Medical scramble



Gov. Jim Gibbons, whose governorship began with a nasty battle over his attempt to remove a state gambling regulator, is now engaged in another prickly dispute over his attempt to remove three medical regulators.

Gibbons called on doctors Sohail Anjum, Javaid Anwar and Daniel McBride to step down from the Nevada Board of Medical Examiners in the wake of the medical clinics crisis in which clinics around the state were found to have gone long periods without inspection, prompting recent discovery of shoddy practices, a huge health alert, and seven cases of hepatitis.

Twenty days after the crisis began, Gibbons—who previously had not been heavily involved—said he would try to remove the three from office “for cause” if they do not step down voluntarily. He cited as his reason that they have links to Dipak Desai, owner of a Las Vegas clinic, and so have had to abstain on matters involving that clinic.

However, Nevada statutes do not provide for the members to be removed “for cause,” only “for good cause.” The statutes say they serve fixed terms ("the term of office of each member of the Board is 4 years") so that they are insulated from political removal except for good cause. Since the state’s ethics in government statutes also authorize them to abstain, that would appear to exclude abstentions from the category of “good cause.” Three abstentions would not prevent the board from acting, since there were still six other members, and state law permits appointment of temporary members.

Gibbons call for the resignations prompted a rare public comment about the governor by his predecessor, Kenny Guinn, who said the board members’ recusals were proper, and removing people from public agencies for abstentions would lead to heavy turnover and inexperienced regulators.

In any event, Gibbons would have to go to court to remove the three. In 1983, Gov. Richard Bryan tried to unilaterally remove a member of the Nevada Public Service Commission who was serving a fixed term on grounds that she was not qualified for the position, but he was blocked by the attorney general and forced to go to court to make the removal actually happen.

Gibbons himself also has links to Desai, who served on one of his transition teams and gave the governor campaign money. Gibbons has endorsed Desai’s management of the Endoscopy Center of Southern Nevada, saying there was “no gross negligence” and “only” six cases of hepatitis. A seventh case was subsequently identified.

The governor also wants the medical examiners board’s executive director, Tony Clark, to step down. Clark is a former state adjutant general, state parole board member and member of the Tahoe Regional Planning Agency who once removed Gibbons from duty in the air guard, reducing Gibbons’ pension. Gibbons said he wants Clark out because the governor believes he failed to act quickly enough in the clinics crisis, an accusation that has been leveled more often against the governor himself. Clark, who said he assigned an investigator to the case two weeks before Gibbons took any action, declined to step down because he works for the board, not the governor.

And Gibbons did fire his state licensing chief, Lisa Jones, whose office oversees clinics. Jones is one official who tried to get out in front of the problem of clinic inspections. Last year, she requested an additional 10 state inspectors, but Gibbons quashed the request. However, the Nevada Legislature knew of it and provided for six more positions. Gibbons said removal of Jones was necessary to reestablish trust.

At all events, Gibbons will soon get to make two appointments to the suddenly politically sensitive medical examiners board. The term of former Washoe County commissioner Jean Stoess will expire on June 30 and that of physician Cindy Lamerson on Aug. 30.