Case Title: Taylor v. Wyoming Bd. of Medicine

Citation: 

Docket Number: 

State: wyoming

Court: Wyoming Supreme Court

Date: 1997-01-21T00:00:00Z

Document:
Taylor v. Wyoming Bd. of Medicine1997 WY 7930 P.2d 973Case Number: 96-103Decided: 01/21/1997Supreme Court of Wyoming

Jack E. TAYLOR, M.D., Appellant 
(Petitioner),

v.

WYOMING BOARD OF MEDICINE, Appellee 
(Respondent).

Appeal from District Court, Laramie County, Edward L. 
Grant, J.

Mark E. Macy of Bayless, Slater & Macy, 
P.C., Cheyenne, for Appellant (Petitioner).

Don W. Riske, Special Assistant Attorney 
General, Cheyenne, for Appellee (Respondent).

Before TAYLOR, C.J., THOMAS, GOLDEN and 
LEHMAN, JJ., and VOIGT, District Judge. 

VOIGT, District Judge.

[¶1]      This is an appeal 
from the district court's order affirming appellee's decision to deny 
appellant's second application for reinstatement of his physician's license. 
Finding that appellee's decision was not arbitrary, capricious, characterized by 
an abuse of discretion, nor in violation of law, and that the decision was 
supported by substantial evidence, we affirm.

I. ISSUES

[¶2]      The parties' 
wording varies only slightly in stating the issues:

1. Whether the 
decision of the Wyoming Board of Medicine to deny Dr. Taylor's second Petition 
for Reinstatement of his physician's license was arbitrary, capricious, an abuse 
of discretion and otherwise not in accordance with the 
law.

2. Whether the 
decision of the Wyoming Board of Medicine to deny Dr. Taylor's second petition 
for reinstatement of his physician's license was unsupported by substantial 
evidence.

II. FACTS

[¶3]      In 1970, 
appellant, Jack E. Taylor (Taylor), was licensed to practice medicine in 
Wyoming. For several years thereafter, he engaged in the general practice of 
medicine in Gillette, Wyoming. However, in 1985, he pled guilty to obstruction 
of justice in a federal court case arising out of allegations that he had 
improperly obtained and dispensed controlled substances. Taylor was incarcerated 
for approximately fifteen months of a three-year sentence as a result of this 
conviction, and his license to practice medicine in the state of Wyoming was 
revoked.

[¶4]      In 1993, Taylor 
applied to the Wyoming Board of Medicine (Board) for reinstatement of his 
license. After a hearing on February 6, 1994, the Board denied Taylor's 
application for reinstatement. Taylor applied again in August of that year. The 
hearing on this application for reinstatement was held on February 4, 1995. 
Taylor's application for reinstatement was again denied. It is this latter 
denial that is the basis of this appeal.

III. STANDARD OF 
REVIEW

[¶5]      Judicial review 
of administrative agency action takes place pursuant to the dictates of Wyo. 
Stat. § 16-3-114 (1990). W.R.A.P. 12.09; United States Steel Corp. v. Wyoming 
Environmental Quality Council, 575 P.2d 749, 750 (Wyo. 1978). In an appeal from 
a decision of the Wyoming Board of Medicine, this right to appeal is also 
specifically recognized at Wyo. Stat. § 33-26-407 (Cum.Supp. 1996). A party not 
satisfied with the result of an appeal to the district court may seek further 
review by this court. Wyo. Stat. § 16-3-115 (1990). In such case, this court 
accords no special deference to the district court's conclusions, but inquires 
into the matter as if it had come directly from the administrative agency. 
Chevron U.S.A., Inc. v. State, 918 P.2d 980, 982 (Wyo. 1996); Matter of Andren, 
917 P.2d 178, 180 (Wyo. 1996).

[¶6]      These statutory 
judicial review standards have been analyzed countless times by this court. See, 
e.g., State ex rel. Wyoming Workers' Compensation Div. v. Espinoza, 924 P.2d 979, 981 (Wyo. 1996); Laramie County Bd. of Equalization v. Wyoming State Bd. of 
Equalization, 915 P.2d 1184, 1188-89 (Wyo. 1996); Matter of Goddard, 914 P.2d 1233, 1236-38 (Wyo. 1996); Devous v. Wyoming State Bd. of Medical Examiners, 845 P.2d 408, 413-15 (Wyo. 1993). Consistently, it has been stated that the party 
contesting the administrative agency decision has the burden of proving that the 
agency's decision was reached in violation of one or more of the standards set 
forth in Wyo. Stat. § 16-3-114(c). Devous, 845 P.2d  at 414; Mountain Fuel Supply 
Co. v. Public Service Com'n of Wyoming, 662 P.2d 878, 883 (Wyo. 1983). Upon 
review of the entire record, if the reviewing court finds the administrative 
agency decision to have been based upon substantial evidence, and in conformity 
with the law, the court will not substitute its judgment for that of the agency. 
Olheiser v. State ex rel. Wyoming Workers' Compensation Div., 886 P.2d 269, 272 
(Wyo. 1994); Devous, 845 P.2d  at 414. Substantial evidence is defined as 
relevant evidence that a reasonable mind can accept as adequate to support the 
administrative agency's conclusion. Coleman v. State ex rel. Wyoming Workers' 
Compensation Div., 915 P.2d 595, 598 (Wyo. 1996); Devous, 845 P.2d  at 414. In 
its review of the administrative agency action to determine whether such was 
arbitrary, capricious, or characterized by an abuse of discretion, the court 
looks to whether the administrative agency's decision is based on a 
consideration of relevant factors and whether it is rational. Tri-State 
Generation and Transmission Ass'n, Inc. v. Environmental Quality Council, 590 P.2d 1324, 1330 (Wyo. 1979).

IV. DISCUSSION

[¶7]      The practice of 
medicine in Wyoming is governed by the Medical Practice Act. Wyo. Stat. §§ 
33-26-101 through 33-26-511 (1987 & Cum.Supp. 1996). Pertinent sections of 
the Act as it appeared at the time of relevant events provide as 
follows:

1. The Wyoming 
Board of Medicine is created to regulate the practice of medicine. Wyo. Stat. § 
33-26-201 (Cum.Supp. 1996).

2. No person may 
practice medicine in this state without first having obtained a license from the 
Board. Wyo. Stat. § 33-26-301 (1987).

3. Mandatory 
requirements for licensing are adopted, and the Board is authorized to impose 
additional regulations "necessary to implement" the Act. Wyo. Stat. §§ 
33-26-202(b)(v), 33-26-302, 33-26-303(a)(x) (Cum. Supp. 
1994).

4. Specific 
standards are adopted whereby the Board "may refuse to grant or renew, revoke, 
suspend or restrict a license or take other disciplinary action * * *." Wyo. 
Stat. § 33-26-402(a) (Cum.Supp. 1994).

5. Reinstatement of 
a license may be sought by petition to the Board, which petition "shall state 
reasons and contain information demonstrating that the petitioner is no longer 
impaired and is able to safely, skillfully and competently resume the practice 
of medicine." Wyo. Stat. § 33-26-406(b) (1987).

6. Upon denial of a 
petition for reinstatement, the petitioner must wait a full year before 
submitting another such petition. Wyo. Stat. § 33-26-406(d) 
(1987).

[¶8]      Pursuant to its 
statutory authority, the Board has adopted certain Rules and Regulations for 
Physicians and Physicians Assistants. Section 5(b) of Chapter 4 thereof contains 
the Board's requirements for a personal interview with any applicant for license 
reinstatement:

In addition to the 
requirements of W.S. 33-26-303 and pursuant to W.S. 33-26-303(x), the Board 
shall require all applicants, other than applicants for a temporary license, to 
appear before the Board and to establish in a personal interview, by oral 
responses his or her knowledge of and ability to practice medicine and to 
answer, to the satisfaction of a majority of Board members, any questions 
regarding past or pending disciplinary actions in this or any other state and 
personal and professional history.

[¶9]      Taylor presents a 
two-pronged attack against the application of this body of law in his case. 
First, he contends that "the Board has not provided any meaningful objective 
standards that must be met or criteria that must be satisfied before an 
applicant's medical license can be reinstated." Second, he alleges that the 
Board failed to make adequate findings of fact to support its denial of the 
application for reinstatement. While his first argument, when made to the 
district court, was couched in terms of due process, it is made to this court 
under Wyo. Stat. § 16-3-114.

[¶10]   The denial of Taylor's second 
application for reinstatement of his license can only be understood in the 
context of the denial of his first application for reinstatement, and the 
earlier revocation of his license. A review of the entire record reveals an 
uncomplicated course of significant events. In 1985, Taylor, a licensed 
practicing physician, pled guilty in federal court to a felony (obstruction of 
justice) in a case involving underlying allegations of unlawful prescription 
drug practices and sexual contact with patients. As a result, Taylor's license 
to practice medicine in the state of Wyoming was revoked in 1986. Some seven 
years later, Taylor made his first petition for reinstatement of that 
license.

[¶11]   On February 6, 1994, the Board 
provided Taylor with a hearing on this first application for reinstatement. The 
record contains a twenty-page transcript of this hearing. Taylor was questioned 
in detail about the incidents leading to his criminal conviction, about his 
plans for the future practice of medicine in the event his license were to be 
reinstated, about his knowledge of particular medical procedures, about any 
medical education since revocation of his license, and about his views and 
opinions of the propriety of physician/patient sexual relationships. The Order 
Denying Application for Reinstatement of Physician's License resulting from the 
hearing contains the following relevant findings:

3. Taylor's 
application for reinstatement and his own statements to the Board during his 
personal interview before the Board on February 6, 1994, reveal that Taylor 
served a three year term in a federal penitentiary as the result of a guilty 
plea entered by him to felony obstruction of justice charges. It was admitted by 
Taylor that the charges stemmed from several incidents involving his practice of 
medicine in the State of Wyoming and controlled substance prescriptions for 
family members and friends with whom he had or was having sexual relationships. 
Taylor also admitted acquiring a controlled substance for himself through the 
use of a prescription which he wrote for an employee. Taylor did not indicate to 
the Board that he had any remorse about such incidents or accept responsibility 
for such events.

4. Taylor's 
interview also revealed that he has not practiced medicine since 1986 and that 
he does not possess current and complete knowledge in the scope of practice 
indicated in his application to enable him to safely and competently provide 
medical care and treatment to the people of the State of 
Wyoming.

5. Taylor's 
interview also revealed that he had not considered at the time of the events 
which led to his felony conviction, nor was he aware of at this time, the 
considerations of appropriate physician/patient 
boundaries.

[¶12]   Taylor's second application for 
reinstatement, the denial of which is presently before this court, was made on 
August 12, 1994, about six months after the above-described hearing and order. 
In response to the application for reinstatement, the Board's Licensing Officer 
notified Taylor that he should provide two reference letters and verification of 
his license to practice in other states. Taylor provided four letters of 
reference, information as to his prior licensing in other states, and additional 
supportive documentation. A follow-up letter from the Board's Executive 
Secretary on September 12, 1994, then reminded Taylor to

be prepared at that 
meeting to show the Board additional training and documentation of continuing 
education to bolster your petition for reinstatement. Because you have not 
practiced medicine for several years, the Board will be concerned about your 
currency in many areas of medicine and it would be helpful to them, and expedite 
the process for you, to have that information readily available * * 
*.

[¶13]   In January 1995, Taylor forwarded 
to the Board copies of continuing education certification for two programs he 
had completed - an 11.5 hour primary care course at Vail, Colorado, and a 60 
hour video taped family practice course from the University of Nebraska Medical 
Center. Finally, on January 10, 1995, the Board's Executive Secretary contacted 
Taylor again, advised him of the exact time, date, and place of the hearing, and 
informed him that

the Board will ask 
you questions regarding your medical knowledge, personal and professional 
history and intentions for practicing medicine in this State. Additionally, 
please be prepared to answer detailed, specific questions pertaining to medical 
practice in your area of expertise as a general 
practitioner.

[¶14]   To summarize, it is apparent that 
when Taylor appeared for the hearing on this second application for 
reinstatement, he had access to or knowledge of (1) the relevant statutes; (2) 
the relevant administrative rules; (3) everything discussed at the first 
hearing; (4) the findings and conclusions from the first hearing; and (5) the 
concerns of the Board expressed by the Executive 
Secretary.

[¶15]   In this setting, the February 4, 
1995 hearing commenced with the Board asking Taylor the following general 
question: "[W]hat has occurred over the past year which would convince this 
Board to grant you a license to practice medicine in the State of Wyoming?" 
Taylor's only response was to mention the two continuing education courses he 
had completed, and to suggest that he had read some medical journals or 
magazines. This was followed by another general question from the Board as to 
whether there was anything else Taylor wanted to bring up. Taylor then mentioned 
the letters of recommendation he had supplied. Board members then asked Taylor 
nine or ten specific questions about the continuing education programs and the 
fact that he had not practiced medicine for seven years. Finally, the Board once 
more asked Taylor if he had any "additional insights" for the Board. Taylor 
responded that he had some ideas that might involve working with occupational 
medicine or planned parenthood. He did not expand upon those ideas. Neither did 
he address any of the specific concerns that had been brought to his attention 
at the previous hearing or in the letters from the Executive 
Secretary.

[¶16]   By letter dated February 9, 1995 
from the Board's Executive Secretary, Taylor was informed that his application 
for reinstatement had been denied. The stated reason was "your failure to 
demonstrate that you are no longer impaired and that you are able to safely, 
skillfully and competently resume the practice of medicine. W.S. 33-26-406(b)." 
The Board's later official Findings of Fact, Conclusions of Law and Order 
Denying Application for Reinstatement of Physician's License was more detailed. 
Relevant Findings of Fact included:

3. On the 30th day 
of June, 1986, the Board revoked Taylor's license due to his conviction of a 
felony as the result of a guilty plea entered by him to felony obstruction of 
justice charges. Taylor served a three year term in a federal penitentiary on 
such charges.

* * 
*

6. During his 
interview on this application, Taylor's [sic] admitted that he has not practiced 
medicine since 1986. Taylor described the medical education courses that he had 
pursued since his appearance before the Board in February, 
1994.

7. Based thereon, 
the Board finds that Taylor does not possess current and complete knowledge in 
the scope of practice indicated in his application to enable him to safely and 
competently provide medical care and treatment to the people of the State of 
Wyoming.

[¶17]   The Board's Conclusions of Law were 
as follows:

1. This application 
is governed by the procedures and standards set forth in W.S. § 
33-26-406.

2. Taylor does not 
possess current and complete knowledge in the scope of practice indicated in his 
application to enable him to safely and competently provide medical care and 
treatment to the people of the State of Wyoming.

3. Since Taylor 
does not possess current and complete knowledge in the scope of practice 
indicated in his application to enable him to safely and competently provide 
medical care and treatment to the people of the State of Wyoming, his 
application must be denied.

V. CONCLUSION

[¶18]   Taylor does not dispute the fact 
that it was his burden at the hearing to show that he met Wyoming's standards 
for practicing medicine. From the above-cited statutes and administrative 
regulations, from his previous hearing, and from the Executive Secretary's 
"warning letters," Taylor could not have been unaware that the chief concern of 
the Board was his ability "to safely, skillfully and competently resume the 
practice of medicine," given the nature of his earlier offenses, and given the 
passage of seven years since he last practiced medicine. Yet he produced almost 
no evidence in that regard. Consequently, he cannot be heard to complain that 
the Board's findings of fact were insufficient. As correctly pointed out by the 
district court in its affirmance of the Board's decision, the law does not 
require an administrative agency to make basic findings of fact when the agency 
concludes that a party has failed to meet its burden of proof. City of Casper v. 
Utech, 895 P.2d 449, 451-52 (Wyo. 1995). Even if this were not the law, we would 
hold the basic findings of fact to be adequate in this case to allow judicial 
review and to support the ultimate findings of fact and conclusions of law. The 
decision of the Wyoming Board of Medicine is affirmed.