Blunder doctors face scrutiny

Over 50 doctors, dentists, physiotherapists and psychologists have been forbidden to practice in the Netherlands after being caught up in malpractice scandals. Joep Derksen uncovers the Health Care Inspectorate’s long list of blunder doctors.

For many years, the Dutch believed they had the best health care system in the world. Over the past years, however, they have been proven wrong. A series of reports on medicinal and operational blunders, published by the Inspectie voor de Gezondheidszorg (Health Care Inspectorate, IGZ) reveals over 50 organisations and professionals who have made medicinal blunders or failed to improve their practice. In these malpractice cases, there are three measures the IGZ can take: administrative, disciplinary and criminal sanctions. An administrative sanction happens mostly when healthcare providers or organisations do not follow outlined procedures and endanger patients or clients. The disciplinary sanction is imposed only in cases where standards are seriously violated. According to the IGZ, this measure is first and foremost meant as “an instrument to make professionals learn from their mistake.”

Investigation Criminal sanctions, the most severe IGZ action, often involves an investigation by the Openbaar Ministerie (Public Prosecutor, OM).The icon and most prominent example of this last example is arguably Jansen Steur, a neurologist working at the Medisch Spectrum Twente (MST), who was heavily addicted to narcotics. Between 1998 and 2004, he declared dozens of patients terminally ill without having done a proper physical examination. The MST forced Steur to resign in 2004, but that did not deter the doctor. He continued his work at Germany's Mittelweser Hospital in Nienburg for some time.

Currently, the OM is investigating the suicide of one of Steur’s patients. The authorities believe that a wrongful diagnosis from the former neurologist may have led the patient to end his life. A court date has not yet been set. In a more recent case, a Dutch-based vascular surgeon made headlines when it was revealed alcohol addiction affected his work. The IGZ launched an investigation into suspected medical misconduct as early as 2007, but has not yet charged the physician. This is partly due to the fact that the doctor left the Netherlands and now resides in the United Kingdom.

Another case involves a physician at the Scheper Hospital who specialised in stomach operations. He did this despite being previously condemned in Germany for making mistakes in the operating room, causing the death of at least one of his patients. When deaths were recorded at the Scheper Hospital after similar surgeries, this doctor became the IGZ’s suspect number one. The OM is currently investigating the matter.

Scrutinised

Alternative therapies are also being scrutinised by the Ministry of Justice. An estimated 67 percent of oncologists have at least one patient a year who stops treatment and opts for alternative therapy. One of these patients was Dutch actress, Sylvia Millecam. She profoundly refused the medically approved methods of treating her cancer and put her full trust in the alternative scene. Her death in 2001 led to heavy criticism of alternative therapy, with doctors claiming Millecam would have had a solid chance of beating cancer had she chosen to fight the disease with intense hospital supervision.

Even now, 80 percent of oncologists are of the opinion that patients should be wary of alternative therapies. In 2008, cancer research organisation, KWF Kankerbestrijding announced they would publish a blacklist of alternative healers who claim that they can cure cancer. However, legal risks have held up the process and a list has thus far not materialised. “The publication of the blacklist was more complicated than we anticipated,” says Marsja Meijer, press spokesperson for the KWF. “We cannot freely publish the names of people without their consent.” Meijer says the KWF hopes to publish a list of treatments that are not scientifically proven by year's end. The aim is to provide solid advice to cancer patients and map out effective treatments.

Supervision

Already available is an overview of institutions and healthcare providers who are currently under strict supervision, published by the IGZ and dating back to September 2009. Wilbert Ransz, spokesperson for the IGZ, denies that this is a so-called blacklist. The source is meant to provide the public with important information regarding the status of healthcare practitioners. In 2010, about 30 disciplinary cases were filed by the IGZ and the problematic practices added to the list. Among these, the strictest disciplinary measures were taken against Mater Misericordiae nursing home Tilburg (March 2011), Accres dental practice in Den Helder en Medemblik (February 2011) and hospital-pharmacy Noord-Brabant (December 2010). An order to cease all activities was given to dentist R. Fiereg in Amsterdam (September 2010) and physician J. ter Laake in Damwoude (November 2010).

Ceasing activities does not necessarily mean the end of the world, however. Zepeda Cambronero used to be a doctor and a psychotherapist until the IGZ condemned his practice. Now, he is a barber in Oegstgeest.

More information on care providers under supervision can be found on: www.bigregister.nl/zoeken/zoekenopbevoegdheidsbeperking and www.igz.nl/onderwerpen/handhavingsinstrumenten/maatregelen/verscherpt-toezicht.

Published in "The Holland Times".