Wednesday was a difficult day for The American Independent News Network, which is the larger entity that operates The Iowa Independent. Our chief executive and founder announced two of our sister sites would close and their content would be moved to The American Independent.
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A national anti-abortion group displeased with the result of a complaint filed against an Iowa physician is now calling for the resignation of a state official.
Cheryl Sullenger, senior policy adviser for Kansas-based Operation Rescue, received a letter from Mark Bowden, executive director of the Iowa Board of Medicine, indicating that her complaint against an Iowa physician had been resolved.
“After a thorough investigation and careful review of the investigative materials obtained in this matter, the Board voted to close the file without taking disciplinary action against Dr. [Susan] Haskell,” wrote Bowden. “Although this may not be the outcome you were seeking, you can be assured that your complaint was investigated and the Board reached its decision after full review of the investigative record.”
Bowden also writes that, under Iowa law, the complaint filed by Sullenger and materials from the investigation itself are confidential and will not be made public.
Although state officials are bound by law not to disclose the nature or even the existence of complaints received, information posted on the Operation Rescue website makes clear that the complaint against Haskell is part of the organization’s ongoing scrutiny of the use of telemedicine by abortion providers in Iowa.
According to Bowden, who spoke with The Iowa Independent by phone Friday, the letter is not something that would have been released publicly by himself or the Board.
“In fact, it is only because this letter has been made public [by Sullenger] that I can acknowledge it, but I still cannot discuss any of the circumstances specific to the complaint or the investigation,” he said.
Bowden did provide clarification as to a sentence that appears at the bottom of the letter: “The Board’s investigation of this complaint should not be confused with the Board’s continued review and updating of the laws and rules governing the practice of medicine.”
The essentially means, according to Bowden, that questions regarding overall state guidance of medical tools such as telemedicine remain unanswered.
“The Board has two ad hoc committees … one of those has been tasked with looking into policy and rules surrounding use of telemedicine,” Bowden said, indicating that he was unsure when the committee would present findings or recommendations to Board members.
Representatives from Iowa will be on hand in March when the Federation of State Medical Boards hosts a conference specific to telemedicine. The national group, which works with 70 boards of medicine, hopes to identify the policy and structural resources needed to ensure use of such tools provide quality health care and patient safety. Throughout the state, a wide variety of institutions, including the Iowa Department of Corrections, use telemedicine to provide patient care and dispense prescription medications, but the policies that guide use of the tool haven’t been updated since the 1990s.
“We take every complaint we receive seriously,” Bowden said, who outlined the often months-long and intensive process of cataloging and investigating a complaint against a physician.
“Complaints are confidential from the moment they are received. … About 70 percent of the complaints we receive are of the variety of ‘the doctor didn’t smile at me,’ but we open an investigation on each one.”
When investigators have completed their shoe leather work, reports are handed to members of the Board. In turn, the Board has several options at their disposal, including additional peer review. Outcomes can include a closing of the complaint without disciplinary action, letters of warning to physicians that point to a need for additional training, or public announcement of specific charges.
“The public, generally, would never know who complained, what complaints we have or the nature of those complaints until such time that the Board announced that a certain physician has been investigated and is being charged. Only then are the details of the violation spelled out,” Bowden said.
“You know, people can send us a complaint about anything, and the Board takes each one seriously and investigates. The notoriety that would come with the complaint that was revealed … could be very damaging to professional reputations, even if there was no merit to the claim.”
In responding to the letter from Bowden, Sullenger apparently confused her complaint against the individual physician with her complaint about the use of telemedicine for abortion services.
“This decision has done nothing to alleviate our concerns about the legality of this push-button abortion pill scheme,” Sullenger is quoted as saying on the organization’s website. “Operation Rescue is calling for the resignation of Mark Bowden over this scandalous disregard for the law and women’s lives.”
The organization has asked supporters to launch an e-mail and telephone campaign to the office, requesting that Bowden step down.
Roughly 70 percent of physician complaints sent to the Medical Board result in no action and the complaint being closed. About 20 percent result in a confidential letter from the Board to the physician, indicating an issue not constituting gross negligence that needs to be addressed. Only about 5 percent of all complaints investigated by the Board rise to the level of gross negligence and result in public charges. For example, in 2010, the regulatory agency filed charges against 47 physicians out of the total 10,500 licenses administered by the Board.
Last year, a telemedicine program utilized by Planned Parenthood of the Heartland to provide chemical abortion came under fire by anti-abortion activists. The system allows women in rural areas to visit local clinics, have an examination by staff on site and then meet with an abortion provider through video conferencing. If the woman chooses to forward with the abortion, which is only available during the first nine weeks of pregnancy, and the provider approves, a signal is sent by the provider to the rural clinic where a small drawer containing medication is opened.
The program has been underway in Iowa for roughly two years, although it only came under scrutiny by anti-abortion groups in 2010. The state is the first in the nation to utilize the convenience of telemedicine to provide this type of service to women in more rural settings. Anti-abortion activists, however, fear that unchecked use of telemedicine for chemical abortions will spread throughout the nation and likely undermine their own successes of closing clinics and encouraging abortion providers (often through violence) to stop practicing.
As The Iowa Independent reported in 2009, access to reproductive health services, including childbirth services, is shrinking in rural sections of the state and nation. As rural residents lose neighborhood access to physicians, psychologists and psychiatrists, many are hopeful that technological advances like use of telemedicine will help close the gaps.
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