Authorities: Physicians can be disciplined for allowing others to dictate decisions

BISMARCK — The State Board of Medical Examiners unanimously decided Friday that physicians can be disciplined if they allow others to dictate their medical decisions.

The action was taken following a request for guidance by Dr. Luis Vilella, the medical director for Workforce Safety and Insurance, the state’s workers’ compensation agency.

Vilella wrote the board in February, concerned that a draft policy circulating within WSI would allow managers to “dictate” his medical review of claims seeking benefits by injured workers.

Separately, Vilella told The Forum he had twice rebuffed managers’ attempts to have him alter his medical opinions.

He wanted to know whether, in performing his duty as medical director in reviewing claims, he was subject to the board of examiners’ purview.

If so, he wanted to know, if he allowed managers to dictate his medical opinion, could he be subject to disciplinary action?

The board unanimously answered yes to both questions — but made clear that its position on whether doctors could be subject to disciplinary action for allowing others to “dictate” their medical opinion was a broad finding, not meant exclusively for WSI.

Duane Houdek, an attorney and the board of medical examiners’ executive secretary, said the board’s only jurisdiction involves licensed physicians or physician assistants.

Therefore, he said, the board cannot and does not assess the policies of other agencies or institutions, including hospitals or state agencies.

“I was pleased with the board’s attitude and their interest in the matter at hand,” Vilella said.

Vilella, who has asked Houdek to put the board’s position in writing, said his understanding of the action makes clear that attempts by others to direct his medical opinions is not allowed.

He became concerned when a memo circulating within WSI said the attorney general’s office “saw no need to include counterarguments” in medical reviews, which Vilella said would allow others to dictate his medical reviews.

“Nothing should prevent or limit a physician’s ability to advocate on behalf of a patient or exercise his or her medical opinion free of interference,” he said, adding that was his interpretation of the board’s position.

Clare Carlson, WSI’s deputy director, said he welcomed the medical board’s input of its draft policy.

“We are not surprised by the board’s conclusions,” he said in a statement to The Forum. “The board confirmed that so long as our policy does not try to control the medical opinion within a medical review, our policy may guide the structure and the layout of medical review reports.”

He added that WSI will work to develop “improved policies for medical reviews consistent with the board’s review and guidance.”

Tags: news, crime, health