A neurosurgeon’s struggle with the state medical board [PODCAST]

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Neurosurgeon Jeffrey Hatef, Jr. discusses his article “Responsible till confirmed harmless? My expertise with a state medical board.” On this episode, Jeffrey shares the stunning story of how his medical license was summarily suspended with no listening to and the way incomplete data, flawed professional testimony, and questionable authorized techniques created a course of stacked in opposition to him. He recounts how impartial opinions from backbone surgeons and letters of help from practically sixty physicians affirmed his commonplace of care, but the board pursued the case with relentless willpower. Jeffrey emphasizes the hazards of a system that prioritizes profitable over equity, the impression on affected person autonomy, and the necessity for transparency and accountability in medical board proceedings. Listeners achieve an inside look into the excessive stakes of licensure protection and the significance of due course of for physicians.

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Transcript

Kevin Pho: Hello, and welcome to the present. Subscribe at KevinMD.com/podcast. As we speak we welcome Jeffrey Hatef, Jr.; he’s a neurosurgeon. As we speak’s KevinMD article is “Responsible till confirmed harmless: My expertise with a state medical board.” Jeffrey, welcome to the present.

Jeffrey Hatef, Jr.: Thanks for having me.

Kevin Pho: All proper, so I feel your story is articulated in your article, so why don’t we begin from there? Simply inform us just a little bit about your self after which your story that you just shared with us on KevinMD.

Jeffrey Hatef, Jr.: Nicely, I’m a neurosurgeon. I’ve been working towards for simply a few years. I completed residency in 2022, and the story I shared was about my expertise with our state medical board. I used to be summarily suspended in February of this yr and am telling the story of what’s unfolded after that.

Initially, I knew that some complaints had been lodged. I didn’t know by whom. However there have been a number of of them on a number of totally different sufferers. I’ve since realized that it was an previous colleague who was dissatisfied with me. However the abstract suspension simply got here out of the blue.

They got here to my home and served me with the suspension, and I had no thought the place this had come from. Judging from what I wrote within the article, there have been sufferers they usually did have unhealthy outcomes, however I didn’t assume that there was any malpractice or points with the usual of care.

Shortly after the suspension got here, I acquired a lawyer. We began our protection, we subpoenaed our personal data, and we quickly came upon what occurred. That was that the medical board had subpoenaed incomplete data. They’d solely subpoenaed and reviewed just some days of care centered proper across the surgical procedures, they usually didn’t see the whole lot of the care.

For all of those sufferers, I’d identified them for a lot of months; for the 2 sufferers with the unhealthy outcomes, for six months plus.

Initially, there have been three sufferers on this grievance kind for the suspension. For one of many sufferers, what the state’s professional with the state medical board had stated was primarily that the entire process was indicated and unwarranted.

For that affected person, they solely had data from the very temporary first hospitalization. I had finished a staged process on him and even on the time of the suspension, he had accomplished his surgical procedures. He had utterly recovered, and he’d gone from being on 30 to 40 milligrams of Oxycontin a day to being off ache meds utterly. It was actually an excellent success.

So, via my protection group, we’re sitting, we’re these data and we’re saying, “This isn’t proper. What occurred?” And now we all know they simply had incomplete data, however we nonetheless needed to undergo the method. We acquired our personal specialists.

We had 4 totally different specialists who all agreed with me that there have been no points with the usual of care in any way. We submitted this data to the board when it was required based on the timetables. And I anticipated that they’d in all probability simply dismiss the case. It was 4 to 1.

There was this error with the data, however we by no means anticipated what they did, which was to vacate the suspension and dismiss one affected person (the one the place probably the most egregious errors had been made, the one who did effectively) after which resuspend me for the opposite two sufferers and keep it up as if nothing had occurred.

Kevin Pho: Let me unpack a few of the issues that you just stated at the start. You stated that originally a few of these complaints got here from sufferers with unhealthy outcomes, however then additionally might have been initiated by a colleague that interacted with you previously.

Jeffrey Hatef, Jr.: We all know that now. Initially, I didn’t know who was submitting these complaints. The medical board had been in communication with me and stated, “Now we have some complaints.” And that’s the best way that the majority their investigations begin: via complaints. Sure. By legislation, they’re confidential. They’re not allowed to inform me who submitted the complaints initially.

All of the sufferers had been discrete; a lot of them didn’t even have problems. It was actually a random assortment of complaints and I used to be fairly confused. Now, and it’s via the medical board that we all know this, they had been considering calling this particular person as a witness, however I now realize it’s a former colleague who had left the observe who was simply submitting grievance after grievance.

Kevin Pho: So that you talked about that through the medical board course of, one of many complaints was dismissed, however then the opposite two you had been resuspended for. Inform us, while you had been speaking to your authorized group, you talked about that this was an entire shock. What was their response?

Jeffrey Hatef, Jr.: They had been completely astounded. My lawyer has been doing this. He began with the medical board as a medical board lawyer himself 25 or 30 years in the past, every time he acquired began, and he has been on the protection facet for many years. He stated he’s by no means seen something like this. So we instantly needed to deliver it into the courts, which is the place it’s now. However they stated it’s actually unprecedented and strange to say the least.

Kevin Pho: And from the medical board’s perspective, what was a few of the rationale behind their determination?

Jeffrey Hatef, Jr.: They didn’t record any rationale or describe something. If you happen to look on-line, you’re capable of finding a few of these public report paperwork and it actually simply says that on the board assembly, they described needing to vacate the suspension they usually simply go forward and do it. There’s not any dialogue or rationale about it.

Kevin Pho: And when it comes to the unfinished medical data that the board reviewed, what was the explanation that it was incomplete? Was it simply merely an oversight or was there any motive why they subpoenaed incomplete data?

Jeffrey Hatef, Jr.: Nicely, on the listening to, we had been in a position to name one of many principal board attorneys who investigated the case, and he or she did reveal that. She simply didn’t know that my employer was not the hospital. My employer was a special authorized entity.

So, I did these circumstances at a hospital, however I used to be employed via a separate medical group that employs a pair hundred physicians. All through the course of investigating me, she simply didn’t know that.

And so they submitted the subpoenas to the hospital, however the hospital is barely in possession of the hospital data and they also didn’t get the data they wanted. The neurosurgeon who reviewed them, the professional witness, he knew they had been incomplete and didn’t inform anybody about that. However we presume that no board legal professionals learn the data in any respect. They simply compiled them after which handed them off.

Kevin Pho: So that you’ve been going via this ordeal. You stated it began earlier this yr. We’re now talking in October, so about eight months. Inform us what your skilled life has been throughout that point.

Jeffrey Hatef, Jr.: None in any way. I used to be suspended in February. Initially, I used to be positioned on administrative go away as a result of a part of the abstract suspension is they are saying there’s clear and convincing proof, nevertheless it hasn’t been adjudicated. I didn’t have my say but, my listening to. However shortly thereafter, a few of the newspapers coated this after which my employer determined to terminate the connection. Since then, I can’t observe drugs. I don’t have a license.

As physicians, we don’t have a lot coaching to do the rest, so I’ve been occupying my time. We had a brand new child. I’ve been teaching my youngsters’ groups, I’ve misplaced some weight, issues like that. However professionally, there hasn’t been a lot apart from maintaining with CME.

Kevin Pho: So earlier than this incident, have you ever had any expertise with unhealthy outcomes, medical malpractice, or affected person complaints?

Jeffrey Hatef, Jr.: By no means. The one complaints had been those we now know are from this particular person. I had by no means been sued. No malpractice, nothing like that.

Kevin Pho: Now, as you mirror on this, and I’m positive you might have had plenty of time to mirror on this, is there something you assume that you may have finished otherwise to keep away from a state of affairs like this?

Jeffrey Hatef, Jr.: Nicely, I may haven’t taken on the complicated circumstances. However I don’t assume in the end that’s the reply.

When the complaints got here in, a board investigator spoke with me. I thought that they’d have just a little bit extra due diligence. Perhaps I shouldn’t have had that presumption and may have been just a little bit extra aggressive on my finish with authorized counsel forward of time. However even with that, I don’t know if something would’ve modified.

Kevin Pho: You talked about that physicians don’t get plenty of coaching for this, and that’s completely true. So inform me, what sort of help have you ever had and what sort of help would you wish to have had?

Jeffrey Hatef, Jr.: Nicely, I’m fortunate to have a very good household. My spouse has been utterly supportive. She’s a physician as effectively, a radiologist. That is a kind of issues. It’s not probably the most egregious accusation that the medical board may levy, nevertheless it was fairly unhealthy.

And I’m fortunate that buddies and colleagues have been supportive. A part of the method of going via the listening to was getting letters of help from the neighborhood. We had been fortunate; 60-plus members of the neighborhood wrote letters of help.

And that’s not even together with what I’ve since realized via another folks: that my former employer was discouraging anybody from talking out. So most of my colleagues within the medical group weren’t in a position to write letters of help after I know that they’d have. And plenty of of them had a really shut relationship with me.

Authorized-wise, there’s no coaching in any way. I take into account myself somebody that has an curiosity on this. I’ve written some papers on medical malpractice points after I was in residency and had an curiosity within the authorized side, and that’s let me work effectively with my lawyer, understanding a few of what’s occurring. However I by no means anticipated one thing like this occurring.

Kevin Pho: So presently the case is tied up within the courts. Simply define what are some potential paths ahead.

Jeffrey Hatef, Jr.: At present, the authorized side of that resuspension that they did is within the courts. The deserves of the case are working their means via the medical board course of. We had our listening to. The listening to examiner not too long ago produced a report, and this coming Wednesday, so I consider it’s the eighth, on the medical board assembly, it is going to be determined.

Kevin Pho: And from what you anticipate, is there a chance of a positive consequence? Is it 50/50? What’s your authorized group getting ready you for as potential outcomes?

Jeffrey Hatef, Jr.: What the listening to examiner stated was that his opinion was that one of many sufferers was inside the usual of care, one of many sufferers was not, and he really helpful a reprimand: principally the minimal tremendous and minimal punishment.

What we predict is that these points with the method of the medical board and in addition a few of the points with the board’s professional himself weren’t effectively accounted for by the listening to examiner. And we predict the board members themselves, the voting members, are more likely to pay just a little bit extra consideration to that. Now, is it going to be a dismissal? I don’t know. I hope, and that’s what I feel is the simply consequence. However in the end we’ll have to attend and see.

Kevin Pho: So via this entire ordeal, inform us a few of the issues that you just’ve realized about medical board politics and the affected person grievance course of that you just didn’t know earlier than.

Jeffrey Hatef, Jr.: I feel the principle factor I’ve realized is that a minimum of in our state, should you think about this as a legal state of affairs the place there’s a prosecutor and there are grand juries and judges, and there are lots of people at play. In our state, there’s the board workers, and there are two board members who’re the investigative members, that’s the secretary and the supervising member, they usually’re those who make this willpower that I ought to have been summarily suspended. They’re those who made the willpower to vacate the suspension and resuspend me.

The opposite board members aren’t in a position to evaluation any proof till now, till the case is over. So it’s actually plenty of energy entrusted to only two people with out another checks, so to say.

Kevin Pho: And these two people, have they got coaching in what you do, in neurosurgery? They’re each physicians?

Jeffrey Hatef, Jr.: No, they’re not neurosurgeons. They’re each physicians.

Kevin Pho: And in one of many circumstances the place they stated that what you probably did fell outdoors of the usual of care, are you at liberty to speak about extra particulars and whether or not you agree with that evaluation?

Jeffrey Hatef, Jr.: The whole lot is public report. We simply can’t use sufferers’ names. So something you’d like to speak about, I feel we will.

Kevin Pho: Certain. So inform us concerning the medical case the place they accused your conduct as being outdoors of the usual of care.

Jeffrey Hatef, Jr.: Each had been aged girls with spinal points. The primary one was in her late seventies and I’d identified her for a while. She had undergone a earlier spinal surgical procedure for a spinal fracture that didn’t stabilize the fracture, and so she had an unhealed fracture and he or she was growing spinal stenosis at that stage.

I first met her in spring of 2024, and at the moment she was in ache, however she was strolling. Over the course of about six months, it turned progressively extra painful with progressively extra deformity, and in the end she offered again to my workplace in a wheelchair.

We introduced her to the hospital and obtained pre-op clearance, and it was principally famous that it is a high-risk affected person. She’d had minimally invasive coronary heart surgical procedure earlier than; she had a left bundle department block. She had a lot of comorbidities. She was a troublesome affected person, a sick affected person. However she had extreme spinal stenosis and was barely in a position to transfer her legs.

So we talked to her and stated principally, “If we need to attempt to protect ambulation, we’ve got to try surgical procedure.”

And I did the surgical procedure with my companion. We had a bit extra blood loss than anticipated, however even the state’s professional agreed that each side of the surgical procedure was inside the usual of care: the blood loss, what I did, all of these issues. The state’s personal professional agreed that that was all to the usual of care.

She, sadly, did have a cardiac arrest shortly after we completed surgical procedure. We completed it efficiently, however her potassium was very excessive. And he or she did have a cardiac arrest, so it was a foul consequence. A really unlucky consequence, although. In no way what I anticipated, under no circumstances what I wanted for. Nevertheless it was actually the rationale and the argument that the board made that was complicated to me.

Initially, they stated that their professional stated I wanted to switch her to a different hospital. After we offered our reviews, we thought, “That doesn’t make sense.”

I did two fellowships in backbone deformity. I’m within the Scoliosis Analysis Society. That is what I do with my observe. I’m early in my observe, don’t get me mistaken. I’m not the senior man within the nation, nevertheless it doesn’t make sense that I must switch. We’re doing it at a serious city trauma heart.

After the state noticed these reviews, they modified their argument they usually stated, “Nicely, you didn’t must switch. However you simply shouldn’t have finished the surgical procedure. Nobody ought to have finished the surgical procedure.” And the state’s professional even stated, “Worse issues in life than being in a wheelchair. You must haven’t finished surgical procedure, ought to have allowed her to progress to develop into paralyzed.” Which is simply actually uncommon; it goes in opposition to every thing that you concentrate on when you concentrate on affected person autonomy and medical decision-making.

Kevin Pho: So that you clearly shared your story on KevinMD. You’re showing on this podcast to share your story. In your personal phrases, what’s the aim of sharing your story, and for the opposite physicians who’re listening to you, what sort of message would you like them to come back away with from listening to you?

Jeffrey Hatef, Jr.: The aim of sharing the story is simply that: to let folks hear what’s occurred, hear what’s persevering with to occur. I really feel I’ve been handled unfairly and unjustly, and I’ve all religion that the board members are going to make issues proper come subsequent week. Nevertheless it’s nearly getting the story on the market.

As for what suggestions I’d make to folks, it’s onerous. If you happen to’re going to tackle circumstances like this (frail, previous sufferers who’ve comorbidities however are going through paralysis), sadly, everyone knows in neurosurgery it’s such a high-risk subject that not every thing goes to go effectively. Not each subject has these dangers, however in neurosurgery, we all know that very effectively. Not each case goes to go the best way you hope.

So the query is, do you not do these for worry of the medical board? I don’t assume that’s truthful to sufferers. I’ve religion that the system goes to make issues proper and that the proper reply goes to come back down. However in the end I feel that it’s a must to do what you consider is true for the affected person.

Kevin Pho: We’re speaking to Jeffrey Hatef; he’s a neurosurgeon. As we speak’s KevinMD article is “Responsible till confirmed harmless: My expertise with a state medical board.” Jeffrey, let’s finish with some take-home messages that you just need to go away with the KevinMD viewers.

Jeffrey Hatef, Jr.: Simply what I used to be talking about, which is for clinicians to all the time do what’s proper for the affected person. Hold that in thoughts in the beginning, after which what occurs afterwards, you may take care of it. As I stated, I’ve religion that issues are going to be made proper and the simply consequence goes to come back. However we’ll take it one step at a time.

Kevin Pho: Jeffrey, thanks a lot for sharing your story, time, and perception. Thanks once more for approaching the present.

Jeffrey Hatef, Jr.: All proper, thanks.