Pines, D.O. v. State Board of Medicine, 351 P.3d 1203

Background

Richard J. Pines, a licensed DO and board-certified psychiatrist, was accused by the Idaho Board of Medicine of inducing four young men into nude "practice" massages for relicensing and engaging in sexual contact; no criminal charges were filed.
Four counts (I, II, III, V) alleged violations including sexual contact with a patient (I.C. § 18-919), crimes of moral turpitude (I.C. § 54-1814(21)), and abuse/exploitation of a patient or conduct related to the practice of medicine (I.C. § 54-1814(22) and IDAPA rule).
A hearing officer recommended certain findings; the Board rejected parts of that recommendation, found all four men were Pines’ "patients," revoked his license, and awarded costs and fees.
The district court affirmed the Board on counts I and II, vacated the award of costs/fees for procedural defects, and affirmed revocation; Pines appealed and the Board cross-appealed.
The Idaho Supreme Court reviewed whether the Board relied on uncharged conduct, whether substantial evidence supported patient findings for each complainant, whether the statutes were vague as applied, and whether due process was violated.

Issues

Issue	Pines' Argument	Board's Argument	Held
1) Did the Board rely on uncharged/irrelevant conduct (e.g., references to minors) denying due process?	Board impermissibly relied on uncharged conduct (conduct while subjects were minors), depriving Pines of fair notice and defense.	References were erroneous but harmless; age irrelevant to patient-status analysis; Board did not rely on uncharged conduct to prove violations.	Harmless error. Court held Board did not rely on uncharged juvenile-conduct to find statutory violations.
2) Is there substantial evidence that Pines committed the alleged violations in Counts I–V (i.e., were the four men "patients")?	Majority of findings unsupported; "practice patient" alone insufficient; Board misdefined "patient" and failed to apply a fact-by-fact analysis.	‘‘Practice patients’’ were patients because Pines performed affirmative medical acts and invoked his physician status to obtain contact.	Mixed. Substantial evidence supports that N.R. and D.P. were patients (Counts I & II affirmed). Insufficient support that S.G. and B.H. were patients; Counts III & V vacated.
3) Did application of the statutes and rule deprive Pines of due process (vagueness / lack of notice)?	Statutes insufficiently clear as applied to "practice patients"; Pines lacked fair notice sexual contact was prohibited here.	Statutes and rules clearly proscribe sexual contact with patients; a physician should know that diagnosing, treating, or providing medication creates a doctor-patient relationship.	No as-applied vagueness violation for N.R. and D.P.; Pines knew or should have known his acts created a patient relationship. For S.G. and B.H., court did not reach due-process analysis because they were not patients.
4) Was the award of costs and attorney fees procedurally proper?	Award improper because Board failed to afford Pines opportunity to be heard on fees/costs before imposing them.	Board maintained fee award was appropriate.	Not addressed on merits; district court vacated fees for procedural defect and Supreme Court remanded for further proceedings where fees can be reconsidered.

Key Cases Cited

Pearl v. Bd. of Prof’l Discipline of Idaho State Bd. of Med., 137 Idaho 107 (discusses due process when Board relies on uncharged facts)
Krueger v. Bd. of Prof’l Discipline of Idaho State Bd. of Med., 122 Idaho 577 (Board reliance on uncharged allegations can require reversal for due process)
Williams v. Idaho State Bd. of Real Estate Appraisers, 157 Idaho 496 (standards for agency review and remand)
Park v. Banbury, 143 Idaho 576 (due process requires impartial tribunal)
Cooper v. Bd. of Prof’l Discipline of Idaho State Bd. of Med., 134 Idaho 449 (evidentiary/standard-of-proof discussion in licensing discipline)
Korsen, State v. Korsen, 138 Idaho 706 (as-applied vagueness / notice analysis)
Tuma v. Bd. of Nursing, 100 Idaho 74 (vagueness doctrine applies to agency regulations)