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The BOMEX Files

They say everyone deserves a second chance. At last count, Dr. Bipinchandra Jadav has had 15. The doctor, a general practitioner in Mesa, has had more than a dozen complaints filed with the state Board of Medical Examiners (BOMEX). He has had his license restricted once, has been ordered not...
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They say everyone deserves a second chance. At last count, Dr. Bipinchandra Jadav has had 15.

The doctor, a general practitioner in Mesa, has had more than a dozen complaints filed with the state Board of Medical Examiners (BOMEX). He has had his license restricted once, has been ordered not to practice in Arizona for a period of six months and to take a medical competency exam--he failed the first time, passed the second. He is currently on probation for prescribing hundreds of potentially dangerous and addictive painkillers to a single patient, and making false statements about his hospital privileges.

According to his probation, Jadav may no longer practice anesthesia--his former specialty--and is either supposed to reenter a residency training program or have a management consultant help his practice. He is not allowed to prescribe certain drugs.

BOMEX even threatened to take away Jadav's license once. Instead, the agency let him keep practicing because he agreed to go on probation--the board's equivalent of a plea bargain.

Considering his record, you might wonder why the state agency that is supposed to protect the public from unqualified and incompetent doctors hasn't simply pulled his ticket.

That's undoubtedly something that the parents of 8-year-old Jessica Felker would also like to know. Their daughter died of pneumonia, after she'd been brought to Jadav with a severe cold and coughing.

Jessica suffered from Down's syndrome, but the pneumonia was apparent on her x-ray--which no one read until two days after she died. Jadav ordered it, but never bothered to look at the film.

Jessica Felker's death speaks volumes about serious problems at BOMEX, the state's most important health-care regulator. The agency is supposed to be the thin white line between Arizona's 15,000 doctors and a vulnerable public, protecting patients from abusive, incompetent and dangerous doctors.

It's failing.
For Jadav--and many other doctors with multiple complaints and disciplinary actions who continue to practice--BOMEX is a home of second chances and procedural delays.

New Times analyzed about 14,000 complaints, against about 5,500 doctors, using a computer database of records dating back as far as 20 years. In addition, the newspaper interviewed current and former board and staff members, local and national experts and political leaders responsible for overseeing BOMEX. The newspaper also reviewed court records, documents on file with other agencies as well as BOMEX's own files. The investigation revealed:

* Dozens of doctors have been investigated by BOMEX time and again. In fact, 79 doctors have had a dozen or more complaints against them; 69 are still practicing. These doctors account for 10 percent of all of BOMEX's complaints. One doctor, eye surgeon Gary Hall, has had 121 complaints lodged against him since he began practicing in 1982. He recently lost a malpractice verdict and has settled out of court on numerous other lawsuits.

* In nearly 90 percent of its cases, BOMEX takes no disciplinary action at all.

* BOMEX has a significant backlog of cases. Nearly 1,000 complaints are still open, some dating back several years. Other state medical boards that regulate as many or more doctors than BOMEX have significantly fewer open cases.

* BOMEX is operating nearly the same as it was four years ago, when the state auditor general released a critical review of the agency. Since 1995, it has taken BOMEX an average of 16 months to resolve a complaint. That's three times as long as recommended in the 1994 audit.

* Accusations of sexual misconduct take even longer to resolve, despite BOMEX's self-proclaimed "zero tolerance" policy. There have been 42 sexual misconduct complaints filed with BOMEX. It's taken the agency nearly two years, on average, to resolve the complaints.

* Last year, BOMEX sent only two cases to a state administrative law judge for possible license revocation. The state Office of Administrative Hearings says it could easily handle more cases, except BOMEX isn't passing them along. Only three have been scheduled for hearing so far this year.

In addition, BOMEX has been struggling with internal staff turnover. BOMEX's former executive director, Mark Speicher, was asked to resign after what some BOMEX insiders say was a behind-the-scenes power struggle with the agency's legal counsel. Four of the board's seven medical consultants have resigned, and one of the agency's six investigators has also quit, leaving BOMEX shorthanded in the investigation of complaints.

Most of BOMEX's 12 members are doctors, asked to police their own. The board now has seven doctors from a variety of specialties, one nurse and three lay members representing the public. One position remains open.

By law, the board is supposed to discipline physicians who violate medical practices and ethics, including revoking a doctor's license if necessary. The agency has a staff of about 30 and a $3 million annual budget.

The prognosis for BOMEX is uncertain. Those who oversee the agency--from the Legislature to the governor to the chairman of the medical board--aren't demanding much in the way of immediate improvements. Instead, they say they'll wait as long as another year to see if a new executive director can bring the agency back to health.

Meanwhile, if the trend holds, another 1,000 complaints will be filed with BOMEX while officials watch.

Chronic Complaints
At first glance, Dr. Gary Hall is the American dream wrapped in a doctor's white coat. Educated at Indiana University and the University of Cincinnati, he took a year off from med school to compete as an Olympic swimmer. He was a member of three Olympic teams. The father of an Olympic gold medalist, he's also the son-in-law of Charles Keating, who built a billion-dollar financial empire before it crumbled in lawsuits and federal indictments. Hall came to Phoenix in 1982 with his family, and since then has built a successful and well-known ophthalmological practice.

Some people, however, take a dimmer view of Dr. Hall. He's had 121 complaints filed against him, according to the BOMEX database.

Hall has been on probation since 1996 for unprofessional conduct after patients complained about billing, advertising and quality of care. More than half of the total complaints against him have been racked up since he's been on probation.

Neither Hall nor his attorney returned phone calls seeking comment for this story.

Christine Hachey is one of those complaining. But, she says, she has a dim view of pretty much everything since her eye surgery by Hall. Hachey says Hall damaged her eyesight, rather than improve it. She won a small verdict against him last year in Maricopa County Superior Court.

Hachey went to Hall's clinic in 1993 for an eye exam, and was invited to one of the seminars Hall was holding on RK--radial keratotamy, an increasingly common procedure where microscopic incisions are made on the surface of the eye's cornea to flatten imperfections and correct defects in vision.

Hall was one of many doctors who were aggressively selling RK. The elective procedure could be performed quickly on many patients. RK was tagged by some as "slash for cash."

In 1993, when Hachey underwent four procedures, Hall was performing between 80 and 100 surgeries in a row, according to news accounts. He would turn on a swiveled stool between two chairs as patients came in and out of the surgery suite from a waiting area, Hachey recalls.

Hachey says she couldn't see anything clearly after the first surgery. After three more, her eyes were getting worse. She called it quits.

About the same time, BOMEX was investigating other complaints filed by Hall's patients--many of which were eventually dismissed. But as other complaints were filed, Hall's problems with the state board came to a head in 1996.

BOMEX agreed not to go after his license when he agreed to probation for unprofessional conduct.

It's a tactic BOMEX uses frequently. It allows the agency to avoid the time and expense of taking doctors to a formal hearing, which can then take additional years of appeals and courtroom time.

Hall agreed to inform patients more fully about RK surgery and provide them with a more detailed consent form. He also agreed to 80 hours of community service, random office surveys by board staff and a $10,000 penalty to cover the costs of the BOMEX investigation.

In 1997, Hall was brought before BOMEX again for inappropriate advertising. All BOMEX gave him was a letter of reprimand. Because advertising practices were not a part of his probation, it was not considered a violation of his probation.

Hachey says she had never heard about the complaints against Hall before she went into the surgery in 1993. She says friends had called BOMEX about Hall and were told that the doctor had a clean bill.

And, at the time, he did. Even though there were several pending complaints against him, BOMEX hadn't taken any action on them.

Hall has testified that Hachey was an appropriate candidate for surgery, and that his actions did not damage her eyes. Hall also argued that Hachey was well aware of the possible complications of the surgery, which didn't come with any guarantees.

Hall has always maintained he is practicing good medicine, and that opinions about RK surgery differ greatly between ophthalmologists.

"It's never going to be black and white, because vision is subjective," he told the board in 1994. "I still feel and would always recommend something that would be in their [the patients'] best interests. I've always done that. I will always do that. I practice in no other way. I love my patients, and I only want them to see better."

BOMEX, made up largely of doctors who know how easy it is for things to go wrong in their profession, agreed that objective standards are difficult to set in ophthalmology. So the board was reluctant to reprimand Hall for his judgment calls.

"I get the impression," one former board member said while interviewing Hall, "that this is a very controversial area with different points of view, and that perhaps one should have taken a more lenient point of view of what was done in this instance."

Non-medical people haven't found it as hard to point the finger at Hall. More than 40 lawsuits have been filed against Hall in Maricopa County Superior Court. He paid out $57,500 in one settlement; almost all other cases have been settled, many with gag orders. Hachey is the only one to make it to court in the Valley and win a jury verdict; she got $2,000. Her attorney, Don Loeb, says the amount of the award is on appeal.

Today, Hall is marketing a new technique for correcting vision: LASIK, a laser-assisted eye surgery. LASIK is not covered under Hall's probation. And even while 63 complaints are pending against him at last count, Hall is advertising on the radio and in the paper for new patients.

While Hachey is angry at Hall, her harshest words are reserved for BOMEX. She cannot believe that Hall is still allowed to practice, even after a malpractice verdict.

"I should think that if you've screwed up enough and a jury of your peers finds against you, then something should be done," she says.

Dozens of Arizona's doctors have had multiple complaints filed against them, but BOMEX doesn't see that as evidence of lax oversight on its part.

Donna Nemer, the agency's acting deputy director, says BOMEX considers the number of complaints against a doctor an "aggravating factor." But she adds that BOMEX deals with each complaint on a case-by-case basis; the number of complaints alone is not a basis for action against a doctor--even when they have as many complaints as Hall.

Or, for that matter, as Dr. Jadav.
Jessica Felker's death is now at the center of a bitter lawsuit. Jadav, who contends he told Jessica's father to take her to the emergency room, maintains his innocence. The trial has been postponed, while Jadav goes through bankruptcy proceedings.

"I think I did what was supposed to be done," Jadav says.
Jadav also says his history at BOMEX doesn't accurately reflect his skill. He says that he failed the first competency test ordered by BOMEX because of family problems distracting him, and that he's now complying with all terms of his probation.

And the real problem BOMEX has with him, he contends, is his race, not his skill.

"BOMEX has told me that there will be no [East] Indian doctors after the year 2000, and I'm going to be one of them," he says.

There's an East Indian doctor on the board. But that doesn't matter, Jadav says. When asked why BOMEX has this vendetta against East Indians, he replies, "Why do some people hate black people? We don't know."

No matter what BOMEX tries to do to him, Jadav says he's in Arizona to stay. "I'm not going to let them run me out of town," he says. "I'm complying with everything they told me to do. I'm doing everything they told me to do for the last 10 years."

Bleeding Hearts
Just after midnight on June 17, 1994, a 28-year-old man went to a Valley emergency room with a ruptured bowel. Dr. Hara P. Misra was paged at 1:52 a.m. and told there was an emergency situation.

He said he'd be there "ASAP." But he never showed up. And at 3:36 a.m., the patient was dead.

Hospital personnel said they'd paged Misra twice more before the man died, with no response.

Neither Misra nor his attorney returned phone calls for this article, but Misra agreed to the facts of the case when it came before BOMEX in January.

BOMEX initially censured Misra, but then the board decided his actions hadn't contributed to the patient's death. Instead, the board settled on a reprimand, the lightest possible penalty under the law.

And even that was unusual for BOMEX. Most of the time, it doesn't take any disciplinary action against doctors at all.

New Times' computer-assisted analysis shows that, since 1995, 89.3 percent of all complaints resolved by BOMEX have ended with dismissals or a "letter of concern"--which, by law, is a nondisciplinary action.

Dr. Thomas Bodnar twice violated the terms of an agreement he'd reached with BOMEX requiring him to get more training after complaints about the quality of his medical care. For whatever reason, he failed to do it. The board's reaction? Sign another agreement to get the training.

Dr. Phillip Keen, chairman of the medical board, insists BOMEX is not too lenient.

BOMEX officials note that Arizona has been ranked as one of the top 10 medical boards in the country when it comes to taking action against doctors. In 1997, BOMEX was put at the top of boards "taking actions" by the Texas-based Federation of State Medical Boards, and number five by the consumer advocacy group Public Citizen.

The 1998 rankings, just released by the Federation and by Public Citizen, however, sharply diverge: While the Federation shows Arizona as taking the most actions for all state medical boards of its size, Public Citzen, based on the same data, has dropped BOMEX to a tie for 19th and 20th place.

Dr. Sidney Wolfe, the head of Public Citizen's Health Research group, says being the strictest medical board is a lot like being the tallest midget.

Up until 1996, Wolfe says, Arizona had a "disproportionately high rate of actions in the category of slaps on the wrist." While BOMEX showed improvement in 1996, no medical board in the country is doing enough to protect the public, he contends.

"Most states have a long way to go before they even begin to offer serious protection for citizens from doctors who are incompetent, who sexually abuse patients, or who otherwise have serious problems," Wolfe wrote in a statement accompanying Public Citizen's most recent rankings.

BOMEX officials say it's Arizona's law that is the problem, not the agency itself. The penalties allowed under the law--reprimand, censure and license revocations--can only be used when specific circumstances occur, Keen says. For instance, the board can't reprimand a doctor if a patient has been harmed. That leaves censure or revocation in cases where someone gets hurt or worse; but BOMEX thinks those penalties are too tough in many of those instances.

Keen says, "A decree of censure should be reserved for those cases where there is clearly wrong behavior, not just a bad decision, but clearly wrong behavior by the physician."

Instead, the board has taken to issuing something it calls a letter of concern--which isn't a disciplinary action at all under the law and in reality has little practical effect. A doctor who has harmed someone can still practice with no restrictions.

Even a decree of censure doesn't really impede a doctor's practice.
Keen says that censure can often mean serious economic penalties for a doctor--he can be dropped from health plans, and lose patients and money.

"It's not uncommon for a person to lose 40 percent of his practice after receiving a decree of censure," Keen says.

But while censure might hurt a doctor economically, it doesn't stop him from practicing in any way. The doctor can keep on seeing patients as if nothing had happened.

"The letter of concern and reprimand and et cetera doesn't do a thing to protect the public," according to Stephen Myers, an attorney who's been representing doctors before BOMEX since 1979.

"Censure? What does that do for the public? It doesn't do squat, and if they've got it wrong, they've unduly harmed the doctor."

But both Keen and Nemer argue that protecting the public isn't necessarily about disciplining doctors. BOMEX, they say, is focused more on educating and rehabilitating a doctor than taking action against him for what he's done.

"There's more to protection of the public than revoking licenses and suspending licenses," says Nemer. "Good doctors who make errors can be reeducated and helped to improve their practice and provide better patient care, and that's the philosophy of our board."

Keen says that doctors have put in years of work that shouldn't be thrown away for what might be just an isolated mistake.

"That's kind of at the heart of what we try to do here. We have physicians who have a lot of experience. We don't just want to throw that out because you were unlucky, find another career, go pump gas for a while," he says. "It may just be a matter of fine-tuning their skills, or reducing the scope of their practice."

In fact, the public is pretty much cut out of the loop once BOMEX takes on a case. Even the patient who files the complaint is no longer included in BOMEX's considerations.

"When you file a complaint with the board, it is an action between the board and the doctor. The person bringing us the information is not a party to that action," Nemer says.

At the last board meeting, BOMEX did decide to notify complainants when their cases are to be heard, a move toward what Nemer calls a more "customer-friendly" environment. Before, people didn't know what was going on with their complaints unless they specifically asked.

Still, the board does not notify patients of the outcome of a case, and doesn't make any general attempt to let the public know if a doctor has been found to do something wrong. In its own agency newsletter, BOMEX doesn't even give the names of doctors it takes action against.

BOMEX officials say the public should trust the agency to do what's best. And that, they say, is concentrating on really serious cases of malpractice or abuse.

Unfortunately, many of the most serious cases BOMEX handles are stuck in the whirlpool of bureaucratic politics.

Surgical Scrubs
A turf battle between BOMEX and the state Office of Administrative Hearings has all but paralyzed the process by which a bad doctor's license is revoked.

When BOMEX decides a doctor's conduct is serious enough to warrant taking away his license, the board orders the case to a formal hearing before an administrative law judge.

In 1996, OAH was given the job of holding administrative hearings for all other state agencies. BOMEX had 10 hearings before OAH's judges in 1996--which ended in reprimands, probation or license revocation for the doctors involved.

But in 1997, the BOMEX board, citing concerns about the quality of OAH judges, ordered all pending cases withdrawn. The judges didn't have the knowledge to decide medical matters, according to board chairman Keen.

"[OAH] put forth to us a list of people whose expertise was in the area of contracts and contractors and building-type people, whose experience in medical matters was zero," Keen says.

Cliff Vanell, director of OAH, says that's not true. The judges OAH provided "met or exceeded" the credentials of the judges BOMEX hired before OAH was established, he says.

Vanell adds that OAH has never had a backlog, and has always scheduled cases promptly.

As a result of this dispute, only two BOMEX cases were heard by OAH in 1997, and only three are on the docket for this year.

Vanell considers the matter resolved, since BOMEX has accepted the results of cases OAH decided last year. Donna Nemer says BOMEX is reviewing the findings of OAH's judges and is proceeding cautiously.

Keen says that most of the doctors ordered to formal hearing aren't practicing, so the public wasn't put in danger by the wait. "In many instances, these were people who weren't practicing at the time," he says.

He's wrong. According to BOMEX's database, 15 of the 21 doctors ordered to formal hearing since 1992 are still eligible to practice.

The bottom line: The most serious complaints of physician misconduct have been left on hold for about two years.

Still, it's not like those cases are the exception. For most of the complaints at BOMEX, a two-year wait is better than average.

The Waiting Room
One of BOMEX's chronic maladies is its long-standing backlog of cases. Patients who want to see some kind of action against bad doctors are looking at a long wait.

The board currently has 993 complaints still open, according to a computer-assisted analysis, and the number grows every day. Since 1995, it's taken BOMEX an average of 477 days--nearly 16 months--to resolve a complaint.

The number of open cases before BOMEX has been a problem for years.
"There was always a backlog, but we could never figure out who to blame," former board member Burt Drucker says. "We did our best to protect the public and protect the doctors."

In 1994, BOMEX was criticized by the Auditor General's Office for the size of the backlog, which had reached more than 1,400 cases.

BOMEX's officials say they've made headway since then.
"The number of open cases is significantly lower than it was," Dr. Keen says. "We've reduced it by at least a third."

But not much has really changed in the four years since the audit's release. Even if you accept BOMEX's argument that the really, really old cases should not be included in any review of a backlog--since many of those cases are on appeal before the courts, and BOMEX can't make them move any faster--it still takes the agency about 250 days to resolve a case. That's still much longer than the 180 days recommended by the audit.

And it's longer than other states which have a similar number of physicians to regulate.

Connecticut, for example, takes just 7.2 months, on average, to resolve a case--about half the time it takes BOMEX. Connecticut also only has 629 cases open as of March, compared to BOMEX's 993. Colorado, which regulates a similar number of doctors, doesn't keep track of how long it takes to resolve complaints, but only has about 450 cases open now. Minnesota's Board of Medical Practice had 705 open complaints.

The board votes--without discussion--to dispose of dozens of cases each time it meets.

Myers, the doctors' attorney, notes that in 1996, the board reviewed 1,400 complaints. "You'll never convince me that 12 members . . . read every one," Myers says. "You'd have to work around the clock and not have a job to read all those medical records."

The reason for that, Myers contends, is because BOMEX is using a system developed in the '60s for the caseload of the '90s. Then, he says, there were only about 2,400 doctors compared to the 15,000 physicians now licensed to practice in Arizona.

Nemer disagrees that cases are being lost in the shuffle. She says the board moves swiftly if the public is in real danger.

Nemer cites the example of Dr. Allen Browne, the Mesa gynecologist accused of videotaping his girlfriend's daughters while they were in the bathroom. (He's currently awaiting trial on criminal charges.) Within two months of Browne's arrest, BOMEX had entered into an agreement to restrict the doctor's practice with some female patients, Nemer says.

Unfortunately, BOMEX rarely moves that fast. Most of the time, even serious complaints can be left behind.

Bedside Manner
Sexual misconduct is one of the most serious violations of trust between a doctor and patient. Keen says that BOMEX has a "zero tolerance" policy for doctors who cross that line. These cases are considered top priority and, under BOMEX's complaint prioritization guidelines, are supposed to be investigated and presented to the board within three months.

Instead, it takes BOMEX an average of 565 days--nearly two years--to resolve sexual misconduct cases, the database analysis shows.

And while the penalties for this kind of complaint are more serious than BOMEX usually hands down, in the past three years, no physician has had his license revoked for sexual intimacies with patients.

The wait turned out to be too long for Rena Headlee. She killed herself while she waited for BOMEX and the courts to deal with her accusations against Dr. Mark Goldberg of Mesa.

Headlee was one of two of Goldberg's patients who accused him of sexual misconduct. Before she died, Headlee said Goldberg prescribed painkillers for her and gave her free medical care in exchange for sex in his office.

She filed charges against Goldberg with the Mesa Police Department in February 1996, after someone at BOMEX discouraged her from filing a complaint with the state medical board, according to a Mesa police report.

"[Headlee] said the female she spoke with at the medical board asked her if Dr. Goldberg was married," the report states. "She asked [Headlee] if she knew the impact this would make on Dr. Goldberg. She warned that this could break up his family. The person suggested that it might be easier if she saw another doctor. She cautioned [Headlee] about making a complaint."

It wasn't the first time Goldberg had been investigated for sexual misconduct. The state Attorney General's Office had previously sent an undercover agent posing as a patient to see Goldberg after receiving a complaint about him.

Goldberg helped the agent create a workers' compensation claim for a bad knee, even though the agent told Goldberg she was in no pain. Goldberg also charged the agent for examinations that he never performed, according to records from both BOMEX and the Attorney General's Office.

Instead of prosecuting, the AG referred the matter to BOMEX, which questioned him about it in January 1996, just a couple weeks before Headlee went to see the Mesa police about him. The board censured Goldberg for helping perpetrate the workers' comp fraud, but dismissed the original sexual misconduct allegations. Staff concluded the allegation stemmed from a "vendetta" by Cyndie Mathers, the patient who lodged the complaint. She's filed a lawsuit against him, which is pending. In court papers, he denies any improper behavior or sexual advances.

Later in 1996, Goldberg was placed on probation by BOMEX for overprescribing controlled substances and for failing to read an x-ray which showed a tumor in the lung of a patient who later died of lung cancer.

Headlee's accusation of sexual misconduct was ordered to formal hearing at the end of 1996, and she also filed a lawsuit against him.

But because of BOMEX's dispute with the state's administrative law judges, the hearing was never scheduled.

Headlee shot herself in the head last June. She'd tried to kill herself before; this time she succeeded. Her complaint against Goldberg remains open, however, because the agency hasn't taken steps to resolve it.

Goldberg is still practicing today in Mesa.
Goldberg's attorney, Stephen Myers, says the charges against the doctor are groundless. "Nobody could prove this case, for the basic reason it's simply untrue," he says. "This case could be tried 100 times and Dr. Goldberg would win 100 times."

James Burr Shields, Headlee's attorney, thinks BOMEX drags its feet on sexual misconduct because the board members don't want to "soil their hands with these types of complaints."

Shields says he provided BOMEX with all of the evidence he'd gathered in the civil case, and BOMEX also has the results of the police's investigation and the attorney general's investigation.

"The evidence is there," Shields says. "They can't say the evidence isn't there."

But, Shields says, "BOMEX is much more comfortable with a chest x-ray than sexual complaints. They'd rather pass the buck and leave it to criminal prosecution."

Nemer disagrees. She says BOMEX takes sexual misconduct claims very seriously--which is one reason the agency takes more time with them.

"They're difficult and need to be investigated very, very carefully," she says.

BOMEX also won't take action while a criminal investigation is going on, Nemer explains.

"We wouldn't go charging in when we may actually compromise their ability to obtain evidence," she says.

Staff Infection
While BOMEX is supposed to be keeping track of Arizona's doctors, lately it's had a hard enough time keeping its own house in order.

BOMEX insiders, who didn't want to be quoted by name, say much of BOMEX's floundering when it comes to policing the medical community is simply the result of personality conflicts and office politics within the agency.

Over the last several months, the agency has been hamstrung by a personal conflict between Mark Speicher, the former executive director, and Nancy Beck, the assistant AG who acts as the board's legal counsel. Speicher was forced to resign.

In January, the board asked Speicher to step down after what some BOMEX insiders call a behind-the-scenes power struggle between Speicher and Beck. "It's not uncommon for the executive director of any agency to get fired; but Mark Speicher was ambushed," says one.

They say Beck wanted the executive director job herself. And she did apply for it after Speicher left. She didn't get it either, and the board has hired a California woman as its new director. She starts work next week.

Speicher declined to comment for this article, and Beck says she had nothing to do with Speicher's termination.

Beck says her own application for the executive director job wasn't a conflict of interest because she didn't advise the board on any matters related to Speicher, and she didn't even plan to apply until well after Speicher was fired. When asked about Beck's application, Keen said he didn't see any conflict, either.

Stuart Goodman, Governor Jane Hull's liaison with BOMEX, says there was some concern about the selection process. The governor appoints BOMEX members, and has started keeping a closer eye on the agency.

"To be candid, we thought that was bad form," Goodman says.
Some board members have had conflicts with Beck as well.
Burt Drucker, a former board member, says the board could run more efficiently with less interference from the assistant attorneys general.

Drucker says that at times he'd "cross swords" with Beck. At one point, Beck told him he had to recuse himself from a case. He disagreed--and walked out on a board meeting.

"I didn't go on BOMEX to be treated like a kindergarten student," he recalls. "I got extremely annoyed, I walked out of that meeting, it was near the end of my term, and I don't think I ever went back."

Beck says that board members are pleased with how she's done her job. "What I know is that we do an excellent job for the board, and they appreciate it," she says.

Speicher's departure might have been the most abrupt, but it wasn't the only one. Five other BOMEX staffers--one agency investigator and four medical consultants--have also resigned, hurting the board's ability to investigate complaints. And the board itself has only 11 of its 12 positions filled. (Last week, Hull selected another new board member: former legislator Becky Jordan, who is awaiting confirmation.) Spotty attendance by some board members has made it difficult to run meetings. The board was down to eight members before Hull began appointing people to fill the gaps.

Board member Carole Dooley says she also was thinking about resigning from BOMEX until recently.

"I had decided for all intents and purposes that I was going to resign because I just couldn't handle the pressure anymore, being the outsider, so to speak."

Dooley is the only current board member with no connections to the health-care industry; she's a hotel consultant. "Doctors are in their own world. On a number of cases, I have come down very, very hard on a number of doctors that the rest of the board was just passing off as something blase. And I really am there as a voice of the public, and looking at things in a different perspective," she says.

Dooley now says she's encouraged by the new members appointed by Governor Hull and by Keen's presence as chairman. Although Keen's two-year term will end July 1, he likely will stay on until a new appointment is made by Hull, which could be next year.

BOMEX, Hull and legislative leaders are hoping staff turmoil will be resolved when a new executive director joins the agency next week. She is Claudia Foutz, the executive director of the California Optometric Association. And she has her work cut out for her.

Face Lift
The arrival of Claudia Foutz as BOMEX's new director is being hailed in terms close to the second coming. But her hiring has also given those policy makers responsible for BOMEX an excuse to do nothing to improve BOMEX's performance.

At the very least, Foutz isn't intimidated by the challenge of BOMEX. She doesn't care about past staff intrigue and any problems that may have caused.

"I don't think that's news," she says. "That's gone, that's over, you've got a new director there, watch my smoke. I don't let conflicts happen under my watch. If they happened under somebody else's watch, then that's history."

She plans to hire more staff, increase the pay for BOMEX's medical consultants and invest in staff training.

"If we've got a backlog of 900 complaints, you can bet that--within 90 days--we're going to have a game plan to deal with those," she says. "We will end up with a three-year strategic plan that makes sense, that the common man can understand."

Hull wants to wait and see how Foutz works out before taking any action to beef up the agency, Goodman says.

"We're taking responsibility for making sure the board has the members to do the job it's supposed to do, which is to protect the public," Goodman says.

But, he says, it will be at least six months and maybe a year before Hull goes any further then making routine appointments.

"We're not dismissing the problems that have been there in the past," Goodman says. "But when you criticize BOMEX, you have to equally recognize that with new leadership, you can expect new changes."

Complaints about BOMEX's administration have been chronic, according to Representative Sue Gerard, who chairs the House of Representatives' health committee.

She says BOMEX is an independent agency, and that limits what both the governor and the Legislature can do.

"They really don't answer to anybody," Gerard says. "Even the Governor's Office, the only control they have is to appoint members."

Right now, BOMEX is undergoing another audit, due later this year. Even if the results are as dismal as the 1994 auditor general's report, little will change, Gerard predicts.

"This is exactly what will happen: The audit will come out and we'll have a meeting of the health committee and we'll ask them to explain it," Gerard says. "And they'll say, we have all these new board members and a new executive director and we're working on these problems. And then we'll give them a year."

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

Stephen K. Doig, Knight Chair in Journalism at Arizona State University's Walter Cronkite School of Journalism, assited with theis computer-based analysis.

DR. PHILLIP KEEN, chairman of the board, has been with BOMEX since 1991, longer than any other board member. His term expires July 1, but he will probably stay on until a new appointment is made. A trained forensic pathologist, Keen is also the medical examiner for Maricopa and Yavapai counties.

DR. RAM KRISHNA, Yuma, vice-chairman of the board, is an orthopedic surgeon who has held several leadership positions in the Yuma County Medical Society, including chairman. Krishna's term expires July 1, 1999.

CAROLE A. CREVIER, Phoenix, is secretary of the board and a "public member" of BOMEX--responsible for representing the public's interest at board meetings. She is also the executive director of a group practice of physicians and a former hospital administrator. Her term expires July 1, 2000.

DR. PATRICK CONNELL, Phoenix, is currently a staff emergency physician at Maryvale Samaritan Medical Center and Samaritan West Valley Health Center, and is also corporate business manager of Maryvale Emergency Physicians. His term expires July 1, 2002.

CAROLE DOOLEY, Tucson, is the board's other public member. She is the executive vice president of a hotel company. Her term expires July 1, 2001.

DR. TIM HUNTER, Tucson, was appointed to fill the term of former board member Rudolph Kirschner. A radiologist, he currently practices at the University of Arizona Health Sciences Center. His term expires July 1, 2001.

DR. PAMELA POWERS, Phoenix, is a psychiatrist and a former consultant to BOMEX. Formerly on the faculty at Good Samaritan, she now works with MedPro, providing psychiatric services in managed care. Her term expires July 1, 2002.

DR. EDWARD SATTENSPIEL is an obstetrician in private practice in Phoenix and has held numerous staff positions and professional leadership posts over a long career. His term expires July 1, 1998.

DR. EDWARD SCHWAGER, Tucson, is a family practitioner and medical director of Carondolet Medical Group, a health-care group with about 50 primary-care providers. His term expires July 1, 1999.

DR. WILLIAM WALDO practices as a general surgeon in Show Low. A former ER surgeon in Long Beach, California, and chief of medical staff at the Navapache Hospital in Show Low, his term expires July 1, 2000.

BECKY JORDAN is a former legislator. She was appointed last week to the board and still needs to be confirmed.

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