Tuesday, November 27, 2007

Leslie A. Gallant, Executive Administrator, Alaska State Medical Board Says...

I spoke to Leslie A. Gallant, Executive Administrator of the Alaska State Medical Board today to find out how someone could prevent an applicant from getting a license to practice medicine in Alaska.

BACKGROUND

Doug Pope, Bill Bobrick's attorney, alleged in court today and again in an interview after court that Lesil McGuire had called his client's wife and threatened that if Bobrick testified against Tom Anderson (Lesil's husband) that Jessica (Bobrick's wife, who was in medical school) would never get licensed in Alaska to practice medicine. As I understand it, he was trying to use this as an example of risk that his client faced by cooperating with the government. If there was a great risk, then Bobrick might be able to lower the points used to determine the length of his sentence. From television courtroom trial shows I've seen, I'm guessing this was intended for organized crime or other cases where witnesses testify at great risk - even death. [This is all related to the Tom Anderson trial and other political corruption investigations going in Alaska.] And in the end, the judge said he didn't give much credit to this issue.

Aside from the fact that the phone call apparently was not recorded so we really don't know what was said, I began to wonder whether someone could actually derail a doctor's medical licensing. So I called the Executive Administrator of the State Medical Board, Leslie A. Gallant.

Basically, she said that a person's application goes before the eight member medical board and they have specific statutory requirements for approving or rejecting an applicant. If they reject someone, they have to cite the statutory reason for rejection. Lesil McGuire's father was on the board in the mid-1990's. Below is my summary of the whole telephone interview. It's close to verbatim, but since I didn't have it on tape, I've changed it from first person to third unless I use quotes. But essentially these are Gallant's words.


INTERVIEW

Leslie Gallant said that the State Medical Board grants and denies licenses. Anyone who submits the proper credentials and goes through the process is considered on their merits. They don’t consider who they know or who their dad is, they only consider the applicant.

Five doctors, one PA [physician assistant] and two Public Members sit on the board. Dr. David McGuire [Lesil McGuire's father] was appointed to the board in April 1992, but he resigned from board - she didn’t know the exact date - sometime in 1995, because they had a very public case with another doctor named McGuire. People were confusing the names of the two physicians, so he resigned so there would be no confusion that their action didn’t involve him.

Dr. David McGuire is one of the people that interviewed and hired Gallant in 1993. “He has never, never tried to influence a board decision, at least not through me.” [I understood that from her intonation that she was simply saying nothing she knew about, and not implying that he might have through someone else.]

When I asked how someone could affect whether someone got a license or not she said that she gets calls sometimes from legislators because some medical office or clinic is riled up because they are hiring a new doctor and complaining because we aren’t doing it fast enough. They call their legislator, that "we aren’t fast enough. 'What are you guys doing?' they ask. We aren’t licensing them because we have an issue with them. When we have an issue, we have to gather more information. I just explain what’s going on.”

Meetings of the board are open, public meetings. Disciplinary proceedings, everything is in the public domain. A few documents held confidential. AMA (American Medical Association) profile, National Physicians’ Data Bank (NPDB) report, and the exams scores when they got out of medical school. Those three documents are confidential, because the originating organizations require that they be held confidential. Later she added that health information about applicants is also confidential. They have an attorney general ruling saying that certain health information should be redacted. They ask this information to be sure that a doctor doesn’t have a health problem that could negatively impact their ability to practice - say a surgeon who has Parkinson's and has tremors. They can restrict their practice to certain things, like independent medical evaluations - for workers comps or personal injury lawsuits - but never procedures. They can restrict their practice making accommodations so they can still practice without endangering the public.

Everything else is open to the public. License from other states, application, etc.

"It’s never happened in my experience that someone has tried to prevent someone from being licensed." The Board is the entity of state government that grants or denies a license. They have to cite legal grounds for denial. They have to cite specific statute or regulations that the denial is based on. For example, a suspended license somewhere else is grounds for denial, because the law says that.

They are taking quasi-judicial actions when they deny or discipline. They have to cite their legal grounds for anything or everything they do. If the board tried to deny someone, and it happens sometimes - say there is a doctor with marginal exam scores, not glowing recommendations, maybe behavior problems, not the sharpest knife in the drawer. “But when those come before the board, I have to say, you might not like the application, but you don’t have the grounds to deny it.”

The person’s due process rights allow them to appeal the denial. It goes before an administrative law judge. Even a single medical board member would have to convince seven other board members. It wouldn’t happen. “I have no experience of anyone ever calling me asking me to deny an application. We have eight members, if they see no grounds, they can’t deny.”

I asked if the public files were available on line. She said no, they were all in Juneau, but that anyone can ask for a copy of a licensee file and they can get it.

End of interview, me talking again. I know that people can talk to people, not everyone is honest, and not everything is totally clear cut. But it seems that someone coming out of medical school, with passing grades, no disciplinary actions, or other negative marks on her record is certainly going to be very hard to turn down for a license, even if you had connections to the board members. I'm not saying it couldn't be done, but it sounds like it would be pretty hard to get away with. This would seem more clear cut than grading bar exams for example.


A couple notes. As I said in an earlier post, I have spoken with Tom Anderson. I think that I have covered the trials in a relatively objective manner so far. I think that my talking to Anderson or his wife [Lesil McGuire] rather than biasing me to slant things, makes me more sensitive to possible other views on things. I'll just leave this note here and let the reader decide. I think, for example, I would have had this question anyway. In fact, Leslie Gallant said that the ADN had already called her today. I don't know if that was LisaDemer's doing, but I suspect it was. You continue to impress me, Lisa.

7 comments:

  1. So is the court going to rattle Lesil's cage a bit about her calling Bill? Since there is no recording there is no solid evidence. She may get herself locked up after all. If she did call him-- she should know better. Isn't she a JD?

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  2. David Shurtleff's piece on APRN today says that there is a recording of the call. That contradicts what I heard Bottini say in court today. It seems to me that they've known about this since January. I don't pretend to know how the prosecutors strategize. They treated Lesil with kid gloves during Anderson's trial, regularly saying things like she didn't know what was going on. And Bottini said at the end of his closing argument something like "if Anderson didn't think he wasn't doing anything wrong, why hadn't he told Lesil? Because he knew she would have told him it was wrong."

    She does have a law degree, I don't think she actually took the bar in Alaska.

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  3. It seems like with the FBI on Bill that they would have had a recording of the call, wouldn't it? I've been talking to people who know the players and while the view I have is biased, I've heard that Lesil's family can bully people.

    Tom, I have heard, is a great guy. Why, as the rumor has it, did Lesil talk him into not ratting anyone else out?

    I read in the comments section that Lesil sponsored some bills. JetRx at the comment section said, "As Chairperson of the Senate Judiciary Committee, some of her nefarious accomplishments included: Ramroding the bill requiring anyone making allegations against a legislator liable for that legislator's legal bills; $5000 fines for anyone revealing existance of investigations of legislatitive members to the public (bills custom tailored to help fine upstanding folks like Ben Stevens, Pete Kott, & Tom Anderson in their bid to make Alaska better for all)."

    I hope the legislature changes this if it's true. Of course she couldn't have pessed such things without a little help from her friends.

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  4. http://www.comics.com/comics/chickweed/index.html

    This is today's (28 November 2007) 9 Chickweed Lane, one of the finest comics ever drawn. This would illustrate your blog and Alaska's corruption scandle very well!

    ReplyDelete
  5. I agree with your analysis. It would be next to impossible for legislator (or even the governor for that matter) to prevent someone from being licensed. If the applicant met established standards, and had a clean disciplinary record the burden not to license falls squarely on the State Medical Board.

    However, in the context of the lobbying world maybe such an alleged threat might be taken more seriously. It is my observation that lobbyists sometime make a lot of money by letting things take their natural course and then taking credit for it. After awhile perhaps they begin believing their own bullsh**. They start to believe systems and processes can be manipulated and things can be made to happen or not by forces outside the standard practice.

    So maybe, such an outsized "threat" may be more realistic to someone like Mr. Bobrick who may think outside forces (like lobbyists) can consistently have some sort of sinister impact on established processes -- even when realistically they can't.

    A p.s. -- I know Ms. Gallant professionally, and in my opinion she is a great asset to the Medical Board and a good public servant.

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  6. Ms. Gallant didn't seem like a problem at the very least. The medical board seems pretty on the up and up.

    That's interesting what you say about lobbyists eventually believing they have an impact-- isn't that how religions happen? I liken it to the Skinner box where a random pellet comes out and fifteen minutes later, the little bird is hopping on one foot!

    I do know what doctors can be badasses and bully other doctors. There is a certain specialty that has a lot of doctors working for ONE clinic but there are no independents practicing in part because of the tactics of that clinic's owner. (Achoo!) I wonder if the threat to Jessica was her going in to Lesil's dad's specialty and him putting pressure on her once she was in.

    ReplyDelete
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    ReplyDelete

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