CHARLOTTE, N.C. -- Three Charlotte-area physicians have been fined $85,000 each by the N.C. Medical Board. It's the largest amount levied since the licensing agency got authority to issue fines in 2006.
Dr. Neal Michael Goldberger, an anesthesiologist, and Drs. Chason Spencer Hayes and Seth Lewis Jaffe, both orthopedic surgeons, also had their licenses suspended for 18 months. But the board stayed the suspensions immediately, allowing the doctors to continue work at Carolina Bone & Joint in Monroe and Charlotte.
Consent orders, signed by each doctor and the medical board president, say the doctors performed diagnostic tests that led to immediate surgery, called plasma disc decompression, on seven patients. The board raised several objections to that practice, including that it is better to "not have the operating surgeon do both the diagnostic test and the surgery" because it could be a conflict of interest. The board also said none of the seven patients cited had spinal abnormalities that justified having surgery.
From August 2006 to September 2008, the board said the doctors performed 900 such procedures on patients who suffered from neck and back pain, usually as the result of motor vehicle or workplace accidents.
Dr. Robert Nantais, president of Carolina Bone & Joint, said he has confidence in his partners, who have worked for 10 years or more in the orthopedic, pain management and rheumatology practice.
He said he disagrees with the medical board conclusion that the decompression procedure does not meet the standard of care. It has been used nationally and internationally with "excellent results," he said. Accepting the consent order "was a business decision," Nantais said. "We wanted to get it behind us and get back to doing what we do best, which is patient care. ... This was not related to patient complaints. The vast majority of our patients did very well."
Joyce Fitzpatrick, a Raleigh communications consultant representing the doctors, said the board got complaints from insurance companies who had "financial responsibility for accident-related injuries" that were being treated. The doctors billed an average of $74,500 for each 30-minute procedure. But they were reimbursed an average of $5,642 per patient, board documents say.
The three doctors stopped performing the surgery in September 2008 after Medicare, the federal government's health plan for the elderly, stopped reimbursing for minimally invasive decompression procedures, Fitzpatrick said.
In the consent orders, the board also accused the doctors of unprofessional conduct for sending solicitation letters to personal injury lawyers, advertising the benefits of decompression surgery for people injured in motor vehicle accidents. The board said the letters were provided by ArthroWand, the company that makes devices used for the surgical procedure.
Board documents said Goldberger performed the diagnostic test, called a discogram, and that most results were positive, indicating patients needed surgery. Either Hayes or Jaffe would immediately perform surgery, using the ArthroWand to vaporize vertebral disc tissue with electrical current.
"The board has evidence from which it could conclude the physicians' utilization of the ... procedure fell below acceptable and prevailing standards of medical practice," the orders said. "Discograms that produce nothing but positive results are invalid."
Fines collected by the medical board go to the N.C. Department of Education, and the money is distributed to local school districts.
In other action, the medical board recently suspended indefinitely the license of Dr. Cathy Dover in connection with operation of weight-control and wellness clinics in Concord and Calabash. A consent order she signed says Dover admitted to board investigators that she had been self-prescribing two medicines that have the potential for abuse. She also admitted pre-signing a prescription for use by her office staff and prescribing a pain reliever for someone with whom she had "a significant emotional relationship."
The board said it also found that Dover required her Concord staff to administer medicines to patients before she saw them . Dover could not be reached for comment.
