AZ medical board survey

1. Circle the term that best applies

Response
SA A N D SD NK
Count

1 The AMB does a good job of 25.6% 30.2% 19.8%

8.3% (29) 8.9% (31) 7.2% (25) 348
protecting the public. (89) (105) (69)

2 The AMB should simply be 16.9% 26.9% 35.7%

4.9% (17) 8.3% (29) 7.4% (26) 350
reauthorized, without change. (59) (94) (125)

3 If the AMB investigates me, I am

15.2% 17.8% 27.2% 29.8%
confident the investigation will be 4.9% (17) 5.2% (18) 349
(53) (62) (95) (104)
fair.

4 If doctors have a problem with

the AMB, they can rely on 14.0% 29.1% 39.3% 10.3%
2.3% (8) 5.1% (18) 351
organized medicine to help through (49) (102) (138) (36)
its relationship with AMB officials.

5 The policies of the AMB help to

create a climate that is likely to 28.0% 25.1% 26.9% 10.0%
2.6% (9) 7.4% (26) 350
attract excellent physicians to (98) (88) (94) (35)
Arizona.

6 AMB policies are friendly to 22.0% 28.3% 25.4% 18.3%

1.7% (6) 4.3% (15) 350
innovation. (77) (99) (89) (64)

7 Patient care in Arizona has been

21.3% 19.5% 23.0% 24.7%
improved by AMB's sanction on 2.6% (9) 8.9% (31) 348
(74) (68) (80) (86)
physicians who treat chronic pain.

8 The AMB should require electronic

10.3% 23.2% 56.7%
medical records as a condition of 2.6% (9) 4.3% (15) 2.9% (10) 349
(36) (81) (198)
licensure.

9 The AMB should require

maintenance of certification by an 11.5% 16.6% 14.0% 19.5% 37.0%
1.4% (5) 349
AMA-approved specialty board as a (40) (58) (49) (68) (129)
condition of licensure.

answered question 352

skipped question 3

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2. My opinion of the AMB is based on

Response Response
Percent Count

personal experience 75.9% 262

knowkedge of colleague's
59.7% 206
experience

information from medical society 19.4% 67

reports in the public media 25.8% 89

Other (please specify)

6.4% 22

answered question 345

skipped question 10

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3. My impression is that the AMB is:

Response Response
Percent Count

lax 1.8% 6

lenient 3.6% 12

consistent 9.5% 32

reasonable 20.2% 68

well-informed 4.7% 16

open 4.5% 15

out of touch 27.3% 92

tough 20.2% 68

harsh 33.5% 113

arbitrary 41.2% 139

biased 32.0% 108

politicized 36.2% 122

secretive 29.1% 98

rigid 22.8% 77

Other (please specify)

8.6% 29

answered question 337

skipped question 18

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4. My impression is that the AMB treats physicians with

Response Response
Percent Count

respect 14.4% 49

professionalism 21.4% 73

suspicion 60.4% 206

condescension 37.0% 126

it depends
13.5% 46

answered question 341

skipped question 14

5. Other comments:

Response
Count

49

answered question 49

skipped question 306

2. My opinion of the AMB is based on

1 Discussion with former AMB member Feb 2, 2011 11:32 AM

2 AMB web site Feb 2, 2011 11:42 AM

3 involved in medical peer reviews Feb 2, 2011 12:35 PM

4 overall Feb 2, 2011 2:27 PM

5 expert review of cases Feb 2, 2011 3:34 PM

6 discussion with many colleagues and attorneys Feb 2, 2011 3:55 PM

7 via M.I.C.A. Feb 4, 2011 11:09 AM

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2. My opinion of the AMB is based on

8 none Feb 4, 2011 12:07 PM

9 Very little info in media. Most colleagues do not share experience. Feb 4, 2011 12:13 PM

10 experience of attorneys Feb 4, 2011 12:28 PM

11 consultant for AMB specialty Feb 4, 2011 12:29 PM

12 review of outcomes for other physicians Feb 4, 2011 12:34 PM

13 harrassment Feb 4, 2011 12:49 PM

14 I work doing Board cases in AZ Feb 4, 2011 12:51 PM

15 my husband's experience Feb 4, 2011 12:55 PM

16 I treat many physicians who have come to the attention fo the Medical Board. Feb 4, 2011 12:59 PM

17 website Feb 4, 2011 1:19 PM

18 reading minutes of board meeting Feb 4, 2011 1:24 PM

19 MICA defense attorneys (several) opinions Feb 7, 2011 4:26 PM

20 Internet Feb 7, 2011 4:30 PM

21 Personal opinion Feb 11, 2011 2:18 PM

22 Takes too long! It took too long (over 6 months) back in 97. I hope it's faster Feb 16, 2011 10:50 AM
now.

3. My impression is that the AMB is:

1 Criminal Feb 2, 2011 11:46 AM

2 no opinion Feb 2, 2011 12:59 PM

3 not that familiar Feb 2, 2011 1:01 PM

4 inconsistent, unpredictable Feb 2, 2011 1:52 PM

5 inconsistent Feb 2, 2011 2:04 PM

6 slow Feb 2, 2011 2:54 PM

7 OK Feb 2, 2011 3:41 PM

8 antiphysician with an attitute of "guilty until proven innocent" Feb 2, 2011 4:42 PM

9 Sometimes dangerous. I don't feel protected. I feel I am at risk of unjust Feb 4, 2011 10:46 AM
accusation but have been lucky so far to have not been.

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3. My impression is that the AMB is:

10 Assumes guilt until proven innocence, not innocence until proven guilt. Does not Feb 4, 2011 11:19 AM
follow legal standards.

11 unknown Feb 4, 2011 12:08 PM

12 Can't tell, has to abide by privacy rules. Feb 4, 2011 12:13 PM

13 unknown Feb 4, 2011 12:13 PM

14 dysfunctional Feb 4, 2011 12:28 PM

15 unfair Feb 4, 2011 12:49 PM

16 Too many physicians that should be sanctioned are not and some that are Feb 4, 2011 12:51 PM
should not be.

17 unprofessional Feb 4, 2011 12:55 PM

18 presumption of guilt, rather than innocence Feb 4, 2011 12:58 PM

19 punitive; inappropriate and unwilling to correct its own mistakes Feb 4, 2011 1:03 PM

20 acrimonious Feb 4, 2011 1:03 PM

21 just another bureaucracy that one has to survive Feb 4, 2011 1:09 PM

22 nonprogresive Feb 4, 2011 1:44 PM

23 Difficult to judge given limited details disclosed of investigations or defendant Feb 4, 2011 1:53 PM
physican's defense/explanation and potential for politicized influences (since
AMB members serve at the pleasure of the governor.

24 Imbalanced; too regulated; too lawyered Feb 7, 2011 4:43 PM

25 Overwhelmed; risk-averse; bureaucraticizied Feb 16, 2011 11:27 AM

26 varied Feb 18, 2011 10:19 AM

27 Unsure yet Feb 23, 2011 12:45 PM

28 no experience Mar 14, 2011 11:25 AM

29 unfair Mar 21, 2011 4:44 PM

4. My impression is that the AMB treats physicians with

1 on who you know Feb 2, 2011 11:46 AM

2 "guilty untl proven innocent" Feb 2, 2011 12:31 PM

3 no opinion Feb 2, 2011 12:59 PM

4 abhorrent lack of concern over their actions Feb 2, 2011 1:48 PM

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4. My impression is that the AMB treats physicians with

5 condescension towards rural physicians in Arizona Feb 2, 2011 1:50 PM

6 The nature of the complaint, the frequency of complaints against that physician Feb 2, 2011 2:04 PM
and the source of the complaint are all factors

7 guilty until proven innocent Feb 2, 2011 2:28 PM

8 suspect publicity does (but shouldn't) plays a large role Feb 2, 2011 2:35 PM

9 if the physician knows someone on the board Feb 2, 2011 2:50 PM

10 depends on the politics of the day Feb 2, 2011 3:36 PM

11 varies on circumstances Feb 2, 2011 3:39 PM

12 Does not communicate well with physicians who are being investigated. (I was Feb 2, 2011 3:51 PM
incorrectly named in an investigation (never took care of patient) and have not
heard back after submitting information >1 month ago).

13 very arbitrary Feb 2, 2011 3:55 PM

14 Favours board certified physicians/surgeons even when thry have done Feb 2, 2011 4:01 PM
something wrong.

15 I've seen good and bad with colleagues and others. Feb 2, 2011 4:21 PM

16 My experience and my colleaugues' experiences have been mixed. The Feb 2, 2011 4:24 PM
complaints filed by patients are often ridiculous. A screening process by AMB
would be helpful.

17 Patients can make unsubstantiated claims and some patients are just plain Feb 4, 2011 10:46 AM
crazy.

18 considered guilty immediately Feb 4, 2011 10:54 AM

19 Respect when renewing lisence. Difficulty when doing investigation. Feb 4, 2011 11:03 AM

20 Seems they have an agenda and push it rather than fairness. Feb 4, 2011 11:06 AM

21 Depends on how much of a pain in the butt the patient is. Depends on if the Feb 4, 2011 11:09 AM
patient is in a politically favored group or a politically favored ethnicity.

22 Disrespect Feb 4, 2011 11:11 AM

23 guilty until proven innocent Feb 4, 2011 11:17 AM

24 Have read some accounts in newspapers. Feb 4, 2011 11:18 AM

25 no comment Feb 4, 2011 12:00 PM

26 Non-professional investigators seem to have a chip on their shoulders. Feb 4, 2011 12:03 PM

27 no comment Feb 4, 2011 12:04 PM

28 no comment Feb 4, 2011 12:07 PM

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4. My impression is that the AMB treats physicians with

29 unknown Feb 4, 2011 12:08 PM

30 unknown Feb 4, 2011 12:13 PM

31 unknown Feb 4, 2011 12:13 PM

32 They are on a witch hunt. Feb 4, 2011 12:28 PM

33 Politics seems to affect their aggressiveness in pursuing physicians. Feb 4, 2011 12:35 PM

34 The cases that I have reviewed have shown appropriate concern for physician Feb 4, 2011 12:51 PM
practice standards.

35 like trash Feb 4, 2011 12:55 PM

36 Maybe this is defined by statute. Feb 4, 2011 12:58 PM

37 on reviewers for written assessments Feb 4, 2011 1:01 PM

38 like an item on an assembly line. Feb 4, 2011 1:09 PM

39 MDs are treated as if guilty until proven innocent. Feb 4, 2011 1:15 PM

40 no comment Feb 4, 2011 1:28 PM

41 as subjects Feb 4, 2011 1:44 PM

42 Nature of accusation, current sociopolitical/media agenda(s), possible prejudice Feb 4, 2011 1:53 PM
of AMB panel member(s) (racial/ethnic/gender/foreign medical
school/religion/faith, etc.)

43 no opinion Feb 11, 2011 2:18 PM

44 The letter sent was rather frightening but the opportunity to present my respons Feb 16, 2011 10:50 AM
in person and then the decision of the board was as I expected.

45 Really doesn't have transparency or always reliable reviewers Feb 18, 2011 10:19 AM

46 no experience Mar 14, 2011 11:25 AM

5. Other comments:

Response Text

1 Some members reasonable, others are not at all. They are not well-informed in Feb 2, 2011 11:23 AM
sub specialtiy matters in which they carry rule of law. Several members are
clearly anti-physician.

2 The board "protects" the public from physicians-No one "protects" physicians Feb 2, 2011 11:28 AM
from the public!!

3 Uses unqualified consultants Feb 2, 2011 11:42 AM

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5. Other comments:

Response Text

4 Should not list complaints against doctors until proven true by a hearing. Just Feb 2, 2011 12:57 PM
because a patient complains should not be on internet unless complaint verified
and justified.

5 unknown but suspect proffesional Feb 2, 2011 1:01 PM

6 Strict rules of evidence, not implication or innuendo or hurt feelings of patients, Feb 2, 2011 2:12 PM
must guide rulings. Clear guidelines of proffesional behavior must be public.
Patient surveys must seek objective information never hearsay or feelings.

7 They are working in favor of the public not physicians Feb 2, 2011 2:22 PM

8 Anyone can make a complaint regardless of legitimacy that cost the M.D. Feb 2, 2011 2:33 PM
hundreds of hours and thousands of dollars to defend regardless of whether
there is a basis. In regards to narcotics especially changes protecting the doctor
would help.

9 AMB members are political apointees who will screw as many doctors as Feb 2, 2011 2:37 PM
possible so that they can justify their existence and look good in the public eye.

10 Physician is presumed guilty with each complaint. Lacks balance. Laypersons Feb 2, 2011 2:49 PM
on board lack appropriate knowledge base.

11 AMB should be run by a physician or at a minimum the head should be approved Feb 2, 2011 2:53 PM
by organized medicine in Arizona.

12 The AMB is broken, plain and simple. I have no respect for them as a body of Feb 2, 2011 3:07 PM
my "peers."

13 The AMB wastes time on petty, frivolous complaints. Feb 2, 2011 3:15 PM

14 I feel that CME requirements should be increased to at least 40 credits/yr. 20 is Feb 2, 2011 3:33 PM
not enough and many of us are doing more anyway.

15 Strongly disagree with AMA certification as a condition of licensure. Strongly Feb 2, 2011 4:30 PM
disagree with a requirement for electronic medical records.

16 There is no appeal process for an advisory letter. Feb 2, 2011 4:38 PM

17 It's too easy for patients to submit frivolous complaints without fear of Feb 2, 2011 4:45 PM
accountability.

18 The AMB abuses process to get the results its non-medical staffers want. The Feb 4, 2011 10:50 AM
system is totally unfair and unjust. I would certainly not have chosen to practice
in Arizona if I knew how this board operates. Needs reform badly.

19 "Experts" are incompetent, make ludicrous recommendations and fabricate data. Feb 4, 2011 10:54 AM

20 I was investigated and the Board consultant was extremely fair and thorough and Feb 4, 2011 10:56 AM
accurate.

21 A physician is guilty until proven innocent under current AMB policy. Anyone Feb 4, 2011 11:24 AM
can register a complaint of any nature with AMB and the physician is then
considered guilty.

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5. Other comments:

Response Text

22 It takes forever for a complaint to be resolved. In the interim you are treated as Feb 4, 2011 11:30 AM
guilty until proven otherwise. There is no protection of physicians from patients
who enjoy causing trouble/problems.

23 Let's have the same standards for the legal community. The Bar Assoc. really Feb 4, 2011 12:00 PM
protects its members to the point of stopping most complaints before they get
started.

24 Get good professional nonbiased investigators. Feb 4, 2011 12:03 PM

25 Policies and procedures regarding impaired physicana is illogical, inconsistent Feb 4, 2011 12:06 PM
and punitive.

26 Physicians are treated harshly in the letters sent out. You get the impression Feb 4, 2011 12:10 PM
you are "Guilty until proven innocent." Heavy-handed. Should be appealable in
a court of law. Definitely

27 Close the medical board. The board does not benefit physicains and is an extra Feb 4, 2011 12:18 PM
layer of police on physicians.

28 A patient has filed a complaint to AMB against me. Over the next 14 months, Feb 4, 2011 12:28 PM
she returned to AMB and kept changing her story. She interviewed with AMB
staff on 3 different occasions over 14 monthsa dn told them a different story
each time. At her final interview, she alleged that we had a sexually
inappropriate relationship. She attended that interview with her attorney and
subsequently filed a malpractice suit against me. Even though the board's own
evaluation wrote off that she was an unreliable historian, the board ordered that I
undergo a psychiatric evaluation (at my expense.) This was excessive and
completely unnecessary. Further, even though the patient changed her story at
each interview, her statements were not admissable in the malpractice suit due
to the board's policy of keeping complaints confidential. This is a major flaw in
our state legal system. The board membership is very unbalanced--primary care
is only represented by one member and most board members are surgical sub-
specialists who think they know everything there is to know. When I was
interviewed ( 3 times) to deal with this complaint, they refused to even tell me
what I was being accused of, or what the patient was alleging. The AMB needs
a complete overhaul.

29 The Board allows unqualified reviewers to review specialty cases, for example-- Feb 4, 2011 12:31 PM
thoracic surgeon review vascular case

30 Reviewers for AMB should be physicians who have practiced in the valley for Feb 4, 2011 12:34 PM
several years and have practiced full time in this area. Part time physicians may
not be informed regarding current trends and treatment protocols.

31 The complaining patient is typically given credibility that their allegation is correct Feb 4, 2011 12:40 PM
(without reservation); the defending physician is considered strongly suspect
unless he can exonerate himself--prove without any doubt that the complainant
is in the wrong!!

32 They are bad. Feb 4, 2011 12:42 PM

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5. Other comments:

Response Text

33 Guilty until proven innocent. I have had 3 similar incidents. My experieces were Feb 4, 2011 12:49 PM
that someone left an anonymous, misspelled, poor grammar, vague complaint
that I prescribed too much pain meds for their father ON A WEBSITE. I was
evaluated by a sub. abuse MD (tested for sub abuse herself), sent to Betty Ford
for further evaluation, underwent scrutiny of all my personal medical records,
submitted 5 medical records of my patients (which were evaluated) and after 1
1/2 years was cleared. It cost me time, I paid everything, and humiliation. Guilty
until proven innocent.

34 AMB is unprofessional, racial, mean-spirited. They are group of gang members Feb 4, 2011 12:55 PM
who are there for their personal purpose/gain. They should be punished.

35 They don't punish the really bad actors--like the Carlotti's Feb 4, 2011 1:05 PM

36 When any uneducated patient, that is unhappy for any reason can lodge an Feb 4, 2011 1:07 PM
email complaint that takes hours of my time to answer, then something is wrong
with the system. While I am not in favor of a free-for-all legal system, at least
with lawsuits, plaintiff attorney will refuse to take a case if it has no merit. This is
not the case with the AZ Medical Board complaint system.

37 They accepted false witness/testimony from a physician who used her own Feb 4, 2011 1:14 PM
opinion to render her impression in my case. Had I had more time I would have
turned her in to my medical specialty board for a reprimand. I have heard that
they can be even uglier to physicians if you appear before the board and attempt
to refute their nasties that they post for all the public to see and there is no way
for truly defend oneself. The director increased fees for the physicians (due
every two years) and actually commented in the reasoning that these increased
fees can be recuped by physicians by increasing fees for patient care!!! How out
of touch. I almost responded to this, but who would be willing to attach their
name to a complaint against board policies? It is so revolting to pay for our own
torture!!!

38 A provider is presumed guilty and must prove innocence. There is inconsistency Feb 4, 2011 1:18 PM
in censure/punishment. There is no assistance in providing legal recourse. Not
all physicians are treated the same. Problem with addiction/bad behavior dealt
with more leniently--ie Dr. Schwartz (until too late)

39 We definitely need an entity which concerns itself with physicians' competence Feb 4, 2011 1:24 PM
and performance. Such a complex profession necessitates peer review but
some non-MD community members would bring a valuable perspective also.

40 I have had only one experience with the Board. During residency one of the Feb 4, 2011 1:28 PM
members I had a conflict with about a patient who was septic. He said the
patient was not septic and cancelled my orders to admit the patient to ICU. The
patient died 8 hours later--septic shock! I felt he should have removed himself
from the board or review of my case. I felt I was harshly judged because of his
personal anger towards me.

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5. Other comments:

Response Text

41 My 30-year medical career has been constanly overshadowed by fear that the Feb 4, 2011 1:44 PM
Board will come down on me from a complain process that is one-directional,
coming from a public that is encouraged and enticed to be litiginous, entitled and
enabled by interest groups, politicians and the unethical, profiteering legal
profession. As for pain management, I am the only few of the physicians in our
area who dares provide for a few such service with constant urging by my clinic
colleagues to drop those patients: too much time, too much liability, too much
documentation, pressure, and even then it may not be enough! The biggest
problem I see with the AMB is that evey inquiry, and even the yearly renewal of
license is immediately associated with threats of fines, loss of license, criminal
charges if not immediately complied. I cannot understand how any physician
can honestly offer their services to serve on the board in any capacity to be
judge and jury over their colleagues when they themselves are a potential victim
to the Board process as long as they are practicing. There needs to be a
grievance process for the public, of course, but that complaint first should go
through review process, i.e. is the complaint valid, self-serving, vindictive,
frivolous with hope for financial gain, distorted from the truth. That review should
be done by physicians in the same specialty, preferably the same geographical
and demographical area, totally clinical and no lawyers allowed. This would be
strictly for clinical complaints. Other, obvious societally injurious behavior,
misconduct, unethical behavior only should be in the perview of the Board. The
reason for the distinction that in the clinical world, practice applications are often
"out of box.," often years ahead of practice guidelines, today's negative Board
decision is tomorrow's evidence-based practice. Take the 40 year back-and-
forth on baby aspirin; pain management: yesterday's pain management
guideling today is considered poor practice and chargeable as not meeting
today's patient's right to pain relief even to the point of criminalization of
undertreatment accusations. BUT, my question is--- all this time I felt as a
physician, alone, as all my other colleagues, working under the Board shadow,
vulnerable, hapless, hopeless and hoping never to go through Board processes
that I hear and read about. And now toward the final years of my career, I hear
about an organization, since 1943!!! that fights on our behalf. How come I didn't
know. Sign me up!

42 Strong tending for bias. Leader tends to sway panel. Fairness of hearing is at Feb 4, 2011 1:47 PM
times questionable. Expert witness at times not an expert in his field. Shoud
have a manual for standard operating procedures. Requirements for witness-
certification, experience, etc. Observations are personal having testified on
behalf of another physician.

43 Probation of 3 years is mandatory to be on record for life. This would be fine if Feb 4, 2011 1:57 PM
not "probation"--scarred for life, lost jobs, costs thousands more to license.
Did everything they wanted, plus some, should be role model, not "prisoner" of
words.

44 (1) Inconsistent quality of reviewers who are loath to change their minds even if Feb 7, 2011 4:26 PM
other consultants disagree.
(2) Boards seems to believe all medical records received are inadequate.

45 Board members should only be active practitioners not retired nor partially Feb 7, 2011 4:29 PM
retired.

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5. Other comments:

Response Text

46 Too many lag people; Not enough "executive" oversight"; Unable to use Feb 7, 2011 4:43 PM
professional judgement; Too constrained in having to waste time on frivolous;
Not harsh enough on obvious bad action and too tough on questionable ones;
too constrained by public and lacking understanding of real medicine;
understaffed

47 What physician in practice would do the AMB's job? A condition of licensure Feb 9, 2011 11:27 AM
should be like jury duty. Important complaints should be reviewed by 3 paid
physicians(one hundred dollar/hr for max $300) of same specialty from a
different community (IE Phoenix for Tucson complaints, Tucson for Phoenix
complaints). Vote Yes, no, or undecided with one paragraph why, AMB decides.

48 I am not aware of sanctions in overprescribing narcotics. I really like the state Feb 16, 2011 10:50 AM
board pf pharmacy's controlled substance prescription monitoring hotline.
Needs to be closer to real time. Have had scripts from my urgent care not put in
for over 2 weeks.
The only other contact I have had has been paying my annual license. This
process is good, efficient. Thank you!

49 I feel the board does a good job, but the lengthy and cumbersome process for Mar 14, 2011 11:25 AM
physicians, even if a complaint is clearly bogus is a true burden on a physician,
who seems to be viewed "guilty until proven innocent." Also, the threat of
sanctions if a physician discusses with anyone serve to isolate the physician
further. This must be changed.

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