In addition to performing its licensing functions, the Arizona Board of Medical Examiners is supposed to protect the public from "unlawful, incompetent, unqualified, impaired or unprofessional" physicians.
Just how well is Bomex monitoring and disciplining Arizona's 7,900 doctors?
Although national groups say the board is among the most active in the country, the Arizona auditor general, who has investigated Bomex extensively for years, contends that the agency, while slowly improving, is not sufficiently protecting the public from dangerous medical practitioners.
In a series of reports dating back to 1981, the auditor general has repeatedly reported that, to protect the public from bad doctors, Bomex must do a better job of tackling backlogged complaints, investigating and monitoring doctors and, most of all, disciplining offending physicians strictly.
The auditor general identified one major problem at Bomex early on. The board consists of eight doctors, three members of the public and one nurse--all of whom are gubernatorial appointees.
Through the years, some of those appointed to Bomex have been political hacks. Others have been conscientious professionals.
Because the makeup of the board changes from governor to governor, regardless of the quality of the members, the board's decisions can be inconsistent from year to year. Willard Hunter, for example, has appeared before the board at least six times since 1982. He has been judged by Babbitt, Mecham, Mofford and Symington appointees.
The Symington board has gotten the highest marks by the auditor general. Even so, the auditor general blasted the board in 1994 for carrying a backlog of nearly 1,500 complaints, and for failing to take appropriately strong disciplinary action against doctors.
The report also noted that complaints were not adequately investigated, at least in part because Bomex investigators were busy collecting urine samples from doctors known to be substance abusers.
Last year, Bomex officials responded by reducing the backlog somewhat, by streamlining the way the board handles malpractice cases and by hiring an ombudsman to deal with the public.
The auditor general, however, says it "is too early to tell if recent changes in investigative procedures may positively impact the board's disciplinary actions."
Bomex officials have often hinted that the auditor general's long-standing criticism is unwarranted.
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They point to a recent report by Bomex's parent organization, the Federation of State Medical Boards, which ranks Bomex as the most active board in the nation. The federation says Arizona disciplined or wrote warning letters to 13 of every 1,000 physicians in Arizona in 1994, the last year for which statistics are available.
The Washington, D.C.-based Public Citizen's Health Research Group also gave Arizona a reasonably high ranking--in 1994, Arizona's board rated 17th in the country in regard to the number of serious disciplinary actions undertaken. In 1994, Bomex disciplined five out of every 1,000 Arizona doctors.
But Public Citizen's rankings are not meant to suggest it is impressed by the state of medical oversight in the country.
All states need to "strengthen the structure and functions of their licensing boards," the watchdog group concluded.--Terry Greene