Opinion ID: 1355978
Heading Depth: 2
Heading Rank: 1

Heading: Did the Board's procedure generally deviate from statutory, evidentiary, and constitutional standards?

Text: Dr. Painter contends Board actions or procedures violated statutory, evidentiary, and/or constitutional standards as follows: 1. The Board failed to provide notice of Dr. Painter's right to have an independent physician in attendance at the mental and medical competency examination; 2. The Board refused to give Dr. Painter the report resulting from her mental and medical competency examination; 3. The Board permitted improper ex parte contacts between the prosecuting attorney at the contested case hearing and the Board sitting as the decision maker; 4. The Board failed to provide expert testimony to prove Dr. Painter engaged in conduct contrary to standards of the medical profession and hence violated ethical rules; and 5. The Board used a preponderance of the evidence standard instead of a clear and convincing evidence standard. We address these contentions in order:
Section 33-26-403(d) and Board rules provide examined licensees the right to designate an independent physician to be present and to submit an independent report to the Board. Board of Medicine Rules and Regulations, ch. 4, Rules of Practice and Procedure for Disciplinary Complaints Against Physicians § 4(f)(iv)(D) (1997). Here, Dr. Painter received notice on February 3, 1998, that she was to submit to a mental and medical competency examination on February 13, 1998. She did not receive notice of her right to designate an independent physician. Understandably, Dr. Painter objected to the short notice and appeared at the examination without waiving her objection to the Board's failure to comply with its rules regarding notice. Administrative rules and regulations have the force and effect of law. MB v. Laramie County Department of Family Services in Interest of LB, 933 P.2d 1126, 1130 (Wyo.1997). An administrative agency is bound to strictly follow its own rules and regulations. Id. Failure to do so may result in reversal of the agency's action. Here, the Board's failure to provide Dr. Painter notice of the right to designate an independent physician, coupled with the short time frame between delivery of the notice and date of the examination, effectively precluded her from exercising the right to provide independent analysis.
As discussed, the Board ordered that Dr. Painter submit to a mental and medical competency examination. The statute assumes the results of any examination are admissible as evidence in Board proceedings as § 33-26-403(b) provides: (b) Every licensee is deemed to have consented to submit to a board requested mental, physical, or medical competency examination and waived all objections to the admissibility of the results of the examination in board proceedings on the ground that the results constitute a privileged communication. The Board denied all of Dr. Painter's requests for copies of the examination report, claiming denial was authorized by § 33-26-408(c): (c) All board records except final orders are not subject to public disclosure or discovery and are not admissible in any nonboard proceeding except when necessary for further board action or upon judicial review of a board order. Statutes must be read as a whole and in conjunction with other statutes on the same subject matter. Parker Land and Cattle Company v. Wyoming Game and Fish Commission, 845 P.2d 1040, 1042 (Wyo.1993). When § 33-26-403(b) and § 33-26-408(c) are read together, it is clear that § 33-26-408(c) relates to confidentiality regarding third persons unrelated to the proceeding. The report is not confidential as between the proceeding's actual parties. To hold otherwise would allow the Board to unilaterally decide whether to disclose either inculpatory or exculpatory facts. That, of course, is not how the adversarial system of law works and cannot be what the statutes intend. The Board deprived Dr. Painter of due process by withholding the report. Basic notions of fairness and due process prohibit requiring an accused (civil or criminal) to be evaluated or examined and then using the results in the prosecution without affording the accused the right to have the results to prepare a response. See Mishler v. State Board of Medical Examiners, 109 Nev. 287, 849 P.2d 291, 297 (1993) (a board abuses its power when it uses its own rules of confidentiality as an excuse to obstruct a doctor's access to evidence); Christiansen v. Missouri State Board of Accountancy, 764 S.W.2d 943, 952 (Mo.Ct.App.1988) (denying licensee the right to material pertaining to a disciplinary proceeding is contrary to concept of fairness and tantamount to denial of due process).
Dr. Painter alleges improper ex parte contacts occurred between the Board's attorney (who represented the Board and prosecuted Dr. Painter at the contested case hearing) and the Board sitting as decision maker. She asserts these contacts adversely affected her right to a fair, unbiased hearing. Due process requires that an agency provide a fair trial without the appearance of bias or prejudice. State Transportation Commission of Wyoming v. Ford, 844 P.2d 496, 497-98 (Wyo.1992); ANR Production Company v. Wyoming Oil and Gas Conservation Commission, 800 P.2d 492, 499 (Wyo.1990); Wyo. Stat. Ann. § 16-3-112(a) (LEXIS 1999). Additionally, Wyo. Stat. Ann. § 16-3-107(k) (LEXIS 1999) (emphasis added) prohibits the following contacts: (k) ... Any person representing an agency at a hearing in a contested case in which the agency is a party shall not in the same case serve as presiding officer or provide ex parte advice regarding the case to the presiding officer or to the body or any member of the body comprising the decision makers. The record and oral arguments make it clear the Board's attorney: (1) advised the Board throughout the development of the case against Dr. Painter; (2) prosecuted the case before the hearing panel which was comprised of Board members; and (3) continued to advise the Board during preparation of the final findings and order. The separation of these functions is necessary to assure fairness. The contacts between the Board and its attorney violated § 16-3-107(k) and contributed to the overall appearance of unfairness regarding the proceedings. Additionally, the hearing officer originally ordered that two members of the Board were disqualified from sitting on the hearing panel or participating in decision making. However, one of those disqualified members signed the Board's final order. The Board claims the signature was merely a ministerial function, but this act, in conjunction with others, contributes to the appearance of unfairness.
The Board found Dr. Painter's participation in a patient case study using an EDS machine was unprofessional conduct contrary to recognized standards of ethics of the medical profession under the American Medical Association's Code of Medical Ethics, supra, and thus a violation of § 33-26-402(a)(xxvii). The Code of Medical Ethics, supra, requires that participation in any such clinical study be part of a systematic program competently designed under accepted standards of scientific research to produce scientifically valid and significant data. The Board provided no expert testimony on this count. We addressed virtually the same issue in Devous v. Wyoming State Board of Medical Examiners, 845 P.2d 408, 418 (Wyo. 1993), in regard to § 33-26-402(a)(xv), (xviii), and (xxvi): The crux of the issue is whether the record must include expert testimony with respect to [the pertinent] statutory grounds, or whether we must acknowledge and accept the expertise of the Board members in establishing standards that demonstrate infringement of the statute.... If judicial review has any purpose, it must be exercised by objectively evaluating evidence in the record. There is no way that a judicial review could reach the subjective determination of standards by individual members of the Board. Just as expert testimony is needed in the above paragraphs, it is also essential in paragraph (xxviii). Without expert testimony from the Board on the issue, no substantial evidence exists to sustain the allegation. Devous, 845 P.2d at 418.
We have previously held that clear and convincing evidence is required to discipline the holder of a medical license. Devous, 845 P.2d at 416; see also JM v. Department of Family Services, 922 P.2d 219, 223 (Wyo. 1996) (clear and convincing evidence standard applies in professional disciplinary hearings). However, in 1995 the Wyoming legislature adopted a preponderance of the evidence standard for Board disciplinary proceedings. Section 33-26-407(b). Statutory enactments are presumed to be constitutional, and one who challenges a statute on constitutional grounds bears the burden of showing the statute is unconstitutional beyond a reasonable doubt. Hoem v. State, 756 P.2d 780, 782 (Wyo.1988). While this Court has the duty to maintain the constitutionality of statutes when possible, `it is equally imperative that we declare them invalid when they transgress the Wyoming Constitution.' Id. (quoting Brenner v. City of Casper, 723 P.2d 558, 560 (Wyo. 1986)). Dr. Painter alleges the Board's reliance on the statutory preponderance standard rather than on a clear and convincing standard violated her constitutional rights to due process and equal protection.