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Md. board backs continual monitoring of charges against doctors

A Maryland board is proposing continuous monitoring of doctors for criminal activity.

Maryland doctors would be fingerprinted and continually monitored for criminal charges under draft legislation the state Board of Physicians plans to propose next year.

The policy would require them to apply for a background check when first seeking a medical license, or for currently practicing doctors, when they next renew their licenses. Background checks would occur once for each doctor. The board plans to use an FBI program that allows indefinite monitoring that would alert regulators to any new criminal activity.

But the proposed legislation does not prescribe circumstances under which the board would deny or revoke a license, instead giving officials flexibility to consider the severity of the crime, the applicant's age when it was committed, how much time has passed, and what he or she has been doing since.

The legislation would close a regulatory gap exposed when a former Catonsville family doctor was charged with sexually assaulting a female patient in Western Maryland. The charges were dropped when he surrendered his license. The Baltimore Sun reported that the doctor had been convicted of rape in Florida nearly 30 years earlier, unknown to Maryland health officials who granted him a medical license in 1996.

The measure is expected to receive broad support because most professionals in the state, including nurses, therapists and social workers, are subject to criminal background checks. Maryland is one of few states that does not include doctors in that group. A state doctors association said the proposed policy appears reasonable.

"This is a really sorely needed legislative fix to help increase the public's protection through stricter licensure standards," said Dr. Devinder Singh, chairman of the Board of Physicians.

The board began researching a background check policy this summer as it investigated how Dr. William Dando was granted a medical license despite having disclosed that he had once faced criminal charges for "assaulting someone." When doctors apply for a license in Maryland, they are asked to disclose any arrests, charges or convictions for crimes "of moral turpitude." If they do, board officials are supposed to investigate further.

Dando was convicted in 1987 of following a Florida woman home and raping her at gunpoint, and served four years of a 10-year sentence. Within two years of his release, he was treating patients as a resident at the University of Maryland Medical Center and was licensed in 1996.

But the rape conviction never came up during his licensure, or when he faced disciplinary action in 2009 for failing to meet standards of care with several patients.

Under the proposed legislation, new applicants for licensing as a physician, physician assistant or other health professions would be required to undergo criminal background checks starting Oct. 1. The Board of Physicians oversees doctors and nine other "allied health" professions.

When doctors renew their licenses starting July 1, 2016, they would also be subject to background checks. Renewal occurs every other year.

Doctors would not be required to apply for a new check at each renewal. The Board of Physicians is covering the cost of the FBI's "rap back" services, which allows authorized agencies to be notified if any criminal activity is reported after a check is performed. The checks would occur through the Maryland Department of Public Safety and Corrections' Criminal Justice Information System, which maintains databases of fingerprints, criminal identification and criminal record information for the state.

Should a background check turn up a criminal history for a doctor, the proposed bill suggests that the board consider the applicant's age at the time of the crime, the circumstances, the amount of time since the incident and work history over that period. It suggests use of employment and character witnesses.

Singh called it a moderate amount of leeway for regulators.

"If we do find out somebody shoplifted a Snickers bar in 1986, it doesn't necessarily mean their license is going to be revoked," he said. "The board has discretion to look at that and figure out what the appropriate sanction is."

Gene Ransom, CEO of MedChi, the state's medical society, said he expects his organization to support the measure. MedChi supports the background checks, but officials were concerned that the board might place too much of a burden on doctors by requiring frequent checks.

"It looks like they've come up with a pretty reasonable solution," Ransom said.

Singh said he is "extremely optimistic the bill will pass." The Maryland General Assembly has passed laws in recent years requiring background checks of chiropractors, counselors, physical and mental health therapists, and mortuary drivers.

"It's a public safety issue. It's a patient safety issue. It's a quality of care issue," said Sen. Joan Carter Conway, a Baltimore Democrat who said she plans to sponsor the bill.

Del. Eric Bromwell declined to speak on the pros and cons of the proposed bill, but said he will consider it in his role as chairman of the health facilities and occupations subcommittee of the Health and Government Operations Committee.

"We've worked it out in the past as far as background checks for other occupations," the Baltimore County Democrat said.

Maryland is one of 13 states that does not conduct background checks on physicians, according to the Federation of State Medical Boards.

In 2007, instituting a background check policy was among 31 recommendations state auditors made to the Board of Physicians. Though the Assembly passed legislation that year reforming the way the board handles doctor discipline, it did not include a background check provision.

Two bills were proposed in 2013 that would have given the board authority to conduct background checks, but both were withdrawn after the state attorney general's office raised an issue with a single word in both: "may." To access a national FBI database of criminal records, a state law must require background checks, not simply allow them to be conducted, the attorney general's office said.

The proposed legislation says applicants "shall" apply for background checks before being granted licenses.

Implementing the policy could be a challenge for the board, Singh acknowledged. It oversees 29,000 doctors and 14,000 other health professionals in the state. In the first few years after any background check policy would be enacted, the board would be flooded with information about all of them.

Board officials plan to consult with the Board of Nursing, which oversees much larger numbers of nurses in the state, for advice, Singh said.

"It's going to be an incredible volume of information we need to administratively prepare for," he said.

Baltimore Sun reporter Colin Campbell contributed to this article.

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