Staff Infection

Several top staffers have left Arizona's troubled Board of Medical Examiners (BOMEX).

The agency, which has struggled for several years with a huge backlog of
complaints against doctors, last week lost its chief lawyer and deputy director, departures apparently prompted by the arrival of a new executive director.

Assistant Attorney General Nancy Beck, a key figure at the agency for nearly a decade, requested a transfer from the agency last week. BOMEX's deputy director Donna Nemer also resigned. At the same time, Claudia Foutz, the new executive director, has hired a former colleague as ombudsman at the agency.

The turnover comes a little more than a month after Foutz started on the job. She describes the changes as a natural part of the transition at BOMEX.

"I think we've hit the 'storming' phase of this relationship," Foutz says. "I think a big wave just hit me, but I'm encouraged. . . . The barge has broken loose, and we're moving forward."

BOMEX has been overrun with more than just staff problems. The board has a backlog of more than 1,000 complaints against Arizona's doctors, and it takes the agency an average of 16 months to resolve a complaint. Even BOMEX's most serious cases--which could involve suspending or revoking a physician's license--face months of delays while BOMEX tries to decide if it will send them to the state Office of Administrative Hearings (OAH). And in nearly 90 percent of its cases, BOMEX takes no disciplinary action against doctors at all.

Beck has been with BOMEX for nine years and has left a strong mark on the agency. Known as a zealous advocate, she's also seen her share of controversy. She's been blamed for the forced resignation of former executive director Mark Speicher. She later applied for the job herself, but lost to Foutz.

Agency insiders say Beck's clashes with Foutz over the direction of BOMEX led to her request for a transfer. But Foutz dismisses that as idle gossip. "I don't know where people come up with this stuff," she says.

Foutz praised Beck as a "brilliant litigator, one of the best I've seen" and said there were no issues with her performance.

However, Burt Drucker, a former board member who clashed with Beck in the past, called Beck's departure "the best news I've heard in a long time."

Nemer's resignation letter directed several pointed comments at the change of leadership in the agency, according to BOMEX insiders. Foutz wouldn't comment, except to say Nemer did not give a reason for her departure. "She typed a long letter, but she didn't give a reason," Foutz says.

Foutz declined to release a copy of Nemer's letter, saying it was protected under personnel rules.

Beck and Nemer did not return calls for comment.
The board's other assistant AG, Victoria Mangiapane, is also leaving the agency at the end of July.

Assistant attorney general Michael Harrison will replace Beck. Doretta Leake, the board's administrative assistant, has resigned to take a position outside state government.

Meanwhile, Foutz has hired a former colleague from her previous employer, the California Optometric Association, to serve as BOMEX's ombudsman. Foutz says the position, which was created to answer citizens' concerns about doctors, will expand under Eric Nickell.

Nickell, who will be paid $47,000 a year, holds a master's in public policy from Princeton. He says the ombudsman's position will eventually include lobbying and monitoring activities, as well as public information. The ombudsman's office will be able to take some of the pressure off BOMEX's investigators by checking doctors' progress in rehabilitation and on probation, Nickell says. He expects the number of staffers to increase as well, to about six.

"As long as there is choice in health care, people should be more discriminatory in choosing providers, and we're going to help them do that," he says.

Board chair Phillip Keen will be replaced with a new appointment despite earlier statements from the governor's office that he would stay in his position even after the expiration of his term.

Stuart Goodman, Governor Hull's liaison with BOMEX, says keeping Keen on past his term became unworkable. It would've meant an 18-month lag between appointments, he says.

"The numbers just don't make sense," he says.
Goodman thinks the changes at the agency are good.
"Whenever you get into a situation where there's so much turmoil, so much innuendo, change can be positive if it's managed correctly," he says.

The latest departures add to BOMEX's list of staff resignations. Before Foutz was hired, four of seven of the board's medical consultants quit, as well as one investigator, leaving the board short-handed in dealing with complaints.

Foutz remains optimistic that she can solve BOMEX's problems. "Someone asked me if I wanted to take on Bosnia next," she says.

Contact Chris Farnsworth at his online address: [email protected]

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Chris Farnsworth