Category Archives: Health

Medical Board takes 2-1/2 years to revoke license of controversial doctor

On May 13, 2016, Dr. Daniel Susott finally had his license to practice medicine in Hawaii revoked when the decision by the Hawaii Medical Board was filed and posted. The action came 2-1/2 years after California authorities stripped Susott of his license to practice in that state, and two months after the Medical Board adopted its proposed order in the case and cited the need “to handle this matter expeditiously.”

Susott was one of those featured in a Honolulu Star-Advertiser series last year on issues surrounding the discipline of physicians.

The Star-Adveriser reported:

In November 2013 California revoked Susott’s license for gross incompetence, unprofessional conduct and dishonesty after investigators discovered he was recommending medical marijuana without adequately examining patients or taking medical histories, according to Medical Board of California documents. He sometimes approved medical marijuana from Hawaii, even though the patients were in California, the records said.

At one medical marijuana event in the Bay Area, Susott saw 254 patients over two days, checked hearts and lungs by looking at the patients and recommended marijuana in all cases, the records show.

After his California license was revoked and while a DCCA investigation was pending, Susott continued to practice on Oahu, and his prescribing activities attracted the attention of state narcotics enforcement authorities, according to court records.

In seeking court permission for a search warrant, an agent with the Department of Public Safety in July said he believed Susott had violated laws related to the prescribing of controlled substances, according to the court documents. The agent cited several cases from earlier this year.

DCCA acknowledged a pending licensing complaint against Susott but declined comment. His Hawaii license still is listed as valid.

Two hearings were held on Susott’s case by the Office of Administrative Hearings, part of the state Department of Commerce and Consumer Affairs, to consider a recommendation to revoke Susott’s Hawaii license. Despite a variety of issues brought to the state’s attention during its investigation, including the narcotics issues cited by the Star-Advertiser and allegations of abuse previously raised publicly, the recommendation was based solely on Susott’s failure to comply with a requirement that Hawaii regulators be notified promptly when a doctor is Hawaii is subject to discipline elsewhere.

The hearings, in December 2015 and early January 2016, provided Susott an opportunity to present evidence on his own behalf.

“i’m a good doctor and have been licensed for 35 years,” Susott told the hearing officer. “I’ve never a patient complaint.”

He blamed his legal woes in California to his open support for the legalization of marijuana.

“Advocacy of cannabis as medicine got me in trouble over there,” he said, according to the official recording of the hearing.

Susott said he had over 1,200 patients, mostly in California and some in Washington, and that he was still making recommendations for use of marijuana in other states.

Hearings Officer David Karlen asked: “Have you ever turned down or not recommended cannabis for a patient?”

Susott answered: “No, because I believe it is safer than aspirin, it hasn’t killed anybody in 10,000 years.”

Susott also told the board he had hired an attorney in California and expected his medical license to be reinstated within a month.

Susott said needed additional time to collect additional documents, letters from supporters, and to have his reinstatement considered in California. However, Susott failed to appear at at the second hearing and did not submit any of the documents or testimonials he had cited earlier.

In the end, the medical board voted unanimously to revoke Susott’s license to practice.

Susott seemed resigned, saying that he would continue to try to help people even after losing his license to practice medicine.

“I didn’t go to medical school to get a medical license,” he told the hearing officer in December.

To Susott’s detractors, that isn’t comforting news.

Meanwhile, two bills that would have allowed the medical board to take quick reciprocal action when a physician faces discipline in other states. However, a Senate bill died after being sent over to the House, and HB2335 died in conference.

So it appears that doctors who have lost their right to practice in other states will continue to have a long grace period practicing in Hawaii until the slow administrative process finally catches up with them.

Now there are four

Thank you to those who sent kind thoughts to Ms. Kili. The news, I’m afraid, is not good.

We got up yesterday morning and scheduled a trip to our regular vet, hoping to get some Kili some relief. She was the oldest of our five cats, had eaten almost nothing for several days, and had been having obvious difficulty breathing.

Earlier yesterday, in response to a comment on a post about Ms. Kili’s health issues, I wrote:

I’m terribly afraid that there are cascading issues piling up, one upon the other, and it’s going to be hard to stop the downhill slide.

That unfortunately proved to be exactly the case.

We came home late in the afternoon after unexpectedly having to say goodbye to her.

It wasn’t how we had hoped to be ending the day.

Such is life, I guess.

We lost her sister, Ms. Wally, in early July 2015. They were the last of that generation of our cats born in the 1990s.

And now there are just four remaining cats sharing our household.

The details aren’t pretty. We had been focusing on Kili’s congestion and sniffles, which seemed to be the focus of her breathing issues. But after our vet, Ann Sakamoto, examined Kili and took an x-ray, it turned out those were only symptoms of the bigger problem.

What she found was that Kili’s abdomen was full of fluid, which put pressure on her internal organs and made breathing difficult.

“There are several possible causes, and none of them is good,” Dr. Sakamoto said.

We discussed possible options, and realized none of them offered Kili any kind of quality of life. It was, unfortunately, time to face the inevitable. We said a tearful goodbye

We can say that she lived nearly 18-1/2 pampered years, most of that in Kaaawa with free access to the outside world, where she proved to be our most adept huntress. She had very few illnesses or injuries over the years, certainly none serious, and the end, when it came, was not marked by a drawn out period of suffering. She was a lucky cat.

Kili & WallyThis is a photo of Kill and Wally, just after we rescued them from Kahekili Highway back in January 1998. We called them the “auction cats,” because we had been on our way to an estate auction in town when they were literally dropped into our lives.

For the record, we had nine cats when 1999 began. Then we lost Leo (1999), Silverman (2013), Harry and Wally (2015), and now Kili.

And now, Kili and Wally in their prime (photo taken in 2002).

2002

Clearing the day to deal with cat health issues

Sometimes life comes along and just knocks your plans for the day totally off course.

Today’s it’s a cat medical crisis, maybe an emergency. I’m trying hard not to be alarmist.

It’s our oldest cat, Ms. Kili. She got a pretty good report card after a recent check-up, all systems fairly normal for her age. But now she’s suddenly developed a lot of congestion. She already had a weird growth on her nose which we’ve been watching for a few years. The combination is suddenly making it hard for her to breath, or to eat. There’s lots of snorting and sneezing when she addresses a bowl of food or water. And at her age, this isn’t good.

This became noticeable yesterday morning, when we were out on the windward side after spending the night in Kaaawa. Our cat sitter was alarmed and contacted us, and we’ve been carefully monitoring her since. Yes, I’m feeling a bit of guilt, and worry that I wasn’t watching her carefully enough to notice warning signs on Saturday afternoon, before we left for the evening in Kaaawa.

I was on the phone with the vet as soon as we got back from the early morning walk, and have a late morning appointment. Since Meda and I only have one car, I’ve had to clear my calendar in order to get Meda to the UH campus, then get back and pick up Ms. Kili for the run out to Hawaii Kai.

And that doesn’t allow me time to do a proper blog post this morning. Hopefully I’ll be able to get back and do a substantive post later in the day. Stay tuned, and cross your fingers for Ms. Kili.

PBS interview misses the politics of motherhood

“If your only tool is a hammer, then every problem looks like a nail”

I thought of that old phrase while watching a segment of the PBS Newshour on the risk of postpartum depression among women. The featured guest on this segment was Dr. Hal Lawrence, CEO of the American Congress of Obstetricians and Gynecologists.

…we know that 20 percent of all women will have some depression during their lifetime, and so some women actually enter pregnancy with some signs of depression.

Some may have already had a diagnosis of depression or psychological illness, and those people are at increased risk. So, picking that up early, or if you don’t know about it, helps you be careful about those parents when they become postpartum.

So, screening during pregnancy is very important. Screening postpartum is very important, and screening, you know, earlier than even six weeks.

The frequent depression among mothers (and I think that they’re talking here about U.S. mothers) is reduced to a mental health issue that should be dealt with by beefing up mental health services to individual patients based on widespread psychological screening.

There are lots of mentions of the stress of pregnancy and motherhood.

Here’s Dr. Lawrence:

Well, it’s such a stressful time. And everybody looks at pregnancy as this joyous moment.

And it is joyous, and you have a healthy mother, and you have a healthy baby. But there’s also a lot of stress. That woman’s life has changed. She feels — she’s so dedicated to her baby. And then anything that makes her feel uncomfortable, she questions herself: Am I doing the right thing? Am I doing it good enough?

The issue of “stress” is again reduced to a psychological problem of the patient.

But what isn’t mentioned at all are the social and political dimensions of pregnancy and childbirth.

After all, as one study after another have quickly found, the United States is one of the only countries without paid maternity leave and other support services for mothers and families.

Here’s one summary:

Recently released reports show that the U.S. and Papua New Guinea are the only two nations to not guarantee paid maternity leave for working mothers, while Hungary and Slovakia give 160 or more paid weeks of leave, according to the Organization for Economic Co-operation and Development.

There are lots of good articles to be found. Here are a few.

The US is still the only developed country that doesn’t guarantee paid maternity leave,” The Guardian.

Paid Parental Leave: U.S. vs. The World (INFOGRAPHIC), HuffPost Parents

Among 38 nations, U.S. is the outlier when it comes to paid parental leave,” Pew Research Center.

Lots Of Other Countries Mandate Paid Leave. Why Not The U.S.?” NPR.org

Without the public services and support for mothers and families are routine in other developed countries, it’s no wonder that motherhood is an unusually stressful period in the United States.

It is a wonder, though, that the political aspects of motherhood were not even mentioned by the interviewer or his guest.

Ask a doctor, and he’ll tell you it’s a medical/psychiatric issue. Remember the hammer and all those nails….

From a “green flash” to comments on a couple of S-A stories

Kahala, Sept 2015

We learned something this morning. It was very clear, with almost no visible clouds. Seconds before this photo was taken, as the sun just began to clear the edge of Koko Crater, there was a clearly visible sliver of a green flash. For a fraction of a second, it clung to the visual edge of the crater before being overtaken by the emerging sunrise.

So we can see the green flash at dawn from Kahala Beach, even though the sun isn’t rising out of the ocean. It’s different from the situation in Kaaawa, where the flash came as the sun rose over the ocean.

A small thing, but it did provide us a moment of excitement.

And then a media comment. Here’s a story headline from the Star-Advertiser that got caught up in my “bad headline” filter.

The article describes a proposal by U.S. Rep. Mark Takai’s to utilize unspent federal highway funds to rebuilt Farrington and Kamehameha highways in Pearl City after construction of the city’s rail project is completed in the area.

It just struck me that the headline’s attribution of the idea to a “politician” was unnecessarily disrespectful to Takai, who represents Hawaii’s 1st Congressional District.

Romeo

Yes, Takai is an elected official and, by definition, a politician. But he’s not any run of the mill politician. He’s our area’s elected representative in Congress.

Why not a headline that refers to his position, “Congressman,” or used his name, “Mark Takai,” or just last name, “Takai.”

Another story that caught my eye was Sophie Cocke’s investigative piece on overtime pay to several DOH accounting staff (“Several Department of Health workers have raked in overtime pay amid dubious circumstances“). It was a good piece of enterprise reporting, indicating that recruiting Cocke from Civil Beat will give the S-A a reporting boost.

It’s a solid story. Substantial overtime pay without adequate documentation of work done, hours spent, etc., etc.

But after reading the story, I did wonder whether this was one of those offices where budget and staffing was cut to the bone during the Lingle years and the rest of the 2008-2009 recession, leaving those remaining staff to somehow cover an increasing, and increasingly complex, workload, with millions of dollars at risk if the work didn’t somehow get done.

That would be a different story than the implied wrongdoing by DOH staff conveyed by Sunday’s piece.

Perhaps a follow-up is in order to fill in that piece of the puzzle.