Last Week Tonight With John Oliver (2014) s11e04 Episode Script
State Medical Boards
1
Welcome, welcome, welcome
to "Last Week Tonight"!
I'm John Oliver, thank you so much for
joining us. It has been a busy week.
Biden gave his State
of the Union speech
to a room including George Santos
in a bejeweled collar,
serving A-plus "Housewives" energy.
Sweden officially joined NATO,
and the Bellagio shut down
its fountains because, and this is true,
a rare bird landed in them.
And that's a pretty good bird!
Not the best bird, as we all know,
but still pretty good.
Meanwhile, Kamala Harris
nearly made big news
when it seemed like she was
issuing the call for a ceasefire in Gaza
that people have
been demanding for months now,
only to step on the crowd's enthusiasm
with a pretty major asterisk.
Given the immense scale
of suffering in Gaza,
there must be an immediate ceasefire,
for at least the next six weeks,
which is what is currently on the table.
As calls for peace go,
that is right up there with,
"Mr. Gorbachev, tear down this wall,"
"for a two month trial period,
after which, you can put it back up."
Harris forgot
the cardinal rule there,
that bad news should always come first.
There is a reason that conversations
at the hospital don't go,
"Your husband's going to live."
"Thank you so much, doctor."
"For the next six weeks, too late,
you thanked me, no takebacks, bye!"
But we're going to focus tonight
on the 2024 election,
specifically, one of the down-ballot
races that took place on Tuesday.
Because North Carolina
Republicans chose their candidate
for governor this fall,
Mark Robinson.
He's currently
the state's lieutenant governor,
and won the nomination
on the strength of, among other things,
this high-profile endorsement.
This is Martin Luther King
on steroids, okay?
I told that to Mark.
I said, "I think you're better
than Martin Luther King."
"I think you are
Martin Luther King times two."
And he looked at me,
and I wasn't sure, was he angry,
because that's a terrible thing to say,
or was he complimented?
I have never figured it out.
Right?
When I said that to you,
you looked like,
"I don't know if I like that comment."
You should like it.
There is a lot there.
From starting with, "I think you are
Martin Luther King times two,"
as if the only way for Trump
to gauge Black people
is in factors of the other one
he knows,
to the way that he said
"you should" like it.
Do you know how racist you have to be
to give a Black person a compliment
that starts by quantifying their human
value, and then ends with a demand?
It's a lot. Although, Robinson's
reaction to Trump's compliment
might have been hard to read because
his own feelings on MLK are,
at best, complicated.
He's called him a communist
on his Facebook page,
and on a podcast appearance in 2018,
expressed skepticism
more generally about the movement
that King helped lead.
Robinson references what he calls
the, quote,
"so-called civil rights movement."
At one point, he talks about
the sit-in movement in the '60s.
That movement began at Woolworth's
in Greensboro
when the restaurant refused
to serve Blacks at the counter.
Robinson referred to the movement
as ridiculous
and took aim at the civil rights
movement itself.
So many things were lost during
the civil rights movement.
So many freedoms were lost during
the civil rights movement.
They shouldn't have been lost.
That is genuinely shocking.
Not so much that someone is making
controversial, inaccurate claims
about the civil rights movement
on a podcast,
but that it's happening without Joe
Rogan occasionally popping in to say,
"That's wild, bro,"
before pivoting to an ad for a protein
supplement that promises
to make your dick veinier.
If you're wondering what on Earth
Robinson meant by that,
his argument was that the sit-in
participants in Greensboro
shouldn't have demanded to be allowed
to eat at segregated restaurants,
because that cost us the liberties
of a free-market system.
Which is the argument
not just of an asshole,
but an asshole on steroids.
An asshole times two, if you will.
So, Robinson has some extreme views.
Some of them are par for the course
for a Trump-endorsed conservative,
but he can still express them
in striking ways.
For instance, he's a supporter
of book bans
and a staunch opponent
of LGBTQ rights,
which he summed up in one
appearance at a church like this.
Ain't but two genders.
Two genders.
They're dragging our kids down
into the pit of hell,
trying to teach 'em that mess
in our schools.
Tell you like this, that ain't
got no place at no school.
Two plus two don't equal
transgender. It equals four.
I mean, to be fair, it does.
He is right about
the very last thing there.
It's actually a great discursive tactic,
finish an incomprehensibly offensive
rant with one incontrovertible fact.
I'll show you. Seagulls have
no business being birds.
They're rats with wings,
undeserving of flight.
The capital of Turkmenistan
isn't seagulls. It's Ashgabat!
Whatever weird shit I said about
seagulls beforehand,
your instinctive takeaway is,
"I admit, he was technically
right about the last bit."
Robinson also has some pretty intense,
if unsurprising, views on abortion.
He's said the goal is to get it down
to being banned after six weeks,
and then just keep moving from there,
and justifies his position like this.
We're talking about a culture
that we have created in this society
that tells you, when you want
to feel good, go on, go in there,
and go lay down and do your thing,
and if you get in a little trouble,
it's all right to murder somebody
to get out of it. It is not!
You need to be the one in control
of your body.
And once you make a baby, it's not
your body anymore.
It's y'alls body.
That is pretty bad!
Though it sounds less like a stance
on abortion
and more like what Tommy Lee Jones
would say about Vincent D'Onofrio
in "Men in Black."
"When a space cockroach wears
your skin like a suit,"
"it's not your body anymore.
It's y'alls body."
Although, I will say, if the women
of this country do think it's all right
to murder someone
to get out of trouble,
they are currently showing
incredible restraint.
Robinson's whole career has been built
on saying attention-grabbing things.
His big break came just six years ago,
when he spoke at a city council
meeting in support of gun rights,
and referred to himself
as "the majority"
in opposition
to "loonies from the left."
It quickly went viral, making him
a conservative rising star overnight.
But his journey to that point
actually began online.
If you read his memoir,
which I do not advise,
he talks about how, when he first
joined Facebook in 2007,
"I did so for one reason and one
reason only:"
"to talk about professional wrestling."
But then, quickly realized that he could
get more attention for saying
wild political stuff
and making awful memes,
explaining, "I wanted to be as
demonstrative as possible,"
"because I wanted people to,
as the guy said, come at me, bro."
"I wanted people to read my page
and go 'did he really say that?'"
"And that's what happened."
And boy, did he get his wish.
Because people have been going
through his Facebook page,
and I'm guessing, saying exactly that.
Robinson has a history of making
statements on social media
that Jews and others consider
to be antisemitic.
He said the movie "Black Panther"
was, quote,
"created by an agnostic Jew to pull the
shekels out of your Schvartze pockets,"
using the Yiddish words for "money"
and "Black."
Asked about those comments today,
Robinson said they were poorly worded.
I don't think the problem was
that they were poorly worded.
Poorly worded is something like, "You
have been broken up with by me."
I think the main issue there was
his flagrant antisemitism.
This guy clearly isn't
Martin Luther King on steroids.
If anything, he's much more like
your shittiest uncle on Ambien.
Because he has a long history
of willfully provocative posts,
including one where he complains that
the liberal media are always talking
about the "six million Jews" killed
in the Holocaust, in scare quotes.
He also once quoted Hitler on Facebook
and then defended it by saying
that quoting him doesn't mean
he supports him,
and that, "I guess every history book
in America supports Hitler now."
Which is bullshit
for a bunch of reasons,
including that a history book
and a personal Facebook page
are very different. Context matters.
That's why you'll never see a
motivational poster at HomeGoods
that says, "'Never lose hope,
be persistent and stubborn,"
"and never give up. Ted Kaczynski."
Actual quote, by the way.
It's pretty nice.
But wait, 'cause there's more.
He's also referred to the Parkland
shooting survivors
as "these silly little immature
media prosti-tots,"
posted this image of himself
with a sign reading,
"Beyoncé's songs sound like Satanic
chants, change my mind,"
and has said, "I truly believe
that the judgement' format"
"of these reality competition shows
like American Idol,"
"Dancing with the Stars and Chopped
is a sign of things to come"
"in the reality of the new world order."
A bonkers take
that he explained by saying,
"The format of these shows reminds me
of Stalin's show trials"
"where people were lined up
and judged then executed."
"Of course, no one is being killed,
but all the elements are still there."
"Sometimes I think these shows are
setting people's mind"
"on this type of format
for a more sinister reason."
And while that seems very unlikely,
if we did learn that Dancing
with the Stars was secretly
a state-led brainwashing campaign
to get us more comfortable
with public executions,
I'd immediately have a hell
of a lot more respect for that show.
At least it'd be trying
something daring,
rather than have a Chmerkovskiy brother
perform yet another uninspired foxtrot.
Again and again, Robinson has gone
out of his way to say
the worst things
in the most provocative way.
We are called, getting ready to get
in trouble, called to be led by men!
God sent women out when
he was supposed to do,
when they had to do that thing,
but when it was time to face
down Goliath,
sent David, not Davita, David
When it was time to lead
the Israelites out of Israel,
he sent Moses, not Momma Moses,
Daddy Moses!
See, God knew what he was doing
when he made men big and hairy
and ugly 'cause you're supposed
to scare away predators,
whether they're in the woods
or standing in front of your kids
in elementary school.
What is going on there?
Is this a sermon
or are you working on stuff
for a shitty Netflix special?
If you're gonna make the argument
that men are better leaders
because they can fight,
those are two terrible examples.
When did David
or Moses ever throw hands?
They defeated their enemies through,
respectively, a slingshot and magic.
One thing any gender can do,
and the other, nobody can!
Also, "big and hairy and ugly?"
This twink? Please.
And look, we're almost certainly not
done learning things about Robinson.
But the depressing truth is,
he's not an outlier.
He's a pretty good marker
for where his party is today.
Because Republicans have gotten
steadily more radicalized
on sites like Facebook,
and it was just a matter of time until
online trolls crossed over
from ranting about policy to writing it.
It is all pretty bleak, but hopefully,
if the people of North Carolina
do the right thing this November,
the number of years this particular
troll serves as governor
won't be two plus two.
It'll be fucking zero. And now, this.
And Now: C-SPAN Callers Show Once
Again Why They're America at Its Best.
I am a 25-year-old, turning 26,
so I'm still under
my parent's health care.
With my birthday coming up, I'm going
to have to switch over to Obamacare.
Is cost a concern?
Yeah, I mean, obviously, you know,
I have a small cock.
I have a tiny penis and…
Eric from Cedartown, Georgia.
If you lose weight, what will happen?
Well, if you lose five pounds, the male
will gain one inch on his penis.
Okay, caller, we'll leave it there.
With all this happening,
there's an example that I think
I'd like to compare it to,
I can't remember the last time that
I was able to renew my subscription
with my penis enlargement…
I was actually in D.C. last week
and I had the pleasure of seeing
the Washington Monument
and, believe it or not, it looked
exactly like my erect penis.
We'll move on.
You know, cyberbullying has actually
affected me personally, too.
This guy told me I had a tiny cock.
We're gonna move on to Michael
in Huntsville, Alabama.
- Hi, am I on?
- You are, go ahead.
Hi, I would just like to talk about
how my dick is huge as fuck…
Russell, Houston, Texas.
We were pulling for you to run
for president yourself,
but your support of Mitt Romney
means I'm supporting him as well.
Mitt Romney has very high
expectations for the campaign
and for his victory
in the New Hampshire primary.
I was wondering, what size lead
do you think he needs to avoid
a disappointment, and also how big
is Mitt Romney's penis?
Moving on. Our main story tonight
concerns medicine.
The thing that Tums technically are,
even though personally,
I consider them candy.
Medicine is obviously a high-stakes
profession, and mistakes can happen,
as evidenced by scenes like this,
from the procedural drama
"9-1-1: Lone Star".
Fred? No pulse.
I'm starting compressions.
Cap, medical's here.
Okay!
You've probably got a lot of questions,
so let's dive straight in.
"Why did that guy's chest cave in?"
He was frozen. "How did he get
so frozen?"
He got stuck in his in-home
cryotherapy chamber.
"What?"
He was a billionaire who had a
cryotherapy chamber in his home,
and got stuck in it
after getting paralyzed
because of the poison that he'd
been trying to use to kill his wife,
this lady, with whom he had
an open marriage,
and who, yes, good guess,
was fucking Rob Lowe.
And finally, "Why was
that man's chest hollow?"
Honestly, I'm not sure about that one.
I didn't think cold temperatures
automatically turned human beings
into hollow chocolate bunnies,
but I admit, I'm not a doctor.
In that case, the mistake of performing
chest compressions
on a man who is frozen solid,
at most, added insult to injury.
But in other instances, medical errors
can have far more dire consequences.
And they're more common
than you might think.
A 2016 analysis concluded that more
than 250,000 deaths per year
are due to medical error in the U.S.,
making it the third leading cause
of death.
Now, I should say,
most of those errors are systemic,
rooted in things like poorly coordinated
care or fragmented insurance networks.
And good doctors can make
honest mistakes,
the human body, after all, is a sloppy
puzzle of wet nooks and dry crannies.
Every inch of this skin sack
is confusing.
So, let me be clear: this isn't going
to be a takedown of medicine.
I don't want anyone to spin this
into a headline that says,
"John Oliver, Champion of Illness
and Death, Finally Destroys Doctors."
Doctors are great!
They're one of the top things any parent
would say they want their kids to be,
besides "engineers"
and "just like, not annoying".
The vast majority of doctors
are dedicated professionals
who strive to meet reasonable
standards of care for their patients.
But a small fraction aren't,
and can end up doing shit like this.
A doctor performs surgery
on the wrong baby.
There's no excuse for operating
on the wrong baby.
The 52-year-old doctor
actually admitted to using drugs
while conducting
his medical practice.
In videos she posted online,
Dr. Windell Davis-Boutte is both
dancing dermatologist
and singing surgeon.
She mugs for the camera
and raps with an unconscious
patient inches away.
Look, there are many situations
where it's appropriate to dance,
like at a wedding, or when a cartoon
racist shoots at your feet,
or on a certain grave.
But "in the middle of surgery"
is not on the list!
There is a reason
the Hippocratic Oath doesn't go:
"First, do no harm.
Then, slide to the left!"
That doctor, unsurprisingly, has been
sued multiple times by patients,
who claimed her negligence
left them disfigured,
and in one case, brain damaged.
And those sort of errors,
ones caused by negligence,
incompetence, or misconduct,
are a cause for serious concern.
Because a very small number
of doctors can commit a lot of them.
In fact, one analysis found that less
than 2% of physicians were responsible
for half the money paid out in
malpractice suits over 25 years.
Now, the good news is,
there's a regulatory body
that's supposed to protect us from
bad doctors, state medical boards.
These are the panels whose job it is
to issue licenses,
suspend them, or in extreme cases,
take them away.
Hospitals can fire a doctor,
patients can sue them,
but only a state medical board
can ensure
that they never practice medicine
in your state again.
That dancing doctor was suspended
by her state's board.
But that's actually a pretty rare
occurrence,
because the percentage of physicians
who face any sort of real consequences
from medical boards
can be surprisingly low.
One study found that, nationwide,
of nearly 900 physicians
who had been judged by their own
peers to be an immediate threat
to health or safety,
only around half had ever had
licensure action taken against them.
And there are doctors who will tell you
that this is a problem.
Like this one, who actually
ran Mississippi's medical board.
What folks have to realize is that
the medical board
is not a substantial barrier
to them being injured by a physician.
Well, that's not great news.
It's probably one of the least
reassuring things a doctor could say,
besides, "Oopsies!"
or, "I'm running for Senate".
So, given that these boards seem
so lax, and the stakes are so high,
tonight, let's talk about
state medical boards.
And let's start with how
they're supposed to work.
While boards' processes vary widely
from state to state, very basically,
when a board gets a complaint,
they review it
and if they find it credible,
investigate.
And if they want to take action,
like suspending or taking away
a license,
that can start a lot of negotiations
between the doctor and the board.
So, it's a long process
that can be very expensive.
Which is a problem,
given that many medical boards
are strapped for resources.
California's, for instance, has openly
called itself "severely underfunded,"
and an outside monitor found that
that has led to delays, disruptions,
and other investigation deficiencies.
And that may help explain why,
in many states,
cases can move very slowly.
One local news investigation in Nevada
found that some cases had spent
up to seven years under investigation
with no resolution.
And think about that.
That means, if a case was resolved
today, it could've been filed in 2017!
In that time frame,
we've had a global pandemic,
a president who looked directly
at a solar eclipse,
an armed insurrection,
a different president who ended
a speech on gun control with,
"God save the Queen, man,"
a Sophie Turner/Joe Jonas wedding,
a Sophie Turner/Joe Jonas divorce,
and the entire series run
of "The Marvelous Mrs. Maisel."
Seven years is just seven years,
but it's also 6 000 years.
And all the while,
doctors can continue to practice.
Boards can continue deliberating,
even if a doctor's been convicted
of a crime.
Take Dr. Ghyasuddin Syed.
A few years ago, he pled guilty
to conspiracy
for funneling lab testing to a company
in exchange for kickbacks,
but even after that,
Texas' medical board was still
deciding what to do about his license.
Which is especially wild because
this was by no means
his first go-around with the board.
In 2016, the board found Syed "failed
to meet an adequate standard of care."
In 2019, the board found he was
prescribing drugs to patients
he should not have been.
And just last year, the board ruled
the doctor behaved inappropriately
with three female patients.
Syed kept his medical license
through all of it. Has it right now.
Is still seeing patients!
You've been convicted of a serious
crime by the federal government.
You're going to report to prison
in a few months.
Yeah.
That's some oddly upbeat
energy there,
given the question
that he's responding to.
He was still practicing medicine
when that interview happened!
For all we know, there was a patient
waiting for their appointment to start,
wondering what the holdup was,
and then the nurse came in and said,
"Dr. Syed will be right with you,
he's currently on the news
admitting, weirdly happily,
that he's going to prison.
Just go ahead and put on a gown."
And the fact that doctors can keep
treating patients
while their case goes through
the system can be infuriating
to anyone who gets hurt in that time.
Take this woman, who says she
underwent a botched cosmetic surgery
that resulted in sepsis and
an unplanned double mastectomy.
It was only afterwards
that she learned some troubling details
about her doctor, and a prior case
he'd had where a patient died.
The medical board of California had
actually reached a decision
about Dr. Malavi in the 2018
patient death this past May,
but it wasn't until October
that decision took effect
and Malavi's medical license
was suspended.
It was within that five-month window
in August,
before any discipline,
that Millie had her surgery.
I think that things need to change.
I think that the laws need to change.
I think the medical board
needs to change.
I mean, I'm a hairdresser
and the state board of cosmetology
is so on you.
I mean, for hair.
Why isn't it like that for our doctors?
She's right. And look, I say this as
someone who has gone through
my fair share of high-stakes
hair butcherings in the past,
but even I think medicine should
be regulated more tightly than hair.
So, medical boards
can be underfunded and slow,
and patients can suffer in the gaps.
But the problem isn't just one
of resources,
it's also who is on these boards.
Because most are made up heavily
of doctors, which makes sense!
There are many scenarios where
physicians have to make
difficult decisions that only other
medical professionals
can effectively judge.
But it's generally agreed that boards
should also feature public members,
like advocates, who can speak
on behalf of patients.
The thing is,
that doesn't always happen.
The federation of state medical
boards recommends
that the public should make up
a quarter of each board's membership,
but only about half the boards across
the nation meet that standard.
In fact, up until recently,
Louisiana's board didn't have a single
member who wasn't a physician.
And that can be a problem because
doctors tend to protect their own.
Just listen to this man, who served
as one of the non-physician members
on California's board, describe
what he saw in the room.
The way they speak is always
with doctor care in mind.
You never hear patient care ever.
And I mean ever.
Do you think the way the medical
board functions
in the state of California actually
ends up costing patient lives?
There's no question
that it costs patients' lives.
It's not ideal if a board never thinks
of patient care,
since patient care is kind of doctors'
whole thing.
Without patients, doctors
are really just failed urine collectors.
That guy has actually called
for California to be much stricter
with physician misconduct,
and it's kind of telling the extent
to which some of the doctors
who served on that board with him
didn't appreciate his input.
One physician member on the board
chastised Watkins last month
for rocking the boat.
In my eight years on this board,
I have not encountered another board
member who has been
so negative about our process
as Mr. Watkins.
That's pretty harsh. Although, I have
to say, I have not encountered
another person who looks more like
a long-lost member
of the Trump legal team.
He looks like someone you'd expect
to see selling scalped tickets
for a Bon Jovi concert outside
Madison Square Garden.
I could go on, but I won't.
Except, you know what,
I will actually do just one more.
He looks like the "before" photo in a
Rogaine commercial starring Al Pacino.
Now I am actually done.
But also, I will say, saying that
you've never encountered someone
so negative about your medical
board's process might say less
about that guy, than it does about
your process.
Because reticence about punishing
fellow doctors is part
of a much bigger problem
in the culture of medicine,
it's a phenomenon so common,
it's been called
"the white coat code of silence".
In fact, even when medical boards
initially hand down harsh punishments,
doctors can still negotiate lighter
sanctions with them,
which boards, too often,
can contrive weird excuses to do.
Take this case, of a doctor who
was eventually convicted
for illegally writing prescriptions
for over a million pain pills.
In 2016, the board's own records
show he was suspended
for operating an unlicensed
pain management clinic,
where nearly 10,000 prescriptions for
controlled substances were written.
But 10 months later,
the board lifted his suspension.
In its records, the board cites factors
like he "expressed remorse,"
had a genuine misunderstanding
of pain management requirements,
and was "a very young
and inexperienced physician,"
even though he was 46 at the time,
and had been practicing
for over a decade.
I don't know if 46 counts
as "young and inexperienced."
I'm 46, and I've been doing this job
for over a decade,
and people could say
many things about me.
He's squawky, he's hyper,
he seems more like a coked-up
Sotheby's auctioneer than a comedian,
if it weren't for how much he hates
everything about Sotheby's.
But no one would say
"very young and inexperienced".
It's just objectively not true.
This leniency can even extend
to doctors who've engaged
in sexual misconduct.
A 2016 investigation found that some
doctors who sexually violated patients
were returned to practice with as little
as a three-day course
on appropriate doctor-patient
boundaries.
Which really doesn't seem like enough.
If you'd asked me to guess how long
they should face discipline for,
I'd definitely say something longer
than one Lollapalooza.
In fact, nationwide,
that investigation found
of the 2,400 doctors publicly
disciplined for sexual misconduct,
half still had active medical licenses.
And this was particularly bad
in some states.
Georgia and Kansas, for example,
allowed two of every three
of those doctors to return
to practice,
while in Minnesota,
it was four of every five.
Which is so bad, I'd like to propose
a new state slogan for Minnesota.
"Land of 10,000…
Actually, forget about our lakes,
someone needs to figure out what's
going on with the doctors here. Jesus!"
So, to recap: punishments
for doctors can be rare,
light, and dangerously slow in coming.
And there is one more issue here,
which is that you may simply
never find out about them.
A recent survey found that it remains
too difficult for the public to find
complete information about physicians
on their state medical board websites,
due both to poorly designed
and confusing websites
and to gaps in the types
of available information.
What that means is that sometimes,
the only way people learn
about a doctor's past is if a news
organization looks into it.
This man's mother's leg was left
paralyzed after a spinal surgery,
and when CBS looked
into the doctor involved,
they discovered some awful facts.
We dug through state
and court records and found
that Dr. Svabek lost his surgical
privileges at two Indianapolis hospitals
after his "practice fell below
the standard of care"
and concerns were raised about
his "honesty and truthfulness".
Dr. Svabek has settled five suits
over more than a decade,
the most of any orthopedic surgeon
in Indiana in the last 20 years.
I don't know
if you're aware of this or not.
I had no idea. You know, kind of like
whenever you buy a car,
it has a Carfax. You know, it's almost
like a doctor should have a doctor fax.
Yeah, there probably should be!
Because doctors know everything
about us,
if we smoke, if we're depressed,
how deep all of our holes go,
but we know next to nothing
about them.
Now, the good news is, there actually
is something like that,
the National Practitioner Data Bank,
or NPDB.
It's a federal repository of information
on medical practitioners
including board discipline, hospital
discipline, and malpractice payments.
Which sounds great!
Unfortunately, you can't access it.
It's only available to hospitals,
medical boards,
and a few select medical
and government entities.
On top of which, not all problem
doctors show up in it.
In fact, over the past 13 years,
of the over 6,000 hospitals
in this country,
only around a third submitted at least
one report on action they've taken
against a doctor.
Which feels suspicious,
'cause I doubt two-thirds of hospitals
have gone 13 years
without a single doctor fucking up.
One reason for that is that hospitals
can find ways to skirt
the reporting requirements.
For instance, they're required to report
a doctor who loses privileges
for more than 30 days,
but sometimes, hospitals
will just limit the term to 29 days,
so it doesn't have to be reported.
And this can be for multiple reasons,
including an investment
in their doctors' reputations.
In New Hampshire, this top-earning
cardiac surgeon was once featured
in ads for his hospital.
But even as he was racking up
what would become
one of the worst surgical malpractice
records among all physicians in the US,
the hospital seemed anxious
to downplay it.
So much so,
that even after a serious incident,
when he was on call, but did not come
to the hospital for hours
despite repeated phone requests
to deal with a patient
having a life-threatening situation,
he was suspended for 28 days,
a number conveniently just shy
of what would've been required
for him to be reported to the database.
And I would say that that was the most
shameless coverup in a hospital
that I've ever seen, but I have seen
this episode of "Melrose Place",
where Dr. Kimberly Shaw tries
to throw people off the scent
of her involvement in a hit-and-run.
Think about it. The driver of that car
was wearing a short blond wig.
Now, how could I get all of this hair
under something like that?
This answer your question?
You're a dead man, Fielding.
That is television right there!
Step aside, "9-1-1: Lone Star",
"Melrose Place" walked
so that you could run.
But even if a doctor is reported
to the database,
that report still might not be seen
because, incredibly,
some state medical boards simply
don't check it when granting licenses
to doctors who've moved from out
of state.
In 2017, 13 state boards
didn't check it once.
And some states,
including, until recently, Texas,
even employ
an honor-system approach,
which relies on physicians
to self-report.
But guess what? The bad doctors
tend not to do that,
because, you know,
they're bad doctors!
So, unsurprisingly, when a Texas
news station bothered to look into
who was practicing in their state,
they found 49 doctors who'd had their
medical licenses suspended,
revoked, or surrendered
in other states.
And some of the stories
were shocking.
Among the doctors currently practicing
in Texas,
a Colorado neurosurgeon disciplined
for performing surgery
on the wrong spinal disc.
A Wisconsin orthopedic surgeon whose
license was suspended indefinitely
for operating on a patient
while intoxicated.
And a Florida doctor reprimanded
for prescribing, quote,
"excessive quantities of oxycodone,"
leading to a patient's death.
All of them still showing
a clean record in Texas.
It's true. A surgeon who operated on
the wrong part of someone's spine
still had a clean bill of health
in Texas.
And you know who probably doesn't?
His fucking patient.
But it's not just Texas.
At least 500 physicians who have
been publicly disciplined, chastised
or barred from practicing
by one state medical board
have been allowed to practice
elsewhere with a clean license.
And some have almost made
an art of it,
like this cosmetic surgeon,
who was disciplined in 2015
after a patient's death in Oregon.
He then began practicing in Illinois,
where he was investigated
after another patient died in 2016.
Five years after that, Illinois' medical
board declared him
an immediate danger to the health
and safety of the public
and suspended him
for at least 18 months.
But you'll never guess
what happened next.
Despite being found to be grossly
negligent in multiple cases
across two states,
Dr. Sharma still held an active
medical license in one state, Indiana.
We're working late today.
And as we discovered,
he's actively practicing there today.
Yeah, he wasn't just still practicing,
he was broadcasting it online, too.
And general tip: if any part of your
"get ready with me" routine
involves scrubbing up,
stop recording right now!
Because there are a few things I just
never want to see my doctor do:
cry, get drunk, or say,
"Hey guys, welcome to my channel,
we're workin' late tonight,"
over my unconscious nude body.
But the larger fact is,
if you are a doctor with a trail
of irreparable harm behind you,
it seems that you can just hop
around until you find a state
that'll look the other way.
It's just one of ways that doctors
are like Catholic priests,
along with having fun outfits
that are just fancy pajamas
and quietly thinking they're God.
And incidentally,
if you want to check yourself
whether a doctor's been disciplined
out-of-state, that might be difficult.
Because a survey a few years ago
found that the medical board websites
in all these places don't include
actions taken in other states.
Honestly,
based on what we've seen so far,
the best thing you can do as a patient
to successfully vet your doctor
might be to check TikTok
to see if they're posting videos
of their surgeries online,
because that seems to be the only
surefire sign of disaster.
So, what can we do here?
Well, first, we need to acknowledge
that doctors have
powerful lobbying groups that have
fought medical board reform hard,
so change is going to be difficult.
How difficult it's going to be?
Well, in researching this story,
we found this CBS report from nearly
40 years ago
that could've aired last week.
It featured a bad doctor
who'd moved from state to state
to avoid consequences, and this
explanation of the larger problem.
The Massachusetts board, indeed,
most state boards, suffer
from underfinancing, understaffing,
and under-organization.
The board here employs
only two investigators.
Because the boards are staffed mostly
by doctors, consumers, lawmakers,
and even some doctors
are now asking
whether the medical community
can police its own
and still provide quality care.
Most doctors in this country
are practicing good medicine.
Most of the 400,000 doctors,
but perhaps 10, 20, 30, 40,000 doctors
are not practicing good medicine.
Most of them are never disciplined.
It's too dangerous a situation
to keep tolerating.
Yeah, it is too dangerous a situation
to keep tolerating,
but it seems like we've done it.
Because that is from
four decades ago.
It's this whole story, with warning
signs about funding
and calls for reform, all told by,
let's be honest, a much hotter me.
But regardless…
You laughed too hard at that.
But regardless, there are some
obvious steps that we could take here.
Lawmakers could add more public
members to state medical boards
and increase their funding.
They could also require that
all disciplinary actions taken
against a doctor in whatever
state they've worked in,
plus info like malpractice settlements
and hospital discipline,
be easy to find on a public website.
And while we're talking transparency,
the NPDB was created
exactly for that reason,
so state boards should be required
to regularly use it.
Look, the vast majority of doctors
help people
and are worthy of the value
that society places in them.
But this is a field that relies,
pretty uniquely, on absolute trust.
And again, I am not saying that all
or even most doctors are bad,
nor am I telling doctors
how to do their jobs.
I'm only 46, so I'm very young
and inexperienced.
But what I am saying
is that it would serve everyone,
including those many good doctors,
to fix this mess,
because the way we've been running
medical boards is a bit like giving CPR
to a frozen solid man,
it's absolutely baffling, and I cannot
believe someone ever thought
it was a good idea. And now, this.
And Now: People on TV Love to Talk
About Their Big Fuckin' Heads.
These are cute, but they're huge.
- Yeah, they really are huge.
- Maybe 'cause our heads are huge.
Do you have one of those big melons?
I have a large head.
You have such a great hat head.
I have a giant head
that needs to be covered.
You always look great in a hat.
I have a huge head. This makes
my head look bigger.
- I don't think it does.
- I got a big noggin.
Can I borrow your hat?
Always need a hat.
It's all right, I got a big head.
I have a giant head, highlighted
by this angle right now, I'm sorry.
I've got a giant head, Scott,
there's a big head and neck.
He has a big head, many people
say I have a big head.
Don't tell anybody
I have a big head.
We both have large heads.
I have a big head too.
Makes my butt look smaller.
Is it extra big for my big head?
Jen and I are always debating
who has the bigger head.
I said, "Who?" She goes,
"You win." I go, "Wait, what?"
- You won or I do?
- I did.
My head is a half an inch bigger
than yours.
So, just so you know, as measured
by the professionals,
I'm a winner, my head's huge.
That's our show, thanks so much
for watching,
we'll see you next week,
good night!
Welcome, welcome, welcome
to "Last Week Tonight"!
I'm John Oliver, thank you so much for
joining us. It has been a busy week.
Biden gave his State
of the Union speech
to a room including George Santos
in a bejeweled collar,
serving A-plus "Housewives" energy.
Sweden officially joined NATO,
and the Bellagio shut down
its fountains because, and this is true,
a rare bird landed in them.
And that's a pretty good bird!
Not the best bird, as we all know,
but still pretty good.
Meanwhile, Kamala Harris
nearly made big news
when it seemed like she was
issuing the call for a ceasefire in Gaza
that people have
been demanding for months now,
only to step on the crowd's enthusiasm
with a pretty major asterisk.
Given the immense scale
of suffering in Gaza,
there must be an immediate ceasefire,
for at least the next six weeks,
which is what is currently on the table.
As calls for peace go,
that is right up there with,
"Mr. Gorbachev, tear down this wall,"
"for a two month trial period,
after which, you can put it back up."
Harris forgot
the cardinal rule there,
that bad news should always come first.
There is a reason that conversations
at the hospital don't go,
"Your husband's going to live."
"Thank you so much, doctor."
"For the next six weeks, too late,
you thanked me, no takebacks, bye!"
But we're going to focus tonight
on the 2024 election,
specifically, one of the down-ballot
races that took place on Tuesday.
Because North Carolina
Republicans chose their candidate
for governor this fall,
Mark Robinson.
He's currently
the state's lieutenant governor,
and won the nomination
on the strength of, among other things,
this high-profile endorsement.
This is Martin Luther King
on steroids, okay?
I told that to Mark.
I said, "I think you're better
than Martin Luther King."
"I think you are
Martin Luther King times two."
And he looked at me,
and I wasn't sure, was he angry,
because that's a terrible thing to say,
or was he complimented?
I have never figured it out.
Right?
When I said that to you,
you looked like,
"I don't know if I like that comment."
You should like it.
There is a lot there.
From starting with, "I think you are
Martin Luther King times two,"
as if the only way for Trump
to gauge Black people
is in factors of the other one
he knows,
to the way that he said
"you should" like it.
Do you know how racist you have to be
to give a Black person a compliment
that starts by quantifying their human
value, and then ends with a demand?
It's a lot. Although, Robinson's
reaction to Trump's compliment
might have been hard to read because
his own feelings on MLK are,
at best, complicated.
He's called him a communist
on his Facebook page,
and on a podcast appearance in 2018,
expressed skepticism
more generally about the movement
that King helped lead.
Robinson references what he calls
the, quote,
"so-called civil rights movement."
At one point, he talks about
the sit-in movement in the '60s.
That movement began at Woolworth's
in Greensboro
when the restaurant refused
to serve Blacks at the counter.
Robinson referred to the movement
as ridiculous
and took aim at the civil rights
movement itself.
So many things were lost during
the civil rights movement.
So many freedoms were lost during
the civil rights movement.
They shouldn't have been lost.
That is genuinely shocking.
Not so much that someone is making
controversial, inaccurate claims
about the civil rights movement
on a podcast,
but that it's happening without Joe
Rogan occasionally popping in to say,
"That's wild, bro,"
before pivoting to an ad for a protein
supplement that promises
to make your dick veinier.
If you're wondering what on Earth
Robinson meant by that,
his argument was that the sit-in
participants in Greensboro
shouldn't have demanded to be allowed
to eat at segregated restaurants,
because that cost us the liberties
of a free-market system.
Which is the argument
not just of an asshole,
but an asshole on steroids.
An asshole times two, if you will.
So, Robinson has some extreme views.
Some of them are par for the course
for a Trump-endorsed conservative,
but he can still express them
in striking ways.
For instance, he's a supporter
of book bans
and a staunch opponent
of LGBTQ rights,
which he summed up in one
appearance at a church like this.
Ain't but two genders.
Two genders.
They're dragging our kids down
into the pit of hell,
trying to teach 'em that mess
in our schools.
Tell you like this, that ain't
got no place at no school.
Two plus two don't equal
transgender. It equals four.
I mean, to be fair, it does.
He is right about
the very last thing there.
It's actually a great discursive tactic,
finish an incomprehensibly offensive
rant with one incontrovertible fact.
I'll show you. Seagulls have
no business being birds.
They're rats with wings,
undeserving of flight.
The capital of Turkmenistan
isn't seagulls. It's Ashgabat!
Whatever weird shit I said about
seagulls beforehand,
your instinctive takeaway is,
"I admit, he was technically
right about the last bit."
Robinson also has some pretty intense,
if unsurprising, views on abortion.
He's said the goal is to get it down
to being banned after six weeks,
and then just keep moving from there,
and justifies his position like this.
We're talking about a culture
that we have created in this society
that tells you, when you want
to feel good, go on, go in there,
and go lay down and do your thing,
and if you get in a little trouble,
it's all right to murder somebody
to get out of it. It is not!
You need to be the one in control
of your body.
And once you make a baby, it's not
your body anymore.
It's y'alls body.
That is pretty bad!
Though it sounds less like a stance
on abortion
and more like what Tommy Lee Jones
would say about Vincent D'Onofrio
in "Men in Black."
"When a space cockroach wears
your skin like a suit,"
"it's not your body anymore.
It's y'alls body."
Although, I will say, if the women
of this country do think it's all right
to murder someone
to get out of trouble,
they are currently showing
incredible restraint.
Robinson's whole career has been built
on saying attention-grabbing things.
His big break came just six years ago,
when he spoke at a city council
meeting in support of gun rights,
and referred to himself
as "the majority"
in opposition
to "loonies from the left."
It quickly went viral, making him
a conservative rising star overnight.
But his journey to that point
actually began online.
If you read his memoir,
which I do not advise,
he talks about how, when he first
joined Facebook in 2007,
"I did so for one reason and one
reason only:"
"to talk about professional wrestling."
But then, quickly realized that he could
get more attention for saying
wild political stuff
and making awful memes,
explaining, "I wanted to be as
demonstrative as possible,"
"because I wanted people to,
as the guy said, come at me, bro."
"I wanted people to read my page
and go 'did he really say that?'"
"And that's what happened."
And boy, did he get his wish.
Because people have been going
through his Facebook page,
and I'm guessing, saying exactly that.
Robinson has a history of making
statements on social media
that Jews and others consider
to be antisemitic.
He said the movie "Black Panther"
was, quote,
"created by an agnostic Jew to pull the
shekels out of your Schvartze pockets,"
using the Yiddish words for "money"
and "Black."
Asked about those comments today,
Robinson said they were poorly worded.
I don't think the problem was
that they were poorly worded.
Poorly worded is something like, "You
have been broken up with by me."
I think the main issue there was
his flagrant antisemitism.
This guy clearly isn't
Martin Luther King on steroids.
If anything, he's much more like
your shittiest uncle on Ambien.
Because he has a long history
of willfully provocative posts,
including one where he complains that
the liberal media are always talking
about the "six million Jews" killed
in the Holocaust, in scare quotes.
He also once quoted Hitler on Facebook
and then defended it by saying
that quoting him doesn't mean
he supports him,
and that, "I guess every history book
in America supports Hitler now."
Which is bullshit
for a bunch of reasons,
including that a history book
and a personal Facebook page
are very different. Context matters.
That's why you'll never see a
motivational poster at HomeGoods
that says, "'Never lose hope,
be persistent and stubborn,"
"and never give up. Ted Kaczynski."
Actual quote, by the way.
It's pretty nice.
But wait, 'cause there's more.
He's also referred to the Parkland
shooting survivors
as "these silly little immature
media prosti-tots,"
posted this image of himself
with a sign reading,
"Beyoncé's songs sound like Satanic
chants, change my mind,"
and has said, "I truly believe
that the judgement' format"
"of these reality competition shows
like American Idol,"
"Dancing with the Stars and Chopped
is a sign of things to come"
"in the reality of the new world order."
A bonkers take
that he explained by saying,
"The format of these shows reminds me
of Stalin's show trials"
"where people were lined up
and judged then executed."
"Of course, no one is being killed,
but all the elements are still there."
"Sometimes I think these shows are
setting people's mind"
"on this type of format
for a more sinister reason."
And while that seems very unlikely,
if we did learn that Dancing
with the Stars was secretly
a state-led brainwashing campaign
to get us more comfortable
with public executions,
I'd immediately have a hell
of a lot more respect for that show.
At least it'd be trying
something daring,
rather than have a Chmerkovskiy brother
perform yet another uninspired foxtrot.
Again and again, Robinson has gone
out of his way to say
the worst things
in the most provocative way.
We are called, getting ready to get
in trouble, called to be led by men!
God sent women out when
he was supposed to do,
when they had to do that thing,
but when it was time to face
down Goliath,
sent David, not Davita, David
When it was time to lead
the Israelites out of Israel,
he sent Moses, not Momma Moses,
Daddy Moses!
See, God knew what he was doing
when he made men big and hairy
and ugly 'cause you're supposed
to scare away predators,
whether they're in the woods
or standing in front of your kids
in elementary school.
What is going on there?
Is this a sermon
or are you working on stuff
for a shitty Netflix special?
If you're gonna make the argument
that men are better leaders
because they can fight,
those are two terrible examples.
When did David
or Moses ever throw hands?
They defeated their enemies through,
respectively, a slingshot and magic.
One thing any gender can do,
and the other, nobody can!
Also, "big and hairy and ugly?"
This twink? Please.
And look, we're almost certainly not
done learning things about Robinson.
But the depressing truth is,
he's not an outlier.
He's a pretty good marker
for where his party is today.
Because Republicans have gotten
steadily more radicalized
on sites like Facebook,
and it was just a matter of time until
online trolls crossed over
from ranting about policy to writing it.
It is all pretty bleak, but hopefully,
if the people of North Carolina
do the right thing this November,
the number of years this particular
troll serves as governor
won't be two plus two.
It'll be fucking zero. And now, this.
And Now: C-SPAN Callers Show Once
Again Why They're America at Its Best.
I am a 25-year-old, turning 26,
so I'm still under
my parent's health care.
With my birthday coming up, I'm going
to have to switch over to Obamacare.
Is cost a concern?
Yeah, I mean, obviously, you know,
I have a small cock.
I have a tiny penis and…
Eric from Cedartown, Georgia.
If you lose weight, what will happen?
Well, if you lose five pounds, the male
will gain one inch on his penis.
Okay, caller, we'll leave it there.
With all this happening,
there's an example that I think
I'd like to compare it to,
I can't remember the last time that
I was able to renew my subscription
with my penis enlargement…
I was actually in D.C. last week
and I had the pleasure of seeing
the Washington Monument
and, believe it or not, it looked
exactly like my erect penis.
We'll move on.
You know, cyberbullying has actually
affected me personally, too.
This guy told me I had a tiny cock.
We're gonna move on to Michael
in Huntsville, Alabama.
- Hi, am I on?
- You are, go ahead.
Hi, I would just like to talk about
how my dick is huge as fuck…
Russell, Houston, Texas.
We were pulling for you to run
for president yourself,
but your support of Mitt Romney
means I'm supporting him as well.
Mitt Romney has very high
expectations for the campaign
and for his victory
in the New Hampshire primary.
I was wondering, what size lead
do you think he needs to avoid
a disappointment, and also how big
is Mitt Romney's penis?
Moving on. Our main story tonight
concerns medicine.
The thing that Tums technically are,
even though personally,
I consider them candy.
Medicine is obviously a high-stakes
profession, and mistakes can happen,
as evidenced by scenes like this,
from the procedural drama
"9-1-1: Lone Star".
Fred? No pulse.
I'm starting compressions.
Cap, medical's here.
Okay!
You've probably got a lot of questions,
so let's dive straight in.
"Why did that guy's chest cave in?"
He was frozen. "How did he get
so frozen?"
He got stuck in his in-home
cryotherapy chamber.
"What?"
He was a billionaire who had a
cryotherapy chamber in his home,
and got stuck in it
after getting paralyzed
because of the poison that he'd
been trying to use to kill his wife,
this lady, with whom he had
an open marriage,
and who, yes, good guess,
was fucking Rob Lowe.
And finally, "Why was
that man's chest hollow?"
Honestly, I'm not sure about that one.
I didn't think cold temperatures
automatically turned human beings
into hollow chocolate bunnies,
but I admit, I'm not a doctor.
In that case, the mistake of performing
chest compressions
on a man who is frozen solid,
at most, added insult to injury.
But in other instances, medical errors
can have far more dire consequences.
And they're more common
than you might think.
A 2016 analysis concluded that more
than 250,000 deaths per year
are due to medical error in the U.S.,
making it the third leading cause
of death.
Now, I should say,
most of those errors are systemic,
rooted in things like poorly coordinated
care or fragmented insurance networks.
And good doctors can make
honest mistakes,
the human body, after all, is a sloppy
puzzle of wet nooks and dry crannies.
Every inch of this skin sack
is confusing.
So, let me be clear: this isn't going
to be a takedown of medicine.
I don't want anyone to spin this
into a headline that says,
"John Oliver, Champion of Illness
and Death, Finally Destroys Doctors."
Doctors are great!
They're one of the top things any parent
would say they want their kids to be,
besides "engineers"
and "just like, not annoying".
The vast majority of doctors
are dedicated professionals
who strive to meet reasonable
standards of care for their patients.
But a small fraction aren't,
and can end up doing shit like this.
A doctor performs surgery
on the wrong baby.
There's no excuse for operating
on the wrong baby.
The 52-year-old doctor
actually admitted to using drugs
while conducting
his medical practice.
In videos she posted online,
Dr. Windell Davis-Boutte is both
dancing dermatologist
and singing surgeon.
She mugs for the camera
and raps with an unconscious
patient inches away.
Look, there are many situations
where it's appropriate to dance,
like at a wedding, or when a cartoon
racist shoots at your feet,
or on a certain grave.
But "in the middle of surgery"
is not on the list!
There is a reason
the Hippocratic Oath doesn't go:
"First, do no harm.
Then, slide to the left!"
That doctor, unsurprisingly, has been
sued multiple times by patients,
who claimed her negligence
left them disfigured,
and in one case, brain damaged.
And those sort of errors,
ones caused by negligence,
incompetence, or misconduct,
are a cause for serious concern.
Because a very small number
of doctors can commit a lot of them.
In fact, one analysis found that less
than 2% of physicians were responsible
for half the money paid out in
malpractice suits over 25 years.
Now, the good news is,
there's a regulatory body
that's supposed to protect us from
bad doctors, state medical boards.
These are the panels whose job it is
to issue licenses,
suspend them, or in extreme cases,
take them away.
Hospitals can fire a doctor,
patients can sue them,
but only a state medical board
can ensure
that they never practice medicine
in your state again.
That dancing doctor was suspended
by her state's board.
But that's actually a pretty rare
occurrence,
because the percentage of physicians
who face any sort of real consequences
from medical boards
can be surprisingly low.
One study found that, nationwide,
of nearly 900 physicians
who had been judged by their own
peers to be an immediate threat
to health or safety,
only around half had ever had
licensure action taken against them.
And there are doctors who will tell you
that this is a problem.
Like this one, who actually
ran Mississippi's medical board.
What folks have to realize is that
the medical board
is not a substantial barrier
to them being injured by a physician.
Well, that's not great news.
It's probably one of the least
reassuring things a doctor could say,
besides, "Oopsies!"
or, "I'm running for Senate".
So, given that these boards seem
so lax, and the stakes are so high,
tonight, let's talk about
state medical boards.
And let's start with how
they're supposed to work.
While boards' processes vary widely
from state to state, very basically,
when a board gets a complaint,
they review it
and if they find it credible,
investigate.
And if they want to take action,
like suspending or taking away
a license,
that can start a lot of negotiations
between the doctor and the board.
So, it's a long process
that can be very expensive.
Which is a problem,
given that many medical boards
are strapped for resources.
California's, for instance, has openly
called itself "severely underfunded,"
and an outside monitor found that
that has led to delays, disruptions,
and other investigation deficiencies.
And that may help explain why,
in many states,
cases can move very slowly.
One local news investigation in Nevada
found that some cases had spent
up to seven years under investigation
with no resolution.
And think about that.
That means, if a case was resolved
today, it could've been filed in 2017!
In that time frame,
we've had a global pandemic,
a president who looked directly
at a solar eclipse,
an armed insurrection,
a different president who ended
a speech on gun control with,
"God save the Queen, man,"
a Sophie Turner/Joe Jonas wedding,
a Sophie Turner/Joe Jonas divorce,
and the entire series run
of "The Marvelous Mrs. Maisel."
Seven years is just seven years,
but it's also 6 000 years.
And all the while,
doctors can continue to practice.
Boards can continue deliberating,
even if a doctor's been convicted
of a crime.
Take Dr. Ghyasuddin Syed.
A few years ago, he pled guilty
to conspiracy
for funneling lab testing to a company
in exchange for kickbacks,
but even after that,
Texas' medical board was still
deciding what to do about his license.
Which is especially wild because
this was by no means
his first go-around with the board.
In 2016, the board found Syed "failed
to meet an adequate standard of care."
In 2019, the board found he was
prescribing drugs to patients
he should not have been.
And just last year, the board ruled
the doctor behaved inappropriately
with three female patients.
Syed kept his medical license
through all of it. Has it right now.
Is still seeing patients!
You've been convicted of a serious
crime by the federal government.
You're going to report to prison
in a few months.
Yeah.
That's some oddly upbeat
energy there,
given the question
that he's responding to.
He was still practicing medicine
when that interview happened!
For all we know, there was a patient
waiting for their appointment to start,
wondering what the holdup was,
and then the nurse came in and said,
"Dr. Syed will be right with you,
he's currently on the news
admitting, weirdly happily,
that he's going to prison.
Just go ahead and put on a gown."
And the fact that doctors can keep
treating patients
while their case goes through
the system can be infuriating
to anyone who gets hurt in that time.
Take this woman, who says she
underwent a botched cosmetic surgery
that resulted in sepsis and
an unplanned double mastectomy.
It was only afterwards
that she learned some troubling details
about her doctor, and a prior case
he'd had where a patient died.
The medical board of California had
actually reached a decision
about Dr. Malavi in the 2018
patient death this past May,
but it wasn't until October
that decision took effect
and Malavi's medical license
was suspended.
It was within that five-month window
in August,
before any discipline,
that Millie had her surgery.
I think that things need to change.
I think that the laws need to change.
I think the medical board
needs to change.
I mean, I'm a hairdresser
and the state board of cosmetology
is so on you.
I mean, for hair.
Why isn't it like that for our doctors?
She's right. And look, I say this as
someone who has gone through
my fair share of high-stakes
hair butcherings in the past,
but even I think medicine should
be regulated more tightly than hair.
So, medical boards
can be underfunded and slow,
and patients can suffer in the gaps.
But the problem isn't just one
of resources,
it's also who is on these boards.
Because most are made up heavily
of doctors, which makes sense!
There are many scenarios where
physicians have to make
difficult decisions that only other
medical professionals
can effectively judge.
But it's generally agreed that boards
should also feature public members,
like advocates, who can speak
on behalf of patients.
The thing is,
that doesn't always happen.
The federation of state medical
boards recommends
that the public should make up
a quarter of each board's membership,
but only about half the boards across
the nation meet that standard.
In fact, up until recently,
Louisiana's board didn't have a single
member who wasn't a physician.
And that can be a problem because
doctors tend to protect their own.
Just listen to this man, who served
as one of the non-physician members
on California's board, describe
what he saw in the room.
The way they speak is always
with doctor care in mind.
You never hear patient care ever.
And I mean ever.
Do you think the way the medical
board functions
in the state of California actually
ends up costing patient lives?
There's no question
that it costs patients' lives.
It's not ideal if a board never thinks
of patient care,
since patient care is kind of doctors'
whole thing.
Without patients, doctors
are really just failed urine collectors.
That guy has actually called
for California to be much stricter
with physician misconduct,
and it's kind of telling the extent
to which some of the doctors
who served on that board with him
didn't appreciate his input.
One physician member on the board
chastised Watkins last month
for rocking the boat.
In my eight years on this board,
I have not encountered another board
member who has been
so negative about our process
as Mr. Watkins.
That's pretty harsh. Although, I have
to say, I have not encountered
another person who looks more like
a long-lost member
of the Trump legal team.
He looks like someone you'd expect
to see selling scalped tickets
for a Bon Jovi concert outside
Madison Square Garden.
I could go on, but I won't.
Except, you know what,
I will actually do just one more.
He looks like the "before" photo in a
Rogaine commercial starring Al Pacino.
Now I am actually done.
But also, I will say, saying that
you've never encountered someone
so negative about your medical
board's process might say less
about that guy, than it does about
your process.
Because reticence about punishing
fellow doctors is part
of a much bigger problem
in the culture of medicine,
it's a phenomenon so common,
it's been called
"the white coat code of silence".
In fact, even when medical boards
initially hand down harsh punishments,
doctors can still negotiate lighter
sanctions with them,
which boards, too often,
can contrive weird excuses to do.
Take this case, of a doctor who
was eventually convicted
for illegally writing prescriptions
for over a million pain pills.
In 2016, the board's own records
show he was suspended
for operating an unlicensed
pain management clinic,
where nearly 10,000 prescriptions for
controlled substances were written.
But 10 months later,
the board lifted his suspension.
In its records, the board cites factors
like he "expressed remorse,"
had a genuine misunderstanding
of pain management requirements,
and was "a very young
and inexperienced physician,"
even though he was 46 at the time,
and had been practicing
for over a decade.
I don't know if 46 counts
as "young and inexperienced."
I'm 46, and I've been doing this job
for over a decade,
and people could say
many things about me.
He's squawky, he's hyper,
he seems more like a coked-up
Sotheby's auctioneer than a comedian,
if it weren't for how much he hates
everything about Sotheby's.
But no one would say
"very young and inexperienced".
It's just objectively not true.
This leniency can even extend
to doctors who've engaged
in sexual misconduct.
A 2016 investigation found that some
doctors who sexually violated patients
were returned to practice with as little
as a three-day course
on appropriate doctor-patient
boundaries.
Which really doesn't seem like enough.
If you'd asked me to guess how long
they should face discipline for,
I'd definitely say something longer
than one Lollapalooza.
In fact, nationwide,
that investigation found
of the 2,400 doctors publicly
disciplined for sexual misconduct,
half still had active medical licenses.
And this was particularly bad
in some states.
Georgia and Kansas, for example,
allowed two of every three
of those doctors to return
to practice,
while in Minnesota,
it was four of every five.
Which is so bad, I'd like to propose
a new state slogan for Minnesota.
"Land of 10,000…
Actually, forget about our lakes,
someone needs to figure out what's
going on with the doctors here. Jesus!"
So, to recap: punishments
for doctors can be rare,
light, and dangerously slow in coming.
And there is one more issue here,
which is that you may simply
never find out about them.
A recent survey found that it remains
too difficult for the public to find
complete information about physicians
on their state medical board websites,
due both to poorly designed
and confusing websites
and to gaps in the types
of available information.
What that means is that sometimes,
the only way people learn
about a doctor's past is if a news
organization looks into it.
This man's mother's leg was left
paralyzed after a spinal surgery,
and when CBS looked
into the doctor involved,
they discovered some awful facts.
We dug through state
and court records and found
that Dr. Svabek lost his surgical
privileges at two Indianapolis hospitals
after his "practice fell below
the standard of care"
and concerns were raised about
his "honesty and truthfulness".
Dr. Svabek has settled five suits
over more than a decade,
the most of any orthopedic surgeon
in Indiana in the last 20 years.
I don't know
if you're aware of this or not.
I had no idea. You know, kind of like
whenever you buy a car,
it has a Carfax. You know, it's almost
like a doctor should have a doctor fax.
Yeah, there probably should be!
Because doctors know everything
about us,
if we smoke, if we're depressed,
how deep all of our holes go,
but we know next to nothing
about them.
Now, the good news is, there actually
is something like that,
the National Practitioner Data Bank,
or NPDB.
It's a federal repository of information
on medical practitioners
including board discipline, hospital
discipline, and malpractice payments.
Which sounds great!
Unfortunately, you can't access it.
It's only available to hospitals,
medical boards,
and a few select medical
and government entities.
On top of which, not all problem
doctors show up in it.
In fact, over the past 13 years,
of the over 6,000 hospitals
in this country,
only around a third submitted at least
one report on action they've taken
against a doctor.
Which feels suspicious,
'cause I doubt two-thirds of hospitals
have gone 13 years
without a single doctor fucking up.
One reason for that is that hospitals
can find ways to skirt
the reporting requirements.
For instance, they're required to report
a doctor who loses privileges
for more than 30 days,
but sometimes, hospitals
will just limit the term to 29 days,
so it doesn't have to be reported.
And this can be for multiple reasons,
including an investment
in their doctors' reputations.
In New Hampshire, this top-earning
cardiac surgeon was once featured
in ads for his hospital.
But even as he was racking up
what would become
one of the worst surgical malpractice
records among all physicians in the US,
the hospital seemed anxious
to downplay it.
So much so,
that even after a serious incident,
when he was on call, but did not come
to the hospital for hours
despite repeated phone requests
to deal with a patient
having a life-threatening situation,
he was suspended for 28 days,
a number conveniently just shy
of what would've been required
for him to be reported to the database.
And I would say that that was the most
shameless coverup in a hospital
that I've ever seen, but I have seen
this episode of "Melrose Place",
where Dr. Kimberly Shaw tries
to throw people off the scent
of her involvement in a hit-and-run.
Think about it. The driver of that car
was wearing a short blond wig.
Now, how could I get all of this hair
under something like that?
This answer your question?
You're a dead man, Fielding.
That is television right there!
Step aside, "9-1-1: Lone Star",
"Melrose Place" walked
so that you could run.
But even if a doctor is reported
to the database,
that report still might not be seen
because, incredibly,
some state medical boards simply
don't check it when granting licenses
to doctors who've moved from out
of state.
In 2017, 13 state boards
didn't check it once.
And some states,
including, until recently, Texas,
even employ
an honor-system approach,
which relies on physicians
to self-report.
But guess what? The bad doctors
tend not to do that,
because, you know,
they're bad doctors!
So, unsurprisingly, when a Texas
news station bothered to look into
who was practicing in their state,
they found 49 doctors who'd had their
medical licenses suspended,
revoked, or surrendered
in other states.
And some of the stories
were shocking.
Among the doctors currently practicing
in Texas,
a Colorado neurosurgeon disciplined
for performing surgery
on the wrong spinal disc.
A Wisconsin orthopedic surgeon whose
license was suspended indefinitely
for operating on a patient
while intoxicated.
And a Florida doctor reprimanded
for prescribing, quote,
"excessive quantities of oxycodone,"
leading to a patient's death.
All of them still showing
a clean record in Texas.
It's true. A surgeon who operated on
the wrong part of someone's spine
still had a clean bill of health
in Texas.
And you know who probably doesn't?
His fucking patient.
But it's not just Texas.
At least 500 physicians who have
been publicly disciplined, chastised
or barred from practicing
by one state medical board
have been allowed to practice
elsewhere with a clean license.
And some have almost made
an art of it,
like this cosmetic surgeon,
who was disciplined in 2015
after a patient's death in Oregon.
He then began practicing in Illinois,
where he was investigated
after another patient died in 2016.
Five years after that, Illinois' medical
board declared him
an immediate danger to the health
and safety of the public
and suspended him
for at least 18 months.
But you'll never guess
what happened next.
Despite being found to be grossly
negligent in multiple cases
across two states,
Dr. Sharma still held an active
medical license in one state, Indiana.
We're working late today.
And as we discovered,
he's actively practicing there today.
Yeah, he wasn't just still practicing,
he was broadcasting it online, too.
And general tip: if any part of your
"get ready with me" routine
involves scrubbing up,
stop recording right now!
Because there are a few things I just
never want to see my doctor do:
cry, get drunk, or say,
"Hey guys, welcome to my channel,
we're workin' late tonight,"
over my unconscious nude body.
But the larger fact is,
if you are a doctor with a trail
of irreparable harm behind you,
it seems that you can just hop
around until you find a state
that'll look the other way.
It's just one of ways that doctors
are like Catholic priests,
along with having fun outfits
that are just fancy pajamas
and quietly thinking they're God.
And incidentally,
if you want to check yourself
whether a doctor's been disciplined
out-of-state, that might be difficult.
Because a survey a few years ago
found that the medical board websites
in all these places don't include
actions taken in other states.
Honestly,
based on what we've seen so far,
the best thing you can do as a patient
to successfully vet your doctor
might be to check TikTok
to see if they're posting videos
of their surgeries online,
because that seems to be the only
surefire sign of disaster.
So, what can we do here?
Well, first, we need to acknowledge
that doctors have
powerful lobbying groups that have
fought medical board reform hard,
so change is going to be difficult.
How difficult it's going to be?
Well, in researching this story,
we found this CBS report from nearly
40 years ago
that could've aired last week.
It featured a bad doctor
who'd moved from state to state
to avoid consequences, and this
explanation of the larger problem.
The Massachusetts board, indeed,
most state boards, suffer
from underfinancing, understaffing,
and under-organization.
The board here employs
only two investigators.
Because the boards are staffed mostly
by doctors, consumers, lawmakers,
and even some doctors
are now asking
whether the medical community
can police its own
and still provide quality care.
Most doctors in this country
are practicing good medicine.
Most of the 400,000 doctors,
but perhaps 10, 20, 30, 40,000 doctors
are not practicing good medicine.
Most of them are never disciplined.
It's too dangerous a situation
to keep tolerating.
Yeah, it is too dangerous a situation
to keep tolerating,
but it seems like we've done it.
Because that is from
four decades ago.
It's this whole story, with warning
signs about funding
and calls for reform, all told by,
let's be honest, a much hotter me.
But regardless…
You laughed too hard at that.
But regardless, there are some
obvious steps that we could take here.
Lawmakers could add more public
members to state medical boards
and increase their funding.
They could also require that
all disciplinary actions taken
against a doctor in whatever
state they've worked in,
plus info like malpractice settlements
and hospital discipline,
be easy to find on a public website.
And while we're talking transparency,
the NPDB was created
exactly for that reason,
so state boards should be required
to regularly use it.
Look, the vast majority of doctors
help people
and are worthy of the value
that society places in them.
But this is a field that relies,
pretty uniquely, on absolute trust.
And again, I am not saying that all
or even most doctors are bad,
nor am I telling doctors
how to do their jobs.
I'm only 46, so I'm very young
and inexperienced.
But what I am saying
is that it would serve everyone,
including those many good doctors,
to fix this mess,
because the way we've been running
medical boards is a bit like giving CPR
to a frozen solid man,
it's absolutely baffling, and I cannot
believe someone ever thought
it was a good idea. And now, this.
And Now: People on TV Love to Talk
About Their Big Fuckin' Heads.
These are cute, but they're huge.
- Yeah, they really are huge.
- Maybe 'cause our heads are huge.
Do you have one of those big melons?
I have a large head.
You have such a great hat head.
I have a giant head
that needs to be covered.
You always look great in a hat.
I have a huge head. This makes
my head look bigger.
- I don't think it does.
- I got a big noggin.
Can I borrow your hat?
Always need a hat.
It's all right, I got a big head.
I have a giant head, highlighted
by this angle right now, I'm sorry.
I've got a giant head, Scott,
there's a big head and neck.
He has a big head, many people
say I have a big head.
Don't tell anybody
I have a big head.
We both have large heads.
I have a big head too.
Makes my butt look smaller.
Is it extra big for my big head?
Jen and I are always debating
who has the bigger head.
I said, "Who?" She goes,
"You win." I go, "Wait, what?"
- You won or I do?
- I did.
My head is a half an inch bigger
than yours.
So, just so you know, as measured
by the professionals,
I'm a winner, my head's huge.
That's our show, thanks so much
for watching,
we'll see you next week,
good night!