Opinion ID: 1852209
Heading Depth: 2
Heading Rank: 1

Heading: Was the Commission's Decision Supported by Substantial Evidence?

Text: The first issue before this Court is whether the Commission's decision to revoke Almeida's medical license was supported by substantial evidence. This Court has consistently defined substantial evidence as `evidence of such weight and quality that fair-minded persons in the exercise of impartial judgment can reasonably infer the existence of the fact sought to be proved.' Ex parte Bowater, Inc., 772 So.2d 1181, 1182 (Ala.2000) (quoting West v. Founders Life Assurance Co. of Florida, 547 So.2d 870, 871 (Ala.1989)). Upon review of the record, we find that the Commission's decision to revoke Almeida's license was supported by substantial evidence. At the start of the hearing, the Commission heard testimony from three former patients of Almeida's who had complained of Almeida's misconduct toward them. It was on their testimony that the Commission based its findings of fact. The first patient testified that after her exam, when no chaperone was present in the examining room, Almeida kissed her. This same patient testified that on another visit when they met in his private office, they engaged in open-mouth kissing and fondling. He attempted to remove her undergarments and when she resisted, he unbuckled his pants, which the patient interpreted as a request that she perform oral sex. The second patient testified that Almeida conducted improper vaginal examinations of her and that he had also come on to her in the form of winking and smiling at her and making comments regarding her looks during his medical examinations of her. The third patient testified that Almeida had engaged in sexual misconduct in the form of flirting with her during her examinations. This third patient also testified that Almeida had asked her to meet him at various places and had invited her to go on a trip with him, during which they could participate in a threesome. In addition to these three former patients whose complaints formed the basis for the administrative complaint filed against Almeida, the Commission heard testimony from a fourth former patient who provided explicit details of an improper vaginal examination Almeida had performed on her. The fourth patient's testimony that she left the office very upset after the improper examination was corroborated by one of Almeida's former employees who was working the front desk on the day of the incident. The former employee testified that she remembered the fourth patient being very upset, to the point of tears, and that after this encounter she never saw the patient at Almeida's office again. Several doctors in the community also corroborated the testimony of some of Almeida's former patients based on information the patients had disclosed to them soon after their encounters with Almeida. The Commission also heard testimony from a female sales representative who frequently visited Almeida's office about two specific incidents of what she thought was sexually inappropriate conduct by Almeida. The sales representative alleged that Almeida made inappropriate advances toward her and that Almeida insinuated that they have a sexual encounter. Both incidents the sales representative described to the Commission were documented in letters she wrote to her employer, and, as a result of those letters, a male sales representative was assigned to Almeida's office. The Commission also heard testimony from one of Almeida's former nurses, who had also been a patient of Almeida's while she worked for him. While Almeida never performed an inappropriate examination of her, she testified that during other patients' exams he would engage in behavior that she deemed inappropriate, like making smirking gestures towards the patient. This former employee also testified that Almeida was touchy-feely and that he paid more attention to patients who were young, petite, slender, and very attractive. Her testimony, coupled with that of the female sales representative, describes Almeida's general behavior and corroborates the descriptions of his behavior as testified to by the complaining witnesses. Dr. Abel's expert testimony also aided the Commission in its decision. As stated previously, Dr. Abel not only evaluated Almeida over a three-day period, but also interviewed the complaining witnesses. Dr. Abel believed that the testimony given by the complaining witnesses was truthful. He concluded that Almeida had crossed well-recognized sexual boundary lines, that Almeida should undergo treatment for a sexual disorder, and that without such treatment he could not safely practice medicine and would pose a risk to patients. While this Court acknowledges that there were some inconsistencies in the testimony presented to the Commission, which the Commission noted in its order, the resolution of conflicting evidence is within the exclusive province of the Commission. See, e.g., Alabama Dep't of Envtl. Mgmt. v. Hagood, 695 So.2d 48, 50 (Ala.Civ.App.1997); cf. Hubbard Bros. Constr. Co. v. C.F. Halstead Contractor, Inc., 294 Ala. 688, 691, 321 So.2d 169, 172 (1975). This rule is premised on the proposition that the trier of fact  here the Commission  is in the best position to observe the demeanor and credibility of the witnesses, especially in this case where the members of the Commission were members of the profession being regulated. See Ex parte Alabama Ins. Guar. Ass'n, 667 So.2d 97, 101 (Ala.1995). The members of the Commission not only observed the proceedings, they also engaged in the proceedings by rigorously questioning the witnesses after the attorneys had completed their examination of the witnesses. Based upon the totality of the evidence, the Commission found that the inconsistencies in the testimony were collateral to the central issue and unanimously found that the complaining witnesses presented credible testimony that Almeida had actually engaged in the behavior described to the Commission. Because the Commission's decision was based on the testimony of three complaining witnesses, of an expert who had evaluated Almeida, and of numerous other witnesses whose testimony supported the allegations made by the Board, we conclude that the Commission's unanimous decision to revoke Almeida's medical license was supported by substantial evidence.