We have commented in previous blogs about the inadequacy of the self-regulation of physicians by the medical community. Apparently, only in the most egregious cases will medical boards step in to breach to revoke a physician’s medical license. Earlier this month, an anesthesiologist in Pompton Lakes, NJ was stripped of his medical license. Though Dr. Richard Kaul has practiced medicine for many years, he has spent the past several years performing complex back surgeries on patients without being properly trained in spinal surgery. The New Jersey Board of Medical Examiners called this behavior “egregious,” and they report “multiple findings of gross negligence, repeated negligence, professional misconduct and dishonesty.”
This decision from the board came on the heels of a suspension in 2012 for Kaul’s botched treatment of several people, but what is far worse is that Kaul was able to practice in New Jersey for ten years after being convicted of manslaughter in Great Britain when a patient he had anesthetized died after having one of her teeth pulled. Kaul failed to monitor her oxygen levels, which led to cardiac arrest and eventually death. A medical board in Britain aimed to “‘erase” Kaul from the [national] registry of doctors,” but he managed to make a living in the States “treating mostly car accident victims and people with out-of-network coverage in their health insurance plans. His decade here has been marked by misrepresentation, malpractice complaints and allegations of racketeering and insurance fraud.”
This story exposes the equally frightening truth about medical licensing in the U.S., which requires only a “general authorization” rather than one that limits a practitioner to his or her specialty. It is this dangerous and outdated standard that allowed an anesthesiologist–one who received a lifetime certification from the American Board of Anesthesiology and renewed it every two years by filling out a form of yes/no questions–to perform, by his count, over 800 spinal surgeries.
This is not even the first time Kaul has been investigated while in the U.S. He was fined $10,000 and his license was suspended for six months in 2003. Still, he managed to maintain a one-operating room practice in North Jersey, which, due to its small size, “was not subject to inspection or licensure by the state Department of Health.” Kaul promoted this practice dishonestly on his website, which is full of claims about nonexistent board certifications and being a specialist in minimally-invasive surgery, when in fact his only actual training was a two-week course in South Korea.
The medical profession is an honorable one, but at times too protective of its fellow physicians–and it is only in the most extreme cases of negligence that remedial action is taken. The public requires greater vigilance in the licensing of physicians who perform specialized surgery to ensure that they have the necessary qualifications and track record to be permitted to operate on patients. This story is in many ways analogous to the fears about compounding pharmacies that arose in 2012 after the nationwide fungal meningitis outbreak in which patients placed their trust in their doctors, pharmacists, and the government to regulate the medical industry.