Topeka A Kansas doctor disputed allegations at a medical board disciplinary hearing Friday that her records contained inadequate information about mental health exams she conducted on young patients she referred to the late Dr. George Tiller's clinic for late-term abortions.
Attorneys for Dr. Ann Kristin Neuhaus also attempted to bolster her case with the State Board of Healing Arts by calling a University of Kansas Medical professor who has worked with her, interviewed her and reviewed her files. The professor said he believes her exams met accepted standards of care.
A complaint before the board accuses Neuhaus of negligence in performing exams for 11 patients aged 10 to 18 who had abortions at Tiller's clinic in Wichita in 2003. Kansas law required Tiller to obtain an independent second opinion before terminating each pregnancy. Neuhaus concluded the patients were suffering from acute anxiety, acute stress or single episodes of major depression.
Board attorneys presented evidence this week that Neuhaus' records contain little specific information about each patient and that she used a computer program, "PsychManager Lite," to produce "generic" reports. But Neuhaus rejected the idea that her records show no basis for her assessments.
"I disagree, and we've been over this ground before," Neuhaus said when questioned about the records for a patient who had an abortion in August 2003. "I think there's plenty of specific information in here."
The professor who testified, Dr. Allen Greiner, said many family practice doctors don't assess patients' functioning in social, school or work settings in examining their mental health, something Neuhaus did for each one. Greiner, also the health officer for Wyandotte County's public health department, worked with Neuhaus there.
"I believe the standard of care was met," Greiner testified.
Greiner's statements contrasted with testimony from Dr. Liza Gold, a clinical psychiatry professor at the Georgetown University Medical Center in Washington, who concluded after reviewing Neuhaus' records that she failed to meet accepted standards of care. Among other things, Gold cited a lack of specific details about each patient that Gold said could help other doctors treating them.
Attorneys for Neuhaus and the board have been presenting their evidence and testimony to a hearing officer, who will recommend to the full board whether Neuhaus should face sanctions. The 15-member board, mostly physicians, has the power to revoke her Kansas license.
Neuhaus doesn't have an active medical practice, but her license does allow her to provide charity care, which she does. She has asked the board to restore her to having a full, active license.
Neuhaus provided second opinions for Tiller from 1999 through 2006, usually in a private room at Tiller's clinic, generally driving there once a week from her home in Nortonville, about 30 miles north of Lawrence. She testified Thursday that Tiller never pressured her to allow abortions to go forward and that her opinions were truly independent.
Tiller was one of a few U.S. physicians performing late-term procedures when a man professing strong anti-abortion views shot him to death in May 2009. The doctor had been acquitted two months earlier of misdemeanor criminal charges that, in relying on Neuhaus for referrals, he wasn't getting the independent second medical opinion as state law required.
State law then restricted abortions starting at the 22nd week of pregnancy, if the fetus was viable. It required that a patient face death or "substantial and irreversible" harm to "a major bodily function," which included her mental health. Legislators tightened the law this year, and it no longer includes the mental health exception.
Board attorney Reese Hays repeatedly questioned Neuhaus about the lack of definitive statements from her in records stating that patients were seeking abortions, or the lack of her signature on documents. Neuhaus noted that her patients' files had cover letters from Tiller's clinic.
"A reasonable person would conclude that a person coming to an abortion clinic is seeking abortion services," she said. "I didn't realize I had to write something only a contract attorney would."