Judge Recommends Probation, Exam for Gynecologist

A Beverly Hills gynecologist, author and crusader against excess hysterectomies “appears to be an expert of her own creation” who overcharged patients and acted “incompetently” in some cases, a state administrative law judge has concluded.

The finding, in the case of Dr. Vicki Georges Hufnagel, includes a recommendation that the California Board of Medical Quality Assurance place Hufnagel on five years of probation, require her to pass a competency examination, take a special medical ethics course and permit another physician to review her bills before they are sent to patients.

The opinion of the administrative law judge, Robert A. Neher, is the latest development in a state license revocation case against Hufnagel originally filed in 1987 as a result of patients’ complaints against her. Hufnagel, operator of the Institute for Reproductive Health, a Beverly Hills clinic, advocates surgical techniques that are an alternative to a hysterectomy.

Last fall, Hufnagel--a frequent guest on radio and television talk shows--published “No More Hysterectomies,” which was a broad indictment of the medical Establishment. In the book, Hufnagel advocated increased use of her own techniques, which she calls “female reconstructive surgery.”

In the opinion, sent to Hufnagel earlier this month and made available to The Times on Wednesday, Neher concluded that Hufnagel oversold her procedures, most of which are commonly performed by gynecological surgeons. Neher found that a letter to one patient amounted to “an instrument of terror” intended “to coerce the patient into returning for several procedures which (Hufnagel) had every reason to believe were unnecessary.”

Neher found that Hufnagel performed procedures inadequately and repeatedly overcharged, demanding as much as $21,000 for services that should have cost a fraction of that amount.

‘Overblown View’

Testimony in the revocation hearing, Neher concluded, established that Hufnagel’s “zeal for her personal bill of fare got in the way of sound medical judgment in some cases and the standard of care in others. Her overblown view of her own knowledge and skill caused her to act incompetently in (still) others.”

Hufnagel, he concluded, “presents herself to patients, colleagues and (the Board of Medical Quality Assurance) as an innovator, a developer of new procedures and a crusader on the cutting edge. Rather, she appears to be an expert of her own creation, much like the entertainer or politician who begins to believe the truth of his own press releases.”

Neher concluded that Hufnagel’s contention that overbilling resulted from innocent bookkeeping errors by her husband, who was acting as her business manager, “are found to be spurious.”

Hufnagel did not respond Wednesday to requests for comment on the judge’s finding.

Neher’s recommendation is subject to alteration by the full medical board. The board is expected to allow Hufnagel several weeks to respond to the judge’s finding.