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Saturday, 21 April 2012

Returning to Practice After Loss of License

Two years ago I wrote about Dr. Brian Kwetkowsi, a primary care physician in Rhode Island, who lost his license for having a sexual relationship with a patient. According to the Rhode Island Board of Medical Licensure and Discipline, Dr. Kwetkowski is a 1996 graduate of the New England College of Osteopathy, and is Board Certified in Family Medicine. The Board reported that three years prior to his voluntary surrender of his license, Dr. Kwetkowski commenced a sexual relationship with a 19 year old female patient.

The Board required Dr. Kwetkowski to "enter a treatment facility and complete all of the recommendations of the evaluators." Dr. Kwetkowski did this at the Acumen Institute, in Lawrence, Kansas. The clinical staff has impressive credentials. All had formerly been associated with the Meninger Clinic until the Clinic moved from Kansas to Texas in 2003. Here's how Acumen describes its program:
Embedded within all aspects of our individual and group treatment, education, and coaching processes is an emphasis on the components of professionalism, maintaining appropriate role functions, and high-achievement. We endeavor to help our clients to develop the insight and the skills they need to resolve work-related and personal difficulties and fashion life plans that foster integrity, authenticity, and physical and psychological well-being. Within an intensive day treatment/coaching process, our staff helps each physician to:

•Identify deficits in professionalism

•Recognize personal development needs and goals and develop an adaptive way to have those needs met

•Identify and adjust personality attributes that have led to self-defeating outcomes

•Monitor response to medication, if indicated

•Internalize new leadership and personal life skills sets

•Implement new skills that promote a team-based work environment

•Develop a leadership plan tailored to the client's particular strengths and career context
These are the right goals for physicians a licensure board sees as potentially capable of rehabilitation and return to practice.

I learned today from a reader's comment that on March 8, 2011, the Rhode Island Board of Medical Licensure and Discipline reinstated Dr. Kwetkowski's license. He must be monitored by the Rhode Island Physicians Health Committee for five years, continue in weekly psychotherapy, practice only in a group setting, be chaperoned with all female patients, and had to return to the Acumen Institute three times in 2011 for followup assessment, which included polygraph testing "to document the absence of boundary violations."

Many of Dr. Kwetkowski's former patients responded to my original post and described him as an outstanding physician. I assume from the Board's actions that his track record apart from the serious boundary violation must have been good, and that the violation was not part of a pattern carried out with other patients. I further assume that the Board believed that it was safe to allow him to return to practice under the specified conditions. If Dr. Kwetkowski continues to care for patients in the exemplary way former patients described and respects proper boundaries for the remainder of his career, the Board's decision will have been correct.


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