Michael Jackson’s heart doctor isn’t the only one lacking papers

If you, like me, were wondering how a guy like Dr. Conrad Murray, who had not bothered keeping up with his studies enough to continue his certification as a cardiologist, could become the personal physician to the King of Pop, it's instructive to look at Dr. Jagat Narula.

Most of you won't know that name, but his career illuminates the gap between what the public expects when they see "Dr." in front of a person's name and what is often the reality.

Narula is the chief of the cardiology department at the University of California, Irvine, where he is paid more than $400,000 a year. In December 2005, I reported that Narula held this high-paying job despite the fact that he was neither a licensed doctor in California nor a certified cardiologist. I also wrote that his second-in-command, Dr. Mani Vannan, was similarly unlicensed and uncertified.

Both were hired under an academic exception. States like California plead that they can't get enough qualified doctors without bending the rules. I found, though, that UCI was the only school in the UC system that had an unlicensed and uncertified cardiologist running its department. After the Medical Board of California started discussing the status of these two doctors, UCI said that Narula and Vannan both intended to become licensed and certified. My stories resulted in Vannan quitting his executive level position, but Narula kept his job.

I thought about Narula last week when I wrote about Murray. Here was a self-proclaimed cardiologist who had let his cardiology credentials lapse and yet that did not stop him from taking on the initially lucrative but ultimately ill-fated job as Michael Jackson's personal doc.

When I checked to see what Narula was up to, I found out that his lack of training did not appear to be holding him back.

Both Narula and Vannan have gone on to obtain their licenses in California. But, strangely, neither has bothered to become certified as a cardiologist, according to the American Board if Internal Medicine.

Narula was just named the medical director of the Memorial Heart and Vascular Institute in Long Beach, with much boasting on the part of Long Beach Memorial Medical Center.

So why has Narula - and by extension so many doctors like him - succeeded?

It seems in part because of politics, and in part because he is skilled in other areas that don't have much to do with directly treating patients. He is a good researcher who has published extensively, and other academics admire that. Narula's resume says that he was a cardiology fellow at Harvard. Not a bad institution to have on your resume. But when I called them, they said he worked mostly with mice, not humans.

I asked for Vannan's resume, too. Even when you are writing a feature story where the doctor saves a child from the clutches of death, get the doctor's resume. Who knows what interesting detail might await?

"They both have extraordinary resumes and both probably have their greatest strengths as investigators rather than in the clinical care environment," Dr. Andrew Wechsler, who took over for Narula as the cardiology chief at Hahnemann University Hospital in Philadelphia, told me in 2005. "I would think that to have someone directing your department, you would want that person to have a strong clinical background, too."

I've often thought that it would be an interesting project to dismantle the staff of a supposedly well regarded academic medical center to see how much experience the doctors really have treating patients. Find out how many people they treat in a given a day, prescriptions they write, procedures they perform.

And do one basic thing: check the American Board of Internal Medicine and the American Board of Medical Specialties to see what, if any, certifications these doctors have.

"For more than 70 years, Certification by the American Board of Internal Medicine (ABIM) has stood for the highest standard in internal medicine and its 18 subspecialties and has meant that internists have demonstrated - to their peers and to the public - that they have the clinical judgment, skills and attitudes essential for the delivery of excellent patient care," the American Board of Internal Medicine says on its Web site.

Is it too much to ask that the top doctor in a department meet that standard?