Saturday, April 21, 2012

Returning to Practice After Loss of License

Two years ago I wrote about Dr. Brian Kwetkowski, 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.


Anonymous said...

The RI Boards decision was indeed a just one. The man made a terrible error in judgment, yet the fact remains the same ..he is a truly spectacular doctor. We, his patients, all were 100% behind him through this. He is not immune to mistakes and to think that just because of his profession he was put out for all to scrutinize!! I have read you're other blight and see the many supportive comments and the few comments that aren't quite so favorable, especially one depicting him as a man who preys on vulnerable women. How absolutely absurd!!! I understand that loss makes us humans behave in curious ways, but that information is simply untrue and should not have been posted. I admire the mother for her somewhat neutral stance, she wouldn't really say something horrible or something great. But I'd appreciate it, as would many of his fellow patients, if she'd at least 1. Not comment or 2. Not allow others to depict him as a deviant pedofile. As a mother, anger is most certainly warranted. But to allow such a lie go unanswered with the truth is horrid. I mean honestly, clearly the disciplinary action board has no reason to believe he is, we all all know there's no way possible he could be, so lets get real here. If you don't want to be judged, stop giving us all reason to judge you.

Jim Sabin said...

Dear Anonymous -

Thank you for your comment.

As you say, many of Dr. Kwetkowski's patients wrote about him in the same way you do - that they'd found him to be "a truly spectacular doctor." You're right that no human is "immune to mistakes." But I think it was appropriate that as a physician his conduct was "put out for all to scrutinize." Society gives us physicians distinctive rights and privileges, and expects us to conduct ourselves in reliably ethical manner.

Dr. Kwetkowski failed to do that. The RI Board appears to have acted in a thoughtful and responsible manner. I hope that he will conduct himself in the "spectacular" way you've experienced for the rest of his career.

Just we as fallible humans are susceptible to serious lapses, as creatures capable of remorse and reform, we're "susceptible" to what William James called the "twice born" state.

I invite you to write a follow up comment in a year or two as to your observations.