In initial professional compliance grievances, Board issues suspension, censure

By Kathleen Delaney

In the first two grievances heard by the AAOS Board of Directors under the AAOS Professional Compliance Program, the Board suspended the fellowship standing of Edward F. Quinn III, MD, of Milford, Del., for one year, and censured John A. Ogden, MD, of Atlanta. Both were found to have violated the Standards of Professionalism (SOPs) on Orthopaedic Expert Witness Testimony.

The actions came at the December Board meeting, held in Chicago, Dec. 1-2, 2006. The cases were the first two grievances to proceed through the Professional Compliance Program and be heard by the Board.

“With these actions, the profession of orthopaedic surgery has taken a great step forward in fostering ethical conduct among its practitioners,” says AAOS President Richard F. Kyle, MD. “The AAOS Standards of Professionalism adopted by the fellowship address serious public concerns, such as those surrounding expert witness testimony in medical liability lawsuits. They elevate AAOS to a level of professionalism that meets or exceeds other medical associations.”

The grievances were initially heard by the Committee on Professionalism (COP). One of these two grievances was appealed to the Judiciary Committee. Both the COP and the Judiciary Committee made recommendations to the Board, based on findings during their formal hearings.

Under the provisions of the Professional Compliance Program Grievance Procedures, the Board of Directors has the sole authority to impose professional compliance actions, which are immediate and final.

“Each case was carefully, thoroughly and thoughtfully investigated,” says Dr. Kyle. “The established procedures were followed, and every opportunity was provided to the fellows to present their cases. These actions send the message that the AAOS is very serious about upholding these Standards of Professionalism.”

A year-long process

It took more than a year for the first grievance to reach this stage. During each step of the process, the AAOS relied on the expertise of Russ Pelton, JD, General Counsel of the American Association of Neurological Surgeons (AANS), who guided AAOS through the development and implementation of the Professional Compliance Program. (See “Grievance Timeline” on page 12.)

“AAOS now has a process to handle disputes between fellows that provides each party with substantial due process. This is a program in which AAOS fellows can take pride,” says Pelton.

“The AAOS was one of the first medical organizations to establish a process that hold members accountable to a set of established standards,” says Dr. Kyle. “Most medical organizations wouldn’t take the risk, but the AAOS believes this is important to improving the quality of patient care and is willing to accept the challenge.”

AAOS procedures ensure that each party to a grievance has at least two opportunities to be heard. In addition, the procedures require that members of the COP, Judiciary Committee and Board of Directors disclose any conflicts of interest with parties to a grievance and recuse themselves from participating in hearings if conflicts exist. Alternately, parties to a grievance may challenge the participation of any member of the COP, Judiciary Committee or Board for cause. (See “Meet the Players” on page 12.)

Meeting in executive session on December 1, 2006, the Board considered the two grievances separately. One Board member recused himself from participating in one of the grievances; but all Board members participated in the other grievance. None of the parties to either grievance was present at the Board meeting. Non-voting Council Chairs and staff members from the AAOS office of the general counsel were present to observe the proceedings and only participated when asked a specific question by a Board member. A court reporter officially transcribed the proceedings.

Serving as a facilitator, Pelton reviewed the process and called upon the committee chairs to make their reports. Peter J. Mandell, MD, chair of the COP, and Richard D. Schmidt, MD, chair of the Judiciary Committee, each summarized their committees’ findings and recommendations.

The final decision

The Board’s final decision was reached through a secret written ballot. Official professional compliance action taken by the Board must be approved by at least two-thirds of the voting members present and voting. Each of the two actions taken at the December meeting was approved unanimously by the BOD.

Dr. Kyle later praised the work of both the COP and the Judiciary Committee. “On behalf of all of the Board, I extend my thanks to Drs. Mandell and Schmidt and to their committees for their tireless efforts on behalf of AAOS,” he said. Other BOD members echoed these sentiments and commended Drs. Mandell and Schmidt for their efforts on behalf of the fellowship.

“I am happy that the process worked as well as it did,” says Kyle. “Our fellows should feel confident in the AAOS grievance procedure. I would hope these decisions have an impact on behavior, particularly among those involved in the expert witness process.”

Dr. Mandell agrees. “The public expects orthopaedic surgeons to act professionally. Patients and their families should be able to trust in the professionalism of our fellows and members. The AAOS Professional Compliance program is working hard to ensure that AAOS fellows and members meet society’s expectations.”

The Professional Compliance Program was created in response to the fellowship’s wish that AAOS address issues surrounding orthopaedic expert witness testimony. Now broadened to include other topics, the Professional Compliance Program offers a means for fellows and members to have their professional association resolve professional disputes. (See AAOS Professional Compliance Program on page 13.)

Additional information on the Professional Compliance Program is available online at: www.aaos.org/ProfComp.

Kathleen Delaney is the Professional Compliance Program Administrator. She can be reached at professionalcompliance@aaos.org, aaosexpertwitness@aaos.org, or (847) 384-4047.