Dr. Harold I. Eist This is Me

Education

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1. 1. www.mddailyrecord.com

   www.mddailyrecord.com/article. - [Cached]

   Published on: 5/8/2008   Last Visited: 5/8/2008

   Dr. Harold I. Eist
   ...
   At the center of the controversy , which has attracted national attention , is Dr. Harold I. Eist, a respected Bethesda psychiatrist whom the Maryland State Board of Physicians has reprimanded and fined for defying its request for patient records during its investigation that he had allegedly over-prescribed medication.
   
   The allegation was later found to be unsubstantiated and lower courts have overturned the board's punishment of Eist for refusing to disclose patient records, prompting the medical agency's appeal to the state's highest court.
   
   Eist, who has been battling the board since 2001, said he has difficulty understanding why the agency, which enforces medical standards, has sought to punish him for trying to preserve the confidentiality of patient records.
   
   Preserving a patient's confidentiality is "the primary element in quality psychiatric care," said Eist, a former president of the American Psychiatric Association and the Washington Psychiatric Society.
   ...
   That reasoning drew scorn from Eist, who rejected the idea that the profession's standards can be maintained only by breaching the fundamental tenet of confidentiality.
   
   "It's like during the Vietnam era: We had to destroy the village to save it," he said.
   ...
   The battle between the board and Eist began in March 2001, when the agency received a complaint from a man who said his estranged wife and one of their two sons had been medicated by the doctor to the point that she became psychotic, seriously anxious and depressed and the boy had become increasingly agitated.The man and his wife were in a heated divorce and child custody proceedings at the time of his allegations, Eist said.
   
   The board that month sent the complaint to Eist, along with a request for his response and a subpoena telling him to "deliver immediately upon service of process a copy of all medical records of [the woman and her two children]; treated at your facility; which materials are in your custody, possession or control."
   
   Eist said he called the board, telling the agency that the allegations were false and that he would not release the records without the patients' consent, which had not been given.
   
   The board told Eist in July 2001 that his compliance with the subpoena was not contingent on patient consent and that failure to surrender the records was a violation of the state Medical Practice Act, which requires doctors to cooperate with a lawful board investigation.Eist continued to refuse to surrender the records, and the board in February 2002 charged Eist with failing to cooperate, according to court documents.
   
   In March 2002, Eist's representative told the patients' lawyers that the doctor would release the records unless they objected, which they did not.About three weeks later, Eist surrendered the records, court documents state.
   
   The board submitted the records to a peer-review board, which concluded that the allegation of substandard care should be dismissed.
   
   The board, however, did not withdraw its claim that Eist had failed to cooperate by refusing to surrender the patient records.The board issued a reprimand and fined him $5,000.Eist challenged the punishment, arguing that he and his patients had a constitutional right to privacy in the medical records which trumped the board's request for the documents.
   
   That argument won before two administrative law judges and twice before the Montgomery County Circuit Court.The Court of Special Appeals agreed last September, saying that the board's interest in investigating the complaint did not supersede the patients' privacy interest and as a result it cannot be found that Eist "failed to cooperate with a lawful investigation conducted by the board."
   
   Compliance optional?
   
   The state board, in its brief to the Court of Appeals, argues that the lower courts failed to weigh appropriately the state's need for patient records when investigating alleged medical misconduct and the doctor's ethical requirement to preserve patient confidentiality.The records sought from Eist concerned primarily the drugs and dosages prescribed by the physician, data which medical agencies routinely collect as part of their compelling interest in protecting the health of all residents who seek medical care, the board states.

2. 2. Washington Psychiatric Society

   www.dcpsych.org/wps/officers.h - [Cached]

   Published on: 1/13/2008   Last Visited: 1/13/2008

   President-Elect: Harold I. Eist, MD DLFAPA

3. 3. Board Backs Eist in Legal Fight Over Medical-Record Confidentiality -- Hausman 40 (21): 4 -- Psychiatric News

   pn.psychiatryonline.org/cgi/co - [Cached]

   Published on: 11/4/2005   Last Visited: 11/16/2005

   Former APA President Harold Eist, M.D., will receive financial assistance from the Association to help in his battle with the Maryland Board of Physicians over patient confidentiality rights.The physician board has fined and reprimanded him for "failure to cooperate" with its demand that he turn over patient records.
   
   Harold Eist, M.D., expects that his appeal will be heard by the end of the year.
   
   Eist had been treating a woman who was involved in a divorce proceeding and her children (Psychiatric News, April 18, 2003).
   
   Her husband filed a suit to gain custody and insisted that his family's psychiatric records needed to be made available as part of that suit.When Eist did not comply, he filed a complaint with the Board of Physicians charging that Eist was overmedicating his wife and children, leaving the wife "overly psychotic" and the children deteriorating emotionally.When the board informed him that it wanted the records in question, Eist contacted the woman and the children's lawyer, both of whom would not consent to the demand.He told the board of the objections from the mother and the children's lawyer, but the board would not reconsider its demand.
   
   Despite a request by Eist for guidance from the board, the board, after seven months of silence, informed Eist of its medical-misconduct complaint against him without addressing the ethical concerns he raised.After the mother and the children's attorney told Eist they no longer objected to his turning the records over to the board, he did so.
   
   An administrative law judge in Maryland heard the case and ruled in Eist's favor, declaring, "I am convinced that [Eist] followed the only ethical course of action available to him under the circumstances."Nonetheless, the medical board refused to end the proceedings against Eist, maintaining that it had a right to all of the records it demanded, when it demanded them, and without apparently conducting an evaluation of the need for them.
   
   The case then went to a county circuit court, which ruled that the state's medical privacy law required the board to provide a more detailed and comprehensive justification before it was entitled to medical records in this type of case.APA had filed an amicus brief on Eist's behalf in 2003, concerned about imposition of arbitrary limits on patients' rights to control their medical records.
   
   The court then remanded the case to the administrative law judge who again backed Eist, and again the board declined to accede to the judge's ruling, maintaining that without the records it couldn't investigate the charges against Eist.It also maintained that its responsibility to investigate complaints against physicians represents a compelling state interest that overrides privacy protections.
   
   It reprimanded him, fined him $5,000, and reported him to the National Practitioner Data Bank.
   
   Eist's lawyer has filed an appeal with the Circuit Court of Montgomery County (Md.). APA has given Eist $5,000 toward the cost of the litigation and is considering joining another amicus brief in the case.Eist expects that the appeal will be heard by the end of this year.
   
   The Washington Psychiatric Society, of which Eist is a member, has also been involved, writing letters of protest to Maryland's governor, lieutenant governor, attorney general, and each member of the Board of Physicians charging that Eist is being "persecuted" for his stance on behalf of confidentiality rights.
   
   Eist told Psychiatric News that "if not addressed forcefully, cases such as this, one case at a time, will become a cancer attacking the credibility of our treatments and profession.This is the most important psychiatric standard-of-care issue for patients, even children patients."In deciding to financially support the case, he added, the APA Board is backing an issue "of national importance."
   
   {blacksquare}In 2003 Eist won a Profile of Courage Award from the APA Assembly for his stance in this case.