5 lawsuits, 1 doctor, and years of silence: The system that failed to stop a high-risk physician

In February 2025, the Iowa Board of Medicine filed disciplinary charges against Michael J. Page, MD, alleging professional incompetence, unprofessional conduct, and ethical violations. ^[]

Malpractice events generally do not occur in a vacuum—physicians, hospitals, and legal systems, are involved. So, who really holds ultimate responsibility, when patients come to harm?

Known facts and information gaps

Dr. Page has reportedly faced lawsuits including allegations of delayed diagnostics, failure to order imaging before surgery, and errors in planning or scheduling colorectal surgery.

Iowa’s regulatory environment complicates transparency: Since 2021, the Iowa Supreme Court has curtailed public access to the details of physician disciplinary proceedings, effectively allowing boards to withhold factual allegations until final orders are entered (which may take years). ^[]

As a result, physicians and the public often see only vague charges, such as “professional incompetence,” without knowing the conduct in question.

Who should bear what?

1. Physician accountability

• If a physician faces multiple suits or adverse events, transparent self-audit and targeted improvement (e.g., peer review, coaching) are critical.

• Research shows that poor communication, team dysfunction, and issues with professional behavior are correlated with malpractice risk. A 360-degree review of surgeons’ behavior, for instance, found that negative teamwork or disrespect increased the odds of claims. ^[]

• A JAMA Health Forum analysis found that physicians with even one paid malpractice claim are nearly 4 times more likely to have another paid claim within 5 years (adjusting for specialty). ^[] This argues that malpractice events aren’t purely random and that early intervention may reduce future risk.

2. Institutional and hospital oversight

Hospitals often delay intervention until patterns become severe, which allows harm to accumulate. However, well-structured claims-reduction programs (e.g., tiered feedback, education) have shown promise. 

A trial of the Patient Advocacy Reporting System (PARS) reduced malpractice claims costs by over 80% over 16 years. ^[]

"The implementation of PARS was associated with an 83% reduction in malpractice claims cost per high-risk clinician after intervention," per the source. "The study assessed the implementation of the PARS program and subsequent malpractice claims from 2004 to 2020." ^[]

3. Regulatory and board systems

State medical boards are the ultimate backstop, but they often act late. In Dr. Page’s case, disciplinary charges came years after investigations began. Boards must balance due process (fair investigation, hearings) with public protection. 

The 2020 Iowa Supreme Court decision in Irland v. Iowa Board of Medicine held that the board cannot impose conditions, such as a mandatory competency evaluation, in a confidential letter of warning without finding probable cause and without judicial review. ^[]

Annie DePasquale, MD, a board-certified family medicine physician, agrees.

“Patterns matter, and they’re often visible long before a serious event," she says. "Institutions should use non-punitive data review to identify clinicians who may be struggling. Creating a culture where clinicians can safely say, ‘I need another set of eyes,’ is the real safety net.”