Opinion ID: 1996294
Heading Depth: 1
Heading Rank: 5

Heading: Factual Basis For The Imposition of Competency-Based Restrictions In This Case.

Text: Dawson claims that even if a finding or admission of incompetency is not a prerequisite to the imposition of competency-based conditions on reinstatement, the Board's decision to include such conditions in Dawson's five-year probation is unreasonable and arbitrary. He asserts this is so because the CPEP did not recommend such restrictions and there is no other factual basis in the record to justify them. We first point out that the Board, as a professional licensing authority, has discretion to determine what conditions should be attached to probation, and this court will not second-guess the Board's judgment in this regard absent an abuse of that discretion. Burns, 528 N.W.2d at 604-05. Upon our review of the record, we conclude the Board's decision to order Dawson to submit and comply with a written quality improvement plan is not against reason and [the] evidence. Stephenson, 522 N.W.2d at 831. Contrary to Dawson's contention, the restrictions imposed by the Board find substantial support in the report from CPEP. Granted, CPEP pointed out positive aspects of Dawson's professional skills, but it also noted Dawson's aggressive approach to sinus surgery. Significantly, the [CPEP] consultants recommended that Dr. Dawson be more conservative in his choices. We reject Dawson's assertion that the concern over his surgical decisions was merely a reflection of different approaches to treatment of sinus disease. The consultants acknowledged the existence of this professional debate but even within this context viewed Dawson's handling of sinus patients as too aggressive. In addition, while CPEP diplomatically discussed [i]mplications for intervention, these implications were, we think, intended as suggestions for ways in which Dawson's enthusiastic use of surgery might be tempered. See generally Webster's Third New International Dictionary 1135 (unabr. ed.1993) (defining implication in part as suggestion); id. at 1183 (defining intervene as to come in or between by way of hindrance or modification). We disagree with Dawson's characterization of these recommendations as merely general observations ... applicable to all physicians, and his claim they were not directed at ...[him] specifically. In discussing these implications for intervention, CPEP references ways in which Dawson might become aware of alternatives to [his] current approach to sinus disease, of changes in surgical management, and of when consideration of a change in management style needs to occur. It is not a coincidence that these suggestions would assist Dawson in making more conservative choices in his treatment of sinus disease, as recommended by the CPEP consultants. A review of the Board's reinstatement order shows that the Board merely worked off the suggestions made in the CPEP report to devise a probation plan that would encourage Dawson to assess the wisdom of his aggressive approach by tracking patient disease, procedures, complications, and outcome. The fact that the Board's order included conditions in addition to those contained in the CPEP report is not unreasonable, as the Board was entitled to use its professional judgment in devising an appropriate probation plan that addressed the competency concerns for which Dawson was evaluated. These additional conditionspreparation of an informed consent form and a plan for obtaining informed consentreflect an effort by the Board to force Dawson as well as his patients to focus on the risks and benefits of sinus surgery before embarking on that treatment approach. Moreover, they are consistent with the CPEP recommendation that Dawson consider alternatives to his aggressive use of surgery. We find no merit in Dawson's complaint that the Board's reinstatement requirements were at odds with CPEP's conclusion that a formal, structured, supervised [e]ducation [p]lan was not necessary. By its own terms, the CPEP report assessed educational status and clinical competencies. (Emphasis added.) The quality improvement plan required by the Board was, according to the Board's order, intended to address concerns raised in the CPEP report about [Dawson's] aggressiveness in diagnosing and treating sinus disorders. In other words, the quality improvement plan was directed at Dawson's clinical competency, not his educational status. Although the plan was to include a continuing education program, the order did not require that any such program be formal or supervised. In summary, we think the conditions imposed on Dawson's probationary reinstatement by the Board are very reasonable and well supported by the record. Accordingly, we find no basis to overturn the Board's decision. AFFIRMED.