Richard Kaul, MD, is a physician with post-graduate training in general surgery, anesthesiology and interventional pain management. He practiced in the United States from 2002 to 2012 with a minimally invasive outpatient spine facility in Pompton Lakes, N.J., and is now writing about his experiences with money, politics and his New Jersey practice.
His license was suspended in 2012 after performing complex procedures in his outpatient center that later required a revision. Former patients filed lawsuits against him for failed procedures, one of which he settled in the spring of 2014. The Board of Medical Examiners found he displayed "gross negligence" with 11 patients and ordered him to pay several thousand dollars, according to a North Jersey report. Then, he had his licensed revoked in February 2014 after the New Jersey State Board of Medical Examiners found he performed complex spine surgeries without proper training or education.
But Dr. Kaul believed there was more at play than his clinical practice.
"Because of what I went through in the U.K., I was sensitized to that process and didn't want to put a foot wrong; I wanted to make sure I retained attorneys and people who I could work with to make sure I was complying with the word and spirit of the law," says Dr. Kaul. "When the ASC opened, it had AAAHC accreditation and Medicare certification. When the state medical board came in and decided to shut everything down, I began to wonder what I could have done differently. I wrestled with that for as long as I possibly could and saw the only thing I really could have done is to have gone down myself to the medical board, instead of leaving that to my lawyers, and tell them 'I intend to start doing these procedures in the ASC; is that okay with you or not?'"
But Dr. Kaul sees more at play than his medical record, and is publishing a three-part series of books about his career. In a libel lawsuit he filed against a neurosurgeon group, he claimed the surgeons "told patients and other doctors that [he] did not have the credentials or qualifications to perform spinal procedures and encouraged them to file complaints with the state medical board," according to the National Pain Report.
He began by writing blogs while he continued performing charitable work in underserved countries, and was encouraged to write a book based on his experience.
"A large part of what happened to me unfortunately was generated by professional jealousy and the practice had become successful, and that's something some people didn't want to see," says Dr. Kaul.
In the first volume, currently available for purchase, Dr. Kaul tells his chronology of events as he built his practice in New Jersey and leading up to his suspension. There are plans for two additional books to complete the trilogy. The books also weave in information about minimally invasive surgical technology.
"Medicine has always changed and technologies are always changing," he says. "When there are huge financial interests at stake, there is going to be battles and friction. In America, that manifests itself in the legal courts and media."
Dr. Kaul is currently working to have his license reinstated.
"I'm fairly optimistic I will get my license back," says Dr. Kaul. "It does seem the odds are better than worse. However, in terms of what will happen after that, my main thrust is going to be on the educational and business side of healthcare. I don't have any particularly great desire to go back into clinical medicine. The past three years gave me the opportunity to develop my skills and interest in business."
Since his license was revoked in the United States, Dr. Kaul says he has traveled the globe and continues to work with Spine Project Africa, an initiative he founded to provide spine care to underserved populations in Africa as well as educate local physicians.
"In some countries, there are general practitioners who are becoming trained in these spine procedures and performing them," says Dr. Kaul. "In doing so, we'll be able to reduce the overall cost of spine procedures. There will be less hardware and the growing population is becoming more affluent. It started with a set of doctors in New Jersey performing these procedures in outpatient surgical settings; we would like it to grow on a global scale so these treatments are common for patients with spine issues."
In the United States, Dr. Kaul continues a medical consulting business.
"I provide analysis and information to clinical entities from surgical practitioners to ASCs and small hospitals that are struggling," says Dr. Kaul.
One of the biggest areas Dr. Kaul provides consulting in is medical marketing. Traditionally, physicians attracted new patients through word-of-mouth, but now more healthcare providers are marketing their services.
"The marketing is essential," says Dr. Kaul. "That's not something taught in medical school and physicians don't learn it on the job. In today's more competitive environment, if the physician doesn't pick up those tools, it won't be able to sustain itself."