A former Tucson child psychiatrist who was banned from practicing medicine in Arizona by the state medical board in 1998--after descending into a spiral of drug addiction and sexual compulsivity--is back on the job.
The Arizona Medical Board voted 7-1 behind closed doors in an executive session in August 2002 in favor of a consent agreement that allowed Michael Mahl to resume practicing medicine on a probationary basis. Minutes from the meeting say only that "Roberto Pulver, assistant attorney general, stated that all information is contained in his memorandum to the board, which could not be discussed in open session."
Although company officials refuse to confirm his employment, The Weekly has verified that Mahl is working as a psychiatrist in the Phoenix office of Value Options, Inc. Mahl is working with the seriously mentally ill. Value Options, Inc. advertises itself as a behavioral health managed-care company serving 23 million people nationwide with "health and substance abuse programs, workplace services, employee assistance programs, psychiatric disability, Medicaid behavioral health management and child welfare programs."
Once a respected child psychiatrist, Mahl was the owner, operator and psychiatrist of group homes for severely troubled boys 4-17 years old. His life spiraled out of control in 1997. (See "The Sorry Case of the Sex-Fiend Shrink," Tucson Weekly, July 16, 1998.)
Mahl became addicted to drugs, suffered an overdose for which he was hospitalized (testing positive for cocaine), contacted hepatitis and became so bizarre that his employees banned him from his own homes and contact with the residents. The Juvenile Justice Services Division of the Arizona Supreme Court formalized the ban in May 1997 by entering into an agreement with Mahl in which he agreed to removing himself "from any and all direct contact with juvenile court-involved youth and their families."
Mahl was also cited for criminal damage and for threatening and intimidating his ex-wife, who filed for a restraining order. Although the case was eventually dropped, Mahl was remanded to diversion.
But most appalling were accusations from several young men in his care who accused him of sexually molesting them. Some accused him of sodomy. Reports were made to the Tucson Police Department and to Child Protective Services. Mahl was never charged with any crimes related to the allegations. At least one case was never even investigated by the TPD officers.
CPS officials refused to discuss the referrals or acknowledge that reports were made regarding Mahl.
Mahl, who once threatened to sue The Weekly for $10 million if it published a story regarding the allegations, did not return a phone call requesting comment for this story.
Donna Noriega, program manager of the Juvenile Justice Services of the Arizona Supreme Court, expressed surprise that Mahl is practicing medicine again. Noriega says their program would not contract with him and would not send him patients knowing his history.
THAT HISTORY IS tangled legal mess that has continued since Mahl was stripped of his license in 1998. When Mahl appeared that year before the state medical board, he blamed the break-up of his 18-year marriage for his "lapse into using cocaine," according to transcripts of the meeting.
"My issues around sexual compulsivity were during my cocaine abuse," he told the board. "So what I learned at COPAC (a treatment facility) during the compulsivity program, is how my cocaine abuse drove my sexual preoccupation."
Regarding his issues with sexual boundaries, Mahl told the board that "... being a bisexual man and being a psychiatrist, that these are ... that I need to be able to have the advice and help in being very aware of counter-transference issues, which I believe was what was going on in the office. And so I want to continue to work on sexual issues."
Medical board officials learned at the same hearing that Mahl had already failed at least five treatment programs in several states. After the 1998 hearing, the board stipulated that "Dr. Mahl shall successfully complete inpatient treatment at a facility or facilities for sexual compulsivity and chemical dependency. The facility or facilities shall be approved by the board staff prior to Dr. Mahl's admission."
Transcripts from the hearing show that a medical board consultant, Dr. David Greenberg, advised that officials from treatment centers "believe the doctor will need a minimum of five years stringent monitoring and they suggest that Dr. Mahl consider other areas of psychiatry other than with children. ..."
Greenberg added that Dr. Michael Sucher (Greenberg's partner, who was unable to attend the meeting), as Mahl's monitoring physician, recommended that Mahl "enter, for an indefinite period of time, into an institution in Prescott known as Prescott House, which is a facility that does specialize in the treatment of people that have had difficulties going through treatment programs and can give them the type of structure that they need so that they can come to grips with issues regarding sexuality or regarding compulsivity or regarding chemical dependency to follow them."
Greenberg said normal placement in Prescott House was six months to a year.
"And of course, it is Dr. Sucher's strong opinion that this needs to be successfully completed before the doctor would be eligible for our after-care program," Greenberg concluded.
The following year, in September 1999, Mahl and his attorney, Charles Buri, returned to the Arizona Medical Board to request that his medical license be reinstated. Mahl had not followed the directions of his monitoring physician to seek six to 12 months treatment at Prescott House. Instead, his attorney offered that in October of 1998 he completed a 30-day inpatient treatment program at Menniger Clinic and a follow-up in program in February of 1999.
A NUMBER OF MAHL'S former staffers attended the meeting to protest against lifting his suspension. Manuel Saldate, an investigator who had been assigned by the board to examine allegations against Mahl three months earlier, testified that Mahl had not cooperated with requests for making patient files available.
Mahl's request was denied and the board ordered that he undergo psychometric and psychosexual evaluations and biological testing.
Almost one year later, in August 2000, Mahl once again appealed to the medical board for the restoration of his medical license. Again, he was turned down. The medical board referred Mahl's case to an administrative law judge.
"We interviewed patients, staff and other key people connected to this case, and the board found enough evidence on the allegations against Dr. Mahl to go forward to a full evidentiary hearing," said Pete Wertheim, who was then spokesman for the board.
Then-executive director Claudia Foutz told attendees at the meeting that this was a high-risk case, which is why it was being referred to the administrative judge.
A memo dated Sept. 18, 2000, from Wertheim summarized the charges, which included engaging in sexual misconduct with patients, specifically underage male juveniles; using cocaine, methamphetamines and marijuana; and exposing staff members and patients to hepatitis, a communicable disease.
Before leaving the medical board, former investigator Saldate says he spent months investigating the allegations against Mahl. Child psychologist Dr. Martin Glasser accompanied him on some of the interviews.
Saldate turned in a lengthy report to the medical board. He was able to interview many of the youth who accused Mahl of molesting them; he also interviewed Mahl's employees and some family members. Saldate said he believes the statements of the youth were credible.
When asked if he was telling the truth about his accusations regarding Mahl, one alleged victim was quoted as saying: "You could think what you want and believe who you want, people could say what they want to and probably will call me a liar, but I was there. I know what happened."
Saldate said his investigation was hindered by the fact that he got little cooperation from the Tucson Police Department and felt that they "mishandled" the case. Saldate told the Arizona Daily Star in August 2000 that he believes, after his investigation, that Mahl should lose his license to practice medicine.
When Saldate left the medical board for another job, the Mahl case was transferred to investigator Ron Palmer, who saw it through the rest of the process. Although unwilling to talk at length about the case, Palmer said he "could never understand why the Tucson Police Department didn't work up the case." Nor could he explain why the Mahl case never went to an administrative hearing.
In August 2002, Mahl had another hearing in front of the medical board, despite the fact that no administrative hearing had never been held. The board did not allow witnesses to testify.
A 19-page, "Consent Agreement and Order for Practice Restriction with Probation" was voted on by the medical board, offered to Mahl and accepted by his attorney.
"The AMB did rely on the report of their investigator, but apparently felt there was not enough evidence to continue Mahl's license suspension," said medical board spokeswoman Lisa McGrane. "The board received additional evidence from medical consultants that he (Mahl) was not a threat to the public and that he could return to work under limited circumstances."
The agreement, which can be viewed in its entirety at the medical board's website, www.azmdboard.org, included stipulations that Mahl not practice with anyone under 18 years of age; that Mahl participate in the AMB's Monitored After Care Program and be supervised by another physician; that Mahl obtain a treating psychiatrist, attend group therapy and participate in a 12-step program; and that he complete 90 meetings in 90 days in self-help groups for substance abuse. Mahl must submit to drug tests, drink no alcohol and obey all federal, state and local laws.
Palmer said that the public has no way to find out what's being done to ensure that these orders are followed. "The public will only know if the AMB finds that Mahl isn't in compliance," he said.
McGrane assured The Weekly that "Mahl is complying with his consent agreement."
Calls to a Arizona Medical Board member and to other medical board staff resulted in an e-mail from McGrane advising that all further questions were to be directed to her.
In a recent conference call, Arizona Medical Board Director Barry Cassidy and Deputy Attorney General Roberto Pulver said that they must take the path that best protects the public.
"My input to the board in this case was to advise them of their options and the pros and cons of litigating this case," Pulver said.
"It is important to remember that the board only has jurisdiction over Mahl's medical license," added Cassidy, who said that many cases before the board involve "non-provable investigatory information."
"The best way to protect the public is often with a consent agreement that protects the public from the exposure that the board is most concerned about," said Cassidy.
Both were emphatic that the board has an active compliance program, with four people working on cases. They did agree with Palmer that there is really no way for the public to know if the medical board is doing its job in ensuring that doctors are in compliance. Cassidy explained that the public has to just trust the medical board.
Pulver cited findings from psychologists and psychiatrists in 1999 and 2000 testifying to Mahl's progress in complying with board concerns and said that two professionals had found that Mahl did not have pedophile tendencies. As for Mahl's alternative of doing a 30-day residential treatment rather than the six to 12 months that consultants Greenberg and Sucher recommended in 1998, Cassidy said, "Consultants only recommend to the AMB. The AMB considers their recommendations, but then decides on its own whether a doctor has complied."
Both men said they were unaware of court documents on file in Pima County Superior Court regarding Mahl.
THOSE PIMA COUNTY RECORDS show that Mahl has continued to have legal problems since losing his medical license.
In August 1999, in a modification-of-custody document filed shortly after Mahl had appeared before the medical board asking for reinstatement, claiming he had gone through treatment and was ready to resume work, Mahl listed himself as "currently disabled due to drug abuse."
A petition to show cause dated February 2002 reveals allegations that Mahl was, among other things, in default on a promissory note in the amount of $101,000 plus interest and had not paid for his share of medical bills for his children. It alleges that Mahl is in arrears in the amount of $33,600 to pay for his children's nanny and $12,000 in child support payments. (Arizona state statutes allow for the suspension of a professional license for being found in contempt for non-payment of child support.)
The petition also states that "Dr. Mahl's boyfriend, Robert Greves, is a credible threat to the minor children based on the fact that he is a drug addict, has been charged with a serious crime, has threatened the children, assaulted the respondent and broken into the respondent's residence and therefore the children should have no contact with Robert Greves."
According to Pima County criminal records, Greves is an eight-time felon addicted to cocaine and opiates who was picked up off the street by Mahl while he was holding a "Will work for food" sign in 1998. Greves' criminal records show that he was hired by Mahl as a nanny for Mahl's children and became "a companion" to Mahl. Records show that Greves lived with Mahl until 2000 and claims to have maintained a "close relationship" with Mahl since he moved out.
While allegedly not paying child support, Mahl on at least one occasion paid an $1,100 bond for Greves' release from jail.
Greves was sentenced to 12 years in the Department of Corrections in February 2003 for a robbery of a Bank One, theft and resisting arrest.
One of Greves pre-sentence reports lists Mahl as a reference and Mahl is quoted as saying that Greves "provided care for his children and was wonderful with them."
Calls to Mahl's Tucson attorney, Robert Barrasso, regarding this matter, were not returned.
Calls to Mahl's employer, Value Options, Inc. Administrator Michael Zent, were not returned.
Value Options, Inc. communications director Malena Albo would not verify that Dr. Mahl was working at Value Options, Inc. Albo insisted that no information is given out on the doctors who work for the company.
Albo said the company did background checks on all physicians. If a doctor was restricted to practicing only on individuals over 18, Albo said supervisors "would make sure that the client load was appropriate for said employee."
"It is very difficult to find doctors, especially psychiatrists, to hire," Albo added.