The medical license of an Irvine ophthalmologist has been placed on probation for more than three years because he was working full time at a Kaiser Permanente facility in Northern California without informing a San Diego facility that granted him a psychological leave and an insurance company that cut him disability checks.
The Medical Board of California order against Dr. Amir Pirouzian went into effect July 13.
The Tehran, Iran-born, UC Irvine-educated ophthalmologist suffered a bout of depression before being hired by Children’s Specialists of San Diego (CSSD). Pirouzian showed progress under a psychologist’s care through his employment in San Diego. On Dec. 27, 2006, he applied for a new job with the Santa Clara Kaiser Permanente office, but he did not inform the psychologist nor CSSD.
The psychologist’s March 22, 2007, chart notes Pirouzian was “wondering about leaving work, taking a sabbatical.” At an appointment two months later, Pirouzian told the psychologist he was having trouble at work and had received a poor performance evaluation. The ophthalmologist again brought up the idea of a sabbatical, without mentioning he had applied to work at Kaiser. That same month, Pirouzian spoke with his employer’s insurance carrier about his depression, adding that he was seeing a psychologist. The insurance rep wrote in her notes that the doctor mentioned he’d lost interest in his job and life and that there had been patient complaints at his eye clinic. But nowhere is it noted that the doctor mentioned the Kaiser job.
By email that same month, Pirouzian requested a sabbatical from CSSD. He said he hoped to get help for his illness and that the time off would help him on the job once he returned. He did not mention he had already received an oral job offer from Kaiser, let alone that he had applied for a new job. The day after sending the CSSD email, Priouzian received a formal offer to begin at Kaiser on July 16, 2007. He signed a two-year associate physician agreement that would pay him $235,320 a year, which was more than he was making at CSSD.
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Insurance reps and a CSSD human resources manager determined Pirouzian’s disability claim was not due to a medical necessity. However, the psychologist told them Pirouzian did indeed need to take time off. A 12-month sabbatical was declined, but he was granted three months of unpaid leave with an offer to be rehired once he was ready to return. Disability was also approved. His last day at CSSD was June 30, and two weeks later he started at Kaiser.
When CSSD, insurance and disability representatives checked in on Pirouzian in the months that followed, he gave varying stories to explain his absence from the area, including saying he had gone back to Iran. Actually, say state medical board investigators, he was working at Kaiser Santa Clara. The stories unraveled in October 2007, when the father of a CSSD patient showed the company's human resources manager a Kaiser website with the ophthalmologist’s photo and biography, indicating he worked there. The matter was turned over to the insurance company. Pirouzian at first claimed to be working part time in Santa Clara, adding that his psychologist had advised a change of scenery for the sake of his mental health. The psychologist denied knowing anything about it. Later, Pirouzian cited ongoing difficulties with CSSD and workers there as driving him away.
The insurance company turned the matter over to the state Department of Insurance-Fraud Division. On Sept. 2, 2011, a two-count felony complaint was filed in San Diego County Superior Court against Pirouzian. Later added was a misdemeanor count that the ophthalmologist ultimately copped to in exchange for the felonies being dismissed. He was ordered to pay $500 in fines, perform 40 hours of community service and serve three years on probation.
The conviction and dishonesty are the grounds for the Medical Board of California action against Pirouzian. Terms of the three years and eight months that his medical license will be on probation are that he: take an ethics course, undergo a psychiatric evaluation, have his practice and billing services monitored and enter a clinical competence assessment program. He must obey all laws, submit quarterly progress reports to the board, and he cannot supervise physician assistants or advanced practice nurses. Failure to abide might cost him his license permanently.