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Idaho medical board closed a complaint against Dr. Cole — before it even saw patient records

Sen. Ron Johnson (R-WI) Holds Panel Discussion On Capitol Hill, "COVID 19: A Second Opinion"
Drew Angerer/Getty Images
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WASHINGTON, DC - JANUARY 24: Dr. Ryan Cole speaks during a panel discussion titled COVID 19: A Second Opinion in the Kennedy Caucus Room of the Russell Senate Office Building on Capitol Hill on January 24, 2022 in Washington, DC. The panel featured scientists and doctors who have been criticized for expressing skepticism about COVID-19 vaccines and for promoting the use of unproven medications for treatment of the disease. (Photo by Drew Angerer/Getty Images)

Oversight gap is enabled by Idaho laws to protect physicians

The Idaho Board of Medicine did not review patient records before closing a complaint that alleged Dr. Ryan Cole was providing substandard medical care to COVID-19 patients in other states, according to public records and statements by Cole and his attorney.

Because of state laws that protect doctors, the Idaho Board of Medicine’s decision would never have been identified if not for a medical board in Washington that chose to investigate and asked Cole for his patient records.

The secrecy that surrounds Idaho’s medical disciplinary process has created a gap in public oversight of medical professionals. Washington’s sunshine laws allowed the Idaho Capital Sun to review records in the Washington Medical Commission’s case — shining a light through that gap in oversight and raising a question about how much diligence goes into vetting complaints against medical providers.

Meanwhile, Cole has gained more influence as a public figure in the movement to reject public health advice. He has appeared in:

Cole also serves as the only physician on the Central District Health board — the panel that sets budget and policy for Idaho’s largest public health district.
Cole did not respond to questions from the Idaho Capital Sun.

What we don’t know about Idaho doctors — and why it’s a secret

The Idaho board did not choose to conduct its business in private. That choice was made by Idaho lawmakers.

The Idaho Legislature over the decades has passed laws that conceal most allegations against doctors, and conceal the results of peer reviews, Idaho Board of Medicine investigations, and the proceedings of a panel that decides whether a patient has a valid lawsuit against a doctor.

Idaho code prohibits the medical board from divulging information about a licensed professional’s alleged violations — until, and unless, the board takes official action.

Those public actions include when an Idaho doctor’s license is revoked, suspended or placed on probation while the doctor works to remedy their problem.

The board holds anything short of official discipline in strict confidence, in accordance with Idaho’s laws. The board:

  • produces no public record of the complaint;
  • produces no public paper trail to show how the complaint was handled;
  • will not tell the person who filed the complaint how it was resolved;
  • ejects the public and the press from its deliberations on a licensee’s need for discipline; and
  • issues warning letters and takes informal steps in response to complaints — but conceals the names of doctors whose conduct was concerning enough to warrant those actions.

Complaints against Dr. Ryan Cole have taken two paths

Cole is a clinical and anatomic pathologist who specializes in skin tissue. His laboratory, Cole Diagnostics, runs a large array of tests for disorders related to hormones, cancer, sexually transmitted infections and other infectious diseases.

Medicaid and Medicare billing data show that Cole Diagnostics increased its revenues by adding COVID-19 tests to its menu of services.

Cole went from receiving Medicaid and Medicare payments of roughly $418,000 to $723,000 in the five years before the pandemic, to receiving a total of $1.4 million from Medicaid and Medicare in 2020 — nearly half of that as payments for COVID-19 tests.

Cole is board certified to evaluate and diagnose medical conditions by examining patient samples in a laboratory at Cole Diagnostics.

Pathologists do not work as primary care providers, urgent care or emergency room physicians, unlike health care providers who see patients through telehealth platforms such as Teladoc.

According to Cole’s public statements and public records obtained by the Sun, four states’ medical boards opened investigations into his conduct as a care provider for COVID-19 patients. Idaho’s medical board is the only one that declined to begin an investigation, he and his attorney said in public statements and in communications with the Washington board.

A timeline of events suggests that the Idaho Board of Medicine could not have reviewed the charts of Cole’s telehealth patients before it decided not to investigate whether he properly treated them.

May 2021 – September 2021

Cole is listed on the website MyFreeDoctor.com as a physician who treats patients with COVID-19 via telehealth. His title on the website is “dermatopathologist, Covid expert.”

Oct. 7, 2021

Idaho Medical Association files a complaint to Idaho Board of Medicine, alleging Cole fell short of Idaho’s standard of care while treating COVID-19 patients via telehealth — that, as a laboratory doctor and not a patient care provider, “he may not have followed proper clinical procedures for the diagnosis and treatment of patients and may not have kept appropriate patient medical records.” The complaint cites Cole’s statements that he prescribed telehealth patients ivermectin, an antiparasite drug that has shown no effectiveness in treating COVID-19.

Oct. 15, 2021

The Washington Medical Commission says it has opened investigation in response to complaints about Cole’s public statements regarding COVID-19 vaccines and treatments; and about his practice of seeing COVID-19 patients via telehealth.

January 2022

The Washington Medical Commission asks Cole to provide a “complete copy of five different patient records, dating back to March 2020, wherein you prescribed ivermectin. Please provide the entire file including, but not limited to; patient contact information/demographics, charts, office visit notes, progress reports, summaries, aftercare and/or discharge plans, laboratory results, prescription history, copies of all prescriptions and any other ancillary documentation.”

February 2022

Cole tells the Washington Medical Commission that he cannot produce patient medical records because the telehealth platform Medici locked him and others who saw patients through My Free Doctor out of its system.

Cole’s attorney says in a letter to the commission that Minnesota and Arizona had opened an investigation and requested information from Cole, “based on complaints similar to those received by Washington.” Cole responded to them in December 2021, the attorney wrote. “Significantly, despite similar unfounded complaints against Dr. Cole, Idaho declined to open an investigation of Dr. Cole’s practice or his publicly held opinions.”

“He stated during each telehealth encounter, proper records were generated which included medical and medication histories,” the Washington Medical Commission’s investigator writes in a case summary Feb. 15. “While five different patient files where (Cole prescribed) ivermectin were requested, the respondent stated he was unable to provide any.”

July 2022

In a video interview published July 5, Cole tells Dr. Joseph Mercola — a major figure in the anti-vaccination movement — that three state medical boards have active complaint investigations open on his license, but Idaho isn’t one of them. “It’s a war. OK. It’s a war,” he tells Mercola. “I have not had a patient complaint against me in 26 years of being a physician. I still don’t.”

Idaho Board of Medicine says it can be trusted to protect consumers

Idaho law says doctors must maintain medical records for each patient they see via telehealth, and those records must comply with state and federal laws, rules and regulations.

State law also says, before providing treatment or prescribing drugs, “a provider shall obtain and document a patient’s relevant clinical history and current symptoms to establish the diagnosis and identify underlying conditions and contraindications to the treatment recommended. Treatment recommendations provided through telehealth services shall be held to the applicable Idaho community standard of care that applies in an in-person setting. Treatment based solely on an online questionnaire does not constitute an acceptable standard of care.”

It would not be possible to confirm whether a physician met the standard of care and kept proper medical records without looking at a patient’s chart.

The Idaho Board of Medicine declined to comment on its response to the complaints against Cole. It answered only general questions.

Idaho doctors can practice medicine as defined by Idaho law, and the scope of what they can do as doctors “is tied to” their education, training and experience, Idaho Division of Occupational and Professional Licenses Public Information Officer Bob McLaughlin said in an email.

The Idaho Board of Medicine is housed within the Division of Occupational and Professional Licenses, which is in the executive branch under Gov. Brad Little.

A spokesperson for Little declined to comment.

“It is incumbent upon a licensee to ensure he/she has the necessary education, training and experience to practice any aspect of medicine and to ensure he/she complies with the Idaho community standard of care,” McLaughlin wrote.

Asked whether the Idaho Board of Medicine would review patient records before closing a complaint in a hypothetical situation — a radiologist offering to treat cancer patients and prescribing them chemotherapy drugs, for example — McLaughlin said DOPL couldn’t speak to that hypothetical “as it is incomplete. How a complaint is handled is directly tied to the allegations at issue as well as the statutes or rules triggered by the allegations.”

The Sun asked why Idaho patients should have blind faith in the oversight of Idaho’s health boards and trust them to thoroughly investigate complaints about patient care.

McLaughlin responded, saying the Idaho Division of Occupational and Professional Licenses is “committed to consumer protection and the safety of Idaho’s citizens” and that it has “strong investigation and compliance teams in each of its bureaus.” He said the division “carefully review(s)” and gives “due consideration” to all complaints and allegations.

“The framework for that review is based upon a board’s statutory authority, specifically a board’s authority to discipline a license or registration,” he wrote. “The Idaho Legislature in the law has provided the framework for oversight and, as an executive branch agency, we follow the law.”

The Idaho Capital Sun is a nonprofit news organization delivering accountability reporting on state government, politics and policy in the Gem state. As longtime Idahoans ourselves, we understand the challenges and opportunities facing Idaho. We provide in-depth reporting on legislative and state policy, health care, tax policy, the environment, Idaho’s explosive population growth and more. Our mission is relentless investigative journalism that sheds light on how decisions in Boise and beyond are made and how they affect everyday Idahoans. We aim to tell untold stories and provide data, context and analysis on the issues that matter most throughout the state. The Capital Sun is part of States Newsroom, a national 501(c)(3) nonprofit supported by grants and a coalition of donors and readers. We retain full editorial independence.