Case Title: Board of Physicians v. Banks

Citation: 354 Md. 59

Docket Number: 87/97

State: maryland

Court: Maryland Supreme Court

Date: 1999-05-12T00:00:00Z

Document:
No. 87, September Term, 1997
Board of Physician Quality Assurance v. Lester H. Banks * * *
Lester H. Banks v. Board of Physician Quality Assurance
[Whether The Board Of Physician Quality Assurance Could Reasonably Conclude That A
Physician’s Sexually Harassing Conduct Towards Co-employees, Committed While The
Physician Was On Duty At The Hospital And In Working Areas Of The Hospital,
Constitutes Immoral Or Unprofessional Conduct In The Practice Of Medicine Within The
Meaning Of Maryland Code (1981, 1994 Repl. Vol.), § 14-404(a)(3) Of The Health
Occupations Article]
IN THE COURT OF APPEALS OF MARYLAND
No. 87
September Term, 1997
___________________________________________
BOARD OF PHYSICIAN QUALITY
ASSURANCE
v.
LESTER H. BANKS
* * *
LESTER H. BANKS
v.
BOARD OF PHYSICIAN QUALITY
ASSURANCE
__________________________________________
        Bell, C.J.,
Eldridge
Rodowsky
Chasanow
Raker
Wilner
Cathell,
                       
         JJ.
___________________________________________
Opinion by Eldridge, J.
__________________________________________
        
Filed:  May 12, 1999
We issued a writ of certiorari in this case to decide whether the Board of Physician
Quality Assurance could reasonably conclude that a physician’s sexually harassing conduct
towards co-employees, committed while the physician was on duty at the hospital and in
working areas of the hospital, constitutes immoral or unprofessional conduct in the practice
of medicine within the meaning of Maryland Code (1981, 1994 Repl. Vol.), § 14-404(a)(3)
of the Health Occupations Article.
I.
From 1986 until 1991, Dr. Lester H. Banks worked at Carroll County General
Hospital as a medical-surgical house physician.  As house physician, Dr. Banks was expected
to work twelve hour shifts and was responsible for admitting patients into the hospital, caring
for patients, and assisting in the operating room and emergency department.  The house
physician program was new to the hospital and was thus underutilized by the medical staff,
resulting in considerable “down time” for the house physician.  Because of the
underutilization, Dr. Banks often agreed to work twenty-four and thirty-six hour shifts,
frequently working as many as thirty shifts per month.  When on duty, Dr. Banks was not
free to leave the hospital and was expected to be available at all times.  Nevertheless, when
Dr. Banks was on duty but not utilized by the medical staff, he was free to sleep, eat, watch
television, use the telephone, read, or visit with other employees in the hospital.  
The evidence at the administrative hearing in this case disclosed the following.
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During the time Dr. Banks was employed by Carroll County General Hospital, he engaged
in a pattern of sexually harassing female employees while he was on duty.  A unit secretary
at the hospital, witness #1, stated that Dr. Banks on several occasions came to her work
station and repeatedly touched her, rubbed her shoulders, back and neck, put his hands
through her hair, and pinched her behind.  She further stated that Dr. Banks “repeatedly made
rude and unnecessary comments, most often regarding sex.”  She testified that on one
occasion, Dr. Banks approached her from behind and put his hands around her waist and
squeezed her stomach.  Witness #1 was offended by Dr. Banks’s unwelcome advances and
told him to leave her alone.  She indicated that Dr. Banks’s “conduct often occurred in areas
where patients, visitors, and other staff could observe the embarrassing advances.”  Witness
#1 reported the offensive conduct to her supervisor and also filed a written report describing
the conduct.
Witness #2, a unit secretary in the hospital’s emergency department, also reported
sexual harassment by Dr. Banks.  She stated that on one occasion shortly after she began her
employment at the hospital, Dr. Banks was waiting behind her to stamp some documents on
the addressograph machine for a patient he was admitting.  While he was waiting, Dr. Banks
hit witness #2 “very hard on the backside, causing her to jump in surprise.”  Witness #2
testified that on another occasion, an employee had accidentally knocked over a cup of
coffee, spilling coffee on witness #2 and on her shoes.  At that time Dr. Banks asked witness
#2 to retrieve a patient chart for him.  Witness #2 told Dr. Banks that she would retrieve the
chart just as soon as she was able to clean the coffee off of herself.  Dr. Banks responded,
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“[w]hy don’t you let me lick it off.”  Witness #2 told Dr. Banks that he was “disgusting” and
that he should leave her alone.  On a third occasion, Dr. Banks came to witness #2’s desk
and asked her when she would go out with him, to which witness #2 responded “never.”  An
emergency department nurse observed and commented upon this last incident.  Witness #2
subsequently filed a complaint with the hospital administration concerning Dr. Banks’s
unwelcome behavior.
Witness #3, an emergency department registrar at the hospital, testified that Dr. Banks
asked her to go out with him for drinks.  Witness #3 declined, stating that she was only
nineteen years old and that she had a steady boyfriend.  On another occasion, witness #3 was
walking out of the ladies room into the hallway outside the emergency department when
Dr. Banks “pinned” her up against the wall with his arms and knee.  She stated that they were
so close that their stomachs were touching.  Dr. Banks then asked witness #3 “is it going to
be your place or mine?”  To this, witness #3 replied “neither.”  Dr. Banks again asked her
“when will it be?”  She replied “never.”   An orderly who observed the incident pulled Dr.
Banks away from witness #3, allowing her to escape.  Witness #3 overheard Dr. Banks say
to the orderly, “I guess she is not wet yet.”  Witness #3 prepared a written report of this
incident and subsequently filed a legal action against Dr. Banks.   
The director of the emergency department at the hospital counseled Dr. Banks on
several occasions regarding complaints about his conduct.  In December 1987, the director
counseled Dr. Banks concerning a comment Dr. Banks had made to a nurse, to the effect that
“I’d like to get you behind closed doors.”  In May 1988, Dr. Banks was again counseled for
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a comment to a female employee, who was wearing red, that wearing red on certain days
indicated sexual promiscuity.  Finally, in September 1991, Dr. Banks was counseled
concerning the incident with witness #3.  The hospital presented Dr. Banks with several
options, and he elected to take a leave of absence.  The hospital board of directors denied Dr.
Banks’s application for privileges as a result of his conduct.
The Board of Physician Quality Assurance received information that Dr. Banks had
been denied privileges at Carroll County General Hospital and subsequently decided to
charge Dr. Banks with violating §14-404(a)(3) of the Health Occupations Article, which
provides as follows:
“(a) In general. — Subject to the hearing provisions of § 14-405
of this subtitle, the Board, on the affirmative vote of a majority
of its full authorized membership, may reprimand any licensee,
place any licensee on probation, or suspend or revoke a license
if the licensee:
* * * 
(3) Is guilty of immoral or unprofessional conduct in the
practice of medicine . . . .”
The Board issued charges and a summons to Dr. Banks to appear at a hearing before an
administrative law judge (ALJ).
In a motion to dismiss the charges, Dr. Banks contended that the Board lacked
jurisdiction and authority to take action in this case because Dr. Banks’s conduct was not in
the practice of medicine as is required by §14-404(a)(3); rather, according to Dr. Banks, it
did not even bear “the slightest relationship to [Dr. Banks’s] performance of the practice of
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medicine, as that term is defined in § 14-101.”  Section 14-101(k) of the Health Occupations
Article defines the “practice of medicine” as follows:
“(1) . . . to engage, with or without compensation, in medical:
(i) Diagnosis;
(ii) Healing;
(iii) Treatment; or
(iv) Surgery.
(2)“Practice of medicine” includes doing, undertaking, pro-
fessing to do, and attempting any of the following:
(i) Diagnosing, healing, treating, preventing, prescribing for,
or removing any physical, mental, or emotional ailment or
supposed ailment of an individual . . . .”
The ALJ reserved ruling on Dr. Banks’s motion until after a hearing on the merits.  After
conducting the evidentiary hearing, the ALJ issued a proposed order finding the facts as
previously outlined and concluding that Dr. Banks violated § 14-404(a)(3) by committing
unprofessional conduct in the practice of medicine, on two different occasions, toward
witness #2.  The ALJ further concluded that Dr. Banks’s conduct involving witnesses #1 and
#3 was not in the practice of medicine.  The ALJ held that Dr. Banks’s conduct while waiting
to use the addressograph machine to admit a patient and requesting that witness #2 obtain
a patient record were “part of the undertaking of patient treatment” and were, therefore,
within the “actual performance of the practice of medicine.”  The ALJ stated that Dr. Banks
was not “undertaking the diagnosing, healing or treating of an individual during the events
described by witness #1 or witness #3.”  The ALJ proposed reprimanding Dr. Banks and
requiring an evaluation by a psychiatrist to determine if psychiatric treatment was necessary.
-6-
The Board of Physician Quality Assurance adopted the ALJ’s basic findings of fact
but determined that all of Dr. Banks’s above-described conduct, including his conduct
toward witnesses #1 and #3, constituted “immoral or unprofessional conduct in the practice
of medicine.”  The Board took the position that Dr. Banks’s conduct occurred within the
“practice of medicine” because his “presence in the hospital and ‘on-call’ status clearly
involved more than merely a ‘general or associative’ relationship with his practice as a
physician.”  Furthermore, the Board reasoned that a “hospital environment must at all times
be conducive to the practice of medicine” because at “any time, an unforseen patient care
emergency may require intensive team effort necessarily involving both physicians and
hospital staff.”  It determined that Dr. Banks’s conduct “risks a breakdown of the cooperation
[among] the medical team which is so necessary to patient treatment in a hospital setting.”
 The Board held that, because Dr. Banks’s “conduct affected and soured the hospital working
environment, there was a direct impact on patient care, thus implicating the actual practice
of medicine.”  The Board ordered that Dr. Banks be reprimanded and placed on probation
subject to terms and conditions, including evaluation by a psychiatrist to determine if he
should undergo psychotherapy.
Dr. Banks filed in the Circuit Court for Carroll County an action for judicial review
of the Board’s decision.  The circuit court affirmed the Board’s decision, reasoning that “the
legislature did not intend to limit the application of Section 14-404(a)(3) to cases in which
a physician is dealing with a patient directly, or face-to-face.”  The court agreed with the
Board that all of Dr. Banks’s immoral or unprofessional conduct towards the three witnesses
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was in the practice of medicine because it occurred while he was “on his shift at the
hospital,” “in uniform” (wearing scrubs), and present in the hospital “for the sole purpose
of practicing medicine.”
  
Dr. Banks appealed to the Court of Special Appeals which affirmed in part and
reversed in part.  Banks v. Board of Physician Quality Assurance, 116 Md.App. 249, 695
A.2d 1260 (1997).  The intermediate appellate court held that, in order to discipline a
physician under § 14-404(a)(3), the immoral or unprofessional conduct must occur “during
the diagnosis, care, or treatment of patients.”  116 Md.App. at 262, 695 A.2d at 1267.  Using
this definition of the “practice of medicine,” the Court of Special Appeals affirmed the circuit
court’s decision with respect to witness #2.  The court reasoned that Dr. Banks’s conduct
was within the practice of medicine because using the addressograph machine and requesting
a patient record were both “necessary procedure[s] and . . . part of the treatment of a patient.”
116 Md.App. at 263, 695 A.2d at 1268.  The Court of Special Appeals disagreed with the
circuit court and the Board with respect to witnesses #1 and #3 because Dr. Banks was not
“diagnosing, caring for, or treating patients while he was sexually harassing witnesses one
or three.”  116 Md. App. at 263, 695 A.2d at 1267.
 
Both sides filed petitions for a writ of certiorari, and this Court granted both petitions.
Board of Physicians v. Banks, 347 Md. 683, 702 A.2d 291 (1997).  Although worded
differently, both petitions presented essentially the same issue, namely whether Dr. Banks’s
conduct, as previously described, constituted immoral or unprofessional conduct in the
practice of medicine within the meaning of § 14-404(a)(3) of the Health Occupations Article.
-8-
II. 
A.
A court’s role in reviewing an administrative agency adjudicatory decision is narrow,
United Parcel v. People’s Counsel, 336 Md. 569, 576, 650 A.2d 226, 230 (1994); it “is
limited to determining if there is substantial evidence in the record as a whole to support the
agency’s findings and conclusions, and to determine if the administrative decision is
premised upon an erroneous conclusion of law.”  United Parcel, 336 Md. at 577, 650 A.2d
at 230.  See also Code (1984, 1995 Repl. Vol.), § 10-222(h) of the State Government Article;
District Council v. Brandywine, 350 Md. 339, 349, 711 A.2d 1346, 1350-1351 (1998);
Catonsville Nursing v. Loveman, 349 Md. 560, 568-569, 709 A.2d 749, 753 (1998).
In applying the substantial evidence test, a reviewing court decides “‘“whether a
reasoning mind reasonably could have reached the factual conclusion the agency reached.”’”
Bulluck v. Pelham Wood Apts., 283 Md. 505, 512, 390 A.2d 1119, 1123 (1978).  See
Anderson v. Dep’t of Public Safety, 330 Md. 187, 213, 623 A.2d 198, 210 (1993).  A
reviewing court should defer to the agency’s fact-finding and drawing of inferences if they
are supported by the record.  CBS v. Comptroller, 319 Md. 687, 698, 575 A.2d 324, 329
(1990).  A reviewing court “‘must review the agency’s decision in the light most favorable
to it; . . . the agency’s decision is prima facie correct and presumed valid, and . . . it is the
agency’s province to resolve conflicting evidence’ and to draw inferences from that
evidence.”  CBS v. Comptroller, supra, 319 Md. at 698, 575 A.2d at 329, quoting Ramsay,
Scarlett & Co. v. Comptroller, 302 Md. 825, 834-835, 490 A.2d 1296, 1301 (1985).  See
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 Liberty Nursing v. Department, 330 Md. 433, 443, 624 A.2d 941, 945-946 (1993); Caucus v.
1
Maryland Securities, 320 Md. 313, 324, 577 A.2d 783, 788 (1990); State Election Bd. v. Billhimer,
314 Md. 46, 59, 548 A.2d 819, 826 (1988), cert. denied, 490 U.S. 1007, 109 S.Ct. 1644, 104 L.E.2d
159 (1989); Supervisor v. Asbury Methodist Home, 313 Md. 614, 626, 547 A.2d 190, 196 (1988).
 On the other hand, when a statutory provision is entirely clear, with no ambiguity whatsoever,
2
“administrative constructions, no matter how well entrenched, are not given weight.”  Macke Co. v.
Comptroller, 302 Md. 18, 22-23, 485 A.2d 254, 257 (1984).
Catonsville Nursing v. Loveman, supra, 349 Md. at 569, 709 A.2d at 753 (final agency
decisions “are prima facie correct and carry with them the presumption of validity”).
Despite some unfortunate language that has crept into a few of our opinions,   a
1
“court’s task on review is not to ‘“‘substitute its judgment for the expertise of those persons
who constitute the administrative agency,’”’”  United Parcel v. People’s Counsel, supra, 336
Md. at 576-577, 650 A.2d at 230, quoting Bulluck v. Pelham Woods Apts., supra, 283 Md.
at 513, 390 A.2d at 1124.  Even with regard to some legal issues, a degree of deference
should often be accorded the position of the administrative agency.  Thus, an administrative
agency’s interpretation and application of the statute which the agency administers should
ordinarily be given considerable weight by reviewing courts.  Lussier v. Md. Racing
Commission, 343 Md. 681, 696-697, 684 A.2d 804, 811-812 (1996), and cases there cited;
McCullough v. Wittner, 314 Md. 602, 612, 552 A.2d 881, 886 (1989) (“The interpretation
of a statute by those officials charged with administering the statute is . . . entitled to
weight”).   Furthermore, the expertise of the agency in its own field should be respected.
2
Fogle v. H & G Restaurant, 337 Md. 441, 455, 654 A.2d 449, 456 (1995); Christ v.
Department, 335 Md. 427, 445, 644 A.2d 34, 42 (1994) (legislative delegations of authority
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to administrative agencies will often include the authority to make “significant discretionary
policy determinations”); Bd. of Ed. For Dorchester Co. v. Hubbard, 305 Md. 774, 792, 506
A.2d 625, 634 (1986) (“application of the State Board of Education’s expertise would clearly
be desirable before a court attempts to resolve the” legal issues).
B.
At the outset, we point out that there was clearly substantial evidence supporting the
ALJ’s findings of basic facts which were adopted by the Board.  The testimony and written
statements by witnesses 1, 2, and 3 directly supported the administrative findings of fact.
Moreover, the ALJ and the Board were certainly justified in characterizing Dr. Banks’s
conduct as “immoral or unprofessional conduct.”  The only real disputed issue in these
judicial review proceedings has been whether Dr. Banks’s conduct occurred “in the practice
of medicine.”
In light of the principles outlined in Part II A above, we believe that the Board’s
conclusion, that Dr. Banks’s conduct with regard to witnesses 1, 2 and 3, occurred “in the
practice of medicine,” was reasonable.  The circuit court correctly affirmed the Board’s
decision.
In 1888, the Maryland Legislature adopted an “original Act creating a system for the
regulation of the practice of medicine and surgery in Maryland.”  Aitchison v. State, 204 Md.
538, 544, 105 A.2d 495, 498, cert. denied 348 U.S. 880, 75 S.Ct. 116, 99 L.Ed. 692 (1954).
Section 7 of this Act authorized denial or revocation of a physician’s certificate upon proof
of “unprofessional or dishonorable conduct.”  Ch. 429 of the Acts of 1888.  It was not until
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 Ch. 469 of the Acts of 1968 allowed a physician to be disciplined for “[i]mmoral conduct of
3
a physician in his practice as a physician.”  Ch. 469 repealed former Article 43, § 145, which merely
required “conviction of crime involving moral turpitude or unprofessional or dishonorable conduct.”
1968 that Maryland law required that the immoral or unprofessional conduct of the physician
occur in the practice of medicine.  Ch. 469 of the Acts of 1968.   Section 14-404(a)(3) of the
3
Health Occupations Article is the most recent version of this statute, requiring that the
physician’s conduct be “immoral or unprofessional conduct in the practice of medicine.”  
On one previous occasion this Court examined what is embraced by the phrase “in the
practice of medicine.”  In McDonnell v. Comm’n on Medical Discipline, 301 Md. 426, 429-
430, 483 A.2d 76, 77-78 (1984), we considered the question of whether a physician’s attempt
to intimidate adverse expert witnesses scheduled to testify against him in a medical
malpractice case was “[i]mmoral conduct of a physician in his practice as a physician” in
violation of § 14-404(a)(3)’s statutory predecessor, Code (1957, 1980 Repl. Vol.), Article
43, § 130(h)(8).  We held that, although Dr. McDonnell’s conduct was “improper and not
to be condoned,” it was “not censurable under § [14-404(a)(3)].”  McDonnell, 301 Md. at
434, 483 A.2d at 80.  The Court agreed that Dr. McDonnell’s act was “related to his
professional practice” but was insufficient to bring his conduct within the statute’s
requirement that the conduct occur in his “practice as a physician.”  301 Md. at 437, 483
A.2d at 81.  We held that immoral conduct merely committed during the term of licensure
or having only a “general or associative relationship to the physician in his capacity as a
member of the medical profession” is not within the language of the statute.  301 Md. at 436,
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483 A.2d at 81.  Rather, the “application of [§ 14-404(a)(3)] is directly tied to the physician’s
conduct in the actual performance of the practice of medicine, i.e., in the diagnosis, care, or
treatment of patients.”  301 Md. at 437, 483 A.2d at 81.  
In the present case, the Board rejected Dr. Banks’s argument that our McDonnell
holding  precluded Board action.  The Board distinguished McDonnell, concluding that the
“connection between [Dr. McDonnell’s] conduct in the judicial arena and the practice of
medicine is tenuous.”  The Board held that Dr. Banks’s conduct was “closely associated with
[his] practice as a physician” because of his “presence in the hospital and ‘on-call’ status.”
It reasoned that Dr. Banks’s conduct had more than a “general or associative” relationship
to the practice of medicine because it “affected and soured the hospital working
environment,” thereby having a “direct impact on patient care” and falling within the scope
of § 14-404(a)(3).
Dr. Banks argues that none of his conduct is within the practice of medicine because,
when it occurred, he was not diagnosing, treating or evaluating patients.  He points out that
when he committed these acts of sexual harassment, he was merely “chatting or socializing
with co-workers.”  (Banks’s brief at 11).  In addition, Dr. Banks relies on the fact that these
co-workers were not nurses, doctors, physician’s assistants, or medical technicians, and,
therefore were “not trained in the practice of medicine or nursing and [do] not participate
directly in the care, treatment or diagnosis of patients.”  (Id. at 9.)  Dr. Banks specifically
disputes the Court of Special Appeals’ conclusion that he was practicing medicine during the
incidents concerning witness #2.  He asserts that stamping a chart on the addressograph
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machine and requesting a chart from medical records are merely clerical functions which are
not within the definition of diagnosing, caring for, or treating patients.  Otherwise, he argues,
when clerical personnel such as witness #2 perform clerical tasks, they engage in the practice
of medicine without a license.  Dr. Banks states that when the addressograph incident
occurred, he had not yet seen or diagnosed a patient.  Similarly, he argues that when he
requested that witness #2 retrieve a chart for him, he merely wanted the chart in order to
“sign off” on it, which is typically done when a patient has already been discharged.  
We agree with the Board that this case is distinguishable from McDonnell.  In
McDonnell, the physician’s conduct occurred during judicial proceedings against him based
upon conduct constituting malpractice.  His conduct did not occur in the workplace where
he was present for the purpose of practicing medicine.  Dr. McDonnell’s conduct had only
a “general or associative relationship” to his “capacity as a member of the medical
profession” rather than being “directly tied to [his] conduct in the actual performance of the
practice of medicine, i.e., in the diagnosis, care, or treatment of patients.”  McDonnell, 301
Md. at 436-437, 483 A.2d at 81.  
The Board could reasonably hold that Dr. Banks’s conduct of sexually harassing
hospital employees was within the practice of medicine because he was on duty and in the
working areas of the hospital.  When on duty, Dr. Banks was responsible for admitting
patients, caring for patients, and assisting in the operating room and emergency department.
He was not free to leave, and he was expected to be available at all times.  When Dr. Banks
was on duty he was there for the purpose of practicing medicine; i.e., for the “diagnosis,
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care, or treatment of patients.”  McDonnell, 301 Md. at 437, 483 A.2d at 81.  Dr. Banks
sexually harassed his co-workers who were present in the working areas of the hospital in
connection with the practice of medicine.  This conduct has more than merely a “general or
associative relationship” to Dr. Banks’s capacity as a member of the medical profession.  The
connection to the practice of medicine was sufficient for the Board to conclude that it is “in
the actual performance of the practice of medicine.” 
The Court of Special Appeals’ interpretation and application of the statute creates a
distinction without a difference.  Under that court’s analysis, Dr. Banks could not be
sanctioned for his unwanted advances towards and touching of witness #1 while she was at
her work station but he could be disciplined for this conduct if he had asked witness #1 to
retrieve a chart for him or to prepare a patient’s file.  Similarly, Dr. Banks could not be
sanctioned for accosting witness #3 in the hallway unless witness #3 was engaged in conduct
such as retrieving a patient’s chart or on her way to use the addressograph machine.  
Dr. Banks urges that the practice of medicine be interpreted even more narrowly.  He
suggests that a physician may only be sanctioned under § 14-404(a)(3) if he or she is in the
immediate process of diagnosing, evaluating, examining or treating a patient and engaged in
a non-clerical task.  This approach would lead to illogical results.  For example, Dr. Banks
concedes that a physician could be disciplined for exposing himself while examining an x-
ray to determine whether a patient broke a bone because this is actual diagnosis and thus falls
within the practice of medicine.  (Banks’s reply brief at 15-16).  On the other hand, if the
physician were to expose himself to a nurse in the hallway immediately before or after
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examining the x-ray, this would not be in the practice of medicine, and hence not within the
purview of § 14-404(a)(3).  This approach so narrowly construes § 14-404(a)(3) that it would
lead to unreasonable results and render the statute inadequate to deal with many situations
which may arise.
Other jurisdictions have rejected such a limited interpretation of statutes similar to §
14-404(a)(3) and have held that a medical professional’s conduct in sexually harassing co-
workers and employees is within the practice of medicine.  The Hawaii Supreme Court
upheld a physician’s suspension from the practice of medicine when he committed acts of
sexual misconduct against his medical assistant in connection with her performance of
clerical tasks.  Loui v. Board of Medical Examiners, 78 Hawai’i 21, 889 P.2d 705 (1995).
The Loui court reasoned that this conduct was sufficient to satisfy the statutory requirement
that the physician’s conduct be “‘substantially related to the qualifications, functions, or
duties of a physician.’”  Loui, 78 Hawai’i at 30-31, 889 P.2d at 714-715.  In Flickinger v.
Com., Dept. of State, 75 Comwlth. Ct. 84, 86-89, 461 A.2d 336, 337-338 (Pa. 1983), the
Pennsylvania court upheld the revocation of a chiropractor’s license when he committed
“gross . . . misconduct in carrying on of such profession” by sexually harassing his co-
workers and employees.  
The primary factors that distinguish this case from McDonnell were that Dr. Banks
was on duty at the hospital, and was present in the working areas of the hospital.  In other
cases considering whether a physician’s conduct was within the statutory requirement of  “in
the practice of medicine,” a critical factor has been whether the conduct occurred while the
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physician was performing a task integral to his or her medical practice.  Courts have not
applied an extremely technical and narrow definition of the practice of medicine.  For
example, physicians have been disciplined for misconduct in the practice of medicine while
performing clerical tasks such as billing third party payors.  See Wassermann v. Board of
Regents of University, 11 N.Y.2d 173, 177-179, 182 N.E.2d 264, 265-266, 227 N.Y.S.2d
649, 650-652, cert. denied 371 U.S. 861, 83 S.Ct. 116, 9 L.Ed.2d 99 (1962) (physician’s
license revoked due to finding of “‘fraud or deceit in the practice of medicine’” when
physician submitted false reports and bills to an attorney even though the fraud was not
perpetrated directly on the patient); Catena v. Com., State Bd. of Medical Ed., 49 Cmwlth.
Ct. 542, 543-547, 411 A.2d 869, 870-871 (Pa. 1980) (physician’s license suspended for
fraudulent medicare claims in the “practice of medicine”).  See also Quintana v. Com., State
Bd. of Ost. Med. Ex., 77 Cmwlth. Ct. 438, 440-442, 466 A.2d 250, 252-253 (Pa. 1983)
(physician’s license revoked, inter alia, for “fraudulent representations in the practice of
osteopathic medicine and surgery” when he fraudulently prescribed drugs for his personal
use even though the action did not “affect the care of patients”).
The Board was justified in holding that Dr. Banks’s conduct posed a threat to patients,
not only because a “hospital environment must at all times be conducive to the practice of
medicine,” but also because his conduct was a threat to the teamwork approach of health care
which requires participation from a variety of hospital personnel in order to deliver effective
patient care.  In fact, the evidence shows that Dr. Banks’s conduct affected the working
environment so deleteriously that it caused hospital employees to avoid him.  For example,
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witness #1 testified that she “tried to avoid being around when he [Dr. Banks] was doing his
job at the nurses’ station.”  On another occasion, when Dr. Banks and witness #1 were alone
in the kitchen, and when Dr. Banks engaged in the innocuous task of closing the kitchen
door, witness #1 became so “frightened” that she “immediately left” the room.  In the
Board’s charges filed against Dr. Banks, it stated that Dr. Banks’s application for privileges
was denied, in part, because of the “unwillingness of the nurses [and] victims of his
harassment, to allow [him] to return to hospital duties” as well as the “real possibility of a
serious moral[e] problem among the hospital’s female employees should [Dr. Banks] be
granted privileges.”  Obviously Dr. Banks’s misconduct could easily have an adverse effect
upon patient care.
Dr. Banks suggests that sexual harassment of employees is within the jurisdiction of
the employer and the Maryland Commission on Human Relations, and therefore should not
be the concern of the Board.  See Code (1957, 1998 Repl. Vol.), Art. 49B, §§ 14-18.  Simply
because the Human Relations Commission may also have jurisdiction over a matter,
however, is no indication that the matter is beyond the Board’s authority.  More than one
administrative agency can have jurisdiction over a matter.  See, e.g., Insurance
Commissioner v. Equitable, 339 Md. 596, 604-605, 664 A.2d 862, 867 (1995); Equitable
Life v. State Comm’n, 290 Md. 333, 430 A.2d 60 (1981); Equitable Trust Co. v. State
Comm’n, 287 Md. 80, 411 A.2d 86 (1980).
This Court has emphasized that “sexual harassment in any context is patently
unacceptable.”  Attorney Grievance Comm’n v. Goldsborough, 330 Md. 342, 364, 624 A.2d
-18-
  For a discussion of the prevalence of sexual harassment in the health care industry see Decker,
4
Sexual Harassment in Health Care: A Major Productivity Problem, 16(1) Health Care Supervisor
1-14 (1997); Kinard et al., Sexual Harassment in the Hospital Industry: An Empirical Inquiry, 20(1)
Health Care Management Review 47-53 (1995); Haratami et al., Legal Medicine for Sexual
Harassment of Health Care Workers, 10(7) HealthSpan 12-13 (1993).  In a 1994 nationwide survey
of hospitals, results revealed that sexual harassment charges within the health care industry are
increasing at an “alarming rate.”  Kinard, supra, at 52.  Nearly 3/4 of women working in health care
reported being sexually harassed.  Decker, supra, at 3.  Nurses and clerical employees filed the
greatest number of complaints, Kinard, supra, at 51,  and nearly 10% of the allegations were brought
against physicians.  Id. at 52.  
503, 514 (1993).   The Board of Physician Quality Assurance consists of 15 members, 11
4
of whom must be “practicing licensed physician[s].”  See, § 14-202(a) of the Health
Occupations Article.  Certainly the Board has a high degree of expertise in determining what
constitutes unprofessional conduct “in the practice of medicine.”  Cf. Bd. of Ed. For
Dorchester Co. v. Hubbard, supra, 305 Md. at 787-792, 506 A.2d at 631-634.  The Board
of Physician Quality Assurance is particularly well-qualified to decide, in a hospital setting,
whether specified misconduct by a hospital physician is sufficiently intertwined with patient
care to constitute misconduct in the practice of medicine.  In light of the deference which a
reviewing court should give to the Board’s interpretation and application of the statute which
the Board administers, we believe that the Board’s decision in this case was warranted.
When a hospital physician, while on duty, in the working areas of the hospital, sexually
harasses other hospital employees who are attempting to perform their jobs, the Board can
justifiably conclude that the physician is guilty of immoral or unprofessional conduct in the
practice of medicine.
JUDGMENT OF THE COURT OF SPECIAL
-19-
APPEALS 
AFFIRMED 
IN 
PART 
AND
REVERSED 
IN 
PART, 
AND 
CASE
REMANDED TO THE COURT OF SPECIAL
APPEALS WITH DIRECTIONS TO AFFIRM
THE JUDGMENT OF THE CIRCUIT COURT
FOR CARROLL COUNTY.  COSTS IN THIS
COURT AND IN THE COURT OF SPECIAL
APPEALS TO BE PAID BY LESTER H.
BANKS.