Doctors Behaving Badly: Nebraska medical board gives love tap to doctor

CHJ Fellow

October 1, 2010

It's a phrase only a bureaucrat could love: "assurance of compliance."

The federal government uses the term frequently. When an agency is considering giving money to state or local government or to a private organization, it often makes them fill out an assurance of compliance asserting that they are followingcivil rights laws, research guidelines, and other restrictions.

The Nebraska Board of Medicine and Surgery uses it as a fig leaf. Instead of disciplining a doctor who has strayed outside of ethical and legal boundaries, the board issues the doctor an "assurance of compliance." Unlike the federal government, the state board waits for a violation to happen and then allows the doctor to retroactively clean up their mess by "assuring" that they are "complying" with the rules.

Dr. Matthew M. Glenn, a family practitioner in Lincoln, allegedly had "intimate relations" with a patient in August 2005, according to medical board documents. As we saw earlier in Michigan, this is enough for doctors to temporarily lose their license in some states.

The Nebraska board, instead, issued an "assurance of compliance" to Glenn in October 2006, accusing him of unprofessional conduct but also stating, "This Assurance of Compliance is not a disciplinary action against Dr. Glenn's license to practice as a medical doctor." The board let him keep practicing and told him to take a "boundaries course" within the next six months.

Six months later, Glenn had not taken the course, but the medical board's compliance assurers must have been on a long holiday. The board did nothing.

Glenn found himself in need of compliance reassurance again in August 2007. This time, the board accused him of prescribing domperidone, a drug used to treast nausea. As the board noted, domperidone "is not approved by the U.S. Food and Drug Administration, unless the physician has acquired an Investigational New Drug Application."

Glenn did not have the authority to prescribe this drug, but he did it anyway. To find out what can happen when a doctor without the training or the authority to prescribe certain drugs breaks those rules, ask Dr. Conrad Murray. He used the anesthetic propofol in an inappropriate setting – Michael Jackson's bedroom – and without certification in anesthesia. He's now facing involuntary manslaughter charges.

Murray may be an extreme example. It's difficult to gauge the gravity of these infractions because the Nebraska board provides only the barest of details about Glenn's case. What exactly happened with the first patient is completely secret. What he was doing with the drugs is completely secret.

For the drug prescription, he was told in his "assurance of compliance" to not do that again. The board might have thought to ask him at this point, "Are you going to take that class we mentioned a year ago when you had ‘intimate relations' with a patient?"

It never came up.

Not until five years after Glenn's dalliance did the board finally take Glenn's pattern of behavior seriously.

Kind of.

In April 2010, it filed a "Petition for Disciplinary Action" against Glenn. Documents like this are usually full of dates, descriptions, patient testimony, and the like. This petition was barely more than two pages long and mostly boilerplate. And listen to this tough talk. The board said that because Glenn had brushed off the board's request that he take a boundaries course, it was going to "enter an order for appropriate disciplinary action".

And what was the disciplinary action?

Glenn was told he could have more time to take the course. His latest due date is October 1, 2010.

The Nebraska Board of Medicine and Surgery calls that a "civil penalty."

Final question: How many members of the Nebraska Board of Medicine and Surgery are physicians? Six of the eight.

Jenn Harris contributed to this report and last week's report on Dr. Elizabeth Bennett Cox.

To see this doctor, and others, on the map, click here.

To inquire or to quibble, write askantidote [at] gmail [dot] com.

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The Doctors Behaving Badly tour thus far:

Medical board gives addicted Montana doctor last chances galore

Michigan medical board keeps physician's misdeeds under cover

Doctor dinged twice by Missouri med board decries rising insurance costs