Endoscopy center doctors getting free ride compared to DMV scofflaws

Citizens like to complain about the Nevada Department of Motor Vehicles, but that's largely because it's a well-oiled machine.

With the law on its side, it issues driver's licenses and vehicle registrations at a staggering rate. Although lines are sometimes long, the DMV's system appears to work smoothly with relatively little inconvenience to customers. The department's customer service efficiency has improved with the passage of time and the advancement of technology.

Although it doesn't advertise the fact, the DMV also acts as a watchdog for insurance companies and traffic courts. If your auto insurance lapses, even for a short time, you'll be slapped with a $250 fine, which might be reduced if you grovel sufficiently at traffic court. If you've neglected to pay a handful of parking tickets -- and I speak from first-hand experience here -- you're not allowed to register your vehicle or renew your driver's license until you've paid your fines.

Then there's the annual emission certification to consider. It's about $20 if your vehicle passes the inspection. If it fails, however, you might wind up paying several hundred dollars in repairs before limping back into a department office to renew your registration. In Clark County, many emission exemptions are granted only after a car owner has spent at least $450 in repairs with a certified mechanic.

But that's life at the DMV. Rules are rules. Scofflaws beware. Cough up the cash, or face the consequences.

Driving, after all, isn't a right. It's a privilege.

It's too bad that same hard-nosed approach hasn't existed in other areas of state government.

As the Endoscopy Center of Southern Nevada story grinds on, with more than 50,000 patients potentially exposed to the hepatitis and HIV viruses because of substandard practices at the clinic, perhaps the most embarrassing element to emerge is the abject lack of hard scrutiny given the clinic and its doctors by the Nevada State Bureau of Licensure and Certification.

It's no DMV, I assure you.

In fact, the average procrastinating car owner could easily end up spending more than the amount that the Bureau of Licensure levied against the endoscopy center for each of its three "deficiencies." Although the city of Las Vegas forced the closure of the clinic and muscled a $500,000 fine against the managing doctors, the state penalized the center just $3,000 for three areas of concern. That's just $1,000 per violation despite the fact each of those "deficiencies" could end up costing lives. And the agency never calculated the number of days the center was deficient in an effort to roll up the fines.

Add to the annual car registration costs a few overdue tickets, an insurance lapse, and an emission repair bill, and you're spending upward of $1,000. And there's no grace period.

It has not been that way at the Bureau of Licensure, where, until the health department and the press exposed its downright dainty approach to potentially deadly problems at the endoscopy center, it has been one amazing grace period. Rules were broken, but it was business as usual.

Obviously, some well-connected, politically active physicians have exercised far greater lobbying power than average automobile drivers. Rules are rules, but some are applied more strictly than others.

In part because the state failed to diligently enforce the rules, eventually millions will be spent in an effort to ensure proper testing is conducted. But that's what you get when you let insiders run the system meant to keep doctors honest.

While the state has remained in a daze on this issue, the city of Las Vegas responded rapidly. Not only did Mayor Oscar Goodman and the City Council quickly vote to suspend the endoscopy center's business license, but it recently fined the physicians $500,000.

With a health center, the district attorney's office and Metro police requesting a piece of those funds, that $500,000 won't go far. Anticipating the funding need, Senate Majority Leader Harry Reid recently requested a $5.25 million addition to an upcoming spending bill to pay for blood tests and other expenses related to the endoscopy center mess.

The sad fact is the wrong people are paying this bill.

Thanks to soft laws and softer state scrutiny, Nevadans continue to pay a devastatingly high price in the endoscopy center scandal.

John L. Smith's column appears Sunday, Tuesday, Wednesday and Friday. E-mail him at Smith@reviewjournal.com or call (702) 383-0295.