South Dakota med board speaks too softly but carries a big stick

Medical boards all across the country let doctors get away with fakery on their resumes.

But not South Dakota.

The South Dakota Board of Medical and Osteopathic Examiners makes applicants for licenses in a range of medical professions sign an affidavit saying "that any derogatory information regarding [the licensee's] personal background that was not disclosed when completing the application shall disqualify [the licensee] for registration in South Dakota." Then the board follows through by actually verifying the information with other state boards, law enforcement agencies, hospitals, and, presumably, the National Practitioner Data Bank.

This year, the board has taken action against 38 licensees. Five of those have been against fibbers.

Dr. Mark Swaim, a gastroenterologist in Jackson, Tennessee, applied for a license in South Dakota in August 2009. Swaim answered no to some key questions, as the board noted in a disciplinary action:

Whether he had been notified of a complaint by a medical facility or health-related entity.

Whether he had been subject to proceedings or investigations for any reason by any medical facility or health-related entity.

Whether he had a mental or emotional condition which could preclude him from performing the essential functions of his practice.

The board, unlike so many boards nationwide, did not take the "no" answers at face value. The board checked. And the board found that Swaim had been hit with multiple complaints "due to his disruptive behavior" and that he had "failed to complete a voluminous amount of required dictation," ultimately leading to his being placed "under medical care for emotional issues."

Failing to complete dictation in medicine is serious business. Those assessments of patients are what drive diagnoses, treatment decisions, surgeries, referrals to specialists and the list goes on. Whether any patients were harmed as a result is left unsaid, as is nearly everything else about Swaim's history. Tennessee is no help, either. The Medical Board there lists no actions against Swaim.

His "disruptive behavior" could have been the result of some understandable irritability after having his office destroyed by a tornado in 2008. Or it could have been something much worse. Consumers are never allowed a glimpse of the board's secret knowledge.

Another applicant for a license was fired from her previous job and lied about it. One had, literally, had his head examined by his previous employer and lied about it. One fudged the details about her previous DUI convictions, while another not only lied about his DUI conviction but also was convicted of another DUI during the license application process.

South Dakota either denied these applicants a license or intimidated them enough with its background investigations that the applicants backed out of the licensure process altogether.

Final question: Why not make this information easy to find? Patients cannot even easily verify whether a doctor has a license in South Dakota. To do so requiresa consumer to register with the board's website and provide a full name, email address and street address. To actually verify the license, a patient must pay a fee, too.

Forcing patients to register in order to view a public record is intimidating. Forcing them to pay is unnecessarily burdensome. Both run counter to a public safety mission. Is the goal to protect patients or protect physicians from scrutiny?

What makes this lack of disclosure even more remarkable is how South Dakota is taking action where other states, like Tennessee, have failed. Check out Dr. Samir Jain in Rhode Island or Dr. Khristine C. Botezan in Florida. The South Dakota board took seriously what these states ignored. It should take its stated mission "to protect the health and welfare of the state's citizens" seriously, too.

Jenn Harris contributed to this report. Photo credit: Angelinamerkel via Flickr

View Swaim and other doctors on the Doctors Behaving Badly Google map.