Board shakeup

Over the past week, Nevadans have watched Gov. Jim Gibbons attempt to weigh the severity of the health care crisis blossoming in Southern Nevada.

Attempting to do so from 400 miles away might present difficulties enough. But it now appears the governor has been working under an even greater handicap: Many of those whom he has trusted for advice in the medical realm turn out to be friends and associates of those who have purposely adopted the unsafe syringe procedures -- or even the perpetrators themselves.

Dr. Dipak Desai, who ran the now-closed Endoscopy Center of Southern Nevada, has long had friends on the State Board of Medical Examiners, on which he himself served from 1993 to 2001. Dr. Desai has also had strong ties at the state Board of Health. Dr. Javaid Anwar, president of the Nevada Board of Medical Examiners, is a longtime friend and has done business with Dr. Desai. He, along with Dr. Ikram Khan, a health care adviser to Gov. Gibbons, performed consulting work for Dr. Desai last year.

"The conflicts of interest are incredibly glaring," said Dr. Sidney Wolfe of Public Citizen, a public advocacy group begun by Ralph Nader. There was "more than enough evidence" to suspend Dr. Desai's license, Dr. Wolfe contends.

Many in the public probably thought Dr. Desai's license had been suspended. But not really. Dr. Anwar finally recused himself on Friday, but not before he and the board's executive director, Tony Clark, brokered an arrangement that allowed Dr. Desai to make a nonbinding promise to not practice medicine in Nevada but to keep his license, leaving the door open for him to take his creative practices elsewhere. Given that these were the people on whom Gov. Gibbons was relying for advice, the governor's apparent see-sawing on the crisis starts to make a little more sense.

At a March 11 news conference, the governor said criminal charges should be brought against Dr. Desai and other medical practitioners if they deliberately jeopardized patients' health through shoddy practices. By Saturday, though, the governor appeared to be channeling Alfred E. Neuman. In a brief interview with the Reno Gazette-Journal, the governor blamed media "buffoonery" for blowing the crisis out of proportion.

Finally, on Sunday, Gov. Gibbons acknowledged he'd been getting bad advice.

In a statement issued Sunday night, the governor said he would ask for the resignations of Dr. Anwar, Board of Medical Examiners Vice President Dr. Sohail Anjum and board member Dr. Daniel McBride, citing their acknowledged conflicts of interest.

The governor will also ask for the resignation of Mr. Clark and will remove Lisa Jones, head of the bureau that oversees the licensing and inspection of the state's surgical centers.

No one is calling for mobs to storm the castle with torches and pitchforks. Some of the doctors who performed procedures at these clinics may have been unaware of the systematic abandonment of sterile procedures; they all deserve due process.

But the governor finally seems to grasp there's a big problem in public confidence here. Having come to that realization, he moved quickly.

And that, finally, is reassuring.