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Medical Boards: Last Week Tonight with John Oliver | Transcript

Main segment: State medical boards and their role in regulating medical malpractice. Other segments: Donald Trump endorses Mark Robinson in the 2024 North Carolina gubernatorial election, Vice President Kamala Harris calls for a temporary ceasefire in the Israel–Hamas war
Medical Boards: Last Week Tonight with John Oliver

Last Week Tonight with John Oliver
Season 11 Episode 4
Aired on March 10, 2024

Main segment: State medical boards and their role in regulating medical malpractice
Other segments: Donald Trump endorses Mark Robinson in the 2024 North Carolina gubernatorial election, Vice President Kamala Harris calls for a temporary ceasefire in the Israel–Hamas war

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[Cheers and applause]

John: Welcome, welcome, welcome to “Last Week Tonight!” I’m John Oliver, thank you so much for joining us. It has been a busy week. Biden gave his State of the Union speech to a room including George Santos in a bejeweled collar, serving a+ housewives energy. Sweden officially joined NATO, and the Bellagio shut down its fountains because, and this is true, a rare bird landed in them. And that’s a pretty good bird! Not the best bird, as we know, but still pretty good. Meanwhile, Kamala Harris nearly made big news when it seemed like she was issuing the call for a ceasefire in Gaza that people have been demanding for months now — only to step on the crowd’s enthusiasm with a pretty major asterisk.

Given the immense scale of suffering in Gaza, there must be an immediate ceasefire — [cheers and applause] for at least the next six weeks, which is what is currently on the table.

John: Wow. As calls for peace go, that’s right up there with “Mr. Gorbachev, tear down this wall… For a two-month trial period, after which, you can put it back up again.” It’s up to you. Harris forgot the cardinal rule that bad news should always come first. There’s a reason conversations at the hospital don’t go: your husband’s going to live…” “Oh, thank you so much, doctor — ” “for the next six weeks, too late, you thanked me, no takebacks, bye!” But we’re going to focus tonight on the 2024 election. Specifically, one of the down-ballot races that took place on Tuesday. Because north carolina republicans chose their candidate for governor this fall, Mark Robinson. He’s currently the state’s lieutenant governor, and won the nomination on the strength of, among other things, this high-profile endorsement.

This is Martin Luther King on steroids okay? Now, I told that to Mark, I said, “I think you’re better than Martin Luther King, I think you are Martin Luther King times two.” And he looked at me, and I wasn’t sure, was he angry, because that’s a terrible thing to say, or was he complimented? I have never figured it out. But I’m telling you… Right? When I said that to you, you looked like, “I don’t know if I like that comment.” You should like it.

John: Oh. There’s a lot there. From starting with “I think you are Martin Luther King times two” as if the only way for Trump to gauge black people is in factors of the other one he knows, to the way he said “you should like it.” Do you know how racist you have to be to give a black person a “compliment” that starts by quantifying their human value, and then ends with a demand? It’s a lot! Although, Robinson’s reaction to trump’s compliment might have been hard to read because his own feelings on MLK are, at best, complicated. He’s called him a communist on his Facebook page, and on a podcast appearance in 2018, expressed skepticism more generally about the movement king helped lead.

Robinson references what he calls the quote “so-called civil rights movement.” At one point, he talks about the sit-in movement in the ’60s. That movement began at Woolworths in Greensboro when the restaurant refused to serve blacks at the counter. Robinson referred to the movement as ridiculous and took aim at the civil rights movement itself.

So many things were lost during the civil rights movement. So many freedoms were lost during the civil rights movement. They shouldn’t have been lost.

John: Wow. That’s genuinely shocking. Not so much that someone is making controversial, inaccurate claims about the civil rights movement on a podcast, but that it’s happening without joe rogan occasionally popping in to say “that’s wild, bro” before pivoting to an ad for a protein supplement that promises to make your dick veinier. And if you’re wondering what on earth Robinson meant by that, his argument was that the sit-in participants in Greensboro shouldn’t have demanded to be allowed to eat at segregated restaurants, because that cost us the liberties of a free-market system. Which is the argument not just of an asshole, but an asshole on steroids. An asshole times two, if you will. So Robinson has some extreme views. And while some of them are par for the course for a Trump-endorsed conservative, he can still express them in striking ways. For instance, he’s a supporter of book bans and a staunch opponent of lgbtq rights, which he summed up in one appearance at a church like this.

Ain’t but two genders. Two genders. They’re dragging our kids down into the pit of hell, trying to teach ’em that mess in our schools. Tell you like this, that ain’t got no place at no school. Two plus two don’t equal transgender. It equals four.

John: I mean, to be fair, it does. He’s right about the very last thing there. It’s actually a great discursive tactic: finish an incomprehensibly offensive rant with one incontrovertible fact. I’ll show you. “Seagulls have no business being birds. They’re rats with wings, undeserving of flight. The capital of Turkmenistan isn’t seagulls. It’s Ashgabat!” Whatever weird shit I said about seagulls beforehand, your instinctive takeaway is, “well, I admit, he was technically right about the last bit.” Robinson also has some pretty intense, if unsurprising, views on abortion. He’s said the goal is to get it down to being banned after six weeks, and then just keep moving from there. And justifies his position like this.

We’re talking about a culture that we have created in this society that tells you, when you want to feel good, go on, go in there and go lay down and do your thing, and if you get in a little trouble, it’s all right to murder somebody to get out of it. It is not! You need to be the one in control of your body. And once you make a baby, it’s not your body anymore. It’s y’alls body.

John: That’s pretty bad! Though it sounds less like a stance on abortion and more like what Tommy Lee Jones would say about Vincent D’Onofrio in Men in Black. “When a space cockroach wears your skin like a suit? It’s not your body anymore. It’s y’alls body.” Also, I will say, if the women of this country do think its all right to murder someone to get out of trouble, they are currently showing incredible restraint. Robinson’s whole career has been built on saying attention-grabbing things — his big break came just six years ago, when he spoke at a city council meeting in support of gun rights, and referred to himself as “the majority” in opposition to “loonies from the left.” It quickly went viral, making him a conservative rising star overnight. But his journey to that point actually began online. If you read his memoir, which I do not advise, he talks about how, when he first joined facebook in 2007, “I did so for one reason and one reason only: to talk about professional wrestling.” But then, quickly realized he could get more attention for saying wild political stuff and making awful memes, explaining, I wanted to be as demonstrative as possible, because I wanted people to, as the guy said, “come at me, bro.” “I wanted people to read my page and go “what did he say? Did he really say that?” And that’s what happened.” And boy, did he get his wish. Because people have been going through his Facebook page, and I’m guessing, saying exactly that.

Robinson has a history of making statements on social media that Jews and others consider to be anti-semitic. He said the movie black panther was, quote, “created by an agnostic jew to pull the shekels out of your schvartze pockets,” using the Yiddish words for money and black. Asked about those comments today, Robinson said they were poorly worded.

John: Yup. I don’t think the problem was that they were poorly worded. Poorly worded is something like “you have been broken up with by me.” I think the main issue there was his flagrant antisemitism being worded at all. This guy clearly isn’t martin luther king on steroids, if anything, he’s much more like your shittiest uncle on Ambien. Because he has a long history of willfully provocative posts, including one where he complains that the liberal media always talks about the “6 million Jews” killed in the holocaust, in scare quotes. He also once quoted Hitler on Facebook and then defended it by saying that quoting him doesn’t mean he supports him and that “I guess every history book in America supports Hitler now.” Which is bullshit for a bunch of reasons, including that a history book and a personal Facebook page are very different. Context matters. That’s why you’ll never see a motivational poster at HomeGoods that says “never lose hope, be persistent and stubborn and never give up” ” Ted Kaczynski. Actual quote, by the way. But wait, there’s more. He’s also referred to the parkland shooting survivors as “these silly little immature “media prosti-tots,” posted this image of himself with a sign reading, “Beyonce’s songs sound like satanic chants, change my mind,” and has said “I truly believe that the “judgment” format of these “reality” competition shows like American Idol, Dancing with the Stars and Chopped, is a sign of things to come in the reality of the new world order.” A bonkers take that he explained by saying, the format of these shows reminds me of Stalin’s “show trials” where people were lined up and judged then executed. Of course no one is being killed but all the elements are still there. Sometimes I think these shows are setting people’s mind on this type of format for a more sinister reason.” And while that seems very unlikely, if we did learn that “dancing with the stars” was secretly a state-led brainwashing campaign to get us more comfortable with public executions, I’d immediately have a hell of a lot more respect for that show. At least it’d be trying something daring, rather than have a Chmerkovskiy brother perform yet another uninspired foxtrot. Again and again, Robinson’s gone out of his way to say the worst things in the most provocative way.

We are called — getting ready to get in trouble, called to be led by men! God sent women out when he was supposed to do when they had to do that thing, but when it was time to face down Goliath, he sent David, not Davita, David! When it was time to lead the Israelites out of Israel, he sent Moses, not momma Moses, daddy Moses! See, god knew what he was doing when he made men big and hairy and ugly ’cause you’re supposed to scare away predators, whether they’re in the woods or standing in front of your kids in elementary school.

John: What’s going on there? Is this a sermon or are you working on stuff for a shitty Netflix special? Also, if you’re going to make the argument that men are better leaders because they can fight, those are two terrible examples. When did David or Moses ever throw hands? They defeated their enemies through, respectively, a slingshot and magic. One thing any gender can do, and the other, no one can. Also, “big and hairy and ugly?” This twink? Please. Please. And look, we’re almost certainly not done learning things about Robinson. But the depressing truth is, he’s not an outlier. He’s a pretty good marker for where his party is today. Because republicans have gotten steadily more radicalized on sites like facebook, and it was just a matter of time until online trolls crossed over from ranting about policy to writing it. It’s all pretty bleak, and hopefully, if the people of north carolina do the right thing, the number of years this particular troll serves as governor won’t be two plus two. It’ll be fucking zero.

[…]

John: Moving on. Our main story tonight concerns medicine. The thing that tums technically are, even though personally, I consider them candy. Medicine is obviously a high-stakes profession, and mistakes can happen, as evidenced by scenes like this, from the procedural drama 911: Lone Star.

Fred? No pulse. I’m starting compressions. Medical’s here.

John: Okay, you’ve probably got a lot of questions, so let’s dive in. “Why did that guy’s chest cave in?” He was frozen. “How did he get so frozen?” He go stuck in his in-home cryotherapy chamber. “What?” He was a billionaire who had a cryotherapy chamber in his home, and got stuck in it after entering the wrong setting and after getting paralyzed because of the poison he’d been trying to use to kill his wife — the blonde lady — with whom he had an open marriage, and who, yes, good guess, was fucking rob lowe. And finally, why was that man’s chest hollow?” Honestly, I’m not sure about that one. I didn’t think cold temperatures automatically turned human beings into hollow chocolate bunnies, but I admit, I’m not a doctor. And look, in that case, the mistake of performing chest compressions on a man who’s frozen solid, at most, added insult to injury. But in other instances, medical errors can have far more dire consequences. And they’re more common than you might think — a 2016 analysis concluded that more than 250,000 deaths per year are due to medical error in the U.S., making it the third leading cause of death. Now, I should say– most of those errors are systemic, rooted in things like poorly coordinated care or fragmented insurance networks. And good doctors can make honest mistakes — the human body, after all, is a sloppy puzzle of wet nooks and dry crannies. Every inch of this skinsack is confusing. So let me be clear: this isn’t going to be a takedown of medicine. I don’t want anyone to spin this into a headline that says “John Oliver, champion of illness and death, finally destroys doctors.” Doctors are great! They’re one of the top things any parent would say they want their kids to be, besides engineers and “just like, not annoying.” The vast majority of doctors are dedicated professionals who strive to meet reasonable standards of care for their patients. But a small fraction aren’t, and can end up doing shit like this:

A doctor performed surgery on the wrong baby.

There’s no excuse for operating on the wrong baby.

Investigators say the 52-year-old doctor actually admitted to using drugs while conducting his medical practice.

In videos she posted online, dr. Windell Davis-Boutte is both dancing dermatologist and singing surgeon. She mugs for the camera and raps with an unconscious patient inches away.

♪ Gut don’t live here anymore. ♪

John: Look, there are many situations where it’s appropriate to dance — like at a wedding, or when a cartoon racist shoots at your feet, or on a certain grave. But in the middle of surgery is not on the list! There’s a reason the Hippocratic oath doesn’t go: first, do not harm. Then, slide to the left! That doctor, unsurprisingly, has been sued multiple times by patients, who claimed her negligence left them disfigured and, in one case, brain damaged. And those sorts of errors — ones caused by negligence, incompetence, or misconduct — are a cause for serious concern. Because a very small number of doctors can commit a lot of them in fact, one analysis found that less than two percent of physicians were responsible for half the money paid out in malpractice suits over 25 years. Now, the good news is, there’s a regulatory body that’s supposed to protect us from bad doctors: state medical boards. These are panels whose job it is to issue licenses, suspend them, or in extreme cases, take them away. Hospitals can fire a doctor, patients can sue them, but only a state medical board can ensure they never practice medicine in your state again. That dancing doctor was suspended by her state’s board. But that’s actually a pretty rare occurrence. Because the percentage of physicians who face any sort of real consequences from medical boards can be surprisingly low. One study found that, nationwide, of nearly 900 physicians who had been judged by their own peers to be an immediate threat to health or safety, only around half had ever had licensure action taken against them. And even some doctors will tell you this is a problem. Like this one, who actually ran Mississippi’s medical board.

What folks have to realize is that the medical board is not a substantial barrier to them being injured by a physician.

John: Well, that’s not great. It’s probably one of the least reassuring things a doctor could say, besides “oopsies!” Or “I’m running for senate.” So given that these boards seem so lax, and the stakes are so high, tonight, let’s talk about state medical boards. And let’s start with how they’re supposed to work. While boards’ processes vary widely from state to state, very basically, when a board gets a complaint, they review it and if they find it credible, investigate. And if they want to take action — like suspending or taking away a license — that can start a lot of negotiations between the doctor and the board. So it’s a long process that can be very expensive. Which is a problem, given that many medical boards are strapped for resources. California’s, for instance, has openly called itself “severely underfunded,” and an outside monitor found that that’s led to “delays, disruptions, and other investigation deficiencies.” And that may help explain why, in many states, cases can move slowly. One local-news investigation in Nevada found that some cases had spent up to seven years under investigation with no resolution. And think about that: that means, if a case was resolved today, it could’ve been filed in 2017! In that time frame, we’ve had a global pandemic, a president who looked directly at a solar eclipse, an armed insurrection, a different president who ended a speech on gun control with “god save the queen, man,” a Sophie Turner-Joe Jonas wedding, a Sophie Turner-Joe Jonas divorce, and the entire series run of “the marvelous mrs. Maisel.” 7 years is just 7 years, but it’s also 6,000 years. And all the while, doctors can continue to practice. Boards can continue deliberating, even if a doctor’s been convicted of a crime. Take dr. Ghyasuddin syed. A few years ago, he pled guilty to conspiracy for funneling lab testing to a company in exchange for kickbacks — but even after that, texas’s medical board was still deciding what to do about his license. Which is especially wild, because this was not his first go-around with the board.

In 2016, the board found syed had failed to meet an adequate standard of care. In 2019, the board found he was prescribing drugs to patients he should not have been. And just last year, the board ruled the doctor behaved inappropriately with three female patients. Syed kept his medical license through all of it. Has it right now. Is still seeing patients!

I mean, you’ve been convicted of a serious crime by the federal government.

Yeah, I — yeah.

You’re going to report to prison in a few months.

Yeah.

John: That’s some oddly upbeat energy, given the question he’s responding to there. But think about that — he was still practicing medicine when that interview happened! For all we know there was a patient waiting for their appointment to start, wondering what the holdup was, and then a nurse came in and said, “dr. Syed will be right with you, he’s currently on the news admitting, weirdly happily, that he’s going to prison. Just go ahead and put on a gown.” And the fact that doctors can keep treating patients while their case goes through the system can be infuriating to anyone who gets hurt in that time. Take this woman, who says she underwent a botched cosmetic surgery that resulted in sepsis and an unplanned double mastectomy. It was only afterwards that she learned some troubling details about her doctor, and a prior case he’d had where a patient died.

The medical board of California had actually reached a decision about dr. Malavi in the 2018 patient death this past May, but it wasn’t until October that decision took effect and Malavi’s medical license was suspended. It was within that five-month window in August — before any discipline — that Millie had her surgery.

I think that things need to change. I think that the laws need to change. I think the medical board needs to change. I mean, I’m a hairdresser and the state board of cosmetology is so on you. I mean, for hair. Why isn’t it like that for our doctors?

John: She’s right. And look, I say this as someone who has gone through my fair share of high-stakes hair butcherings in the past — but even I think medicine should be regulated more tightly than hair. So medical boards can be underfunded and slow, and patients can suffer in the gaps. But the problem isn’t just one of resources, it’s also who’s on these boards. Because most are made up heavily of doctors. Which makes sense! There are many scenarios where physicians have to make difficult decisions that only other medical professionals can effectively judge. But it’s generally agreed that boards should also feature public members, like advocates, who can speak on behalf of patients. The thing is, that doesn’t always happen. The Federation of State Medical Boards recommends the public should make up a quarter of each board’s membership, but only about half the boards across the nation meet that standard. In fact, up until recently, Louisiana’s board didn’t have a single member who wasn’t a physician. And that can be a problem, because doctors tend to protect their own. Just listen to this man, who served as one of the non-physician members on California’s board, describe what he saw in the room.

The way they speak is always with doctor care in mind. You never hear patient care ever. And, I mean, ever.

Do you think the way the medical board functions in the state of California actually ends up costing patient lives?

There’s no question that it costs patients’ lives.

John: Yeah, it’s not ideal if a board never thinks of patient care, since patient care is kind of doctors’ whole thing. Without patients, doctors are really just failed urine collectors. That guy has actually called for California to be much stricter with physician misconduct, and it’s kind of telling the extent to which some of the doctors who served on that board with him didn’t appreciate his input.

One physician member on the board chastised Watkins last month for rocking the boat.

In my eight years on this board, I have not encountered another board member who has been so negative about our process as Mr. Watkins.

John: Wow, that’s pretty harsh. Although I have to say, I have not encountered another person who looks more like a long-lost member of the Trump legal team. He looks like someone you’d expect to see selling scalped tickets for a Bon Jovi concert outside Madison Square Garden. I could go on, but I won’t. Except, I’ll do one more. He looks like the “before” photo in a Rogaine commercial starring Al Pacino. Okay, now I’m actually done. Also, saying you’ve never encountered someone so negative about your medical board’s process might say less about that guy, than it does about your process. Because reticence about punishing fellow doctors is part of a much bigger problem in the culture of medicine — it’s a phenomenon so common, it’s been called “the white coat code of silence.” In fact, even when medical boards initially hand down harsher punishments, doctors can still negotiate lighter sanctions with them — which boards, too often, can contrive weird excuses to do. Take this case, of a doctor who was illegally convicted, who’d written prescriptions for over a million pain pills.

In 2016, the board’s own records show he was suspended for operating an unlicensed pain management clinic, where nearly 10,000 prescriptions for controlled substances were written. But 10 months later, the board lifted his suspension. In its records, the board cites factors like he expressed remorse, had a genuine misunderstanding of pain management requirements, and was a very young and inexperienced physician, even though he was 46 at the time, and had been practicing for over a decade.

John: Yeah, I don’t know if 46 counts as “young and inexperienced.” I’m 46, and I’ve been doing this job for over a decade, and people could say many things about me. “He’s squawky,” “he’s hyper,” “he’d seem more like a coked-up Sotheby’s auctioneer than a comedian if it weren’t for how much he hates everything about Sotheby’s” — but no one would say “very young and inexperienced.” It’s just objectively not true. This leniency can even extend to doctors who’ve engaged in sexual misconduct. A 2016 investigation found that some doctors who’d sexually violated patients were returned to practice with as little as a three-day course on appropriate doctor-patient boundaries. Which really doesn’t seem like enough. If you asked me to guess how long they should face discipline for, I’d definitely say “something longer than one lollapalooza.” In fact, nationwide, that investigation found “of the 2,400 doctors publicly disciplined for sexual misconduct, half still had active medical licenses.” And this was particularly bad in some states — “Georgia and Kansas, for example, allowed two of every three of those doctors to return to practice” while “in Minnesota, it was four of every five.” Which is so bad, I’d like to propose a new state slogan for Minnesota: land of 10,000 — actually, forget about our lakes, someone needs to figure out what’s going on with the doctors here. Jesus.” So, to recap: punishments for doctors can be rare, light, and dangerously slow in coming. And there’s one more issue here, which is that you may simply never find out about them. A recent survey found it remains too difficult for the public to find complete information about physicians on their state medical board websites, due both to poorly designed and confusing websites, and to gaps in the types of available information. And what that means is that sometimes, the only way people learn about a doctor’s past is if a news organization looks into it. This man’s mother was left paralyzed after a spinal surgery, and when CBS looked into the doctor involved, they discovered some awful facts.

We dug through stated and court records and found that Dr. Svabek lost his surgical privileges at two Indianapolis hospitals after his “practice fell below the standard of care” and concerns were raised about his “honesty and truthfulness.”

Dr. Svabek has settled five suits over more than a decade, the most of any orthopedic surgeon in Indiana in the last 20 years. I don’t know if you’re aware of this or not.

I had no idea.

You know, kind of like when where you buy a car, it has a carfax. You know, it’s almost like a doctor should have a doctor fax.

John: Yeah, there probably should be! Because doctors know everything about us — if we smoke, if we’re depressed, how deep all of our holes go — but we know next to nothing about them. Now, the good news is, there actually is something like that — the national practitioner data bank, or npdb. It’s a federal repository of information on medical practitioners, including board discipline, hospital discipline, and malpractice payments. Which sounds great! Unfortunately, you can’t access it — it’s only available to hospitals, medical boards and a few select medical and government entities. On top of which, not all problem doctors show up in it. In fact, over the past 13 years, of the over 6,000 hospitals in this country, only around a third submitted at least one report on action they’ve taken against a doctor. Which feels suspicious, because I doubt two-thirds of hospitals have gone 13 years without a single doctor fucking up. And one reason for that is, hospitals can find ways to skirt the reporting requirements. For instance, they’re required to report a doctor who loses privileges for more than 30 days, but sometimes, hospitals will just limit the term to 29 days, so it doesn’t have to be reported. And this can be for multiple reasons, including that they might have an investment in their doctors’ reputations. In New Hampshire, this top-earning cardiac surgeon was once featured in ads for his hospital. But even as he racked up one of the worst surgical malpractice records among all physicians in the United States, he wasn’t reported to the NPDB. And even after a serious incident — when he was on call, but “did not come to the hospital for hours despite repeated phone requests to deal with a patient having a life-threatening situation” — he was suspended for 28 days, a number conveniently just shy of what would’ve been required for him to be reported to the database. And I’d say that was the most shameless coverup in a hospital I’ve ever seen, but I have seen this episode of Melrose Place where dr. Kimberly shaw tries to throw people off the scent of her involvement in a hit-and-run.

Think about it. The driver of that car was wearing a short blond wig. Now, how could I get all this hair beneath something like that?

Does this answer your question?

You’re a dead man, fielding.

John: That is television right there. Step aside, 911 Lone Star, Melrose Place walked so that you could run. But even if a doctor is reported to the database, that report still might not be seen. Because incredibly, some state medical boards simply don’t check it when granting licenses to doctors who’ve moved from out of state. In 2017, thirteen state boards didn’t check it once. And some states, including — until recently — Texas, even employ an honor-system approach, which relies on physicians to self-report. But guess what? The bad doctors tend not to do that, because they’re bad doctors. So unsurprisingly, when a Texas news station bothered to look into who was practicing in their state, they found 49 doctors who’d had their medical licenses suspended, surrendered or revoked in other states. And some of the stories were shocking.

Among the doctors currently practicing in Texas, a Colorado neurosurgeon disciplined for performing surgery on the wrong spinal disc. A Wisconsin orthopedic surgeon whose license was suspended indefinitely for operating on a patient while intoxicated. And a Florida doctor reprimanded for prescribing, quote, “excessive quantities of oxycodone leading to a patient’s death.” All of them still showing a clean record in Texas.

John: Yeah. A surgeon who operated on the wrong part of someone’s spine still had a clean bill of health in Texas. And you know who probably doesn’t? His fucking patient. But it’s not just Texas, at least 500 physicians who have been publicly disciplined, chastised, or barred from practicing by one state medical board have been allowed to practice elsewhere with a clean license. And some have almost made an art of it, like this cosmetic surgeon, who was disciplined in 2015 after a patient’s death in Oregon. He then began practicing in Illinois, where he was investigated after another patient died in 2016. Five years after that, Illinois Medical Board declared him an immediate danger to the health and safety of the public and suspended him for at least 18 months. But you’ll never guess what happened next.

Despite being found to be grossly negligent in multiple cases across two states, dr. Sharma still held an active medical license in one state: Indiana.

We’re working late today, okay —

And as we discovered —

We’re partway through the transformation.

He’s actively practicing there today.

John: Yeah, he wasn’t just still practicing, he was broadcasting it online, too. And general tip, if any part of your “get ready with me” routine involves scrubbing up, just stop recording right now. Because there are a few things I just never want to see my doctor do: cry, get drunk, or say “hey guys, welcome to my channel, we’re workin’ late tonight” over my unconscious nude body. But the larger fact is, if you’re a doctor with a trail of irreparable harm behind you, it seems you can just hop around until you find a state that’ll look the other way. It’s just one of ways that doctors are like catholic priests, along with the fun outfits that are just fancy pajamas and thinking they’re basically god. And incidentally, if you want to check yourself whether a doctor’s been disciplined out-of-state, that might be difficult. Because a survey a few years ago found that the medical board websites in all these places don’t include actions taken in other states. Honestly, based on what we’ve seen so far, the best thing you can do as a patient to successfully vet your doctor might be to check TikTok to see if they’re posting videos of their surgeries online, because that seems to be the only surefire sign of disaster. So, what can we do? Well, first, we need to acknowledge that doctors have powerful lobbying groups that have fought medical board reform hard, so change is going to be difficult. How difficult? Well, in researching this story, we found this CBS report from nearly forty years ago that could’ve aired last week. It featured a bad doctor who’d moved from state to state to state to avoid consequences, and this explanation of the larger problem.

The Massachusetts board, indeed, most state boards, suffer from underfinancing, understaffing, and under-organization. The board here employs only two investigators. Staffed mostly by doctors, consumers, lawmakers and even some doctors are now asking whether the medical community can police its own and still provide quality care.

Most doctors in this country are practicing good medicine. Most of the 400,000 doctors, but perhaps 10, 20, 30, 40,000 doctors are not practicing good medicine. Most of them are never disciplined. It’s too dangerous a situation to keep tolerating.

John: Yeah, it is too dangerous a situation to keep tolerating, but it seems like we’ve done it. Because that’s from four decades ago. It’s this whole story, with warning signs about funding and calls for reform, and it’s been told by, let’s be honest, a much hotter me. But regardless — you laughed too hard at that. But regardless, there are some obvious steps we could take. Lawmakers could add more public members to state medical boards, and increase their funding. They could also require that all disciplinary actions taken against a doctor in whatever state they’ve worked in, plus info like malpractice settlements, be easy to find on a public website. And while we’re talking transparency, the NPDB was created exactly for that reason, so state boards should be required to regularly use it. Look, the vast majority of doctors help people and are worthy of the value that society places in them. But this is a field that relies, pretty uniquely, on absolute trust. And again, I’m not saying all or even most doctors are bad, nor am I telling doctors how to do their jobs. I’m only 46, so I’m very young and inexperienced. But what I am saying is it would serve everyone — including those many good doctors — to fix this mess, because the way we’ve been running medical boards is a bit like giving CPR to a frozen solid man. It’s absolutely baffling, and I can’t believe someone ever thought it was a good idea.

[…]

John: That’s our show. Thanks so much for watching! We will see you next week! Good night!

[Cheers and applause]

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Hierarchy – Episode 2 | Transcript

After Kang Ha’s daring stunt at the party, he faces the vengeful Kim Ri-an at school. Later, at a retreat, Kang Ha and Jung Jae-i begin to get closer.

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