwide, along with practice monitoring and drug testing. Treatment remains confidential if doctors follow rules.
"The earlier we catch someone in the disease, the better the chances of recovery and getting the physician back into practice," said Ron Hodge, executive director of the Idaho Medical Association.
The success rate is as high as 90 percent, Hodge said. He said he would not hesitate to see a doctor who was or is in the program.
"I know that doctor either is being watched from six or seven different angles, or the physician is clean and sober and healthy," he said.
WHAT HAPPENED WITH HOOFT AND SMITH?
Hooft said he understands the need to help doctors in trouble, but says his history made him a candidate for overzealous scrutiny. That scrutiny turned small glitches into huge problems. "I know I got caught in a net I didn't belong in," he said.
Dyke Nally, superintendent of the Idaho State Liquor Dispensary, took Hooft to the hospital when Hooft slit his wrists.
Nally, a friend and patient at Hooft's clinic, said that when Hooft opened the clinic, he was the only doctor on duty every day. "He wasn't tired. He was battle fatigued," Nally said. "He was like that for months and months. Imagine working seven days a week with people who are sick."
Nally said he has known Hooft since Hooft was a teenage student at Boise State University and a wide receiver for the BSU football team. Nally then worked in alumni relations.
Hooft agreed to an interview with the Statesman and a photograph of his practice. Hooft is accused of "excessive personal use of alcohol, Provigil (a medicine to keep people awake) and Lunesta (a sleep medication)."
Hooft says the Provigil and Lunesta were drug company samples he had access to. The Provigil was for a specific patient who could not afford the medicine on his own. He handed out all but a handful of Lunesta samples to patients. He denies abusing either drug and denies using the Provigil at all, and said he took only three Lunesta pills over four nights, including the night of his suicide attempt.
Some research shows doctors are at higher risk of suicide than the rest of the public, but Hooft said he simply was exhausted after endless months of working at least 12 hours a days, seven days a week, trying to establish his minor-emergency practice. "If I really wanted to kill myself, I'd be dead now," he said.
Smith did not respond to requests for an interview. At least four other health professionals with active licenses in Idaho also are named David Smith, including an anesthesiologist, an optometrist and a dentist. Smith holds license No. M-5762.
Dan Dwyer, the administrator of the clinic where Smith works, said Smith got his shot at redemption by getting contract work at Omega, which recently started offering family practice services. Smith proved he treated patients well, Dwyer said. Because of the intense scrutiny doctors like Smith face, they may be safe bets for patients, Dwyer said.
"The risk is not higher with these guys," Dwyer said. "It's lower."
Patients who rely on the phone book could fare worse, he said. "There are impaired physicians providing services in the community as we speak," Dwyer said. The difference is Smith is getting help, and they aren't, he said.
Board actions can protect not only patients, but also physicians blind to their troubles, said Kerr, the medical board director.
"We've had doctors with denial of their problems here in Idaho who have died or committed suicide because their problem had gone to such an extreme," Kerr said.
Colleen LaMay: 377-6448
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