Disciplinary Actions against
Jonathan W. Singer, D.O.
Stephen Barrett, M.D.
Jonathan Singer, D.O., has been disciplined by the medical boards of Colorado and Wyoming. The relevant records indicate the following:=
- In 1989, the Colorado Board of Medical Examiners concluded that Singer had (a) made unjustified diagnoses of thyroid disease, (b) administered thyroid hormone without adequate monitoring of thyroid function, and (c) administered adrenal cortex injections without medical justification. The board placed Singer on probation and prohibited him from from providing "any type of hormone replacement therapy" to patients. He was also required to complete a competency assessment and have his practice monitored.
- In the mid-1990s, he was notified that his malpractice insurance carrier would not renew his policy because too many malpractice claims had been filed against him.
- In 2001, the Colorado Board admonished him for failing to submit monitoring reports for a 10-month period. The board also extended his probationary period for ten months.
- In 2009, the Wyoming Medical Board issued a consent decree in which Singer acknowledged sexually inappropriate conduct toward a patient and agreed to 5 years of probation that included counseling and chaperone requirements.
- In 2016, the Colorado board issued another order that disposed of additional complaints. The stipulated order, shown below, mentions that in 2009, Singer had inadequately documented care so a patient and that at another time (not specified in the order) he had diagnosed a patient with candida intestinal overgrowth without adequate documented support. The order (a) places him on five years probation, (b) requires him to have a chaperone present when he provides services to female patients unless they sign a waiver, (c) requires him to have his practice monitored, and (d) permits him to prescribe estrogen and progesterone but prohibits him from providing any type of hormone replacement therapy when practicing in Colorado.
Singer does business as HealthFirst with offices in Greenwood Village, Colorado and Cheyenne, Wyoming. The clinic site claims:
There are natural solutions for virtually any health problem that can help you to have more energy; relieve depression; get pain relief with less reliance on drugs; lose fat as you retain muscle; see things more clearly; have a more normal menstrual cycle; lower your blood pressure and improve your circulation; minimize heart disease and diabetes risk; improve your memory; enhance your fertility; normalize skin tone and texture; lessen your need for expensive medications; improve your digestion; reduce the probability that you will need surgery; have greater sexual vitality; go through a smoother menopause; reduce your risk of breast and other cancers; prevent bone loss (osteoporosis); strengthen your immune system; improve your breathing.
The nonstandard modalities offered at HealthFirst include acupuncture and Chinese medicine; alternative cancer therapies; autologous adult stem cell therapies; bioidentical hormones; chelation therapy; homeopathy; intravenous nutrients; nonsurgical spinal decompression; and treatment for multiple chemical sensitivity.
BEFORE THE COLORADO MEDICAL BOARD STATE.OF COLORADO
CASE NO. 2010-1325, 2011-2987, 2011-1843, 2012-3805, 2014-1140, 2014-2167, 2016-3191-A
STIPULATION AND FINAL AGENCY ORDER
IN THE MATTER OF THE DISCIPLINARY PROCEEDING REGARDING THE LICENSE TO PRACTICE MEDICINE IN THE STATE OF COLORADO OF JONATHAN SINGER, D.O., LICENSE NUMBER DR-29309,
IT IS HEREBY STIPULATED and agreed by and between Inquiry Panel A ("Panel") of the Colorado Medical Board ("Board") and Jonathan Singer, D.O. ("Respondent") (collectively, the "Parties") as follows:
JURISDICTION AND CASE HISTORY
1. Respondent was licensed to practice medicine in Colorado on January 19, 1989 and was issued license number DR-29309, which Respondent has held continuously since that date.
2. The Panel and the Board have jurisdiction over Respondent and over the subject matter of this proceeding.
3. On or about May 18, 2011, the Parties entered into a Second Interim Practice Agreement ("Interim Agreement") in lieu of summary suspension pursuant to section 24-4-104(4),C.R.S. This Interim Agreement remains in effect until such time as a Final Board Order becomes effective in this case.
4. It is the intent of the parties and the purpose of this Stipulation and Final Agency Order ("Order") to provide for a settlement of all matters set forth in case numbers 2010-1325, 2011-2987, 2011-1843, 2012-3805, 2014-1140, 2014-2167 and 2016-3191 without the necessity of conducting a formal disciplinary hearing. This Order constitutes the entire agreement between the parties, and there are no other agreements or promises, written or oral, which modify, interpret, construe or affect this Order.
5. Respondent understands that:
- Respondent has the right to be represented by an attorney of the Respondent's choice and Respondent is represented by counsel;
- Respondent has the right to a formal complaint and disciplinary hearing pursuant to sections 12-36-118(4)(c)(IV) and 12-36-118(5), C.R.S.;
- By entering into this Order, Respondent is knowingly and voluntarily giving up the right to a formal complaint and disciplinary hearing, admits the facts contained in this Order, and relieves the Panel of its burden of proving such facts;
- Respondent is knowingly and voluntarily giving up the right to present a defense by oral and documentary evidence and to cross-examine witnesses who would testify on behalf of the Panel; and
- e. Respondent is knowingly and voluntarily waiving the right to seek judicial review of this Order.
6. Respondent specifically admits and the Panel finds that:
- The Board issued an Order effective May 24, 1999, that prohibited Respondent from providing hormone replacement therapy, other than progesterone or estrogen, to patients. In 2010, Respondent wrote a single prescription for a hormone;
- On February 2, 2010, the Wyoming Board issued an order approving a November 12, 2009 Consent Decree, in which Respondent acknowledged inappropriate conduct toward a patient and agreed to 5 years of probation, including counseling and chaperone requirements, which were completed and Respondent's Wyoming license was restored to unrestricted, active status after 18 months by the Wyoming Board of Medicine;
- During the month of September 2009, Respondent provided care and treatment for patient SS. Respondent documented his care and treatment on a medical flow sheet rather than SOAP notes;
- Respondent provided care and treatment for KD, the Board alleges that Respondent diagnosed KD with candida intestinal overgrowth without adequate documented support.
7. The Panel finds that the acts and/or omissions described in the factual basis above constitutes unprofessional conduct pursuant to section 12-36-117(1)(p) (u) and (cc) C.R.S., which state:
(1) "Unprofessional conduct" as used in this article means:
(p) Any act or omission which fails to meet generally accepted standards of medical practice;
(u) Violation of any valid board order or any rule or regulation promulgated by the board in conformance with law;
(cc) . . . repeatedly failing to make essential entries on patient records.
8. Respondent's license to practice is hereby placed on probation for five (5) years commencing on the effective date of this Order. All terms of probation shall be effective throughout the probationary period and shall constitute terms of this Order.
9. During the probationary period, Respondent agrees to be bound by the terms and conditions set forth below.
10. During the probationary period, a "practice monitor" shall monitor Respondent's medical practice. Within 30 days of the effective date of this Order, Respondent shall nominate, in writing, a proposed practice monitor for the Panel's approval. The nominee shall be a physician licensed by the Board and currently practicing medicine in Colorado. The nominee shall have no financial interest in Respondent's practice of medicine. The nominee must be knowledgeable in Respondent's area of practice. If Respondent is board certified in an area of practice, it is preferred, but not required, that the nominee be board certified by that same board. If the Respondent has privileges at hospitals, it is preferred, but not required, that the nominee have privileges at as many of those same hospitals as possible. The Board shall not have disciplined the nominee.
11. Respondent's nomination for practice monitor shall set forth how the nominee meets the above criteria. With the written nomination, Respondent shall submit a letter signed by the nominee as well as a current curriculum vitae of the nominee. The letter from the nominee shall contain a statement from the nominee indicating that the nominee has read this Order and understands and agrees to perform the obligations set forth herein. The nominee must also state that the nominee can be fair and impartial in the review of the Respondent's practice.
12. Upon approval by the Panel, the practice monitor shall perform the following:
- Each month, the practice monitor shall visit all the Colorado offices at which Respondent practices medicine and shall review a minimum of five patient charts maintained by Respondent. The practice monitor shall make reasonable efforts to ensure that Respondent has no notice of which charts will be selected for review. The practice monitor is authorized to review such other medical records maintained by Respondent as the practice monitor deems appropriate.
- Each month, the practice monitor shall review a minimum of five hospital charts of patients whom Respondent has admitted to, evaluated at, or treated at hospitals. If Respondent has admitted, evaluated, or treated fewer than five patients, the practice monitor shall review all the patients so admitted, evaluated, or treated, if any. The practice monitor shall make reasonable efforts to ensure that Respondent has no notice of which charts will be selected for review. The practice monitor is authorized to review such other hospital charts as the practice monitor deems appropriate.
- The practice monitor shall submit quarterly written reports to the Panel.
- The practice monitor's reports shall include the following:
(i) a description of each of the cases reviewed; and
(ii) to each case reviewed, the practice monitor's opinion whether Respondent is practicing medicine in accordance with generally accepted standards of medical practice.
13. If at any time the practice monitor believes Respondent is not in compliance with this Order, is unable to practice with skill and safety to patients, or has otherwise committed unprofessional conduct as defined in section 12-36-117(1), C.R.S., the practice monitor shall immediately inform the Panel.
14. It is the responsibility of the Respondent to assure that the practice monitor's reports are timely and complete. Failure of the practice monitor to perform the duties set forth above may result in a notice from Board staff requiring the nomination of a new practice monitor. Upon such notification, Respondent shall . nominate a new practice monitor according to the procedure set forth above. Respondent shall nominate the new monitor within 30 days of such notice. Failure to nominate a new monitor within 30 days of such notification shall constitute a violation of this Order.
EARLY TERMINATION FROM PRACTICE MONITORING
15. After successful completion of eighteen (18) months of practice monitoring, Respondent may petition the Panel, in writing, for early termination of practice monitoring. The parties agree that the Panel's decision regarding such a petition shall be made at the sole discretion of the Panel. Respondent hereby waives any right to appeal the Panel's decision on this issue.
CPHP TREATMENT MONITORING
16. During the probationary period, Respondent shall receive such evaluation andmedical treatment as is determined to be appropriate by CPHP. All instructions to Respondent by CPHP shall constitute terms of this Order, and Respondent must comply with any such instructions. Failure to comply with such instructions shall constitute a violation of this Order.
17. Within 30 days of the effective date of this Order, Respondent shall sign any and all releases necessary to allow CPHP to communicate with the Panel. Within 60 days of the effective date of this Order, Respondent shall provide the Panel with a copy of such releases. This information may include treatment program records that may be confidential under federal or state law. Respondent shall update any and all releases as often as may reasonably be required to allow the Panel access to Respondent's privileged or confidential information. Respondent shall not revoke such releases prior to successful completion of the probationary period as set forth in this Order .. Any failure to execute such a release, failure to provide copies to the Panel, or any premature revocation of such a release shall constitute a violation of this Order. In the event Respondent revokes such release, CPHP may, because of confidentiality concerns, refuse to acknowledge Respondent's participation in CPHP. CPHP's refusal to acknowledge Respondent's participation with that organization shall constitute a violation of this Order.
18. Respondent shall also complete any and all unrestricted releases as are necessary to permit CPHP to disclose to the Panel information generated by other sources. Respondent authorizes the Panel to re-disclose and rnake public," consistent with Board Policy 10-18, information obtained from CPHP necessary for the limited purposes of enforcing this Order, seeking sanctions for noncompliance with this Order, or other purposes authorized in the Medical Practice Act. Medical records shall not become public records by virtue of such use. Any failure to execute such a release, failure to provide copies to the Panel, or any premature revocation of such a release shall constitute a violation of this Order.
19. CPHP shall function as the "treatment monitor" as that term is used in this Order. CPHP shall monitor Respondent's compliance with this Order and shall submit quarterly written reports to the Panel. The reports shall briefly describe Respondent's treatment monitoring with CPHP. The reports shall also state whether Respondent is in compliance with this Order. If at any time CPHP has reasonable cause to believe that Respondent has violated the terms of this Order, is unable to practice with skill and with safety to patients or has committed unprofessional conduct as defined in section 12-36-117(1), C.R.S., CPHP shall immediately inform the Panel.
20. It is the responsibility of the Respondent to provide information to CPHP in a timely and complete manner and to assure that all CPHP written reports are timely transmitted to the Panel.
21. If, at any time during the probationary period, the Panel finds that Respondent has violated any term of probation, any term of this Order, or committed any act or omission which constitutes unprofessional conduct pursuant to section 12-36-117, C.R.S., the Panel may revoke Respondent's license to practice medicine automatically and immediately. Such revocation shall be effective three days after the date of mailing the notice of the revocation to Respondent by first-class mail to Respondent's address of record with the Board and shall remain in effect through the pendency of the hearing and any exceptions or appeal process. The notice of revocation shall set forth the grounds for the Board's action. Respondent must notify the Board of any change of address pursuant to Board Rule 270. Respondent hereby acknowledges and stipulates to this Rule's requirements.
22. Within ten days of the effective date of revocation, Respondent may request a formal hearing, as provided by section 24-4-105, C.R.S. If Respondent requests a hearing, the Board shall file any Notice of Charges promptly of such hearing request. The sole issues of such Notice and at such hearing shall be limited to any of the issues identified in the notice of the revocation.
23. At the hearing, if the Panel establishes that Respondent has violated any term of probation, any term of this Order, or committed any act or omission which constitutes unprofessional conduct pursuant to section 12-36-117, C.R.S., the parties hereby agree and stipulate that the final sanction shall be revocation.
24. If, after the hearing provided above, the Panel fails to meet its burden of establishing Respondent has engaged in unprofessional conduct, this Order shall continue in full force and effect.
25. The parties agree that this procedure satisfies all due process and consideration requirements.
26. The provisions of this automatic revocation clause do not prevent the Panel from initiating other disciplinary proceedings against Respondent for any violation of this Order or the Medical Practice Act, sections 12-36-101 et seq. C.R.S.
TOLLING OF THE PROBATIONARY PERIOD
27. If at any time, Respondent ceases the active clinical practice of medicine defined for the purposes of this Order as evaluating or treating a minimum of five patients per month, the probationary period shall be tolled for the time the Order is in effect and Respondent is not engaged in the active clinical practice of medicine.
28. Respondent must comply with all other terms of the Order and all other terms of probation. Unless otherwise specified, all terms of the Order and all terms of probation shall remain in effect, regardless of whether the probationary period has been tolled, from the effective date of this Order until probation is terminated. The probationary period shall be tolled for any time that Respondent is not in compliance with any term of this Order.
OUT OF STATE PRACTICE
29. Respondent may wish to leave Colorado and practice in another state. At any time other than during a period of suspension imposed by this Order, and whether to practice out of state or for any other reason, Respondent may request, in writing, that the Board place Respondent's license on inactive status as set forth in section 12-36-137, C.R.S. Respondent's request to place his license on inactive status must include written evidence that Respondent has reported this Order to all other jurisdictions in which Respondent is licensed, as required by the "Other Terms" Section of this Order. Upon the approval of such request, Respondent may cease to comply with the terms of this Order. Failure to comply with the terms of this Order while inactive shall not constitute a violation of this Order. While inactive, Respondent shall not perform any act in Colorado that constitutes the practice medicine, nor shall Respondent perform any act in any other jurisdiction pursuant to the authority of a license to practice medicine granted by the state of Colorado. Unless Respondent's license is inactive, Respondent must comply with all terms of this Order, irrespective of Respondent's location. The probationary period will be tolled for any period of time Respondent's license is inactive.
30. Respondent may resume the active practice of medicine at any time pursuant to written request and as set forth in section 12-36-137(5), C.R.S. With such written request, Respondent shall demonstrate engagement in CPHP activities as required by CPHP and shall nominate any necessary monitor required by CPff P as provided above. Respondent shall cause CPHP to perform an updated evaluation of Respondent. Respondent shall be permitted to resume the active practice of medicine only after approval of the required monitor(s) and only after submission of and approval of an updated evaluation from CPHP.
TERMINATION OF PROBATION
31. Upon the expiration of the probationary period, Respondent may submit a written request for restoration of Respondent's license to unrestricted status. If Respondent has complied with the terms of probation, and if Respondent's probationary period has not been tolled, such release shall be granted by the Panel in the form of written notice.
PERMANENT CHAPERONE REQUIREMENT
32. Whenever Respondent is physically present with a female patient in Colorado, a third person female who is not related by blood or marriage shall be continuously present as a chaperone. Respondent shall be responsible for arranging for the presence of the female chaperone. Respondent shall document the name of the chaperone in the patient's chart for each appointment or contact.
33. The chaperone requirement may not be waived unless the patient executes a knowing and voluntary waiver of the chaperone requirement. In order to establish a knowing and voluntary waiver of the female chaperone requirement, the female patient must sign the following statement:
Waiver of Colorado Medical Board's Chaperone Requirement
1) Dr. Singer was disciplined in Wyoming for a boundary violation with a female patient during an office visit.
2) Dr. Singer is required by the Colorado Medical Board to have a female chaperone present with all female patients.
3) By signing this form, I have read the terms and voluntarily waive the chaperone requirement required by the Colorado Medical Board.
Printed Patient's Name: ____________________________________
34. The chaperone waiver form must be given to all female patients choosing to waive a female chaperone prior to the appointment time or, at the latest, at the time the patient presents to the office for her appointment. A new waiver must be executed upon each additional contact with Respondent.
35. The chaperone waiver form shall be contained on a page with no additional information. As described above, the page shall be titled "Waiver of Colorado Medical Board's Chaperone Requirement". The form. shall be in, at a minimum, 14 point font. As described above, the waiver form must include a signature line and a place for each patient to print her name, together with the date of the signature.
36. No later than the 5th of each month, Respondent shall submit to the Panel a list of every female patient who waived her right to a female chaperone in the prior month, together with the date of the patient encounter.
37. Respondent shall create and use a document entitled "Patient Bill of Rights" as follows:
Patient Bill of Rights
You have the right as a patient in this office to:
Receive consistently high quality health care;
Be treated in full confidentiality with caring, kindness, respect and dignity;
Be treated regardless of your race, creed, religion, color or economic status;
Be treated in a physically safe environment;
Be treated in a psychologically safe environment, free of physically, emotionally or sexually inappropriate behavior on the part of the physician or staff.
You have the right to voice any objections or comments you may have without fear of reprisal. To report any problem(s) or violation(s) by this physician you may contact any of these organizations of which this physician is a member:
American Medical Association
American Osteopathic Association
American Academy of Family Physicians
Colorado Medical Board
PERMANENT PRACTICE RESTRICTION
38. Respondent is permanently restricted from providing any type of hormone replacement therapy to patients. Respondent may petition the monitoring panel to rescind this restriction. The decision to rescind the practice restriction shall be at the sole discretion of the monitoring panel. The monitoring panel may only rescind the restriction if Respondent first establishes to the satisfaction of the monitoring panel that he is fully educated and proficient in evaluating and treating conditions requiring hormone replacement therapy and in administration of hormone replacement medications.
39. Respondent may provide Progesterone and Estrogen therapy to patients. However, Respondent is prohibited from providing all other types of hormone replacement therapy to patients.
40. All patients for whom Respondent provides other types of hormone replacement therapy other than Progesterone or Estrogen therapy must be referred to another health care provider who may legally provide this type of therapy. Respondent is to identify and notify affected patients in writing and strongly suggest that this patient population be transferred to another health care provider.
41. Providing refills of medications to patients is the practice of medicine and is prohibited if such medication refill constitutes a prohibited hormone replacement therapy.
42. At all times during which Respondent is physically located in Colorado, all medical decisions and orders, including the prescription of medications by telephone, and regardless of the location of his patient, constitute the practice of medicine in Colorado. Therefore, as long as and whenever, respondent is physically located in Colorado, he can provide only those medical services permitted by this Order.
43. The terms of this Order do not apply to Respondent's practice in Wyoming.
44. The terms of this Order were mutually negotiated and determined.
45. Both parties acknowledge that they understand the legal consequences of this Order; both parties enter into this Order voluntarily; and both parties agree that no term or condition of this Order is unconscionable.
46. All costs and expenses incurred by Respondent to comply with this Order shall be the sole responsibility of Respondent, and shall in no way be the obligation of the Board or Panel.
47. Respondent shall report this Order to all other jurisdictions in which Respondent is licensed.
48. Respondent shall submit an update to his profile with the Healthcare Professions Profiling Program regarding this Order within thirty (30) days of the effective date of this Order.
49. During the probationary period or any period in which a physician is subject to prescribing restrictions, no physician shall perform an assessment of a patient's medical history and current medical condition, including a personal physical examination, for the purpose of concluding that a patient may benefit from the use of medical marijuana, recommending the use of medical marijuana or certifying a debilitating medical condition for an applicant to the Colorado Medical Marijuana Program. Respondent hereby understands and agrees that he shall not certify to the state health agency that a patient has a debilitating medical condition or that the patient may benefit from the use of medical marijuana.
50. Respondent shall obey all state and federal laws while the terms of this Order are in effect.
51. So that the Board may notify hospitals of this agreement pursuant to section 12-36-118(13), C.R.S., Respondent presently holds privileges at or is employed by the following hospitals and facilities:
53. This Order and all its terms shall have the same force and effect as an order entered after a formal disciplinary hearing pursuant to section 12-36-l 18(5)(g)(III), C.R.S., except that it may not" be appealed. Failure to comply with the terms of this Order may be sanctioned by the Inquiry Panel as set forth in section 12-36-l 18(5)(g)(IV), C.R.S. This Order and all its terms also constitute a valid board order for purposes of section 12-36-l l 7(l)(u), C.R.S.
54. This Order shall be admissible as evidence at any proceeding or future hearing before the Board.
55. Invalidation of any portion of this Order by judgment or court order shall in no way affect any other provision, which shall remain in full force and effect.
56. During the pendency of any action arising out of this Order, the terms of this Order shall be deemed to be in full force and effect and shall not be tolled.
57. Respondent acknowledges that the Panel may choose not to accept the terms of this Agreement and that if the Agreement is not approved by the Panel and signed by a Panel member or other authorized person, it is void.
58. This Order shall be effective upon (a) mailing by first-class mail to Respondent at Respondent's address of record with the Board, or (b) service by electronic means on Respondent at Respondent's electronic address of record with the Board. Respondent hereby consents to service by electronic means if Respondent has an electronic address on file with the Board.
59. Upon becoming effective, this Order shall be open to public inspection and shall be publicized pursuant to the Board's standard policies and procedures. This Order constitutes discipline against Respondent's license. Additionally, this Order shall be reported to the Federation of State Medical Boards, the National Practitioner Data Bank and as otherwise required by law.
Jonathan Singer, D.O
THE FOREGOING was acknowledged before me this 14th day of SEPTEMBER, 2016 by Jonathan Singer, D.O. in the County of Douglas, State of Colorado.
Jonathan Singer, D.O
DUSTIN W HERSHEY
My Commission Expires Aug 27, 2020
THE FOREGOING Stipulation and Final Agency Order is approved this 15th day of September, 2016.
DUSTIN W HERSHEY
My Commission Expires Aug 27, 2020
THE FOREGOING Stipulation and Final Agency Order is effective upon service to Respondent, on September 15, 2016.
APPROVED AS TO FORM:
FOR THE RESPONDENT
|FOR THE COLORADO MEDICAL BOARD|
CYNTHIA H. COFFMAN
Singer, Jonathan, D.O.
1401 Airport Parkway, Suite 150
Cheyenne, WY 82001
3/31/2000 Consent Decree regarding medical records keeping.
Singer, Jonathan W. DO
1401 Airport Parkway, Suite 150
Cheyenne, WY 82001
Physician entered into five year probation with the Board to include continuation of counseling; a chaperone present when treatment requires the disrobing of a female patient. Dr. Singer petitioned the Board for removal of the restriction requiring a chaperone when female patients are disrobed, and the Board granted the petition on Jan. 27, 2012. Dr. Singer currently holds an unrestricted license with the Wyoming Board of Medicine.
This article was posted on November 15, 2018.