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October 16, 2009

Nurse whistleblowers face jail time for reporting quack to medical board

Dr. Dave Gorski reports on a stunning miscarriage of justice: Two nurses face possible  jail time because they filed an anonymous complaint against a doctor who was peddling natural remedies out of the ER of their small rural hospital in Kermit, TX.

The quack turned out to be a vindictive quack. When the Texas Medical Board informed Dr. Rolando Arafiles, Jr. that he was under investigation, he lodged a complaint of criminal harassment with the Winkler County Sheriff, who worked tirelessly to unmask the anonymous tipsters:

To find out who made the anonymous complaint, the sheriff left no stone unturned. He interviewed all of the patients whose medical record case numbers were listed in the report and asked the hospital to identify who would have had access to the patient records in question.

At some point, the sheriff obtained a copy of the anonymous complaint and used the description of a "female over 50" to narrow the potential complainants to the two nurses. He then got a search warrant to seize their work computers and found a copy of the letter to the medical board on one of them. [New Statesman]

This is a a caliber of detective work scarcely seen outside of TV cop shows, especially for non-violent, non-crimes like complaining to a medical board. How did Dr. Arafiles get such vigorous policing from the Winkler County Sheriff's Department? Dave wonders if Dr. Arafiles and Sheriff Robert Roberts, Jr. are buddies. I think I found the answer. According to a lawsuit filed by the nurses, Arafiles and Roberts were--wait for it--associates in the herbal supplement business!

In theory, the Texas Medical Board allows anonymous tips, but privacy protections are so weak that the sheriff was able to figure out who blew the whistle.

The nurses, Anne Mitchell and Vickilyn Galle, were charged with improper use of official information, i.e., the state alleges that they improperly divulged confidential patient information in their complaint to the medical board. In fact, complaints to the medical board are HIPAA-exempt, which means that the nurses didn't have to get patient permission to share medical information with the board.

Dr. Arafiles was familiar with the workings of the Texas Medical Board, having already been disciplined in 2007. That time, the board fined him $1000 for failing to properly supervise a nurse practitioner and ordered him to educate himself on ethics, medical records and the treatment of obesity.

The Texas Nurses' Association has set up a legal defense fund for the Kermit Two, which you can support by clicking here. Dave is encouraging his readers to write polite letters to the Wikler County District Attorney's Office protesting the charges. 


That's horrible!

abuse of power, unethical medical practice, corruption.


Is it better for small towns to have police departments, or is it better for the residents of a small town to just rely on state troopers?

Eric: the answer depends on how much the state government cares about privacy and about enforcing it. At best, central government control creates Reconstruction, when all the good jobs in the South went to carpetbaggers, but the South's internal racial inequalities plummeted. That worked to the extent that the Feds were serious about ending slavery, and, later, about ending segregation. At worst, when the central government doesn't care, you get Mexico's military occupation of its northern states.

Alon Levy -

For my question, I had in mind small towns in modern America.

Since the nurses have the right to notify the medical board of wrongdoing, wouldn't a judge just throw this out? Or is this one of those adaptable scenes from Chinatown: "Forget it Jake, it's Texas."

There are problems with your link including the money link. You probably want to go to a TNA page, not to the donation page directly.

Eric: what I said holds for small towns anywhere, really. If the Texas Attorney General and his immediate subordinates came from a system where privacy is paramount and the state prosecutes corruption at all levels, state troopers wouldn't be able to collude with the doctor, and would tell him to take a hike. If instead the AG didn't care, or were corrupt or incompetent himself, the person in charge of the justice system in the region around Kermit would run his own racket, which would probably be friendly to allied doctors and ruthless to anyone who complained about them.

I'm sure if any jurors scoured the bible they could find a passage covering this disloyalty by *women* towards their *male* superiors, and probably find an appropriate sentence would be stoning...

Seriously, Texas really needs to sort out its legal system: it's become a national embarassment to the USA, and it's the ordinary people who are suffering... =:-O

I don't know how this floated up, but we need to pass this story along. To me, it's serious just like that Justice of the Peace that wanted to refuse a mixed race marriage.

First of all, this is exhibit A on why the medical profession cannot police itself. Whenever they complain about malpractice and so forth, if they would do more vigorous support of whistleblowers, voters would have more sympathy.

Imagine a doctor selling natural remedies and herbal supplements! Why he should be hanged. Does he not know that there are drug company executives who may have curtail their G-V flights if he continues to by pass their products?

>Imagine a doctor selling natural remedies and herbal supplements!

"natural remedies and herbal supplements", wow, it sounds so innocent.

When I look around, I see a lot of quacks making pile of money on such woo placebos and mysterious "treatments". They drive expensive cars, live in the wealthy part of town, their offices look suspiciously better appointed than real doctors. Several have been convicted of operating ponzi schemes.

Sure, "Big Pharma" operates on a profit motive. And companies engage in monopoly practices, and gaming the peer-review system.

But you know what? That happens because they are regulated. They actually have to systematically have their products monitored and tested. There has to be at least half-ass repeatable evidence it actually works.

Within "alternative medicine", almost nothing actually works, there is no evidence, the theories are the worst kind of ignorant hokum (vibrations? energy? toxins? crystal structures in water? subluxations?!!?). Where it does try to act like a science, what you get is at best a cargo cult - white lab coats and fancy looking hardware, the trappings and not the content, like scientologists playing with their "e-meters".

The drug companies are far from angelic. But comparing their failings to those of "alternative medicine" is like comparing the election irregularies in a country like Canada, to those in Zimbabwe.

It's no surprise whatsoever that such a "natural remedy" quack would be colluding with a corrupt small-town sherrif to punish whistleblowers.

Edit: And companies [are caught] engaging in monopoly practices, and gaming the peer-review system.

William Hocke - way to completely miss the point. The whistleblowers reported unethical behavior by a doctor and were charged with a crime, after a completely unethical investigation by a sheriff with a monetary conflict of interest. And you think this is all about supplements? Grunt.

Alon, the idea that during Reconstruction "all the good jobs went to carpetbaggers" is Southron disinfo. During Reconstruction, many good jobs went to Southerners who deserved them, including a lot of former slaves, which is why Reconstruction had to be slandered and stopped. Also, while the South's racial inequalities were diminished only in the law; the reality became clear with the rise of the Klan and violence against Reconstruction.

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