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  1. #1
    azskeptic's Avatar
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    Concern grows in state over doctors from some foreign schools

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    http://www.kentucky.com/mld/kentucky/9855392.htm

    Posted on Thu, Oct. 07, 2004



    Concern grows in state over doctors from some foreign schools

    By Valarie Honeycutt Spears
    HERALD-LEADER STAFF WRITER

    The medical careers of Dr. Bryant D. Draper and Dr. Peter Jannace began at the same small medical school in the Caribbean, and they ended in roughly the same place: prison.

    Draper, who practiced in Madisonville, was sentenced in July 2000 to 63 months in prison for illegally distributing pain pills.

    And Jannace, who practiced in Louisville, was sentenced in May 2003 to eight months in prison after being found guilty of treating patients for weight loss while billing their insurance programs for osteoarthritis and other chronic ailments.

    Both men have since lost their Kentucky medical licenses. If Kentucky had followed the lead of several other states, neither man would have received a license to begin with.

    States such as California and Texas refuse to grant medical licenses to the graduates of certain foreign medical schools, including Universidad Technologica de Santiago or UTESA, the school in the Dominican Republic that produced Draper and Jannace.

    Now, concern about such schools is growing among Kentucky medical officials in a state that depends on foreign-educated doctors to serve in remote rural areas where few others want to go.

    The number of such physicians in Kentucky is increasing -- 30 percent of the licenses granted last year went to foreign-educated doctors -- but the state currently does nothing to examine the quality of their educations. Foreign medical schools often aren't subject to the same accreditation standards as U.S. schools.

    Over the last 17 years, Kentucky has granted at least 24 licenses to physicians who received degrees from foreign medical schools that would have disqualified them in other states.

    Four of the Kentucky licenses went to graduates of St. Lucia's Spartan Health Services University, which one review said "taught in a piecemeal approach."

    "It is impossible for all the basic science classes to be covered in such a small time frame," said a report by the American Association of International Medical Graduates. The group fights discrimination against graduates of foreign medical schools, but also tries to police the field.

    Two other Kentucky licenses went to graduates of Antigua's University of Health Sciences, a school whose graduates are banned in several states and where the international association's review found "insufficient laboratories and a small library with a few old books and journals."

    California's evaluations

    It's neither easy nor inexpensive to inspect a foreign medical school -- and that's one reason why Kentucky doesn't do it already, said Dr. ***** Clark, a Somerset physician and the chairman of the Kentucky Board of Medical Licensure.

    Still, many states have simply adopted the list of "banned" schools that California medical regulators have been assembling since 1983. California regulators inspect schools on the basis of complaints. Graduates of the listed schools cannot be licensed in California or enter residencies in California, said Pat Park, the foreign schools liaison for California's medical board.

    Kentucky's medical licensure board expects to adopt new national standards for foreign schools that are being developed by the Dallas-based Federation of State Medical Boards.

    But once new standards are in place, they will apply only to new license applications, not to any existing licenses, said Dr. C. William Schmidt, the Kentucky board's executive director.

    "I don't think we can be retroactive," Schmidt said.

    One fear associated with bringing tighter scrutiny to foreign medical schools is that all of them might be tainted by the exercise. And Kentucky officials quickly point out that many foreign schools produce good doctors.

    State licensing records show that about 21 percent of the 12,929 physicians licensed in Kentucky were trained at foreign schools.

    But over the past 10 years or so, only 60 of the 642 doctors disciplined by medical regulators -- less than 10 percent -- were trained at foreign schools.

    Certification required

    State officials point out that foreign-trained doctors seeking Kentucky licenses must first get certification from the Educational Commission for Foreign Medical Graduates. To get certification, applicants must show proficiency in English, undergo a clinical skills test and pass the same national licensing test required of U.S. medical school graduates.

    And, Clark said, before the Kentucky board will consider granting a license, it ensures that each applicant has received solid post-graduate training in the United States.

    Clark said the foreign-trained physicians he's familiar with are "superbly trained and excellent physicians" who are sorely needed, particularly in rural areas.

    "Without graduates of foreign medical schools, many Kentucky communities would be without adequate medical care," Clark said.

    Kentucky's medical regulators began discussing physician education in-depth late last year, after Dr. Emery Wilson, the former dean of the University of Kentucky Medical School and a leader in the study of foreign medical education, brought the issue to the board.

    Now, Clark and others expect to consider recommendations from national groups on how to rate international medical schools.

    Dr. Laxmaiah Manchikanti, a member of the licensure board who graduated from a medical school in India that is in good standing in the United States, said he would welcome new scrutiny.

    "Medical schools are popping up in every country," said Manchikanti, a Paducah pain specialist.


    http://www.kentucky.com/mld/kentucky/9855393.htm

    Posted on Thu, Oct. 07, 2004





    Two in Kentucky fear being stigmatized


    An urgent care physician in Lexington and an obstetrician in Bardstown both fear their clean records and reputations will be damaged as the Kentucky Board of Medical Licensure brings new scrutiny to foreign medical schools.

    Gary Cannon, an urgent care physician at Lexington Clinic who graduated from the Santo Domingo school UTESA in 1985, said he had no idea it had been banned by California and several other states as a result of inspections in 1985 and 1997.

    A 1997 inspection of UTESA by California officials cited antiquated laboratories and overall disorder, with deficiencies "broad in scope and deep in extent."

    But UTESA officials have criticized that assessment, saying that hundreds of the school's graduates had passed U.S. licensing requirements.

    Cannon has additional credentials in that he is certified by both the American Board of Family Practice and the American Board of Urgent Care Medicine.

    ********* Michel, medical director at the Lexington Clinic, said that in hiring Cannon, the clinic went beyond state licensing requirements -- as it does with all physicians.

    The clinic requires board certification -- an extra measure of professional accomplishment -- as well as extensive backgrounding, Michel said.

    Said Cannon: "I had what I considered a very quality medical education."

    Cannon said he is in favor of closer scrutiny of both U.S. and foreign medical schools.

    Franklin O. De La Cruz, the Bardstown obstetrician, meanwhile, said he knew that Universidad Centro de Estudios Technologicos or CETEC University in Santo Domingo, where he graduated in 1982, had been banned in California since 1983 and closed after school officials were accused of selling diplomas.

    Both physicians said they received strong post-graduate training in the United States. But they fear that won't mean much if people begin to associate foreign medical schools with poor care.

    "It's a political thing," said De La Cruz. "A lot of people are getting hurt who are legitimate," he said.
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  2. #2
    microphage's Avatar
    microphage is offline Useless Member 512 points
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    Someone should reply to the writer....

    I don't see how policing the schools would help in this case. The two people they described were engaging in illegal activity(billing fraud and distributing drugs) and their medical education had no factor in what they did.

    Pat Park made the newspaper

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    ZAATARI is offline Member
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    ...

    Selling pain pills and billing fraud directly related to med school & education?that is wiered,mentioning 4 Spartan grad in this article is totally unfair and discriminatory statement.

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    teratos's Avatar
    teratos is offline Jedi Moderator 658 points
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    ...

    Quote Originally Posted by ZAATARI
    Selling pain pills and billing fraud directly related to med school & education?that is wiered,mentioning 4 Spartan grad in this article is totally unfair and discriminatory statement.
    Yes, it is unfair. I wonder if it was just coincidence. G
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    microphage's Avatar
    microphage is offline Useless Member 512 points
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    ...

    Quote Originally Posted by teratos
    Quote Originally Posted by ZAATARI
    Selling pain pills and billing fraud directly related to med school & education?that is wiered,mentioning 4 Spartan grad in this article is totally unfair and discriminatory statement.
    Yes, it is unfair. I wonder if it was just coincidence. G
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    wcb22 is offline Elite Member
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    malpractice

    just wait until you're paying more in malpractice premiums, simply b/c you graduated from a caribbean school, and for no other reason.

  7. #7
    ZAATARI is offline Member
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    ....

    Malpractice companies goes by claims history and it would be violation of federal laws to discriminate on the basis of origin of MD degree.
    Most doctors where I practiced does not carry malpractice insurance anymore.

  8. #8
    azskeptic's Avatar
    azskeptic is offline Moderator 666 points
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    ....

    Quote Originally Posted by ZAATARI
    Malpractice companies goes by claims history and it would be violation of federal laws to discriminate on the basis of origin of MD degree.
    Most doctors where I practiced does not carry malpractice insurance anymore.
    they are practicing without coverage or the facility covers them?
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    ZAATARI is offline Member
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    new reality

    the hospital does not cover them,they have to put $250.000 aside and most has no malpractice cover[Palm Beach county,Fl],I have a friend neonatologist attended delivery because the OB used forcep[attending high risk delivery],the baby had erbs palsy[large baby got stuck],100% delivery related injury but the OB did not have malpractice so they are after the Neo because he carries malpractice and he was in the room[neos are never involved in the delivery],very few OB's in S Florida carry malpractice insurance[they getting sued like grazy and premuims going up like grazy.If you are OB and making $250.000/yr and paying $150.000/yr malpractice fees is it worth it?insurance in S Florida going out of control even when I bought my house in the west[not close to water]I could not find any insurance co to buy homeowner insurance I bought it from the state[poor coverage]&that was before the hurricanes!!!!!

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    medmax is offline Junior Member
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    Re: May not be Discrimination

    Quote Originally Posted by ZAATARI
    Malpractice companies goes by claims history and it would be violation of federal laws to discriminate on the basis of origin of MD degree.
    Most doctors where I practiced does not carry malpractice insurance anymore.
    Sometime ago, AZ, astutely, pointed out that risk loss analysis has made its way into malpractice. There are actuarial studies already in the insurance industry that benchmark risk associated with medical schools. Underwriting is a relatively strange process; if origin of an MD degree can have a risk associated with it, then that can justify segmented rates for malpractice. I would find it hard to understand that origin of medical school would be protected under any of the Federal Rules and/or Statutes. Businesses have always discriminated , in general of course, against origin of Business School. Try to research the whitepapers of the large brokerage firms, Aon Corporation or Marsh, Inc, unless the studies are protected intellectual property; actuarial studies can be extremely important in insurance product development.

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