texasmonthly.com: How did the idea to write about Dr. Eric Scheffey come about?

S. C. Gwynne: Earlier this year the Texas State Board of Medical Examiners revoked his license and fined him a record $845,000. I just became curious about why he had been fined so much.

texasmonthly.com: How did you gather all the episodic information, such as the death of Cecil Viands, which went into your story?

SCG: A lot of the material in the story came from legal documents. Viands is a good example. He was one of the cases the State Medical Board used to build the case for revoking Scheffey’s license. His widow also filed a malpractice suit against Scheffey.

texasmonthly.com: Do you think Dr. Scheffey persuaded his patients to undergo so many unnecessary surgeries simply out of greed?

SCG: There is no way to know this with any certainty, because Scheffey himself never commented on it. But the frequency with which the unnecessary surgery was performed suggests at least some profit motive. State regulators, as well as other medical doctors who have reviewed Scheffey’s files, are convinced that he did it out of greed.

texasmonthly.com: Was Dr. Scheffey able to avoid scrutiny in part because he operated predominantly on low-income manual laborers who had workers’ compensation?

SCG: He wasn’t really able to avoid scrutiny. I would say that he was under rather intense scrutiny by the media, the medical community, and regulators from 1985 onward.

texasmonthly.com: Should the media have publicized Dr. Scheffey’s failures even more than they did, or should medical regulators simply have paid more attention to the coverage out there?

SCG: The failure here lies primarily with the licensing body: the Texas State Board of Medical Examiners. They allowed Scheffey to have a license to practice for 24 years in Texas.

texasmonthly.com: Who other than Dr. Scheffey is to blame for the years of dangerous malpractice: the insurance companies, the government, his fellow doctors, his medical school, the hospitals, the press?

SCG: Every one of the above groups knew all about Scheffey. Per the above answer, only the TSBME had the power to take his license away. The Texas Workers’ Compensation Commission could have refused to pay claims—which it eventually did—but it did not have the power to grant or revoke his license. One of the strangest things about this case is that pretty much everyone in the communities you mentioned knew about Scheffey, and they knew about him a long time ago.

texasmonthly.com: Is the state’s medical system uniquely flawed as to allow Dr. Scheffey to practice for so long?

SCG: No, it is very similar to other systems. Doctors everywhere have sought to protect themselves by building strong, well-funded, and very powerful trade associations that have wielded de facto control over state licensing boards.

texasmonthly.com: Will Dr. Scheffey’s case change the Texas State Board of Medical Examiners’ “standard of care” that doctors must maintain to keep their medical licenses?

SCG: No. I think the law itself is explicit on the subject. What Scheffey has become, though, is the poster boy for the State Medical Board’s new willingness to take out doctors for violations of standard of care. They really did not do that much in the past.

texasmonthly.com: What could be done to stop future doctors like this without imposing upon good doctors?

SCG: What is being done now: remove bad docs either by taking their licenses away or by keeping them off approved lists at the Workers’ Compensation Commission.

texasmonthly.com: What could a patient realistically do to make sure his doctor is safe?

SCG: Read Jim Atkinson’s column on that subject, also in the September 2005 issue.