The line between investigating and persecuting is a very fine one and the junior Senator from Wisconsin has stepped over it repeatedly.
In an important victory for the protection of patient privacy and the preservation of professional ethics, Judge Durke Thompson ruled that the Maryland Board of Physicians had erred in their punitive actions against Harold I. Eist. The American Psychoanalytic Association's amicus brief was cited by the judge when he ordered all charges against Eist dismissed.
Eist is a psychoanalyst and child psychiatrist practicing in Bethesda, Maryland. His ordeal began in 2001 when the estranged husband of his patient submitted a complaint against him to the board. Eist had been treating a mother and two children and attested to her fitness as a parent during a bitter divorce. Soon after that, the complaint was filed, charging him with overmedicating the mother and children.
Without investigating further, the board demanded the records to investigate the complaint. Eist contacted his attorney and notified his patient. The patient did not want the records released, nor did the attorney representing the interests of the children. The board insisted that their investigatory powers were unlimited, and that patient consent was irrelevant. When Eist did not immediately surrender the records, he was further charged with failure to cooperate.
Peer review and a review of the record (the patient ultimately gave consent) completely vindicated Eist, and found his clinical treatment exemplary. In the face of this incontrovertible evidence that a false charge had been filed, the board persisted, shifting their focus from content to process. Eist was fined and reported to the National Practitioner Data Bank for failing to act in good faith because he did not immediately relinquish the records.
Over the course of the next five years, the case was reviewed by three judges and four courts; all found in favor of Eist and indicated that the board had exceeded its authority, violating Maryland law. The judges repeatedly praised Eist for his courageous and ethical stand in defense of his patients' rights. Judge Thompson wondered whether the board was “out to get Dr. Eist,” finding it hard to understand why they would pursue ongoing punitive action against him, when the board had acknowledged the original complaint was false and there was no deviation of the standard of care. He indicated that Eist had been placed between a rock and a hard place, an untenable position for an ethical psychiatrist.
The American Psychoanalytic Association played a critical role in this case. The amicus brief was written by our legislative representative, James Pyles. Seventeen patient and professional groups joined us in submitting this brief to the court, including two analytic institutes (PINE and Baltimore Washington), two national psychiatric organizations (the American Association of Practicing Psychiatrists and the American Psychiatric Association), eight state psychiatric groups, and two National Alliance for the Mentally Ill chapters. This case has received widespread attention as medical boards across the nation have become increasingly invasive.
The board has 30 days in which to appeal this decision, having exhausted all other means available to them. Should they choose to do so, Eist is prepared to continue to fight. The principle at stake is crucial to our patients, our profession, and our practices; the right of consent must not be overridden by government agencies or others without legal standing. Privacy is the heart of the therapist-patient relationship and must be protected at all costs.
Janis G. Chester, M.D., is a psychotherapist associate, a member of the Committee on Government Relations and Insurance, a consultant to the Liaison Committee, and president of the American Association of Practicing Psychiatrists. She is in private practice in Delaware.