Physician, heal thyself

The files are thick with tales of second chances. And third chances too.

When a doctor gets in trouble in Utah — gets addicted to drugs, steals drugs, has sex with a patient, even kills a patient through sloppiness and neglect — most of the time the state will try to rehabilitate him so he can continue to practice medicine.

According to statistics gleaned from the Federation of State Medical Boards, Utah would rather put a physician on probation than take away his license. In fact, Utah ranks dead last among the states in percent of revocations, suspensions and surrenders of licenses, choosing instead to let doctors keep practicing with a restricted license.

Redemption and retribution are counterbalances in a system designed to protect both patients and doctors.

Stephanie Puffer has been trying for years now to reconcile her compassion and her anger toward doctors who get in trouble, especially those who backslide more than once.

In the summer of 1996, Puffer had a C-section that she says left her with a torn bladder and recurring pain. She says it caused her son to have residual developmental problems and, now, a brain mass that she has been told may have resulted from the traumatic delivery. She has filed a lawsuit against the physician and hospital, alleging that her obstetrician's ongoing drug use — and the hospital's decision to give him a second and third chance at recovery — put her at risk. She is also considering a suit against the Utah Division of Occupational and Professional Licensing (DOPL).

"If someone can look me in the eye and give me an explanation as to why this was allowed to happen, I would give my undivided attention," she says. "I am teachable, just give me an explanation, and show me where it is written in Utah law or federal law that regardless of repeat offender practices, a doctor is given multiple opportunities to screw up."

Someone needs to be an advocate for patients, she says. "Someone needs to stand up and say, 'No, if you have been disciplined with substantiated evidence of substandard care, diversion of medication, improper prescriptions,' when is enough enough?"

But even when a doctor relapses, that doesn't mean he's irredeemable, argues Dr. Michael Crookston, psychiatrist and medical director of LDS Hospital's Dayspring program. "Do you kick him out of medicine and flush all that experience, or do you do what you can to monitor and intervene early if someone is sliding, so he can continue to practice?"