NEWS

When choosing doctors, it's 'buyer beware'

Amber Hunt

If patient reviews were all you had to go on, Dr. Kurt Froehlich might seem an ideal candidate to deliver your baby.

The OB-GYN has an overall rating of 4.5, on a scale that tops out at 5 stars, according to the user-generated medical review site Vitals.com. Patients there praise him as "the best doctor in Cincinnati," "very professional and kind" and "so caring and involved with my pregnancy."

There's little mention that Froehlich had his license permanently revoked in February by the State Medical Board of Ohio, a decision that he's appealing. Until the headlines detailing the doctor's fall from grace, there were just two clues in Hamilton County public records that indicated something was potentially amiss: A wrongful death lawsuit had been filed against the doctor in January 2012, and in September 2012, TriHealth filed a court injunction objecting to him opening a clinic so close to one of its offices after officials there fired him for sexual harassment.

Froehlich has been under investigation for years by the medical board, but patients had no way of finding this out.

This case, along with the recent investigation of an erectile dysfunction clinic that pays staff commission on the medication it prescribes highlights the difficulties patients face in accessing enough information to make educated choices about which doctors to visit, according to several physicians, medical malpractice lawyers and two bioethicists with whom Gannett Ohio spoke.

That's because the board doesn't comment about business practices, and it keeps confidential any complaints made to it until disciplinary action is proposed. Joan Wehrle, the board's education and outreach program manager, said that confidentiality "encourages people who might otherwise be reluctant to share their story to report their concerns to the Board."

But there's a trade-off: Confidentiality also means that other patients are kept in the dark, at least for a while, both about business practices and about allegations lodged against the doctors with whom they're entrusting their lives.

Few clues before

doctor's troubles

Froehlich is a 17-year veteran whose license has been in jeopardy since at least 2012 after complaints surfaced about repeated instances of sexual misconduct.

In two cases, Froehlich used his finger to show inquiring female patients the supposed location of their G-spots. In a third case, he was convicted of misdemeanor assault for groping a medical assistant in his office, an incident that led to TriHealth firing him.

Additionally, Froehlich settled a lawsuit with the family of former patient Summer Stewart, a 30-year-old mother of two for whom Froehlich had prescribed a dangerously restrictive diet so she could lose about 15 pounds of baby fat. Stewart's husband found her unresponsive less than two weeks into the 500-calorie-a-day diet, according to court records.

Though each of those allegations surfaced before 2013, it wouldn't be until January 2015 that the public would know about the medical board's investigation. Froehlich is appealing his license revocation and is currently allowed to treat patients, with the stipulation that he not be alone with them, pending the outcome of the appeal.

"By law, (the medical board) cannot discuss any complaint against a physician until the board decides to take action on it," said Nicholas Bunch, the lawyer who represented Summer Stewart's husband, Scott, in the medical malpractice suit over her death. "It's difficult finding complaints, as everybody who has ever looked for one has found out."

That's because complaints filed against physicians at a local level are kept confidential by Ohio's Sunshine Laws, said Sharon Darkovich, president of the Bioethics Network of Ohio, a statewide association of health care professionals, lawyers, chaplains and academics with an interest in the ethical issues surrounding medicine and patient care.

The idea behind the secrecy was to allow hospitals and fellow physicians to evaluate doctors without the fear of legal action. By making the complaints confidential, it let criticisms be freely lodged so that concerns could be evaluated first by the hospital, and then, if necessary, by the state board, which would weigh evidence and conduct thorough inquiries on issues it deemed valid.

In short, the secrecy protects doctors from unwarranted witch hunts while providing people an avenue to air concerns.

Bunch, whose son is a pediatrician, understands the restrictions. He said doctors are easy targets for people misdirecting their anger, so unvetted complaints aren't fair barometers by which to measure doctors.

Board investigations

can drag on for years

But the process sometimes takes years. Take Cleveland physician James Bressi, for example. Last year, he was sentenced to 59 days in jail and five years probation for a sexual imposition conviction that stemmed from allegations that began as early as 2011. He's appealing the conviction.

"It's a very long process, and that's what I find frustrating," Bunch said. "It's the length of time that's an issue."

Froehlich's lawyer – James McGovern, of the Columbus firm Graff & McGovern – agreed that the process might benefit from being faster, but he said the medical board needs time to be thorough. The board receives hundreds, if not thousands, of complaints each year, and, as a state agency, is fairly limited, he said.

McGovern said patients have to become more sophisticated in researching their doctors.

"Part of your due diligence, if you're going to see a doctor, is going to look that person up online," he said.

Asked if patients should be alerted to allegations before investigations are complete, McGovern said no.

"If people aren't sophisticated enough to know how to look on a website to see what's going on with their doctor, I don't believe that the average person is sophisticated enough to understand the potential medical or ethical issues at play that the medical board is charged to weigh."

Changing how we

select our doctors

In today's culture of Yelp reviews and easy-access online research, some entrepreneurs are looking to change the doctor-choosing landscape.

David Marsidi, 35, who was born and raised in Dayton, said that consumers are so hungry for information about doctors that his Florida-based scheduling service EZDoctor expanded to include everything from physicians' educational backgrounds and patient reviews to malpractice claims and settlements.

The reports, which cost $19.95, also provide each doctor's most-common procedures and corresponding charges, as compared with the state average cost. Marsidi, whose mother is a physician, said his eventual goal is to make the reports free for consumers, but that's not yet possible because of the staffing required to keep the data up to date.

The data provided wouldn't have told patients of Physicians E.D. – the erectile dysfunction clinic recently investigated – that office managers there are paid on commission, but the reports would have at least highlighted that the doctors on staff at the Sharonville clinic appear to have little experience treating erectile dysfunction.

"It's not a very quick process, and most patients don't get the resolution they really want in a timely manner," Marsidi said of patients' existing doctor-vetting options. "It really needs to be updated both on a federal and state level."

Ryan Nash, a licensed physician who serves as director of the Ohio State University Center for Bioethics, said doctors are pluralistic: On one hand, they share training, but on the other, they can differ greatly in how they "define health, wellness, the good life or the good death."

"There are doctors who think pain is a major problem and that we should more compassionately prescribe opioids for pain. There are others that think opioids are one of the greatest public health crises in modern times," he said. "

And then, of course, there are instances where the doctors' motives might be questionable.

"Even though most physicians are trustworthy, the best bet for patients and family members is to not have blind trust," Nash said. "They should choose their doctors, insurance, hospitals, and health systems wisely – all are not equal."

Questions for doctors

Gannett Ohio asked experts to spell out some questions patients should ask their physicians. Here are some suggested questions:

•How many times have you done this procedure?

•Is your board certification up to date?

•What are the potential complications? How often have you encountered them?

•What tests might I need? What are the tests for? What will the results tell me? How safe are the tests?

•Why do I need this treatment, and are there any alternatives?

•What are the potential side effects of any prescribed medications? Could this medication interact with other medications I take (either prescribed or over-the-counter)?

•Has any state medical board taken any formal action against you anywhere in the country?

•If facing surgery: What are your success, failure and complication rates? How do those compare with your peers?

•What's the hospital's infection rate?

•Do you honor your patients' advanced directives? How involved do you expect the patients' family members to be if outside input becomes necessary?

More resources

To learn if a physician is properly licensed, go to http://med.ohio.gov/ and click on "Licensee Search."

Patients with concerns can file complaints with the state medical board by filling out an online complaint form. Complaints also can be mailed to the board at 30 E. Broad St., 3rd Floor, Columbus, OH 43215.

The Ohio laws pertaining to physician investigations include Ohio Revised Code 2305.24, 2305.25, 2305.251 and 2305.252.

(Disclosure: The writer of this story had been treated for several months in 2013 by Dr. Kurt Froehlich. She was unaware of complaints filed against him until his license was revoked.)