Foster Care Shrinks Face State Discipline

Texas doctors who prescribed drugs faced state discipline

12:31 AM CDT on Sunday, August 17, 2008

By EMILY RAMSHAW / The Dallas Morning News
eramshaw@dallasnews.com

“AUSTIN – More than 20 doctors who have prescribed psychiatric drugs to foster children have also been disciplined by the state – some for allegations as serious as sexually exploiting a patient or missing a fatal drug complication. 

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The doctors account for just a small fraction of the 300 top-prescribing foster care physicians, most of whom have committed their careers to child psychiatry. But they raise questions about how closely the state monitors the doctors who treat Texas‘ most troubled children.

One of the doctors, an Arlington psychiatrist, prescribed mind-altering drugs to 27 foster children in 2003, the same year a young male patient accused him of molestation.

This wasn’t the first such allegation. Throughout the 1990s, the doctor was repeatedly accused of overmedicating patients, and entering young boys’ hospital rooms late at night to kiss and touch them, though the allegations weren’t brought to the medical board until 2003. There’s no way to know whether the doctor, who has since been convicted and incarcerated, victimized any foster children.

Among the other doctors cited by the state medical board for infractions:

•A Killeen psychiatrist prescribed psychiatric drugs to 96 foster children in 2002 despite a nearly 10-year history of citations for abusing alcohol, marijuana and cocaine, and refusing to take drug tests. His license was revoked in 2003, according to medical board records.

•An Abilene doctor, who has prescribed psychiatric drugs to 1,200 foster children since 2002, failed to order enough lab tests or coordinate with another doctor to monitor the level of lithium they were treating a patient with. The patient died, and the medical board determined that lithium toxicity may have contributed to her death, according to state records. The doctor still has his license.

•A Mineola psychiatrist had his license suspended in 2005 for touching a patient “in an intimate manner while demonstrating massage techniques,” according to medical board records. The doctor, who recently retired, prescribed psychiatric drugs to 79 foster children between 2002 and 2007. The doctor said the incident did not involve a foster child, and he rarely worked with them.

None of the other doctors could be reached for comment.

Unless a doctor has been convicted of a crime against a child or had his medical license revoked, he can prescribe drugs for children in state custody. Texas health officials check criminal records for doctors who have been convicted of sexual assault or injury to a child, but otherwise, they rely on the Texas Medical Board’s judgment to determine who’s fit to practice.

The medical board punishes doctors for violations and can put heavy restrictions on them – including bans on working with children and oversight of their practices – for a decade or longer, said Jill Wiggins, a board spokeswoman. Once those orders are terminated, she said, the doctors “can practice like anyone else.”

But these serious medical board violations are either rare or unreported. Last fiscal year, the board took disciplinary action against just 300 of its 59,000 doctors. Of the 7,000 annual complaints against Texas doctors, 7 percent result in sanctions.

Monitoring this behavior doesn’t generally fall to the U.S. Drug Enforcement Administration, either. A spokesman for the agency, which registers doctors who prescribe medicine, said his department rarely deals with “medical practice” issues – those are handled at the state level.”

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