For more than a year, a consumer's voice has been missing from the deliberations at the Georgia medical board.
That's because one of the two seats reserved for consumers on the 16-member medical board is vacant. Gov. Nathan Deal has failed to fill the seat since it became vacant in July 2016. During the year that the consumer seat has been open, Deal has filled at least three other open spots with doctors, including the appointment last week of Dr. Thomas Harbin to serve as the board's newest member.
After being contacted by the AJC, Deal's office said it had vetted candidates for the consumer seat and made offers to one candidate in January and one in May, but both declined.
"Given the nature of consumer board positions, these seats are historically more difficult to fill," the governor's office said in an email. "In this case, we received only a handful of applications in total. The governor’s office continues to welcome applications, nominations and recommendations for this role, as well as for the more than 300 boards to which he appoints members. "
The lone consumer member currently on the board is Ronnie Wallace, a Rome businessman who previously served on the Rome City Commission and as mayor of Rome.
All the other seats on the board are filled by doctors, except for a non-voting seat reserved for a physician assistant.
The board members are volunteers who convene monthly to make final decisions about which doctors will be licensed to practice in Georgia and which will be disciplined -- and how -- after the board's full-time staff investigates complaints.
Almost every state requires consumer representation on its appointed medical boards.
Advocates say having a consumer representative on a medical board is crucial, since the doctor-dominated board is supposed to act in the public's interest.
Boards handle complaints from patients, and the boards must take on difficult issues that include sexual misconduct and improper prescribing by physicians. Much of the Georgia board's work is done behind closed doors and through private disciplinary actions, making it difficult to assess how well the board does when it comes to protecting patients.
"The volunteer, non-physician members who sit on state medical boards are critical voices for ensuring that the best interests of the public are protected," said Helen Robinson, director of advocacy for YWCA of Greater Atlanta.
Robinson said the YWCA recommends filling the seat with a "strong consumer advocate" who has a background in public heath or patient safety issues, including issues related to sexual assault.
"The board cannot be considered fully functioning without both consumer members in place," Robinson said.
In its award-winning series Doctors & Sex Abuse, The Atlanta Journal-Constitution documented a permissive attitude by medical boards in Georgia and other states toward physicians. That series also found that many states reserve a higher proportion of seats for consumer members than Georgia does.
Dr. E. Daniel DeLoach, a Savannah physician who is the chairman of the Georgia Composite Medical Board, told the AJC during an interview on Thursday that the board highly values its consumer members and hopes that the seat will soon be filled.
DeLoach said the consumers members bring to the board a perspective that represents the "public aspect" on the practice of medicine that's important for the board to have.
"The other 13 [voting] members, of course we are all physicians, so we look at medicine through a very different pair of glasses than the consumer does," DeLoach said. "We tend to look at the scientific side, the clinical side and those kinds of things. What the public advocate brings is the patient or the consumer component of it. It’s a little bit harder for us to fully have that perspective. It adds another component to the board that we would not have without them."
Here's how Georgia law works, when it comes to membership of the Georgia Composite Medical Board. It has 15 voting members and one non-voting member who is a physician assistant. Two seats are reserved for consumer members, two are physicians with Doctor of Osteopathy degrees, and eleven are physicians with Doctor of Medicine degrees.