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  • Puerto Rico: Island in shock over fake doctors

    PUERTO RICO

    Island in shock over fake doctors

    Charges that members of Puerto Rico's medical examination board certified unqualified doctors prompted calls to overhaul the system.

    Posted on Mon, Nov. 19, 2007

    BY SUSAN ANASAGASTI AKUS

    Special to The Miami Herald


    SAN JUAN-- When 14-month-old Yadriel Yadid Gonz?lez showed up at a clinic with a high fever, the doctor on duty gave him an antibiotic and sent him home.

    Seven hours later the boy was taken to an emergency room where he died of dengue fever, a mosquito-borne disease.

    The doctor who treated the boy, Richard Pietri Sep?lveda, is now one of 113 people indicted in an expanding federal probe that has rocked Puerto Rico's medical community since August, when charges of doctors obtaining their medical licenses through fraud or bribery first surfaced.

    ''We did everything we could as parents. We put our son's life in his [the doctor's] hands,'' said the boy's father, Carlos Francis Gonz?lez, who along with wife Yaira has filed a $6 million lawsuit in the case against Pietri and others.

    'I fought with him. I said, `Please do something.' I knew something was wrong with my son,'' Gonz?lez said. ``We thought he was a real doctor so I let my guard down.''

    In August, a federal grand jury indicted 88 men and women after an investigation into members of Puerto Rico's Medical Examiners Board who allegedly altered failing test scores to certify unqualified doctors. Almost three months later, federal agents carried out another round of raids across the U.S. territory, arresting dozens more as part of the scandal.

    Among those arrested were two ex-board presidents, one of whom allegedly changed failing grades as political favors for a friend. Authorities say more arrests could be on the horizon.

    ''I'm convinced more doctors and people who have worked for the Medical Examiners Board will continue to be arrested in connection to this investigation,'' said Rep. Gabriel Rodr?guez Aguil?, chairman of the Puerto Rican House committee on health.

    The defendants face charges that include mail fraud and making false statements to Medicare. If convicted, most face prison sentences of five to 20 years and fines up to $250,000. Pietri could not be reached for comment.

    MALPRACTICE CLAIMS

    Rodr?guez said he first became suspicious of the licensing board when he learned of complaints that it was not moving fast enough to review malpractice claims. He says many indicted doctors had dozens of claims against them, but continued to practice.

    Lymarie Llovet, spokeswoman for the U.S. Attorney's Office, could not comment on the total number of malpractice claims filed against the unqualified doctors.

    According to court documents, most of the doctors arrested or indicted studied in the Dominican Republic, Mexico or Cuba before taking the exam to practice medicine in Puerto Rico. The documents did not specify the nationalities of the fake doctors. Some of the unqualified doctors failed the certification exams 10 times before their results were changed to passing grades.

    According to court documents, this is how the scam operated:

    ? In some cases, an intermediary would approach the failed candidates offering to connect them with board officials who could change their grades in exchange for money or personal favors.

    ? After receiving the failing exams from the intermediaries, members of the medical board would cut and paste excerpts from passing exams before photocopying the altered exams. Board members then submitted the changed tests as authentic versions with passing grades.

    ? In some cases, former Board of Medical Examiners presidents Margarita Perocier Aguirre and Rafael Jim?nez M?ndez claimed the board's office was temporarily closed and asked test graders to send the results to their homes, where they altered the results.

    Puerto Rican lawmakers and academics across the island are now seeking to overhaul the nine-member Medical Examiners Board, which is in charge of issuing medical licenses to doctors.

    Rolance Chavier Roper, a doctor and professor at the San Juan Bautista medical school in the city of Caguas, said the scandal has put a cloud over Puerto Rico's entire medical sector.

    ''We're sad that this happened and anyone who has done anything wrong in obtaining their medical license should pay for what they did,'' he said. ``We want justice to be served.''

    But he added that the number of doctors accused in the scandal represents less than 1 percent of the medical community here. About 11,000 doctors serve a population of about 3.9 million.

    ''Everyone is questioning the qualifications of doctors in Puerto Rico. We need to fix that image,'' Chavier said. ``The majority of Puerto Ricans still have faith in their doctors and in Puerto Rico's medical community.''

    Among the proposed changes is a bill now before Puerto Rico's Legislature that would replace local licensing exams with the U.S. Medical Licensing Exam. But the move has sparked controversy because portions of the exam are available only in English.

    Rodr?guez said medical students and doctors on the island would benefit from the change by standardizing Puerto Rico's medical sector and establishing guidelines recognized nationally.

    Rodr?guez also believes Puerto Rico would benefit from having someone from the mainland with no political connections administer the certification exam on the island. Currently, the exams are administered at various hospitals and medical facilities by a doctor designated by the Medical Examiners Board.

    ''That's part of the problem: Too many people know too many people on the island,'' Rodr?guez said. ``At one point or another that's where the questions have been raised.''

    TRAVELING OUTSIDE

    If the Legislature votes to replace the local exam with the U.S. Medical Licensing Exam, candidates would have to travel to the U.S. mainland to take the practical skills portion of the test.

    Chavier said that while he is not opposed to changing the way doctors are licensed in Puerto Rico, he wants the process to be accessible to all students. A student now pays about $100 to take the certification exam. The U.S. Medical Licensing Exam would cost a student $1,000 -- not including airfare or accommodations, Chavier said.

    ''That will cause too many problems,'' he said.

    A year has passed since Gonz?lez buried his son. But his family is still trying to come to terms with his loss.

    ''Every day I pray this is all a nightmare and that I'll wake up with him in my arms again,'' he said.

    "Addressing chronic disease is an issue of human rights that must be our call to arms"
    Richard Horton, Editor-in-Chief The Lancet

    ~~~~ Twitter:@GertvanderHoek ~~~ GertvanderHoek@gmail.com ~~~
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