When I found out about the summary suspension of my medical license in February, I was terrified and shocked, but I knew it was a mistake. There had not been any hearing. I was not even aware they were charging me until I got the letter.
The allegations involved three patients. I had the cases reviewed by four independent spine surgeons, leaders in the field from stellar institutions; all agreed that everything had been done to the standard of care. Almost sixty doctors from my community wrote letters of support. While I never thought I would be in this position, I could not imagine the lengths the state medical board would go to try and “win.” This is not about medicine or standard of care anymore: Winning at any cost is now the only goal.
For example, the medical board’s lead attorney, the lawyer who led the entire investigation, did not know that the hospital where I did the surgeries and the health system medical group (my employer) were different legal entities. She only submitted a subpoena to the hospital, and so never obtained any outpatient records. She did not even read the charts herself; she said at the medical board, it is up to an “individual attorney’s discretion” whether to review the evidence or not.
So, the records were incomplete, missing months of treatments which were key evidence. The medical board then relied on their expert, a neurosurgeon, to interpret the incomplete records. He knew they were incomplete, but he still rendered an opinion, a clear violation of the ethical rules the American Association of Neurological Surgeons and the American College of Surgeons.
He was a surprising choice for an expert. He had a significant malpractice history, including a large jury verdict just prior to reviewing these cases and a prior settlement, both for injuring patients during spine surgery. During the hearing, he admitted that he did not disclose that information to the medical board when he applied for re-licensure. Is it not that required? Yes; the medical board’s attorney testified that physicians get disciplined for that sort of thing. He did not tell the medical board, and they hired him to be their expert.
On top of that, the expert’s reports were riddled with errors. His report regarding Patient 1, whom I treated for severe spine deformity, was the most outrageous. He claimed the scans were normal when a radiologist at his own institution said the stenosis was severe. Did he even look at the imaging? He said surgery was unindicated when one of his partners at the same employer had already evaluated the patient and offered surgery. He said I was obligated to refer or transfer the patients, but never reviewed anything about me, my training, or the hospital. During the hearing, he testified that he agreed his own reports were substandard in terms of content.
And wait, Patient 1 was doing great after surgery, happy with the results, angry with the medical board for suspending me, and upset I could no longer be his doctor. In fact, he was scheduled to come to the hearing to testify, on my behalf, against the medical board. We were confident the medical board would recognize its mistakes; the evidence was overwhelming.
On seeing this evidence, did the medical board admit that they did not review the records, or that they were incomplete? Did anyone try to correct such a blunder? Apologize? No. Instead they did everything in their power to cover it up, to bury the evidence and win by any means necessary. They dismissed the summary suspension and then re-summarily suspended me. Patient 1 was not in the second summary suspension, so I could not cross-examine the expert about any of his numerous errors. They proceeded with the second summary suspension like it never happened. A calculated legal tactic for sure, and a clear sign of how little this had to do with medicine or public safety.
At every turn, they prevented me from presenting evidence. I believe to avoid embarrassment, they tried to prevent Patient 1 coming to the new hearing. “The notice that involved Patient 1 is gone,” the hearing adjudicator said. They even tried to quash the subpoenas to obtain the full records; I guess they thought incomplete evidence was sufficient. No tactic was off limits. The expert’s reports were redacted, “state secrets” had to be protected. I could not even question their vetting process for experts, if there even is one. I expected an open-book proceeding like we have in hospitals when reviewing cases. What I got was the opposite, an agency trying to protect its own reputation instead of trying to get to the truth.
The hearing itself was even more surreal. The expert, who was the medical board’s sole witness and their only evidence, agreed that the surgeries were indicated, informed consent was proper, I was qualified, and all perioperative care was satisfactory and within standard, the complete opposite of what the medical board had charged. I met the standard of care, and the cases were appropriate (the medical board’s expert agreed), yet somehow the case continued. The four experts who reviewed and testified on my behalf all testified that I was qualified, the surgeries were indicated, informed consent was properly obtained, they were performed within the standard of care, and the facility was proper for the performance of the surgeries. Amazingly, the medical board’s expert was permitted to opine that these indicated and well-performed surgeries should not have been offered at all, by anyone. Patient 2 was in a wheelchair, rapidly progressing to paraplegia. Patient 3’s deformity was so severe (she was so curved) she could not drive because she could not fit behind the wheel of a car. The spinal screws were eroding through her skin. Did any of this matter? Not to the expert.
And I guess not to the medical board. They said the “clearance” and “optimization” did not mean anything. They argued “there are worse things than being confined to a wheelchair,” when they knew well that the prognosis for a frail, elderly patient who is paralyzed is abysmal. Self-determination is a major tenet of medicine; can it really be that a paralyzed patient cannot consent to surgery to regain control of her body? I guess patient autonomy is not important in the state, at least not to the medical board.
If the medical board does not know a hospital from an outpatient practice, how can it govern them? Without policies to ensure evidence is reviewed, what will stop any physician from being wrongfully suspended? The medical board made these decisions off one doctor’s opinion, after reviewing an incomplete record set and writing an admittedly substandard report; how many other physicians have been subjected to this process marked by incompetence?
The medical board members will make a final determination in October. Given the one-sidedness of the evidence, I am hopeful and confident. It is tough to disagree with the aligned opinions of true leaders in the specialty. Especially (and more importantly) when the opposing argument goes against all principles of medical ethics. I just hope they are willing to admit a mistake and make things right. Better late than never.
Jeffrey Hatef, Jr. is a neurosurgeon practicing in central Ohio. After earning his medical degree from Duke University School of Medicine in 2015, he completed his neurosurgery residency at The Ohio State University with enfolded fellowship training in spinal deformity. His clinical and research work, highlighted on jeffreyhatefmd.com, focuses on spinal deformity, perioperative care, and neuromodulation. He is active in academic discourse, with studies published in journals such as Spine Deformity and the Journal of Surgical Education, including research on protocol-driven early tracheal extubation and resident duty-hour structure. He also engages the public and professional community through X @JeffreyHatef and LinkedIn.
