Dr. Anna Konopka, the 84-year-old New Hampshire physician who recently lost her medical license in part due to a lack of computer skills , has an uphill battle ahead of her.

In two lengthy phone interviews with Ars on Tuesday, Konopka said if she is reinstated by the state's medical board—at this point, a big if—she would be willing to learn how to use the Internet to comply with the state's new law for an online opioid monitoring program.

Konopka recently sued the New Hampshire Board of Medicine and appeared in court without an attorney last Friday. The board, which is being represented by the state's attorney general's office, has filed a motion to dismiss. The office argues, essentially, that because Konopka voluntarily agreed to relinquish her medical license after a series of investigations, there's no going back now.

In the agreement with the board, which Konopka signed on September 12, she voluntarily surrendered her license to settle pending allegations regarding her "record keeping, prescribing practices, and medical decision making." Those allegations stem from five separate complaints against her. Under the terms of the agreement, she could reapply to regain her license, but the burden would be on her to prove that she did no wrong.

Konopka denied any misconduct and asserted that she was under duress when she voluntarily surrendered her license. She underscored that she wants to continue practicing medicine but simply is not concerned with what she calls "electronic medicine," her term for the vast bureaucracy often associated with modern medical practices.

"I am getting the patients from the system, and I see how badly they are mistreated and misdiagnosed or not diagnosed at all," she said. "Therefore, I am not going to compromise patients' lives or health for the system. Because I am out of the system, it was almost like in Communism, you were like the enemy and you had to be destroyed."

However, her stance on the use of electronic health records and modern health information technology runs counter to that of major medical associations, including the American Medical Association and the American Academy of Family Physicians (AAFP). Both support the use and improvement of modern technology to assist doctors and improve care.

The AAFP "believes that every family physician should leverage health information technology, which includes electronic health records and related technologies needed to support the patient-centered medical home (PCMH)," the AAFP writes on its website. "These capabilities can support and enable optimal care coordination, continuity, and patient centeredness, resulting in safe, high-quality care and optimal health of patients, families, and communities."

In an e-mail to Ars, the AAFP noted that adoption of such technology, including but not limited to computers, is so widely accepted that it does not poll doctors on their use of such equipment.

“Fabricated”

In Konopka's telling, she is simply a local doctor who has been faithfully serving this small New England town of 4,000 people for well over two decades. She sees people under their medical insurance or will accept a $50 cash payment for those who do not have insurance.

"I've never had a problem with anything until now," she said.

Her troubles first began over three years ago, in October 2014, when there was a formal dispute over a seven-year-old female patient, referred to in court documents as "JM."

According to the attorney general's motion to dismiss, Konopka saw JM throughout most of her childhood, from age 18 months through age seven. JM suffered from asthma, and Konopka prescribed dexamethasone and albuterol, two medications commonly prescribed to treat asthma. The attorney general also noted Konopka "rarely noted Patient weight in the record when prescribing and generally left dosing up to Patient parents. Respondent also never tested Patient levels" and "did not attempt to treat Patient with a daily inhaled steroid."

Further, "on several occasions, Respondent prescribed Patient JM aspirin to help reduce fever and treat other ailments, even though aspirin is not recommended for children with asthma."

Konopka dismissed JM's complaints as "fabricated."

"They said I was using wrong medications, and they don't know the medications in the first place," she told Ars. "I was using medications approved by [Federal Drug Administration], and I am using these medications very successfully, and nobody died because they were claiming that I'm treating asthma in the wrong way, because I'm not prescribing inhalers, because inhalers are destroying the lungs. All my patients' children, they are growing out of asthma without COPD (Chronic Obstructive Pulmonary Disease)."

Konopka said she didn't prescribe inhalers because, in her view, they are more trouble than they're worth.

"I am not going to prescribe something that I think is dangerous or expensive," she said. "One inhaler costs $500."

According to Konopka, under her care, JM was "cured" after just three days.

Surrender

However, for whatever reason, JM's family apparently was not happy—it filed a formal complaint with the state medical board the following month. Konopka told Ars that JM's father worked for one of the larger medical facilities in the region, New London Hospital, and that the complaint was seemingly vindictive against her.

As a result of this episode, Konopka was formally reprimanded by the medical board in April 2017, and she agreed to undergo 14 hours of medical training as part of her settlement to continue practicing.

"For as long as she is licensed by this Board, Respondent must refer any diagnosed pediatric cardiac cases to a qualified pediatric cardiologist prior to providing any non-life sustaining treatment in such cases," the consent decree stated.

Following the April 2017 settlement, the New Hampshire Board of Medicine learned of four additional complaints that were being investigated by the board's Medical Review Subcommittee (MRSC). Court records do not reflect the precise nature of these new complaints. Konopka was unable or unwilling to explain precisely what these new disputes were about.

It was then that the medical board moved quickly: in September 2017, the board voted to discipline Dr. Konopka further. With the advice of an attorney assigned by her medical malpractice insurance, Michael Pignatelli, Konopka signed a "voluntary surrender of license" on September 12, 2017. Pignatelli did not respond to Ars' request for comment.

On September 28, Pignatelli asked the board to allow Konopka to keep practicing until the end of November. The request was seemingly denied.

Then, on October 11, Konopka sued the medical board without the help of an attorney. In a handwritten complaint, she told Merrimack County Superior Court Judge John Kissinger that "under multiple duress," she would "loose [sic] my medical license." Konopka asked the judge for an emergency ex parte (one-sided) hearing, but the judge denied her request.

In her civil complaint, she wrote that the medical board had "organized attacks from people unknown to me for [the] past three years forcing me to close my office."

By October 27, Senior Assistant Attorney General Lynmarie Cusack, representing the medical board, filed a motion to dismiss the case.

"Petitioner has not argued that she was prevented from exercising her rights in any extraordinary way or that she was misled about some fact," Cusack wrote. "To the contrary, it appears that Petitioner merely had a 'change of heart' or case of 'buyer's remorse.'"

Konopka said she could not afford an attorney to represent her, yet she maintained that people who have made accusations against her could be "exposing themselves to libel."

"I am not going to accept their abuse, period," she told Ars. "I am going to fight. If I win or lose, I am going to fight. For the sake of the patients, not for me. In my age, my colleagues in this country or in my country, they are retired or are in graves. And I can really go for quite many years working."

A change of heart

Konopka and Cusack faced off during a hearing on Friday, November 3. In an e-mail to Ars, Cusack characterized the hearing as "relatively brief."

"Dr. Konopka indicated that she did not want her patients to be without medical care and the [Affordable Care Act] didn't allow her patients to be picked up easily by other providers," Cusack wrote. "I indicated that the issue before the court was very narrow, and that was whether she could rescind her agreement that she entered voluntarily with the assistance of counsel, after having an opportunity to negotiate the terms of the agreement."

According to Cusack, Judge Kissinger said he would "take the matter under advisement." She added, "I hate to predict what judges will do, so I cannot say when he will rule or whether he was receptive."

For her part, Konopka was somewhat optimistic.

"I hope for the judge, he was very nice fellow—I hope that he would see my point of view, and if he does not, what can I do about it?" she told Ars.

However, Cusack also told Ars that a lawsuit like this is very unusual.

"I have never heard about or seen a doctor sue the board after they entered an agreement to forego discipline and then change their mind," she continued. "I am aware of two cases where a doctor has brought an injunction against the board attempting to stop a disciplinary action. So, no this is not a typical action."

Beth Mole, Ars' health reporter, contributed reporting.