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OPINION: 'Rip Van Winkle accountability exemplifies how Guam licensing boards do not protect people

By David Lubofsky

Accountability is a common and important concern on Guam when it comes to medical care and health services in relationship to consumer’s rights and has been at the forefront of discussions about the Mandatory Medical Malpractice Arbitration Act. The Guam licensing Boards of professionals in the health care fields are supposed to protect the public and maintain that “standards of care” are followed by Guam’s licensed health care professions. This is of particular concern with some of the questionable practices at the Guam Board of Medical Examiners and the Guam Board of Allied Health Examiners.

Last year during a public information hearing, regarding the Mandatory Malpractice Arbitration Act, Guam Senator Therese Terlaje told Dr. Yasuhiro that his testimony was a breath of fresh air. I must agree. Rather than focusing on the pros and cons of the Mandatory Malpractice Arbitration Act, that protects negligent health care professionals who injure or kill us, he discussed the governing licensing boards. This would include The Guam Board of Nurse Examiners, The Guam Board of Medical Examiners and The Guam Board of Allied Health Examiners, among many others, in how they handle complaints by the public against professionals, whether it be doctors, physician assistants, respiratory therapists, nurses or others.

The need for impartial investigations and proper reviews of complaints was stressed by Dr. Yasuhiro and Senator Terlaje which would offset many of the problems that we see with the arbitration law related to medical negligence issues or with complaints against professional licensed medical service providers. Consumers, the people of Guam, have a right to have their complaints heard by the Guam Board of Allied Health Examiners or the Guam Board of Medical Examiners etc. without inherent biases, prejudices, or conflicts of interest.

Sadly, I guess the Guam Board of Allied Health Examiners did not get the “impartiality” message by still following the status quo for years. It is hard to believe that the Guam Board of Allied Health Examiner’s Chair, Ms. Mamie Balajadia, has been on the Allied Board for over 20 years, as has possibly up to four other board members. They need to stop the Rip Van Winkle 20-year sleep and wake to providing current consumer protection.

They are supposed to be reappointed as mandated by law every three years, but that has not happened. No Guam board should have the same members that long, it negates new ideas, new members motivation, etc. It destines a board to the humdrum, apathy, and biases, to maintain the status quo and their fiefdom, not to mention easily leads to possible corruption.

What also worries me are systemic problems within the Allied Board. In just the last year, they went to the legislature to establish ethics guidelines for the Board of Allied Health Examiners licensed professionals to get them approved into law. Ethics for professionals who are already practicing is better late than never, but they should have been established years ago. This should have been a top priority for the board, not to mention the board members who have been there for 20 plus years. With no established standards for years, how can you hold licensed professionals accountable when there are no standards governing them?

National Ethical Standards that most licensees should adhere to based on their professional affiliates are not used to make local decisions on licensee accountability or violations by the Allied Board when complaints are made. As an example, this means even though a Physician Assistant by their national association must adhere to an ethical standard that states that they should get help from other staff if they have an argument with a patient, this ethical standard has no bearing on Guam for professional medical “standard of care” or the Allied Board standards for Physician Assistants in terms of violations for some reason.

Ethical standards are the top priority for any governing licensing board. How can you protect the community and hold people to professional standards, when you never established such standards for 20 years until recently? Who is holding the Guam Board of Allied Health Examiners accountable? I am sure that if you contact similar boards across the country, all will tell you that they have had established ethical standards in place for years.

The Allied Board is required to upload all Board meetings for public view to the Guam Office of Public Accountability, who then allows public access on their website of Board meetings. The Allied Board, possibly the only Board on Guam that has not done this, is 10 months behind its required legal responsibility (at the time this was written). It is required by law to be done 7 days after Board meetings, not 10 months and counting. There is no excuse as all other Boards are current.

The Allied Board does not have an impartial procedure set up in regulations to investigate complaints against licensed professionals, but instead uses people on Guam who are in the same field to investigate their colleagues who are obviously known to them. It is like the old wild west days, in how investigations are supposedly done, shooting from the hip. They do not have set regulations to protect consumers, in terms of timelines, how things proceed, who should investigate, involvement of complainant and processing etc. This seems obvious as they have had complaints sitting around for years.

Up to recently, they rarely would respond to emails or requests. In my case, I was told to refer to the Board meetings online to find out the status of a complaint that I filed regarding my son, but as noted, they never uploaded the meetings, so it was a waste of time. This forced me to attend a Board meeting where I was appalled to find out after 3 months of waiting for news on the complaint, the Board Chair, Ms. Mamie Balajadia, was not even fully aware of the complaints and never even saw the full report that was sent to her. She only allowed me 3 minutes to discuss my concerns. Gee, 10 months of no uploads of meetings, no responses to emails and the Board not having the info that was sent to them and confirmed received by them and I am only given 3 minutes. They apparently did not want to hear my concerns and I was flippantly rushed off.

This is one reason that board members need to be reappointed every three years, to keep people motivated and current in law and actions, which are aimed to protect the community and to hold Board members and licensees’ accountable thru regulations that apparently do not exist now. New members, new blood, new ideas, new graduates, fresh energy, honesty, responsibility, lack of biases etc. are all needed on any board but lacks on the Allied Board.

With this, is the need to establish a real impartial review system for complaints of professionals that the board licenses. Yet, still as everything else at the Allied Board, the impartial review system has not been set up. It is at the same place as it was 20 years ago when these board members joined the Allied Board. Reviews of citizens' complaints with the Allied Board are not impartial, quite the opposite. They are biased from our experience. Many complaints have been sitting there for years, but that is expected as these 20-year members of the Allied Board must see themselves as protected with no legislative oversight governing reappointments of the 20-year members.

This is exactly what Dr. Yasuhiro emphasized in his testimony and Sen. Terlaje discussed, the need for fair impartial boards that we do not have.

Hey, Rip Van Winkle and Guam Board of Allied Health Examiners members, this is not 20 years ago and how things were done back then. It is time for you to move on or act to protect the community in an impartial way, not apparently protecting your personal interests or friends. It is time for the Guam Board of Allied Health Examiners to be under that same law as other Boards with members having to be reappointed every three years and fall under the scrutiny of the legislative process of appointment with public input. It is time for this Board to produce a procedure or regulations that they actually follow each time to protect the public when investigations are needed.

David Lubofsky is a Tamuning resident and the proud father of Asher Dean Lubofsky.

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