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The Kansas medical board is a fifteen-member body, made up mostly of physicians, whose mission is to "utilize the least restrictive yet effective means to protect the public from incompetence, unprofessional conduct or other proscribed practice." After two board committees reviewed his case, Swanson, his lawyer and the board's attorneys drew up a settlement agreement in lieu of a hearing -- thus avoiding testimony by Swanson's former patients and expert witnesses on his competence as a physician.
There was no hearing on whether the complaints were valid, says Lawrence Buening, executive director for the Kansas Board of Healing Arts. Swanson agreed to only three of the counts against him: for negligence in two of the chemical face peels (Mundstock's complaint was not one of them) and for writing an incorrect prescription. The other seventeen counts were dismissed without further investigation. Swanson was ordered to pay the board $40,000 to cover legal fees.
The board banned him from performing TCA chemical peels, as well as liposuction on morbidly obese patients. He couldn't perform liposuction, abdominoplasty and thigh lifts on a single patient in one operation. His practice would be monitored by an appointed physician through October 2001.
Swanson signed an agreement admitting negligence on the three counts in return for having the other seventeen dropped. Such agreements are "very common," says Buening. He characterizes a doctor's agreement with the board as similar to an out-of-court settlement in a civil case or a plea bargain in a criminal case.
Buening says Swanson's twenty counts are "more than normal" but says the board doesn't keep statistics on the number of complaints it receives about doctors.
In June 2000, Swanson and his attorney defended his medical license in a hearing prompted by complaints to the Missouri Board of Healing Arts, which sent Swanson's case to the Missouri Administrative Hearing Commission, a state agency that rules on disputes between individuals and other state agencies. That group found cause to discipline Swanson on five counts. Two of the commission's findings of negligence were for Mundstock and Renée, whose complaints had been dropped by the Kansas medical board.
The eighteen counts in Missouri were "probably higher than usual," says Tina Steinman, executive director of the Missouri Board of Healing Arts. "Any time the board disciplines a physician, it's considered to be a serious matter."
The findings against Swanson prompted the Missouri Board of Healing Arts to warn Swanson in January that if he ever opened another office in Missouri, his license would immediately be subject to a year of probation. (This would be in addition to the seven years' probation the board had already imposed on his license in 1999, after his disciplinary action in Kansas.) Swanson appealed that ruling to the Cole County Circuit Court, which could still override the medical board's decision.
The Kansas medical board had mandated that an independent doctor watch over Swanson's practice through October 2001. The board allowed Swanson to keep performing certain surgeries for which he'd been disciplined, though he had to hand over medical charts for 20 percent of those patients. But in March of this year, when that board denied Swanson's motion to end the limitations on his license, it said Swanson had submitted only one or two medical charts a month during the last three years -- far less than 20 percent. The board decided not to lift the restrictions on Swanson's license.