Q&A with Courtney Perkes: How California Medical Board Reinstated Convicted Felon Doctors

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June 11, 2010

Courtney Perkes could have phoned it in. She was the fourth reporter to have covered the seemingly never-ending saga of Dr. Andrew Rutland, an obstetrician who, most recently, has been accused of botching an abortion that led to a woman's death. A story that requires a lot of "the Register reported in 2001" sentences can quickly become an exercise in burnishing boilerplate. But Perkes took a different tack. She used the Rutland case to ask an important question: how often do doctors like Rutland lose their licenses, only to get them back? The resulting investigation was packed with great findings.

Antidote reached Perkes, a health reporter at The Orange County Register since 2005, at her home in Santa Ana. The interview has been edited for space and clarity.

Q: In January, you wrote about Dr. Andrew Rutland's latest patient death. When did you decide to go a little further?

A: I was talking with Ron Campbell here at the Register back in February and bouncing some story ideas off him on how to follow up on Dr. Rutland. I mentioned how the medical board said it was very rare for doctors to be reinstated and get in trouble gain. Ron suggested that I request the records and take a look at whether that was true. Who else has been reinstated and how many of them got into trouble? I said, "That's a great idea."

Q: What was your first public records request?

A: I requested for the last 10 years the names of every doctor who had successfully regained their license. These were doctors who had either surrendered their licenses or had their licenses revoked. And after I received the names, I went back and asked for the names of every doctor who had been denied reinstatement in the last 10 years so I could compare what seemed to be the factors that made the difference. Why was one doctor reinstated and another denied? They faxed the list of names to me in alphabetical order. It didn't contain the years or anything. In March, I started creating an Excel spreadsheet with all their names. I went through all of the records on the medical board's online database and started entering all the information. That's really how simple it was in many ways. It was very time-consuming, but the fact that all these documents are available on the board website means that any patient could be checking these same records.

Q: Did you encounter any records that you didn't know about before?

A: This whole idea of getting your criminal record expunged was new to me. Nearly every doctor I came across who had been convicted of a crime had his record expunged. For one doctor I didn't include in the story took, it took me two weeks of calling different agencies to see if anyone still had the file on him, and nobody did. The board documents gave this really descriptive account of his criminal case, but by the time I was writing about it, it was as if it had never happened.

Q: What had he done?

A: He was an ophthalmologist who made a house call. He told the patient that he could do a better exam if she were relaxed. So he gave her a tranquilizer and allegedly knocked her out and then sexually abused her. According to the board documents, she was unable to resist and went to the police and pressed charges. I spoke to three different agencies and every agency told me they had no record of him anymore. I left him out of the story, but there was another doctor who was mentioned in the story where I had to talk to the original prosecutor on the case who was able to pull the file and explain how expungement worked. It didn't mean there was something bad with the original conviction, but that this was a process that certain crimes qualified for. However, all of that original information was still in the medical board records. One thing that surprised me was that with one of the doctors who was convicted of sexual battery of a patient, the board included the probation report in the board file. I tried to track down some of the victims mentioned in the probation report, but I couldn't find any of them.

Q: It looked like it was tough for you to track down victims?

A: The medical board uses initials for victims to protect their privacy. In the case of the ophthalmologist, I did come across the name of his victim at one point. But this happened during the 1980s, and she had a very common name. Our news researcher wasn't able to track her down. With the other victims, I tried phone numbers that I was able to find, but none of them worked.

Q: Did you think about trying lawsuits to find the victims?

A: That would have been helpful to do, but I didn't go down that path. And the thing that's amazing is when you write a story about a doctor, as you know, is that you get flooded with calls. I became really affected just by reading such graphic detail of some of the things that had happened, particularly the sexual crimes. I did a daily on the medical board filing an action a plastic surgeon who was accused of having sex with a patient during her exam. After that story came out and other stories that I have written, I have heard from women who have said they also were treated inappropriately during an exam. One woman said after a doctor examined her and she was undressed he said, "Everything looks good," and he gave her a big hug. She was uncomfortable because she was topless.

That just reinforced to me how vulnerable these patients are. Sometimes you can read these cases and think, "Why didn't they scream or call for help or run out of the room or immediately call the cops?" It helped me see how there is such a trust and respect that patients have for their doctors – particularly women with some of the ob/gyns or plastic surgeons. It almost sounded like sometimes it was an out of body experience that these women had. They were watching the doctors do these things, and they couldn't react, they couldn't even comprehend what was happening to them.

Q: Could you believe it when you found out that not one but TWO doctors had hired hit men to kill their wives?

A: (Laughing.) Oh my goodness. I have to say when I came across hit man number one, I was really stunned. And then coming across the second situation, I couldn't believe it. In the story, I didn't give many of the particulars on motive, but this doctor apparently wanted to have his wife killed because she had kidnapped her son and was off to join a religious cult. That's allegedly what motivated him. You just can't make this stuff up. The other thing that really surprised me was just even reading about what some of the doctors did after they lost their licenses. Just some of the very strange unexpected jobs, and I included a few of those examples in the story. I included the guy who worked in a slaughterhouse. It was fascinating to me to what they did when they could no longer practice medicine.

Q: Well, that's always their defense, right? If you take away my license, I won't be able to survive. Did you find any who had found a career comparable to medicine?

A: Some went to law school. One doctor had a lengthy prison term and studied law in prison and helped other inmates with their cases. One doctor was heralded as a hero while he had been in prison. He was in a line of inmates, and there was another inmate who suddenly fell ill and collapsed. This doctor violated the rules by running out of the line and assisting this other inmate. And the board documents pointed out that he was very heroic when he could have faced discipline for running to help out another prisoner. I saw a sort of irony in that.

Q: There's almost a throwaway line in the story. "Although some doctors spent as much time in prison as they did in medical school, they were most often able to show rehabilitation and given a second chance to treat patients." Tell me a little bit about the analysis that went into writing that sentence.

A: It was something that struck me as I was looking at their prison sentences. The comparison just jumped out at me. That line actually has been in the story since the first draft, although it has been located in difference places. That just made the stakes of it really accessible for me to think about.

Q: What were some of the challenges that you went through during the editing process?

A: Not really very many. The editor on the story, Chris Knap, was great to work with and had a lot of good ideas. The story was incredibly long, and I think we just had to keep things really clear and keep it moving along quickly. It was so detailed, and so sometimes what happened in a case or what went into a decision could slow things down.

Q: When did you write your first draft of it?

A: About a month ago, and it was a pretty rough draft. The thing that was most challenging was maintaining my beat while I was working on this story. There were times when I thought I was going to have all day to work on the story, and then, for example, on one Monday I remember vividly, I ended up having to do three stories in one day.

Q: And what sort of fact checking were you doing at the end?

A: On Thursday I was fact checking all their names, and just the day before they had filed a new accusation, so that changed a number in my story. That meant 16 had gotten into trouble again instead of 15 and the board hadn't even sent the email announcement. I kind of had a moment of panic. There was another doctor who was showing up as having a license delinquent and then later in the process he paid his fee and was no longer delinquent. Things were always kind of changing even over a few months. I just had to be really careful.

Q: Did you end up leaving anything on the cutting room floor that you wanted to include in the story?

A: The only thing that I think was the right call. The story was definitely the PG version. If people really went through the documents and had a sense of some of these sexual crimes, they would be horrified. There was another doctor who had sex with a patient during her exam. She was 17 at the time, and it ended up turning into a consensual relationship. The documents said after they had had sex, he would inject the girl with valium so she wouldn't be upset that he was leaving her. This is just kind of a random aside, but you and I have talked about what happens when your own doctor knows you are a health reporter. I was having numbness in my feet when I do yoga, and so my doctor referred me to a neurologist. I still remember the exam. The neurologist told me to walk across the room, and the shoes I was wearing were these sort of wobbly heels. I thought, "I'm going to flunk the exam because of my shoes!" So I am reading through these documents, and I see this same neurologist's name. He was one of the experts who wrote about the case of a neurologist who had been convicted of sexual abuse. Just seeing his name reminded me that I had gone through a normal neurology exam myself, and it definitely didn't involve undressing.