The letter was sent the same day a Review-Journal story detailed how McBride served on the committee of the board that investigates malpractice complaints brought by patients while also serving as chairman of the medical malpractice company that fights paying out medical claims.

Gov. Jim Gibbons is pressuring McBride to step down from his position on the board while an investigation continues into practices at the Endoscopy Center of Southern Nevada, which officials have linked to six cases of hepatitis C.

Gibbons cited conflicts with the clinic's majority owner, Dr. Dipak Desai, as the reason McBride needed to step down. But lawmakers and others questioned whether McBride had additional conflicts.

"You can't be working for Nevadans on medical malpractice questions and for a medical malpractice insurance company at the same time," Assemblywoman Sheila Leslie, D-Reno, said.

The e-mail was sent to board members early Thursday. McBride's letter of resignation was dated Wednesday, the day the Review-Journal contacted him for comment on the story.

McBride had told the newspaper Wednesday: "Put me down for a no comment. I don't want to get into that right now."

McBride did not return repeated calls Thursday. Chip Wallace, marketing director for Nevada Mutual, said Thursday that he wasn't certain whether McBride's letter meant he was resigning.

"I'll try to get back to you," Wallace said Thursday afternoon. "That was a letter he (McBride) shared (with the board)."

Wallace never got back to the Review-Journal.

McBride's letter to O'Brien reads: "Please accept my resignation as chairman and director of Nevada Mutual Insurance Company effective immediately. I will remain as a one of the over 1500 members of the finest physician owned insurance companies in the State of Nevada."

McBride says on the company's Web site that Nevada Mutual "was formed by doctors to provide stable, long term professional liability coverage.

"As a Nevada mutual insurer, we insure only Nevada doctors and our owners are our policyholders."

Gibbons believes McBride's ties to Desai have helped undermine public confidence in the board.

The governor also has asked for the resignations of Dr. Javaid Anwar and Dr. Sohail Anjum.

McBride has acknowledged that Desai, majority owner of the Shadow Lane clinic, referred a large number of cases to him and that they have a long-standing friendship.

Although he recused himself last week from any board work concerning Desai, McBride did not distance himself enough to keep Gibbons from repeating his call for a resignation.

Thursday's developments did not impress the governor's office.

"There is no change in the governor's position," said Ben Kieckhefer, spokesman for Gibbons.

Board member Donald Baepler, a former president of the University of Nevada, Las Vegas, said Thursday that he did not believe McBride should have resigned as chairman of the insurance company.

"He was just trying to help doctors get insurance," Baepler said.

And board member Jean Stoess said McBride should be able to stay on the board.

"I don't know if he has any more conflicts (of interest)," she said. "But he certainly seems to be trying to do the right thing."

Contact reporter Paul Harasim at pharasim@reviewjournal.com or (702) 387-2908.