Gambee v. Oregon Medical Board

Under ORS 677.190(1)(b)(A), a doctor that puts his/her patients at a risk of harm greater than the standard treatment does not qualify as “alternative medical treatment.”

Gambee sought judicial review of the Oregon Medical Board’s order to revoke his license to practice medicine. Gambee had been under an interim stipulated order (ISO) with certain limitations, and the Board focused an investigation concerning his treatment of patients with either thyroid or testosterone treatment. The Board concluded his treatment of nine patients violated prior board orders. Gambee argued that the treatment in question fell under the “alternative medical treatment” definition in ORS 677.190(1)(b)(A), which would exempt him from the general standard of care the Board concluded he breached. The Court of Appeals largely agreed with the Board’s order, except for Gambee’s treatment of patient I and patient C (whose interactions did not rise to violations). An ALJ found Gambee’s conduct breached the standard of care, and constituted unprofessional or dishonorable conduct and gross or repeated negligence. The ALJ focused on the third element in ORS 190(1)(b)(A)(iii), “A treatment that poses no greater risk to a patient than the generally recognized or standard treatment.” Here, there was substantial evidence in the record and expert testimony that Gambee’s testosterone and thyroid treatment posed a greater risk of harm than the generally recognized treatment. Testosterone treatment can expose the patient to certain risks, without first establishing a deficiency, by receiving too much hormone. Gambee failed to test hormone levels, putting the patients at a greater risk of harm. Thyroid treatment, without first establishing a deficiency, exposed patients to greater risks as well. Symptoms consistent with thyroid deficiency may have another cause. Although the Court of Appeals affirmed the Board’s conclusion, except for patient I and patient C, the Board must reconsider appropriate sanctions. Reversed and remanded for reconsideration.