AAOS Bulletin - October, 2005

Compliance Program volunteers complete training

Committees ready to hear member grievances

By Kathleen Misovic

Why did several AAOS members spend a summer afternoon pouring over the legal transcripts of a professional conduct committee hearing of the American Association of Neurological Surgeons (AANS)?

The members belong to two committees that are part of the new AAOS Professional Compliance Program. They read over the AANS transcript during a mock trial exercise, just one part of an all-day training session to prepare them for their roles with the new program.

The Professional Compliance Program, which was adopted by a vote of the fellowship in April 2005, addresses reports and grievances regarding the behavior of an AAOS fellow or member that may violate the AAOS Standards of Professionalism (SOPs). The SOPs included in the program cover patient care, professional relationships and expert witness testimony. Under the program, members may file grievances against other members. The grievances are then discussed during a hearing procedure, after which a recommendation is made whether to take professional compliance action against a member alleged to have violated one of the SOPs.

“This program meets a need our members have wanted to fill for some time now,” said Peter J. Mandel, MD, chair of the Committee on Professionalism (COP), adding that some AAOS members have been looking for a way to take professional compliance action against other members whom they believe have not acted professionally when acting as expert witnesses during medical liability trials.

The Professional Compliance Program includes two committees: the COP, which conducts the hearing and makes the initial professional compliance action recommendation, and the Judiciary Committee, which conducts an appeal process at the request of either the grievant (physician making the grievance) or the respondent (physician alleged of violating one of the SOPs). The COP is chaired by Dr. Mandell and includes seven other members: Michael H. Gordon, MD; Richard A. Brown, MD; William John Hopkinson, MD; Dale R. Butler, MD; Vincent J. Silvaggio, MD; Murray J. Goodman, MD; and Richard E. Strain Jr., MD. The Judiciary Committee, chaired by Richard D. Schmidt, MD, has four other members: Richard Allen Geline, MD; Edward V. Craig, MD; Thomas M. Green, MD; and Joseph C. DeFiore Jr., MD.

During the Professional Compliance training session, AAOS members re-enacted an AANS hearing. Seated around the table (clockwise from far left): Richard D. Schmidt, MD, who portrayed the grievant; Richard E. Strain Jr., MD, the respondent; Russ Pelton, JD, general counsel for the AANS and consultant to the AAOS program; Richard A. Geline, MD, and Pam Winkler, AAOS manager of member services.

All of the committee members were appointed in June, and they met for the first time as a group in August for the all-day training session.

Looking for guidance

During their training, the new committee members “acted out” the AANS transcript to get an idea of what to expect in future professional compliance hearings.

“Because this is a new program, we had nothing within the AAOS to rely on,” explained Dr. Schmidt. “The committee members found it helpful to read a hearing transcript from the AANS, which has had a similar program for 20 years.”

During the mock trial, Dr. Schmidt played the role of the grievant, and Dr. Strain played the role of the respondent, who was accused of serving as an expert witness during a trial without first reading the entire medical record of the case.

Before the exercise began, the new committee members assumed that the grievant and the respondent would each give their statements separately and then leave the hearing area. “We were surprised to find that in AANS hearings the grievant and respondent sit across from each other during the hearing,” Dr. Schmidt said, adding the AAOS will most likely follow the same seating procedure. “That way respondents and accusers can face each other.”

And the verdict is…

After reading the transcript, the committee members gave their opinions on what the outcome of the hearing should have been. They determined that the respondent acted unprofessionally and decided that he should be suspended from membership for six months. Their decision was similar to the AANS panel’s verdict, which suspended the respondent for one year, Dr. Schmidt said.

Besides participating in the mock trial, the new committee members learned how to draft committee reports and reviewed the procedures for handling grievances, offering their suggestions to improve the procedure. They also reviewed the three SOPs that currently serve as the basis for grievances.

Much time and effort was spent on training the new committee members because of the seriousness of their role.

“This is a whole new experience for the AAOS and professional associations in general,” Dr. Mandell explained.

In an attempt to avoid controversy, the AAOS has worked hard to ensure that the program gives both sides equal rights.

“We believe the program procedures are balanced, and that due process is available to each side through the Judiciary Committee,” Dr. Schmidt said. “We believe that maintaining balance and impartiality for both sides is critical for the program’s success.”

When making their professional compliance recommendations, both the COP and the Judiciary Committee determine whether the respondent should be censured, suspended from the AAOS for a stated period of time, or expelled. However, the final decision to take professional compliance action is made by the Board of Directors, which takes the committees’ recommendations into consideration.

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