d that a lower standard of medical care was justified by his patients' economic status.

Based on this evidence, the Third Department found in the doctor's article 78 challenge to his revocation that there was substantial evidence before the Hearing Committee that the doctor repeatedly failed to "exercise the care that a reasonably prudent physician would exercise under the circumstances" and that his conduct was sufficiently egregious to constitute gross incompetence. It thus denied his challenge to his revocation.

It should be noted

Doctors have been prescribing antibiotics for years now when patients come into their office complaining of the common cold (even though antibiotics are ineffectual to treat a cold's viral basis) in large part because of patient demands. This has led to great concern in the medical and scientific communities that such overuse of antibiotics has caused an increase in antibiotic-resistant strains of certain bacteria. Can such over prescription of antibiotics lead to the revocation of a medical license? This intriguing possibility is raised by the Third Department's decision today in Matter of Ostad v New York State Dept. of Health, 2007 NY Slip Op 04020. The facts were as follows. In support of its allegations of negligence, gross incompetence and failure to maintain accurate medical records, the Bureau of Professional Medical Conduct (BPMC) presented evidence that the doctor at issue had repeatedly prescribed antibiotics to four pediatric patients with complaints of sore, red throats without recording adequate medical histories or doing throat cultures, and despite his having made a diagnosis for which antibiotics would be ineffective. BPMC's expert established the standard of care for diagnosing such ailments in children and explained the adverse consequences of the improper prescription of antibiotics.

In his defense, the doctor presented no expert witness at the hearing and admitted that his notes did not reflect the patients' medical histories. However, he explained that he dispensed with throat cultures and routinely prescribed antibiotics because he served a low-income community whose members could not be depended upon to return if the cultures revealed the need for medication and, in any event, red throats always meant strep throat (which would justify antibiotics). The doctor further testified that the nature of his patients' community justified giving lower-cost, but less appropriate, medications, and that he often prescribed antibiotics simply because the parents demanded them. A Hearing Committee found the testimony of BPMC's expert to be highly credible while rejecting the doctor's attempts to justify his actions. It also found that the doctor believed that a lower standard of medical care was justified by his patients' economic status.

Based on this evidence, the Third Department found in the doctor's article 78 challenge to his revocation that there was substantial evidence before the Hearing Committee that the doctor repeatedly failed to "exercise the care that a reasonably prudent physician would exercise under the circumstances" and that his conduct was sufficiently egregious to constitute gross incompetence. It thus denied his challenge to his revocation.

It should be noted

Third Department's decision today in Matter of Ostad v New York State Dept. of Health, 2007 NY Slip Op 04020. The facts were as follows. In support of its allegations of negligence, gross incompetence and failure to maintain accurate medical records, the Bureau of Professional Medical Conduct (BPMC) presented evidence that the doctor at issue had repeatedly prescribed antibiotics to four pediatric patients with complaints of sore, red throats without recording adequate medical histories or doing throat cultures, and despite his having made a diagnosis for which antibiotics would be ineffective. BPMC's expert established the standard of care for diagnosing such ailments in children and explained the adverse consequences of the improper prescription of antibiotics.

In his defense, the doctor presented no expert witness at the hearing and admitted that his notes did not reflect the patients' medical histories. However, he explained that he dispensed with throat cultures and routinely prescribed antibiotics because he served a low-income community whose members could not be depended upon to return if the cultures revealed the need for medication and, in any event, red throats always meant strep throat (which would justify antibiotics). The doctor further testified that the nature of his patients' community justified giving lower-cost, but less appropriate, medications, and that he often prescribed antibiotics simply because the parents demanded them. A Hearing Committee found the testimony of BPMC's expert to be highly credible while rejecting the doctor's attempts to justify his actions. It also found that the doctor believed that a lower standard of medical care was justified by his patients' economic status.

Based on this evidence, the Third Department found in the doctor's article 78 challenge to his revocation that there was substantial evidence before the Hearing Committee that the doctor repeatedly failed to "exercise the care that a reasonably prudent physician would exercise under the circumstances" and that his conduct was sufficiently egregious to constitute gross incompetence. It thus denied his challenge to his revocation.

It should be noted

gnosis for which antibiotics would be ineffective. BPMC's expert established the standard of care for diagnosing such ailments in children and explained the adverse consequences of the improper prescription of antibiotics.

In his defense, the doctor presented no expert witness at the hearing and admitted that his notes did not reflect the patients' medical histories. However, he explained that he dispensed with throat cultures and routinely prescribed antibiotics because he served a low-income community whose members could not be depended upon to return if the cultures revealed the need for medication and, in any event, red throats always meant strep throat (which would justify antibiotics). The doctor further testified that the nature of his patients' community justified giving lower-cost, but less appropriate, medications, and that he often prescribed antibiotics simply because the parents demanded them. A Hearing Committee found the testimony of BPMC's expert to be highly credible while rejecting the doctor's attempts to justify his actions. It also found that the doctor believed that a lower standard of medical care was justified by his patients' economic status.

Based on this evidence, the Third Department found in the doctor's article 78 challenge to his revocation that there was substantial evidence before the Hearing Committee that the doctor repeatedly failed to "exercise the care that a reasonably prudent physician would exercise under the circumstances" and that his conduct was sufficiently egregious to constitute gross incompetence. It thus denied his challenge to his revocation.

It should be noted

pon to return if the cultures revealed the need for medication and, in any event, red throats always meant strep throat (which would justify antibiotics). The doctor further testified that the nature of his patients' community justified giving lower-cost, but less appropriate, medications, and that he often prescribed antibiotics simply because the parents demanded them. A Hearing Committee found the testimony of BPMC's expert to be highly credible while rejecting the doctor's attempts to justify his actions. It also found that the doctor believed that a lower standard of medical care was justified by his patients' economic status.

Based on this evidence, the Third Department found in the doctor's article 78 challenge to his revocation that there was substantial evidence before the Hearing Committee that the doctor repeatedly failed to "exercise the care that a reasonably prudent physician would exercise under the circumstances" and that his conduct was sufficiently egregious to constitute gross incompetence. It thus denied his challenge to his revocation.

It should be noted

d that a lower standard of medical care was justified by his patients' economic status.

Based on this evidence, the Third Department found in the doctor's article 78 challenge to his revocation that there was substantial evidence before the Hearing Committee that the doctor repeatedly failed to "exercise the care that a reasonably prudent physician would exercise under the circumstances" and that his conduct was sufficiently egregious to constitute gross incompetence. It thus denied his challenge to his revocation.

It should be noted that there were additional factors which led to the revocation of the doctor's license (making a false statement on an application for reappointment to the staff of a local hospital, a prior history of prior professional misconduct, and a criminal conviction). Nevertheless, it appears that the doctor's inappropriate prescription of antibiotics constituted a major basis for his revocation. So, doctors will clearly want to take note of this decision. But will this decision be enough to put fear into doctors to overcome their patients' continued demands for antibiotics?