By the time the Board of Medical Licensure called its final executive session Thursday, board members had been in the hearing room, off and on, for nearly 10 hours. Outside, the office plaza’s parking lot was nearly empty.

Since convening at 9 o’clock that morning, the board had heard from more than half a dozen doctors and disciplined four on charges that ranged from illegally accessing a patient’s records to trading drugs for sex.

But the board had one last doctor on its agenda that evening, although his name hadn’t actually been included on it. After calling the final executive session, the board informed the agency’s new executive director, Dr. John K. Hall, that they would not renew his contract.

Since assuming the role of executive director last June, Hall’s tenure has been marked by both furious change and rumblings of controversy. And Hall has not shied away from either, speaking freely — and frequently — with the press about his ideas for overhauling the agency, which approves medical licenses for all Mississippi doctors.

Still, in a conversation with Mississippi Today on Sunday, Hall admitted that even if he was not entirely surprised by the board’s decision Thursday, he was caught off guard.

“Yes and no. I have had a good run. I think I was probably more aggressive than — so, no, it wasn’t really a surprise,” he said.  “I just look at it as the board has a statutory right to sever our relationship anytime — and I’m okay with it.”

The board is not required to give a reason for terminating an executive director’s contract, and Hall said he did not ask for one. Dr. Charles Miles, president of the Board of Medical Licensure, could not be reached for comment.

Hall, who holds Juris Doctor and MBA degrees in addition to his medical degree, said he was brought in to reform the agency, and that’s what he has done. In Hall’s 11 months, he instituted a number of reforms, streamlining the medical license application process, trimming the queue for licenses and adding transparency to several areas of the agency, from the website to investigations.

“I came to the agency from the corporate world where I managed spin for a really large company, so I understand the value of transparency — and not just reacting to things. I think it’s served the agency well, and … you know where that goes,” Hall said.

But, in the media at least, the benefits of these reforms have been overshadowed by one controversial topic: doctor-patient sexual assault, and the fight that Hall has been waging against it.

Last year, a national survey in the Atlanta Journal-Constitution ranked Mississippi last among 50 states and the District of Columbia in protecting patients from doctor sexual assault, scoring near the bottom of almost almost every category of patient-protection laws the study measured.

When interviewed by the Journal-Constitution, Hall’s predecessor, Dr. Vann Craig, explained that sexual assault was not a deal breaker in Mississippi.

“Let me say that it takes a lot of money to educate a physician. If they can be safely monitored and rehabilitated, I don’t see why they can’t come back from drugs, alcohol or sexual misconduct,” Craig said.

But Hall took the opposite view, arguing that a doctor who has violated a patient’s trust to that degree can’t be trusted with the care of other patients.

In January, Rep. Jeff Smith, R-Columbus, introduced legislation he and Hall had worked on together that would have criminalized sexual contact between doctor and patient. But many believed the bill — which made illegal any sexual contact, even consensual kissing — went too far.

One of those with mixed feelings was Dr. Charles Miles.

“I don’t believe a doctor should have sex with somebody he’s treating as a patient. Now should it be a felony? I’m not a lawyer, I’m not a legislator,” Miles said to Mississippi Today in January.

Miles also said he believed doctors deserved a second chance, and Mississippi, which has severe doctor shortages in many parts of the state, needs as many doctors as it can get.

“We would like to have them working in Mississippi for the reason you talked about — access to care,” he said. “Now for some, there’s a reason they have to be monitored, if he’s a drug addict and he’s monitored you know he’s not on drugs. So that’s what we try to do is get people back in to practice if we can.”

The bill died in committee later that month, and with it, much of the media controversy.

But Hall admitted he was frustrated by the fact that the board does not automatically revoke the medical license of someone who commits a crime, especially one that takes advantage of a patient’s trust.

“I told them when I was hired, I made three statements that I stood for. The first is that it’s not okay to divert drugs into the local stream of commerce. It’s not okay to have sex with patients. And sometimes discipline is harsh but it should not be unfair and it should probably not be unexpected. And I still believe in those, and if that makes me a cowboy, then I guess I’m a cowboy,” Hall said.

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Larrison Campbell is a Greenville native who reports on politics with an emphasis on public health. She received a bachelor’s from Wesleyan University and a master’s from Columbia University's Graduate School of Journalism.Larrison is a 2018 National Press Foundation fellow in public health, a 2019 Blue Cross Blue Shield Foundation of Massachusetts fellow in health care reporting and a 2019 Center for Health Journalism National Fellow.