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WASHINGTON - The vice president of Tennessee's medical disciplinary panel said he would have considered a harsher punishment against U.S. Rep. Scott DesJarlais if the Jasper physician had slept with his patients a year or two ago - not 13.
"I would have been open to an ethics course, maybe probation," Dr. Subhi D. Ali said in a Wednesday phone interview. "But all of this happened in 2000."
Based on the recommendations of a state investigation, the Tennessee Board of Medical Examiners voted 8-0 last week to reprimand DesJarlais and fine him $500 for sexual relationships the Tennessee Republican admitted having with two patients in 2000. Considered violations of state law, the affairs were among several revelations published during DesJarlais' 4th Congressional District re-election campaign last year.
Critics derided the sanction as a slap on the wrist.
But some board members pushed for a tougher penalty, according to audio obtained by the Chattanooga Times Free Press.
The recording reveals the medical panel's decision-making process. For eight minutes, a handful of Tennessee doctors and residents debated DesJarlais' fate before settling on a punishment, with no recorded opposition.
"I believe this case was handled in a fair manner," Ali said. "On his record, a reprimand stays forever."
A few moments before the board voted, Dr. Allen Musil said its members should go beyond the state's recommendation.
"I think I would be more comfortable if we at least required an ethics course," the Johnson City physician said. "How does the board feel about that?"
Resistance quickly surfaced.
"I think the time [lapse] is such that if there have been no complaints in 13 years, I don't know how much you're going to teach him by [requiring] an ethics course at this time," Memphis-based Dr. Neal Beckford told his fellow board members.
"For those of us on the west part of the state," Beckford said, "who is Scott DesJarlais?"
Another board member asked why the time the incidents occurred influenced the state's recommended punishment.
"If this is an incident and he admitted to the incident," Nashville resident Barbara Outhier said, "I'm having a hard time understanding [why the time lapse] has anything to do with it."
" ... There haven't been any other complaints or allegations against Dr. DesJarlais [since 2000]," replied Kyonzte Hughes-Toombs, the state attorney who suggested a reprimand and $500 fine. "And so we felt that a reprimand would be sufficient to deter this type of behavior from happening again."
Some questioned the investigation altogether. The state began probing DesJarlais after a Washington-based watchdog group filed an official complaint.
"Why do we believe this person that made the charge?" asked board member Nina Yeiser.
"Because Dr. DesJarlais admitted to the allegations," Toombs replied.
"Well, that was not real smart," Yeiser said.
Laughter broke out among the panel.
"What was not real smart, having the affair or [admitting] it?" board member Dr. Reeves Johnson joked.
"That's for Dr. DesJarlais to decide," Ali said as he brought the meeting to order.
Two of the board's three female members did not vote. Outhier abstained but did not say why. Chattanoogan Patricia Eller recused herself, saying she has a residence in DesJarlais' district. Neither could be reached Wednesday.
Officials have said there is no statute of limitations for complaints alleging physician misconduct. Toombs assured board members that DesJarlais' punishment matched those imposed upon similar offenders.
Last year the state fined a Morristown family practice physician $1,500 for engaging in a consensual relationship with a patient he met at work and later called his "girlfriend." Records show the physician was forced to take several classes, including one at Vanderbilt University Medical Center called "Maintaining Proper Boundaries."
Meanwhile, The Tennessean reported last week that DesJarlais' $500 fine matched the amount assessed against another doctor in 2012 for not paying her professional privilege taxes.
The board never discussed whether DesJarlais attempted to persuade one of his patients to get an abortion, as the congressman has admitted.
"We take nothing from outside," Ali said Wednesday. "We take what the state presents to the board."
Contact staff writer Chris Carroll at firstname.lastname@example.org or 423-280-2025.