FORT WAYNE – It was just before 1 p.m. when the 911 calls started coming in about the Chevy Equinox driving over 90 mph down Interstate 69, swerving all over the road, according to police reports.
The driver ignored sheriffs deputies lights and sirens and even a violent sideswiping of the concrete divider wall, the report said.
I looked over at the driver and observed that his mouth appeared to be wide open, one deputy wrote in his report. It was apparent that he was completely unfazed from hitting the median wall. The driver stared straight ahead and never looked over towards me.
Several miles and two shredded tires later, the belligerent driver rolled around on the ground to keep deputies from handcuffing him, according to the police report, and kept shouting that he was a physician.
He wasnt lying: Charles J. Whalen Jr. is a cancer doctor at Fort Wayne Medical Oncology and Hematology. At Lutheran Hospital, a blood test found marijuana, methamphetamine and amphetamines in his system, court records said.
Whalens arrest was Jan. 7. Ten days later, the Indiana attorney generals office asked the states Medical Licensing Board to summarily suspend Whalens license to practice medicine because he is a clear and immediate danger to the public health and safety.
But Whalen is hardly the only doctor to face discipline: The Medical Licensing Board gets an average of 50 cases a year, more than two-thirds of which involve substance abuse – either doctors abusing drugs and/or alcohol themselves, or prescribing drugs in ways that allow them to be abused.
About one in every eight cases involves sexual improprieties, the same percentage as doctors disciplined for hiding previous discipline cases or cases in other states.
Fifty discipline cases a year can sound shocking without context: There are about 25,000 licensed doctors in Indiana. Even if you combined all the cases in the last five years, less than seven-tenths of 1 percent of licensed physicians were sanctioned in that time.
Still, officials say, considering the trust given doctors – our lives are literally in their hands at times – even one case is disturbing.
Whalen told police his erratic behavior may have been from using Rust Out at his lake cottage. Whalen, 46, of the 1800 block of Glenlivet Court, faced a felony charge of resisting law enforcement and three misdemeanors: operating a vehicle while intoxicated, operating a vehicle with a controlled substance or its metabolite in his body and resisting law enforcement. On Feb. 6, he entered a guilty plea to all four charges. Attempts to reach Whalen for comment were not successful.
Some of the cases involving doctors are, indeed, disturbing. They include a Bluffton doctor who prescribed five beers a day, to a diabetic on probation and forbidden to have any alcohol after a prison sentence for a history of drunken driving, and a doctor facing federal charges of owning an illegal machine gun, an illegal silencer and trying to hire a hit man.
Other Indiana doctors have been disciplined for sexually rubbing themselves on patients, having sex with patients and placing a hidden video camera in the office restroom.
They would begin lining up outside his Middletown clinic at 6 a.m., neighbors said, and when they finally got inside officials said they got what they wanted: prescription drugs. Federal investigators said the doctor wrote more than 96,000 prescriptions in three years – and he worked only three days a week. Sometimes he wrote 400 prescriptions a day; at least nine patients died of drug overdoses.
A majority of our cases do deal with substance abuse or prescriptions, said Kristen Kelley, board director for Indianas Medical Licensing Board. It is kind of on line with the overall addiction rates of the general population.
More than two-thirds of the sanctions the board has handed down in the last five years involved substance abuse or prescriptions, but many of the doctors with addictions will never be disciplined. Instead, doctors with an abuse problem can enter the Physicians Assistance Program, where their addiction is treated and they are carefully monitored for relapses. If they successfully break their addiction and do not relapse, the state will never know they ever had an issue.
If they fully comply, they can avoid discipline by the board, Kelley said.
But if not, or their abuse affects their practice or there are other issues, then their medical license is on the line.
If a physician were to get involved with alcohol at work, or a patient were harmed or a crime committed or they were diverting drugs, thats a different story, she said. But if its just an abuse issue, they can get involved in the Physicians Assistance Program.
Whalen, the doctor in the high-speed chase, will likely be ordered into the Physicians Assistance Program or something similar as part of any discipline the state takes against his medical license. Success in the program, if he is required to participate, would likely be a condition of practicing again.
Relapse and you’re out
In the program since 2007 after a driving under the influence charge, a Scottsburg doctor soon found the power of narcotics too hard to resist: in 2010, he relapsed, then was found to be abusing an OxyContin prescription and deceiving PAP staff. He went through rehab again, but in October 2011 missed his required drug screens and could not document he was attending required therapy. The same day PAP notified the state, officials moved to summarily suspend his license. By Nov. 9 he was barred from practice pending the outcome of his discipline case.
Some say that if discipline rates seem low, its because bad doctors are not being allowed to become doctors.
Its not a very frequent occurrence (that doctors are disciplined), and I think medical schools and residency programs are doing their best to weed out potential problems, said Dr. Rich Frankel, a professor of medicine and geriatrics and also the statewide competency director for professionalism at the Indiana University School of Medicine. What they found is theres a direct link between those physicians who had difficulties as an undergraduate med students and those who had difficulties later as a physician.
Frankel said IUs med school adopted a competency-based curriculum in 1999 – only the second in the country – to emphasize areas such as professionalism, lifelong learning and moral and ethical guidelines. The program has formal curriculum in each of those areas, he said.
Students and the doctors they become will not only be faced with incredible responsibility, but also grueling hours, on-the-job stress, familial stress and financial pressures, all while surrounded by powerful drugs and a society that embraces using alcohol to relax. Frankel said med schools need to prepare students for this ahead of time.
We take any kind of administrative action a student had involving drugs or alcohol use very seriously. That being said, all of us were young once, so we do try to put it in the broader context, Frankel said. The way we look at it is its an opportunity to intervene early. In 99 percent of cases, it takes one incident and working with a student to give them insight on what these behaviors mean to put them back on the straight and narrow.
Still, sometimes doctors fall off the straight and narrow. Sometimes way off.
A Brownsburg pediatrician was suspended from his hospital job and his license suspended after sending sexually explicit text messages and sexually graphic photos of himself to someone he believed was a minor female. Another doctor was convicted of criminal charges of sexual battery and criminal confinement; the doctor claimed the incident was a misunderstanding, as his housekeeper did not speak English.
Cuts that will never heal
The learning-disabled patient, known in documents only as T.M., had seen the Washington, Ind., ob/gyn since she was a teenager. By her 30s, he was not only having sex with her, but attempting to treat her emotional issues with potent psychiatric medicine, including barbiturates, despite not being a psychiatrist. He was also giving her drugs such as Oxycontin, diet pills and Valium out of his pocket – and kept giving them to her. Much of the time she was in a stuporous state, and even after her weight dropped below 90 lbs. he kept giving her diet pills. In 2000, he performed an unnecessary surgical sterilization on her, and a year later performed a hysterectomy – even though she wanted to have more children. She had an I.Q. between 60 and 70, court documents said, and can barely read or write.
Attorney Barclay Wong was a deputy attorney general, where he successfully litigated hundreds of cases before the states licensing boards, but now in private practice he defends doctors in their discipline cases. He says Indiana has found the right balance of protecting patients first but also protecting doctors due process rights.
The (Medical Licensing) Boards first job is to protect the citizens of Indiana, so theyre going to err on the side of safety, Wong said. Their first duty is to the citizens and I think thats how it should be.
When an average citizen is charged with driving under the influence – often a misdemeanor – it rarely makes a splash.
But a doctor will not only suffer the indignity of his crime making the news, but there will likely be professional repercussions, as well. Wong said that goes with the territory.
I think its fair – we hold them to a higher standard, he said. We do give them privileges that regular people dont have, and like I tell the physicians who come into my office, practicing medicine is a privilege, not a right.
Its also a privilege that extends across state lines, especially for doctors who may go to med school in one state, have a residency in another and practice in a third, leaving them licensed in all three. When theyre disciplined in one state, Wong said, that case is reported to the National Practitioner Database, which every state monitors. Not long after, every state the doctor is licensed in often disciplines them, as well.
Thats why I tell doctors to only be licensed in the state you intend to practice in, Wong said. By the time it gets to four or five other states, it can seem like piling on.
But the multiple cases for one infraction has a purpose, officials say.
For one thing, it puts the incident on the books in each state, so it can be noted later if needed. It also lets residents in, say Indiana, know that their doctor was disciplined in a state they may not have been aware he or she was licensed to practice in.
IU School of Medicines Frankel said the relatively small number of discipline cases shows Indianas system of treatment and monitoring doctors with problems is working, especially considering the pressures doctors are under.
The statistics Ive seen suggest (substance abuse) rates are a little higher (for doctors) due to the increased stress of the job, Frankel said. We know they have a higher divorce rate than the general population and more stress-related disorders than most of the population.
Frankel said it is much more effective to deal with substance abuse issues than to simply punish them, and that is what has made Indianas system work so well.
I think we have an excellent system that really reaches out, he said. The first concern is patient safety. The second concern is approaching physicians who have difficulties in a positive way and give them chance to remediate themselves.