SUMMARY

Success Creates Tension

In 1999, Dr. Steven Anagnost brought minimally invasive spinal (MIS) surgery to Oklahoma to improve the quality of spine care to patients. At the time none of the spine surgeons in Oklahoma were performing MIS surgery.   His practice quickly thrived, helping thousands of patients with neck, back, and sciatic pain.  Some of the Tulsa Oklahoma spine surgeon community, however, were not happy about Dr. Anagnost’s success. Minimally Invasive Spinal surgery is technically challenging for surgeons.  The learning curve is steep. Furthermore, MIS surgery is frequently less expensive than more traditional spine surgeries. Many competing spine surgeons in Oklahoma were not happy with the prospect of adopting a new technology that made the surgeon LESS money per procedure.

In 2005, impressed with Dr. Anagnost’s success, a large neurosurgery surgery group, called Oklahoma Spine and Brain Institute approached Dr. Anagnost to join their group. This group also founded a doctor-owned spine hospital, called Tulsa Spine and Specialty Hospital. These competing spine surgeons asked Dr. Anagnost to invest financially in their doctor-owned hospital, and bring his busy surgical practice to their hospital, instead of the community hospital where Dr. Anagnost worked. Dr. Anagnost declined the invitation to join or invest in the group and hospital. Dr. Anagnost’s refusal to join the competing spine surgeons, set in motion a vicious attack and smear campaign against Dr. Anagnost by these competing spine surgeons.

“Clearly these doctors from the Oklahoma Spine and Brain Institute worked for a long time with the board and malpractice lawyers to put a case together against me. It probably took them a couple of years. And it was all done behind closed doors. No one knew. That’s not how a government agency is supposed to work. That’s not how due process works,” said Dr.Anagnost.

The fact that all of the competing surgeons from the Oklahoma Spine and Brain Institute were involved in bringing complaints to the Oklahoma Medical Board, and that some of those same surgeons acted as paid medical experts for the Board, seems to confirm Dr. Anagnost’s statement.

Hearing the Truth

As Tulsa World and Red Dirt Report articles reported, on June 18, 2010, Dr. Anagnost was asked to appear at the Oklahoma Medical Board to face the false accusations. Two competing spinal surgeons from the Oklahoma Spine and Brain Institute were present at the hearing as experts. Both of these surgeons were critical of minimally invasive spinal surgery (MIS) surgery. Both admitted that neither of them performed any MIS surgeries themselves. Both of these doctors also were owners and investors in the competing Tulsa Spine and Specialty Hospital.

At the hearing, these two doctors made uninformed claims against MIS spine surgery and against Dr. Anagnost. The Oklahoma Medical Board, who had been listening to these doctors’ claims, asked Dr. Anagnost to respond to the allegations. Dr. Anagnost presented the truth of how well the patients had done after his surgeries. Dr. Anagnost presented concrete evidence such as MRIs, x-rays, and intraoperative videos, which proved that MIS was a legitimate alternative to traditional spine surgery. He proved to the Oklahoma Medical Board that the accusations were fabricated. In fact, the evidence presented by the competing spine surgeons was so flawed that the Assistant Attorney General Elizabeth Scott, who was in charge of the investigation, stopped the hearing as it was clear that the accusations were false, and that no case could be made.

After the hearing, however, the competing doctors and the Oklahoma Medical Board continued their attack on MIS and Dr. Anagnost. The reasons for this were eventually revealed to the public. There were active medical malpractice trial attorneys, who sue doctors for a living, on the Oklahoma Medical Board. This creates a conflict of interest for a board that is charged with providing due process when investigating doctors. The malpractice attorneys on the Medical Board stood to make millions of dollars if they could get a doctor’s license revoked.

Here’s how some of our political leaders reacted to the appointment of a malpractice attorney to the board:

“The appointment of Gary Brooks or, for that matter, any trial lawyer who makes his living suing doctors, to the medical licensure board creates an outrageous, unacceptable conflict of interest,” said then-Oklahoma Senator Scott Pruitt, who now serves as the Oklahoma Attorney General.

Then-Lt. Gov. Mary Fallin compared the appointment to “a fox guarding the henhouse.”

The Supreme Court Weighs In

The Supreme Court weighed in on the Oklahoma Medical Board and the competing spinal surgeons with a shocking volume of pages – 14 pages of opinions compared to the usual 2 or 3 pages. The Supreme Court stated,

“Dr. Anagnost alleges a significant conflict of interest regarding the Board’s proceeding in that a lawyer and member of the Board … also represented plaintiffs in two separate medical malpractice actions against Dr. Anagnost at the time of the hearing and during the pendency of the current Board proceeding against him. … Dr. Anagnost is correct in his allegations that this creates the appearance of a conflict of interest.”

The Justices further add:

“A two-year delay between the filing of the initial complaint against Dr. Anagnost and the hearing on that complaint due to continuances by the Board is unseemly given that the purpose of the Board is to protect the public.”

Another Justice emphatically states “From the documents, exhibits, affidavits, and pleadings presented, I have grave concerns that the petitioner (Anagnost) has failed to receive even the minimal due process required under our state and federal constitutions.” (Click here for full text of the Supreme Court statements Part 1 | Part 2)

The Press Exposes Competing Doctors and the Oklahoma Medical Board

Reporter Scott Farley, of Red Dirt Report, broke the story to the public with his series of 14 consecutive articles exposing the unconstitutional actions, and financial conflicts of interest of the competing spine surgeons and the Oklahoma Medical Board. His article says that email communications and documents were revealed to the public, which verified the Supreme Court’s concerns about the Oklahoma Medical Board’s failure to perform the due process that every citizen of the United States is guaranteed. The emails showed members of the Oklahoma Medical Board staff working hand in hand with the malpractice trial attorneys and competing doctors to attack Dr. Anagnost for their own personal financial gain.One email from the Oklahoma Medical Board’s investigator to a malpractice attorney shows the Medical Oklahoma Medical Board providing these attorneys with complaint forms and instructions to file as many cases as possible against Dr. Anagnost. The emails state that it is important for all patients to fill out the attached forms. “The more cases we have, the better.”  Other emails and documents attained by the press, revealed growing concerns about financial corruption and the lack of transparency at the Oklahoma Medical Board. The emails offer proof of the “Unholy Trinity” of the Oklahoma Medical Board, the competing spine surgeons, and the medical malpractice plaintiff’s attorneys.  (Click here to see all the Scott Farley news articles)

Fighting Back

When Dr. Anagnost realized what was going on he fought back even harder, to reveal the truth to the people of Oklahoma. Dr. Anagnost exposed the facts to the Oklahoma House and Senate, the office of the Governor, as well as the Attorney General’s Office. Dr. Anagnost also showed the senators the violations of state and federal constitutional rights to the Oklahoma Supreme Court.

Dr.Anagnost Sues Board and Co-Conspirators

Anagnost claims in his lawsuit filed in 2013 that the defendants conspired to take away his medical license after he rejected an offer to join their medical practice and invest in their privately-owned Tulsa Spine & Specialty Hospital. The suit was filed against the competing doctors: Dr. Clinton Baird, Dr.Christopher Boxell, Dr. David Fell, and Frank Tomecek. All of these doctors were investors in their doctor-owned hospital, which Dr. Anagnost declined to join.

Excerpts from a December 15, 2013, Tulsa World article:

“A Tulsa orthopedic surgeon has sued four other surgeons, alleging they conspired with the state medical board to destroy his career with “frivolous” allegations. The lawsuit by Dr. Steven Anagnost was filed last month in Oklahoma County District Court. … The suit names physicians Clinton Baird, Christopher Boxell, David Fell, and Frank Tomecek individually. Anagnost and the defendants specialize in spinal surgeries, and the suit claims they are direct competitors of Dr. Anagnost who stand to gain financially from Dr. Anagnost’s destruction. It states that the Tulsa Spine and Specialty Hospital invited him to become a shareholder in 2005 but he declined the offer. … Anagnost’s suit states the doctors were behind an effort that began in 2009 to file complaints against him with the medical board.”

“Anagnost’s suit claims the defendants “instigated the pursuit of Dr. Anagnost by not only the Oklahoma Medical Board but also worked or collaborated with civil lawyers to encourage the filing and/or prosecution of medical malpractice suits” against him. Charles Weddle, Anagnost’s attorney, said: “Dr. Anagnost is eager to get the doctors he has sued placed under oath and get this matter tried sooner rather than later.” “Dr. Anagnost is not going to give up in his pursuit to restore his reputation,” Weddle said.

“The Oklahoma Medical Board staff initially declared Anagnost’s complaint an emergency, then repeatedly delayed hearing the complaint between 2010 and 2012, records show. Anagnost sued the medical Oklahoma Medical Board in July, claiming the Oklahoma Medical Board violated his due process and failed to follow its own regulations. In a filing, in that case, several Oklahoma Supreme Court justices were critical of the medical Oklahoma Medical Board’s handling of Anagnost’s case.”

“Anagnost states in his suit that the surgeons used the Oklahoma Medical Board “to make reckless, frivolous, abusive, damaging and/or unsupported charges.” He points to a report by a health-care policy expert, Michael Lapolla, who analyzed data regarding Anagnost’s practice. Lapolla’s report found that “Dr. Anagnost’s practice demonstrates complication rates better than the national average and better than those of Dr. Anagnost’s peers, including the defendants,” the suit states.

Oklahoma Legislature Calls for Reform of Medical Board

After the filing of the Anagnost lawsuit, against the competing doctors and the Medical Board, and the many articles in the press which exposed the financial corruption and lack of transparency at the Oklahoma Medical Board, the Oklahoma legislature took action against the Oklahoma Medical Board. A series of hearings were held at the Oklahoma Senate and House, investigating and exposing the Oklahoma Medical Board. Eventually, legislation was proposed by several Oklahoma Senators and Congressman to reform and overhaul the corruption at the Medical Board, in large part from what had occurred with Dr. Anagnost. According to the press articles published on April 23, 2015, the Oklahoma Medical Board has come under public scrutiny because of deceptive practices and failure to adhere to due process rights for physicians it investigates and prosecutes.

“The measure was written, in part, because of a case involving Tulsa spine surgeon Steven Anagnost, who endured years of persecution by the Oklahoma Medical Board with no finding of wrongdoing. Anagnost was never disciplined, retains his medical license and continues to practice in northeast Oklahoma. The surgeon contends in an Oklahoma County District Court lawsuit that the Oklahoma Medical Board, competing surgeons and medical practice attorneys conspired to take away his medical license.”

The Red Dirt Report published the following relevant quotes from lawmakers:

“I think there is sufficient reason that he (Oklahoma Medical Board executive director Lyle Kelsey) should step down and I’m calling on the governor to make that decision. What happened here is an abuse of government power,” State Rep. Richard Morrissette said. “We need to send a message to all our agencies and boards that all citizens need to be protected by the law.”

“This just stinks, it stinks,” Morrissette said, referring to the board’s prosecution of Anagnost. “This is the Spanish Inquisition. They’re the investigators, the prosecutors and the judge. I get the indication that we have a rogue operation going on and it bothers me.”

“Barry Smith, an attorney with McAfee-Taft law firm, testified before the legislators that he represented Anagnost in the July 2013 lawsuit. He told the lawmakers of several conflicts of interest, including that of medical board member and medical malpractice attorney Gary Brooks. … Smith also testified that the medical board violated its own set of rules and policies at least 20 times during the Anagnost investigation. State Rep. Bobby Cleveland (R-Slaughterville) agreed with Anagnost and Smith about the need for honesty and openness. “There should be no place in government that doesn’t offer transparency,” he said.

“State Sen. A.J. Griffin (R-Guthrie) acknowledged that a state medical board case involving Tulsa surgeon Steven Anagnost prompted her, in part, to file Senate Bill 279. “It (Anagnost case) certainly influenced the process,” Griffin said. “There were a number of people on that board who were poised to make money as a result of that investigation. We want to reduce that kind of influence.”

“(State) Sen. Rob Standridge (R-Norman), chairman of the Senate Health and Human Services committee, said he’s willing to join the discussion about the controversy at the state medical board and the conflicts of interest that were apparent in the Anagnost case. “I applaud her (Griffin) for starting the conversation so we can make sense of the whole process,” he said. Standridge said he attended the September 2014 interim study that addressed problems at the state medical board. “I listened to both sides and it doesn’t look correct,” he said. “There are conflicts of interest and we should be doing something.”

“House Bill 1412, authored by Rep. Jason Murphey (R-Guthrie) sought to ensure constitutionally-protected due process rights for every physician accused of wrongdoing by a patient or peers. … Murphey believes the bill has stirred needed conversation about the board’s methods of investigating state physicians. “Within the medical community, there is going to be a lot of support for instituting these checks and balances. When that will occur, I don’t know,” he said.

“State Rep. Doug Cox confirmed Thursday that he intends to work with other legislators and the state board of Medical Licensure and Supervision on reform measures that protect physicians from unjustified prosecutions.”

Anagnost said he was pleased that the effort of the legislators to change the medical Oklahoma Medical Board’s policies is moving forward.

(Link to the full Red Dirt article)

Dr. Anagnost’s Superior Surgical Outcomes

Diagnosing the causes of pain is not an exact science. Surgery doesn’t always alleviate pain even when experts agree it is the best option. No surgeon has a perfect record, but Dr. Anagnost’s outcomes are superior to most. There has been extensive statistical analysis of Dr. Anagnost’s quality of care for his patients. This data was compiled from thousands of patient surgeries performed by Dr. Anagnost, and is found in the now famous LaPolla Report. The report shows that Dr. Anagnost provides superior outcomes when compared to other surgeons in the field of spinal surgery, both in Oklahoma as well as national comparisons. These superior outcomes include shorter length of hospital stay, less blood loss, fewer complications, and lower cost per case.  (Link to LaPolla Data)

Conclusion

“I have emerged from these attacks a stronger and even better doctor. Each patient is still important to me. I have grown closer to God, and my family. The fact that minimally invasive spine surgery has now become the gold standard in spinal surgery, proves my honesty and integrity.  I continue to design new techniques and procedures. I have taught surgeons around the world the benefits of these new spinal procedures, and I continue to strive each day to make the world a better place by teaching doctors, and helping patients improve their lives,” said Dr. Anagnost.