In an unreported opinion filed on July 31, 2015 by the Court of Special Appeals of Maryland (“Appellate Court”), the son of a Maryland physician who worked in his father’s medical office was found to have practiced medicine in Maryland without a license and the Appellate Court affirmed the $10,000 fine imposed by the Maryland Board of Physicians (“Board”). In a related case, the Appellate Court affirmed the Board’s decision to revoke the father’s Maryland medical license in a decision filed on May 29, 2015.
The Board had concluded that the son had violated Md. Code § 14-601 of the Health Occupations Article by practicing medicine without a license, reaching that conclusion despite an administrative law judge (“ALJ”)’s proposed finding that recommended that the Board dismiss the charge. In rejecting the ALJ’s proposed finding, the Board found that the son, who is not a physician, had diagnosed a patient, determined which blood tests to order for the patient, and had ordered those blood tests.
The father’s medical practice treated children with autism and related disorders. On July 5, 2005, the mother of a ten-year-old boy brought her son to the medical practice for treatment of his autism. The Maryland physician and his son interviewed the mother and her son and someone completed an Autism Treatment Evaluation Checklist (“ATEC) that is used to measure the severity of a patient’s autism and the effectiveness of the treatment if the ATEC is used on successive occasions. In the “impression” section of a patient interview form, the person who completed the form wrote “unspecified development delay,” “possible childhood exposure to heavy metals (mercury),” and “possible precocious puberty.” Laboratory testing was recommended but the mother did not bring her son for the recommended testing.
During the next visit to the medical practice, which was on May 19, 2008, the mother completed an ATEC form after which she and her son were brought into an office where the physician’s son was sitting behind a desk in the seat where a physician would sit. The physician was busy with another patient and therefore was not present for the meeting. No one explained to the mother that the physician’s son was not a physician, and the mother assumed that he was. The physician’s son discussed laboratory testing with the mother and advised her that he would send the orders for the testing to her. After the May 19, 2008 appointment, the physician’s son scored the ATEC form and wrote a patient interview form concerning the patient in which he stated, “It is apparent based upon examination of the DSM-IV criteria that [the patient’s] present symptoms are compatible with a diagnosis of pervasive developmental delay – not otherwise specific (PDDNOS).”
The mother complained to the Board that the physician’s son was practicing medicine without a medical license, and the Board concluded that the physician’s son had practiced medicine without a license because the son had diagnosed the patient, he had selected the blood tests to order for the patient, and he had ordered those tests. The physician’s son filed a petition for judicial review in the Circuit Court for Montgomery County, which affirmed the Board’s decision. The son then filed his appeal with the Appellate Court.
The Appellate Court applied the highly deferential standard of review for agency determinations and concluded that the Board’s findings were supported by substantial evidence, there was no error, and therefore the Appellate Court affirmed the Board’s decision.
Source Geier v. Maryland Board of Physicians, No. 0709, September Term, 2014.
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