A number of years ago, I was a member of a licensing board and, occasionally, I might hear about someone who was gaming the system. In fact, one healthcare practitioner took his deceit to a higher level.

His letterhead, which gave his name with several letters after it (always question those letters BTW), also included a number. Most people might assume that number was a license number as required by that state's law. It wasn't. It was his TIN Tax ID number. No one puts that on their letterhead unless they want to create a certain impression, plus, he called himself "Dr." without indicating that he wasn't an MD. What to do.

I wasn't on the licensing board that had governance over his practice, so I bumped it up to the director of my board, who brought it to the attention of his board. He received a letter telling him about appropriate letterhead and "signage." Oh, did I neglect to mention that the sign outside his office said "Dr…." and didn't indicate he wasn't an MD, again? People in the town thought he was since he regularly "prescribed" medications without any prescription privileges and couldn't write scripts, but did so in his notes and reports. A bit of a guy too big for his britches?

It was one of those reports that had come to my desk for my review that brought my attention to him, his letterhead, and prior interactions regarding letterhead and signage from his licensing board. The second time I saw a report that hadn't been amended (he was still "prescribing"), and his letterhead hadn't been amended, I decided to call him for clarification.

Once he was on the phone and I asked about the number on his letterhead, he was furious and began screaming at me. It was then that I told him who I was, the reason I had his report and what I knew about his license. I decided not to endure the screaming and hung up on him.

Within a minute, my phone rang and it was an extremely contrite man on the line. Oh, he fully intended to change his letterhead. No reason why this was his second letter regarding this matter from his board and why it hadn't been changed yet. He agreed, humbly, that he would correct the infraction immediately. I assumed he would and that he'd keep his word. I wouldn't know if he had since I wasn't going to play Dick Tracy and left it to his licensing board.

A few months later, another recent report of his came across my desk. Sure enough, right on top of his letterhead was that "Dr." and his TIN.

I copied the letterhead and sent it to his licensing board director. Just by chance, someone in the office who lived in the town where he practiced, came by my desk and saw his name. Yes, she remarked he was "Dr." and regularly "prescribed" the medications people should be taking. We had a brief conversation where I primarily solicited information and passed it along to my board director who would, again, contact the man's board. His board had responsibility now and I left it to them.

The subject of individuals acting outside the purview of their license came to my attention when I read an article in Axios. I know that dentists want to do facial plastic surgery and others with either MD or other credentials want to expand their practices but I didn't think giving infusions therapy was something legal for spas, beauty salons and in strip mall shops. How could this be that people are providing an invasive "treatment" without any medical licensing?

There are https://www.kctv5.com/news/recent-death-of-johnson-county-man-raises-questions-about-iv-therapy/article_9b288e10-4068-11e9-a08e-334752061f55.html" style="color:#0563c1; text-decoration:underline">consequences and death could be one, albeit there isn't too much information on it, or these "treatments" are just beginning to roll out over the country. Should someone be monitoring licensees more closely? Are gyms licensed for anything? If they have no licenses, how can we be assured they are meeting requirements that would be included with licensing and oversight? IMHO, we shouldn't assume anything when it comes to our health and safety.

Licensee oversight shouldn't be assumed, either. I know that in some states there are only two persons who go out to ensure signage and licensing requirements are met. And, unfortunately, these officials only go out when they're alerted to a problem. No reason to believe we're safe there. Who alerts them? I guess it's up to all of us.

Medical licensing boards, too, may not be as proactive as we believe. One psychiatrist, who was accused by his clinic's staff of sexual assault (he asked mothers to take their bras off in his office), went on vacation and opened an office in another state. No charges were filed and I have to wonder if the new state contacted his prior state to check on his record.

This is not the stuff of my imagination that licensing boards may be lax. Anyone, who wishes some confirmation, is referred to the case of Michael Swango, a serial killer physician, who moved with impunity between states. He was only suspected when a dean of a school was checking on his credentials and informed another facility that there was reason for suspicion.

As always, it's caveat emptor time.