The website for the New York State’s Office of Professional Medical Conduct (OPMC) shows that Pieter’s active license in New York State is on probation for 5 years with a 2002 working agreement with the state because of inappropriate anger in 1999. This was due to sleep apnea so severe that I awoke more than 300 times each night with REM sleep less than 16% of the normal value. It was exacerbated by anxiety-depression, made much worse by the break-up of a 20 year marriage I valued. In 1999, I voluntarily sought help from the State Medical Society’s Committee for Physician Health, from a psychiatrist in Syracuse, and got CPAP set to a high enough pressure that there is no longer apnea. I began an appropriate antidepressant, learned anger management, and have taken additional courses in anger management as well as courses in working with people and groups of people who are upset or “difficult”. I continue on the medicines and CPAP. I have not been accused of anger since 1999.
In more detail: In 1999, a physician asked me to evaluate headaches in a teenage man who turned out to have a history of acting out, aggressive behavior with peers and teachers at school, etc. The patient, accompanied by his mother, was so emotionally and verbally abusive to our nurse that she was in tears. The mother sat by passively and made no effort to control his behavior. I told them that I could not help them, terminated the visit, and ushered the young man out of the office, telling the young man firmly, “Never speak to adults like that.” The young man later accused me of spanking him. I did not have an independent witness for the period of ushering the patient out, and, at the hearing more than two years after the alleged event, it was my word against the patient’s. Legal counsel felt that my chances of success were only 50-50 since I did not have an independent witness, so on her advice, I agreed to settle the case. The order (made in 2002) requires me to have a chaperone present whenever examining a patient under the age of 18 in my office. I have actually had a nurse present as a matter of common practice since 1989.
In addition, I surveyed patients and staff about my demeanor and behavior in the office with monthly confidential questionnaires that a third party reviewed, summarized, and reported with any negative comments to OPMC.
Note: OPMC did not apply these conditions to patients seen in the settings of a hospital, an emergency department, or a clinic, but only in my private office.
Because I retired from practice before the end of the 5 years, the case is “tolled” – held open – indefinitely.
Additionally, when I closed my office in 2004, several patients were reported to OPMC, which interviewed me by telephone in October, 2006. The questions were strangely identical to the wording of claims two Syracuse neurologists had been making since the early 1990s in their attempts to get me to move away from Syracuse. The claims had been turned down by OPMC back then and the diagnoses and differential diagnoses I made had been substantiated by nationally-recognized experts. When an OPMC lawyer in February, 2007, my sense that this was a “put-up” became stronger.
The accusations amounted to saying that I must have been wrong in making certain diagnoses; therefore the findings in my notes that strongly supported those diagnoses must have been mistaken, and I must be incompetent for thinking I saw those findings. In fact, I carefully avoided using the diagnoses most in question. In addition, each of these patients had repeatedly and consistently responded well to appropriate treatment, as was clearly documented in my notes. I felt I could defend myself against the accusations, but the minimal cost was estimated at $50,000 to $100,000. This amount was far beyond my means. I saw no choice but to plead nolo contendere and agree not to pay to renew my license registration in New York State.