As Dr. Daniel McBride fights to keep his seat on the Nevada State Board of Medical Examiners, he repeatedly points out that he has recused himself from reviewing any actions involving Dr. Dipak Desai, whose endoscopy clinics have been linked to seven cases of hepatitis C.
It's true, McBride says, that Desai has referred a large number of surgery cases to him. But he says that fact, just like his acknowledged longtime friendship with Desai, wouldn't affect any other work he does on the board.
"Remember, I won't be involved in that case," he said this week of Desai.
Although he has distanced himself from the case, though still not to the satisfaction of Gov. Jim Gibbons, who wants him to resign, lawmakers and others are critical of what they see as another conflict.
McBride serves on an investigative committee of the board that probes malpractice complaints brought by patients and others against doctors while also serving as chairman of a medical malpractice insurance company that fights paying out medical claims.
That company, Nevada Mutual Insurance Co., insures 1,500 of the state's 4,200 doctors, or about 35 percent.
McBride has been outspoken in his defiance of Gibbons, who cited McBride's ties to Desai in calling for his resignation. McBride declined to talk about whether his work for Nevada Mutual poses conflicts.
"Put me down for a no comment on that," he said Wednesday. "I don't want to get into that right now."
The news that McBride is both on the board while running a malpractice insurance company for doctors disturbed Assemblywoman Sheila Leslie, D-Reno, chair of the Legislative Committee on Health Care.
"Oh, my God, no," she said. "That's why we have to look at how people are appointed. You can't be working for Nevadans on medical malpractice questions and for a medical malpractice insurance company at the same time. Do we have to spell that out for them? That's why we need to completely revamp how members end up on those committees."
Governors make the appointments.
Daniel Burns, a spokesman for Gibbons, said McBride's work for the board and the insurance company "is an example of why the public has lost confidence in the credibility of medical care in Nevada. That's why the governor has asked for his resignation."
The investigative committee that McBride serves on examines about 240 complaints per year, according to Tony Clark, the board's executive director.
Clark said he could recall only two occasions in the past five years when doctors on the committee recused themselves from examining a case, but he couldn't remember on what grounds. Clark said McBride has served on the investigative committee for about two years.
Asked whether McBride has a conflict of interest, Clark replied: "I don't believe so." Clark, who is also being pressured by Gibbons to resign, declined to elaborate.
Clark said the board has investigative committees in both Southern and Northern Nevada. Sitting with McBride on the committee in Southern Nevada are a non-physician member, Donald Baepler, a former president of the University of Nevada, Las Vegas, and Dr. Sohail Anjum. Anjum recently recused himself from hearing any matters concerning Desai. Like McBride and fellow committee member, Dr. Javaid Anwar, he has been asked to resign by Gibbons.
Neither Baepler nor Anjum could be reached for comment late Wednesday.
Clark said investigative panels work like a grand jury.
"They decide when a formal complaint will be filed against a doctor," he said.
In 2006, the board took 20 disciplinary actions against the state's 4,000 plus physicians, revoking three licenses.
James Crockett, a Las Vegas personal injury attorney who is not involved in any of the myriad lawsuits against Desai's clinics, including the Endoscopy Center of Southern Nevada, where the six cases of hepatitis C were discovered, believes McBride is clearly conflicted.
"With McBride on the board there is a great opportunity for an insurance company to work through him to bury a medical claim before it ever gets legs," Crockett said. "Why would anyone who had a claim against a physician think they would get a fair decision?"
The board can fine doctors and suspend licenses in malpractice cases. But Crockett said too that a guilty finding by the board on malpractice cases would be seen by an insurance company as a green light to go forward with a lawsuit.
Desai had served on the board of directors of Nevada Mutual, but a company official said last week that Desai had recently resigned.
Senate Majority Leader Harry Reid, D-Nev., said in an interview that he was "not going to get involved" in the feud over the Board of Medical Examiners, but he disagreed with Gibbons' attempt to dismiss some board members.
"I just think that McBride is right, Anwar is right in not resigning," he said.
"They've recused themselves. They can't vote on anything. I can't understand why they should resign."
Reid acknowledged that both men are longtime friends. He said he has known McBride for years and that Anwar is his wife's physician and "a wonderful man."
The board, he said, could still do its job with three members not voting because there are enough other members.
Review-Journal writer Molly Ball contributed to this report. Contact reporter Paul Harasim at firstname.lastname@example.org or (702) 387-2908.