Louisiana Voice

First it was the State Dental Board exposed by LouisianaVoice as serving in the multiple capacity of prosecutor, judge and jury in investigating complaints against dentists, filing charges and then judging on their guilt or innocence. https://louisianavoice.com/2014/03/07/state-board-employs-intimidation-harassment-to-generate-funds-to-pay-for-lucrative-contracts-worth-millions-of-dollars/

Then there was the Auctioneer Licensing Board and the manner in which it failed to defend an 84-year-old widow against a case of shill bidding (efforts to drive prices up by a  plant) or to protect her from unscrupulous actions by an auctioneer.

Now we have another board, the Louisiana State Board of Medical Examiners (LSBME) which, through its executive director, is being accused of tactics similar to those of the dental board. The result has been a spate of lawsuits, ethics complaints, and court hearings, all revolving around charges brought against a Baton Rouge doctor and encouraged, he says, by his competitor who sits on the board that brought the charges against him.

The one common thread running through each of the regulatory boards is that they receive no state funding. And with the dental and medical examiners boards, at least, there are expenses: staff, including attorneys, investigators and executive directors, and rent of nice, upscale offices in New Orleans central business district.

The lack of state funding coupled with the aforementioned high costs means the boards must necessarily generate funding—lots of it—through licensing fees and disciplinary actions against dentists and physicians. No dentist or physician in the state wants make waves because the boards literally hold the fate of their livelihoods, indeed their licenses to practice, in their hands.

In the legal profession, rainmakers are those within a firm who generate business by enlisting well-heeled clients who can afford expensive legal representation. Legal fees, after all, are the lifeblood of a law firm and the bigger the firm, the greater the pressure to bring clients through the door.

Taking the comparisons between the dental and the medical examiners board even further, the board acts in the capacity of investigator, accuser, and judge in disciplinary cases and, again like its counterpart, depends to a certain extent on penalties imposed on doctors for its operating revenue. Consequently, there is an undeniable incentive to generate revenue to ensure the boards’ survival.

So when it comes down to adding needed revenue to the coffers, it matters little whether the dentist or physician is guilty; if the need for revenue is present, as it usually is, then the boards, to paraphrase British politician and businessman Sir Eric Campbell-Geddes, “will squeeze the lemon until the pips squeak.” https://richardlangworth.com/pips

LouisianaVoice has previously documented strong-arm tactics by the Louisiana State Board of Dentistry whereby a dentist may first be assessed a modest fine for some supposed transgression. Should the dentist resist, he may quickly learn that that modest fine of a few thousand dollars somehow has run into six figures because he is also assessed the costs of the investigation of his practice—and because the board can. https://louisianavoice.com/2015/04/16/13976/

Sitting members of the dental board are allowed to initiate charges against a competing dentist in the same town—and often do just that.

And while physicians may not actually initiate charges against one of their peers, LouisianaVoice has learned that a board member who was a direct competitor with a doctor under investigation may have participated in the investigation, board discussions and votes affecting his competitor.

Baton Rouge pain management physician Dr. Michael Burdine, an LSBME member, has emerged as a key figure in the board’s investigation of Dr. Arnold Feldman, also of Baton Rouge because of his apparent reluctance to recuse himself from discussing Dr. Feldman’s case pending before the board.

The board’s legal counsel did produce somewhat belatedly a document that purported to recuse Dr. Burdine from participating in proceedings relative to Dr. Feldman’s case but board minutes indicate “unanimous” votes on matters pertaining to Dr. Feldman even as Dr. Burdine was supposedly recused. Moreover, Dr. Burdine repeatedly participated in executive session discussions when the subject of the closed session was Dr. Feldman’s case. Board member Dr. Mark Dawson, however, insists that Dr. Burdine did, in fact, recuse himself. “The pain management doctor’s attorneys are playing you for a fool,” he told LouisianaVoice.

The Dental Board until recently brought charges at the recommendation of a private investigator retained by the board whose offices were housed in the dental board’s suite on Canal Street in New Orleans. LSBME, on the other hand, employed its investigator as a full time employee. Following Dr. Burdine’s selection as vice president of the board, investigator Cecilia Mouton, a physician also, was appointed executive director of the board and immediately requested—and received—a 10 percent pay increase to $211,600.

Mouton, while still employed in 2010 as an investigator who looked into complaints about doctors, married attorney Jack Stolier who at the time represented physicians who were subjects of investigations and who had disciplinary action pending before the board and Mouton. Stolier ceased representing physicians before the board following his marriage to Mouton, Dawson said.

Taking the comparisons between the dental and the medical examiners board even further, LSBME acts in the capacity of investigator, accuser, and judge in disciplinary cases and, again like its counterpart, depends entirely on penalties imposed on doctors for its operating revenue.

Dr. Burdine’s Spine Diagnostics of Baton Rouge, one of the largest pain management clinics in the state, had annual receipts of slightly less than $9 million compared to Dr. Feldman’s $6 million in 2012. The two clinics are only about five miles apart. Dr. Feldman maintains that closure of his facility would necessarily mean that Dr. Burdine would inherit much of his caseload, thus enhancing the size of his clinic and providing an economic windfall for him.

The federal Healthcare Quality Improvement Act of 1986 provides that physicians are entitled to a professional review action “before a panel of individuals who are appointed by the entity and (who) are not indirect economic competition with the physician involved.”

Not only has the board, with the active participation of Dr. Burdine claimed by Dr. Feldman, plowed ahead with its prosecution of Dr. Feldman, Mouton, first as board investigator and later as executive director, denied Dr. Feldman access to his investigative file in order that he might formulate a defense, said Dr. Feldman in a 42-page complaint filed with the State Board of Ethics.

The specifics of the board’s complaint against Dr. Feldman have never been revealed but appear to stem from the death of a patient while in Dr. Feldman’s clinic even though the death was determined to be from natural causes and not connected to pain treatments being administered to the patient by Dr. Feldman.

The Ethics Board found no ethics violation in a decision that has become all too familiar since the ethics laws were amended in 2008, effectively gutting the ethics board. But that hasn’t stopped Feldman from seeking justice from what he feels is malicious prosecution, abuse of due process and violation of Louisiana commerce statutes.

He filed suit against Dr. Burdine in Civil District Court in New Orleans last August and the children of one of his patients has filed a separate suit in CDC naming LSBME, Mouton and board investigator Leslie Rye as defendants.

That lawsuit, filed by Alexia Senee James and Albert Lewis James of Baton Rouge, claims that Mouton and Rye intervened in Dr. Feldman’s treatment of their mother, Tonja Guitreau James.

After Tonja James was convinced by Mouton and Rye to leave the care of Dr. Feldman, she subsequently died from a prescription drug overdose, the petition says, adding that Mouton and Rye “violated the doctor-patient privilege, confidentiality and sacrosanct relationship between Tonja James and her physician.”