Bills seeking to mandate the disclosure of current accusations against physicians and shake up the composition of the Guam Board of Medical Examiners received mixed testimony during their public hearings Monday afternoon.
Bill 317-36 would require the GBME to publish online, as part of a physician’s profile, any current accusations filed with the board – but only if it has been pending for more than six months. This includes accusations on appeal. Under the bill, a “current accusation” would mean an accusation “that has not been dismissed, withdrawn, or settled, and has not been finally decided upon by the board.”
Speaker Therese Terlaje, the bill’s author, stated the legislation was intended not only to inform patients, but also to put “a little fire” under the GBME to resolve claims, since some claims have gone years without settlement.
The proposal received opposition from some in the medical community, including two major organizations.
The Guam Medical Society and Guam Medical Association, in a joint statement, called the bill “yet another step” by lawmakers to attack physicians and weaken the “already fragile healthcare system in Guam.”
“Instead of strengthening the board, the Legislature seeks to malign community physicians by including in physician profiles unsubstantiated accusations and claims brought against them. … Instead, we would like to see the legislature and the government of Guam taking steps to adequately fund the office of the Guam Board of Medical Examiners,” the GMS and GMA testimony stated.
The GBME website currently lists physicians’ license status, whether they have criminal convictions and other information.
Terlaje said Monday that the legislative committee on health, which she chairs, had heard from individuals who had filed complaints with the GBME against licensed doctors – some of which involved doctors with past records of misconduct, including sexual assault.
“They all expressed the sentiment that had information on the doctors’ past records been available, they could have made an informed decision when choosing physician care,” Terlaje said.
One of the individuals who testified Monday in support of the legislation was David Lubofsky, the father of a 5-year-old boy who died at the Guam Memorial Hospital in 2018. Lubofsky has been an advocate for regulatory changes since his son’s death. He stated that Bill 317 would offer any Guam consumer an opportunity at a “much clearer look at the profiles of the medical professionals who treat them or their loved ones.”
“With Bill 317, there will be less hiding of medical negligence, etc. to protect doctors and more protection afforded to the people of Guam,” Lubofsky stated.
Others joined Lubofsky in supporting the bill, both in person and in written testimony. Lubofsky and others also supported Bill 318-36, another measure introduced by Terlaje, which would replace one physician member of the GBME with a member of the public at large. This would mean the board would have five physician members and two from the community. The measure would also change the consecutive term limits from three terms to two full terms.
Both bills drew concern from Dr. Annette David and Phil Flores, two members of the GBME present at Monday’s hearing.
On Bill 317, David stated it was important to put out information on cases once a decision is reached, but accusations by themselves are not proof of guilt. David was also concerned with a couple of operational issues.
“It’s not easy to make sure that all the information required is, No. 1 verified, because you do not want to publish anything publicly on physicians that is not verified that could be very harmful to that individual,” she said.
There is also the burden of data entry David said, pointing out members of the board are all volunteers.
“We are provided administrative support by the Health Professional Licensing Office. But please keep in mind the HPLO staff … have to provide support to the eight other boards that exist,” David said, adding that faster reporting would require support for data verification and data entry.”
Flores said Bill 317 would open the door for lawsuits against the board and HPLO staff by asking for accusations to be published prior to being proven.
David previously said that most of the cases she’s handled since serving on the board have been about physician misconduct, sexual assault and impairment issues, rather than inappropriate medical care.
She essentially stated the same Monday but added that, when looking at cases for the entire board, they comprise 60% clinical care issues, 30% patient doctor communication issues – often arising from physician impairment – and 10% nonclinical issues, meaning physician behavior or misconduct.
On Bill 318, David said it was important not to underplay the role of medical professionals who understand guidelines and can discern when medical care is compromised, because that is the majority of cases.
“I do agree that it’s important to have community representation. … But I would strongly urge you, don’t do this at the expense of the physicians … maybe just add on,” David said.
While she would welcome another community member, David said the board needs a physician member with expertise in mental health and substance abuse to address issues of physician impairment, and should consider having a member who is a doctor of osteopathy, to speed up adjudicating cases. She also maintained the importance of having dedicated full-time investigators for the GBME and to support the HPLO.
“It’s difficult to continue to even question some members of the medical community,” Terlaje said as comments were wrapping up on Bill 318. “I am sincerely hoping it’s not all of them, that they don’t all think like that, that they think independently and that they see for themselves the community’s response to cases lingering.”
Terlaje has also been a main sponsor of legislation intended to reform and replace Guam’s Medical Malpractice Mandatory Arbitration Act, which met significant resistance from the medical community. She called back to that bill Monday, stating that she hoped some physicians would also see the community’s response to being precluded from suing for medical malpractice.
“So many of these doctors told us, ‘Stay out of the medical malpractice (arbitration) and get on those boards.’ And now we’re on those boards and I get letters from the Guam Medical Society and Guam Medical Association saying, ‘This is another step by the Legislature attacking physicians in the community,'” Terlaje said, her voice beginning to tremble.
Legislators are not immune to backlash, as Terlaje disclosed what some senators have faced.
“Like I said, we also, ourselves and colleagues have been threatened with not receiving medical care. And of course my voice is changing because that is very unbelievable up to now. And painful and outright, I think, immoral,” she said.
But she also recognized that she can’t regulate that.
“There are certain things that the Legislature is responsible for regulating,” the speaker added, stating that she hoped some initiatives can be found to be reasonable by physicians, while lawmakers attempt to find balance with their legislation.