From the Arkansas Advocate:
After approximately 20 hours of testimony during a two-day hearing, the Arkansas State Medical Board voted to revoke the license of Dr. Alonzo Williams, a Little Rock gastroenterologist accused of sexual abuse and improper prescription practices.
The medical board, led by Dr. Ward Gardner, approved 16 of the 17 charges against Williams, many of which were related to gross negligence or “ignorant malpractice” for the over-utilization of medical procedures such as biopsies, colonoscopies and a specific esophagus examination called an esophagogastroduodenoscopy, or EGD.
The hearing centered around an investigation of six of Williams’ patients, whom he and his attorney Kevin O’Dwyer described as “extreme outliers.”
Medical records — which testimony revealed Williams’ staff did not collect in their entirety for the investigation — showed the six patients frequently underwent sedated procedures and were prescribed opioids even after pharmacies communicated risks for certain patients to Williams’ clinic.
Williams, 73, testified Friday and said he believes some patients “duped” him. In an effort to assuage board members, Williams said he was willing to complete various courses to improve his practice and would stop prescribing narcotics entirely. He said he would refer patients with chronic pain to other practitioners.
As a former member of the Arkansas State Medical Board himself, Williams said he “worked real hard to not be on this side of the table,” referring to his position as the subject of the hearing.
His attempts to relieve board members of concerns did not prove to have enough sway when it came to the charges.
The only charge board members did not approve Friday concerned an allegation of sexual harassment of an employee in a clinic setting. The board rejected the allegations because of a disagreement of whether the alleged victim was an employee of Williams’ and concerns that the woman did not testify.
Williams did testify Friday that he had an inappropriate relationship with one of his coworkers, a woman who was frequently referenced throughout the hearing as his employee. Williams does not consider her to ever have been his employee.
Further, he said their relationship was consensual, brief and was not sexual harassment. He did not provide any further details.
In addition to approving allegations and charges, the medical board also assigned penalties to the separate charges, the majority of which were license revocations. Other approved penalties included reprimand and a one-year license suspension.
The license revocation will take effect upon a signed order, and Williams will be informed of the appeal process.
One member of the board, Dr. Brian McGee, recused from the hearing because he previously practiced gastroenterology in the same clinic as Williams. McGee was not present either day of the hearing. Another board member, Dr. Timothy Paden, was absent Friday and did not participate in the vote.
Gardner, who as chairman doesn’t participate in board votes, was the only member who spoke to the result of the hearing.
“No desire to make any comments, it’s a sad day,” he said soon before the board adjourned after a 13-hour hearing on Friday.
Williams declined to comment on the hearing’s outcome as he left for the evening with his family.
Friday testimony
Two witnesses spoke on Friday, adding to Thursday’s list of 10.
In addition to Williams, O’Dwyer also called on Kevin Olden, a retired doctor who practiced gastroenterology with a focus in psychiatric influence — or how the brain and the gut interact with each other. Though Olden’s most recent practice occurred in Arizona, he did practice medicine in Arkansas in the 2000s.
As the defense’s expert witness, Olden spoke to Williams’ medical practice and the frequency of certain procedures he performed.
At the beginning of his testimony, which lasted approximately six hours, Olden seemed to agree with Williams’ care patterns even in cases of multiple EGDs a year, which would typically only be done on an annual basis.
He testified that these six patients Williams treated were difficult and not representative of typical cases. Olden described Williams’ use of frequent follow-up colonoscopies as “aggressive,” but said care depends on a patient’s needs.
Olden also said it is not common for a gastroenterologist to prescribe narcotics or treat patients for chronic pain, which is what he said it appeared Williams was doing.
“I think Dr. Williams had the best of intentions,” Olden said. “I think he was doing what he thought was right for the patients. But he was over his head, and that’s not saying that he’s not a qualified physician or gastroenterologist. He was taking on management of patients that I don’t think he fully perceived how complex and very different from his skillset they were.”
Olden testified that he had to assume information from the records he reviewed because Williams’ documentation was not robust. Among those assumptions was that Olden said he thought Williams’ patients repeatedly returning for care to be an indication that the procedures were offering relief.
While being questioned by Jordan Broyles of the attorney general’s office, which represented the medical board during the hearing, Olden testified he did not receive all of the documents that were provided to the attorneys.
Olden said he had not reviewed documentation regarding prescriptions of the six patients. Once he did read the records, Olden said information about prescribing opioids to patients who had drug-seeking habits was concerning.
In his practice, Olden said, he would have documented conversations with those patients about the inappropriateness of their behavior. In some cases, he would have terminated care, he said.
Olden concluded that it would be best if Williams didn’t prescribe narcotics. He described Williams’ actions as a “well-intentioned mistake.”