DES MOINES — A state panel that could bar doctors from using a controversial video-conferencing system for providing abortion pills voiced skepticism at the process in a public hearing Wednesday.
Dr. Greg Hoversten, chairman of the Iowa Board of Medicine, suggested the telemedicine system, the first in the nation used for doctor consultations before a drug-induced abortion, amounted to an experiment on Iowa woman.
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"That really bothers me," Hoversten told Dr. Tom Ross, Planned Parenthood physician.
"I sense that, sir, yes," Ross replied. He said the system, which the Iowa Planned Parenthood chapter introduced for several services in July 2008, uses proven methods and is just as safe as office visits in which a doctor personally hands the pills to a patient.
Abortion-rights supporters have accused the board members, all appointed by Iowa's anti-abortion governor, of rushing to judgment. Board members have denied the allegation, but some showed clear doubts about the system Wednesday.
"Iowa women are the first ones to get this in this fashion. There's something wrong there. It just doesn't seem right," said Hoversten, a former Sioux City, Iowa, legislator who sponsored bills that would have limited abortions.
The exchange came during a 3-1/2-hour hearing. The medical board is considering new rules that would require doctors to be physically present when dispensing abortion pills. That would effectively ban Planned Parenthood of the Heartland's video system.
Under the system, staff members at local clinics check the women, then the women have an interview with a Des Moines doctor via a closed-circuit video system. If the doctor decides the woman qualifies, he or she enters a computer command that opens a drawer in front of the woman. She withdraws pill bottles from the drawer and takes the first pill as the doctor watches. Then she goes home, takes more pills and has what amounts to an induced miscarriage.
Several dozen people attended Wednesday's hearing, which focused on patient safety. Supporters and opponents of legal access to abortion convened simultaneous rallies and prayer vigils Wednesday at the state Capitol and a nearby church to make their views known ahead of the hearing.
A petition to stop telemedicine abortions in Iowa sits Aug. 28, 2013, on a pew outside a prayer vigil at Calvary Chapel in Des Moines, just a block away from the Iowa Board of Medicine hearing.(Photo: Mary Willie, The Des Moines Register)
Medical board investigators had examined the video conferencing system two years ago, and board members later dismissed a complaint from abortion opponents. But since then, Iowa Gov. Terry Branstad replaced all 10 board members, and the new board agreed to reopen the matter shortly after abortion opponents filed a petition in June.
In one especially heated exchange, medical board member and West Des Moines physician Bob Bender grilled Robert Shaw, a pediatrician and Planned Parenthood board chairman, about who physically examines patients before an abortion drug is prescribed via the video system.
Bender repeatedly asked Shaw whether he had ever relied on a certified medical assistant to perform an initial patient examination — something another Planned Parenthood representative had suggested sometimes occurred before telemedicine abortions.
At Des Moines Area Community College, becoming a certified medical assistant generally requires three semesters, including a 10-week practicum. A candidate for certification also must pass a test.
Shaw refused to answer the question, arguing that his personal medical experience was irrelevant to questions over the standard of care provided in telemedicine abortions.
"I will write down that you refuse to answer," Bender said.
"I'll write down that you're harassing him," a woman from the front row of the auditorium called out.
“Iowa women are the first ones to get this in this fashion. There's something wrong there.”
— Dr. Greg Hoversten, Iowa Board of Medicine
Several witnesses questioned the credentials of clinic staff members who perform medical exams.
Sue Thayer, who used to manage Planned Parenthood's Storm Lake, Iowa, clinic, told the board that the organization relies on unqualified people to do vaginal ultrasounds on women before they speak to a physician via the video system. She said she has no medical training but was told to take brief training on running the ultrasound machine then train her staff.
She said her supervisor told her, "If you are breathing, you can do this. It helps if you've run a joystick on a video game because it's a lot like moving it around to get the right picture."
Thayer says she was fired after objecting to the idea. Planned Parenthood leaders have said her job was eliminated in a reorganization, and they contend that staff members are adequately trained.
Dr. William Burke, a retired Des Moines obstetrician, said the video system appears to be a safe way to provide medical care. He said he was embarrassed by the medical board's actions.
"I'm going to ask you to please make your decision not on your personal prejudice and not on your religious beliefs, and not on political pressure, whether it's subtle or not so subtle," he said. "But make it based on the evidence."
Jeanine Freeman, a vice president for the Iowa Medical Society, said the board seems to be rushing to adopt a rule change that could cost doctors their licenses.
“I'm going to ask you to please make your decision not on your personal prejudice and not on your religious beliefs and not on political pressure.”
— Dr. William Burke, Des Moines
Freeman said the board has not taken proper time to study the change, which was written by petitioners asking for a ban. She said the board appears to have accepted opponents' wording "hook, line and sinker."
Dan Holman of Keokuk, Iowa, was one of the few speakers who talked directly about the morality of abortion.
"Abortion is, was and always will be coldblooded, premeditated murder," he said.
Hoversten, the board chairman, interrupted him and said the hearing was specifically about the medical standard of care.
Holman responded incredulously: "It's not a standard of care. It's a standard of murder."
At the end of the hearing, Hoversten said the board would consider the matter carefully.
He said board members would discuss the issue Friday, but he was unsure whether they would vote then. Legislators could review any decision the board makes. The matter also could wind up in court if the losing side appeals the board's decision.
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