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Deadbeat doctors face harsh medicine from Uncle Sam


For federal prosecutors, Dr. Thomas A. DiGiovanna is never "in."

The U.S. attorney's office has been trying to see him for nearly two years, but not for medical treatment -- it says it's seeking justice.

Dr. DiGiovanna is on the government's list of eight "deadbeat doctors" in Maryland -- those who refuse to honor their agreement to practice in medically underserved areas after receiving government scholarships to put them through medical school.

The former Johns Hopkins Hospital emergency room surgeon is charged with failing to meet the obligations of a $36,498 National Health Services Corps scholarship that helped pay his way through the George Washington University Medical School. In return, officials say, he was to practice at an Eastern Shore hospital for two years.

The federal government is seeking penalties amounting to three times the amount of his scholarship, plus interest. It pegs his debt at $272,847 -- and rising with interest and penalties.

Authorities have used three private process servers to track down Dr. DiGiovanna and serve a federal complaint that seeks to collect the money, said Jefferson M. Gray, an assistant U.S. attorney on the case. The doctor eluded them all.

Mr. Gray said Dr. DiGiovanna steered officials astray by listing a false address on one of the forms he submitted to the scholarship agency and put his father's Bowie address on another document.

When process servers found his real address on Beach Drive in Baltimore County, they never got an answer at the door although they reported hearing stirring inside the house, Mr. Gray said. They fared no better at Hopkins, where Dr. Giovanna worked until he resigned Dec. 31.

"The response was always, 'He's out of town, he just left the office, he's gone to Boston' -- something along those lines," Mr. Gray said. "What you often see in those sort of cases is that friends and co-workers will serve as screens and hold off process servers." The Sun also was unable to reach Dr. DiGiovanna.

Hopkins could not give the reason for his resignation or disclose his destination, said Michele M. Fizzano, a hospital spokeswoman.

Unlike Dr. Joel Fleischman, who was sent from his native New York to a desolate Alaskan community to fulfill a medical scholarship in the television series "Northern Exposure," Dr. DiGiovanna was assigned close to home, officials said. Still, they said, he failed to report to work July 1, 1983, at the Kent and Queen Anne Hospital in Chestertown.

A civil complaint filed by the U.S. Justice Department said that the doctor was given another chance to fulfill his obligation under a special repayment program, but that he failed to respond.

"He is one of the most egregious cases," said Mr. Gray, who said the government has closed the case for now, but plans to reopen it soon and resume the pursuit.

Federal prosecutors in Baltimore have won seven recent judgments totaling $704,375 against medical professionals who have received public health scholarships through the federal Health Services Corps.

Dr. DiGiovanna is among eight health-care workers being sued by the U.S. attorney's office in Baltimore for a combined $3.1 million.

The largest amount in Maryland is owed by Dr. Mitchell Zeitler of Rockville, according to government officials, who place his debt at $630,412 for four scholarship awards between 1978 and 1981. Dr. Zeitler refused to comment and his lawyers said they could not discuss pending litigation.

The Rockville-based National Health Service Corps, which has run the scholarship program since 1972, says Dr. Zeitler and Dr. DiGiovanna are the exceptions. Some 92 percent of the 16,000 health-care professionals who have gone through its scholarship and loan programs, it says, honor their agreements.

Dr. Robert G. Harmon, administrator of Health Resources and Services at HHS, said the programs look for people seeking careers as doctors, nurses, nurse practitioners and physician's assistants who show a willingness to work in underprivileged areas that could range from Watts in Los Angeles to an Idaho reservation.

"We want people who are willing to give something back," said Dr. Harmon, whose program of scholarships and loan repayments is budgeted for $100 million for the fiscal year that ends Sept. 30. Officials said the program provides 4,400 primary care professionals for 13 million underserved people.

The health service corps awarded $33 million in scholarships last year to 439 students from a list of nearly 2,500 applicants, Dr. Harmon said. Recipients included 285 students in medical school, 23 in dental school, 50 in nursing and 81 in physician's assistant programs. The awards provide up to $35,000 for medical school students.

Some Maryland doctors who owe money from the scholarship program said in court documents that the agency breached its )) end of the bargain. Dr. Zeitler, for one, contends the government soured the deal when it did not allow him to change his specialty from obstetrics/gynecology to anesthesiology.

Because the government refused to allow him to fulfill his obligations as an anesthesiologist, it tried to deprive him of practicing in the discipline for which he was best suited, he said. The government said it denied his request to change specialties because the disadvantaged need primary care doctors, not specialists.

Dr. Deidra Louise Varner of Bowie was awarded $38,833 between September 1978 and June 1981 to help her through Howard University Medical School and was granted a three-year deferment that required her to submit forms each year, court records say. She failed to submit a form for the period from July 1983 to June 1984 and was declared to have breached her agreement.

Dr. Varner signed a repayment agreement in July 1986 and paid $3,450 to the program over the next year, the complaint said. Then, she enrolled in a special repayment program that again would require her to work in an underserved area. She was offered a position at the Watts Health Foundation in Los Angeles, but again was ruled in default when she turned down that job.

Instead, she made a $4,000 payment to the government in June 1990 and signed an agreement to make monthly payments of $2,250. She made only three such payments, however -- in September 1990, January 1990 and last March. In total, she repaid $14,200 of her $38,883. But the government tripled the debt and tacked on interest. It is seeking $295,444 from her.

Reached at her home, Dr. Varner said she tried to work with the government. She said she was willing to go to an underprivileged area, but that the choices were limited.

"You're not going to be able to go where you want to," said Dr. Varner, who refused to comment further.

In her response to the complaint, she said the agency waived its rights to collect money when it refused to allow her to complete her obligation in Washington.

But Assistant U.S. Attorney Jeanette Plante said the scholarship agreements clearly state that the government can send medical professionals to any area in the country where it determines a great need for medical care. "This is not just an attempt to recoup money paid for tuition," Ms. Plante said. "This is an attempt to see to it that people in medically underserved areas have access to health care."

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