The Shadow Practice, Part 3: Immigrant clinic had deep roots in deception

Published on
March 19, 2010

Even a doctor with dead patients in his past can find startup capital.

When Dr. Andrew Rutland was trying to set up shop in the old "Modern Woman's Clinic" building in Chula Vista, he tapped a friend for a loan: Dr. W. Constantine Mitchell.

According to records from the California Office of Administrative Hearings, where Rutland's case before the medical board is currently being heard, Mitchell loaned Rutland $50,000 to help him start his practice.

Sound like a lot of money? For Mitchell, that was about 10 months pay. Back in 1977.

Six years after he earned his medical license in California, Mitchell put out his shingle as an abortion specialist in 1977 at United Women's Medical Services in two Los Angeles locations.

According to medical board records, he earned $5,000 a month, which in today's dollars would be more than $17,000.

But it wasn't quite enough, the medical board alleged.

On top of Mitchell's fee, he started billing insurance companies for the abortions. United Women's Medical Services said that if the insurance company paid, Mitchell had to pass the money along to the patient.

Sometimes he would do that. But by billing the insurance company for more – 90% to 160% more – than the patient had paid, he was able to keep a piece of the action for himself.

Other times he would keep all the money, the board alleged, until some angry husband of one of his patients would show up at his office and demand a refund.

And at least once he billed for an abortion he never performed, the board alleged.

The other problem Mitchell had was that his clinic had never bothered to undergo the registration process with the state. If a clinic is not registered with the state, it essentially does not exist. It can never be inspected. Its physicians could all be working without licenses and performing procedures without the proper training.

The unlicensed clinic where Mitchell worked is exactly the type of clinic where Rutland was working when the Chinese immigrant Ying Chen died in his care. The "Clinica Para La Mujer" in San Gabriel had no state registration or local business license.

Mitchell ended up cutting a plea deal with the medical board. He admitted that he was wrong for not making sure that United had a license but said nothing about the overbilling. He was put on probation for two years and had his license fully suspended for 30 days.

Mitchell went on to establish practices in Santa Ana, which has one of the highest concentrations of recent Mexican immigrants of any city in the US, and in a mostly Latino neighborhood of Los Angeles. Both practices target low-income, Spanish-speaking women.

Mitchell was one of a small group of doctors who agreed to act as "practice partners" with Rutland so that Rutland would not be caught working alone, a key restriction placed on his license when the medical board allowed him to return to medicine in 2007.

Next: A plastic surgeon with a stitching deficiency begs his patients for cash

Related posts:

The Shadow Practice Part 1: Disciplined doctor found an exile community in immigrant health care

The Shadow Practice Part 2: New owners can't exorcise ghosts of clinic's past

The Shadow Practice Part 4: Doc begs patients for loans

The Shadow Practice Part 5: Drug pushers running this clinic were far from saints

The Shadow Practice Part 6: Doctors sell their souls, and their licenses, on the cheap

The Shadow Practice Part 7: Punishment for drug-dealing doctors more severe in Arizona

The Shadow Practice Part 8: How one California clinic became a magnet for bad medicine

The Shadow Practice, Part 9: Woman dies during cosmetic surgeries at unlicensed clinic

The Shadow Practice, Part 10: Coroner rules mistakes that killed patient a "therapeutic misadventure"

California governor and medical board should stand accused in patient's death