If you are a physician, your medical license is your most prized possession. It required years of demanding coursework to obtain, let alone thousands of dollars in tuition money, multiple grueling examinations, and countless hours of clinical practice. That one piece of paper represents your entire livelihood. Without it, you couldn't treat patients, prescribe medicine, operate a practice, or work as a medical provider in any capacity.
Suffice it to say that when your license is threatened by the possibility of disciplinary action by the medical board, it's nothing short of a life crisis. Ironically, all your hard work can be erased in a moment, often by a small misunderstanding that escalates into a real problem. What can you expect? How do you respond? Most importantly, what steps can you take to rescue your career?
Attorney Joseph D. Lento has extensive experience and a track record of success representing physicians in New Jersey, Pennsylvania, and New York who are in danger of losing their medical licenses. The Lento Law Firm has compiled the following information to answer doctors' most pressing questions when facing disciplinary action from the state medical board.
What types of offenses could cause me to lose my license to practice medicine?
Doctors may risk losing their professional license over a wide range of issues and offenses as determined by the medical board (in this case, either the New Jersey Board of Medical Examiners or the Pennsylvania State Board of Medicine). In no particular order, the most common accusations that can result in the loss of license are:
- Fraud. Common examples of health care fraud allegations include using incorrect insurance codes to get more money for procedures (“upcoding”); overbilling the insurance company or the patient; falsifying patient diagnoses for insurance purposes; billing for services not performed; and accepting kickbacks for referring patients.
- Faulty record-keeping. Keeping accurate patient medical records is essential to providing safe health care. Inaccurate record-keeping or altering medical records can get doctors into big trouble.
- Substance abuse/addiction. Alcoholism and drug abuse among physicians represent a violation of board rules in most cases. If a colleague suspects you of abusing drugs or alcohol, he/she has a professional obligation to report you to the board.
- Sexual misconduct. This category may involve allegations of unwanted sexual advances from doctor to patient or between colleagues in a medical facility. In addition, the AMA counts any romantic relationship between a physician and a patient to be unethical. If you date a patient without excusing yourself as their doctor, this action could jeopardize your license.
- Patient abuse or neglect. Allegations of physical, sexual, mental, or verbal abuse can definitely endanger a physician's license. So can gross neglect, and even apparent unintentional abuse if the doctor should have realized a patient's limitations.
- Criminal convictions. Certain criminal offenses may constitute a violation of your medical license. Likewise, if you fail to report a criminal conviction (e.g., a DUI) to the board, this could also jeopardize your license.
- Inappropriate dispensation of medicine. If you're accused of prescribing or administering medications irresponsibly or outside your scope, your license could be at risk.
Can I lose my medical license over allegations of malpractice?
In most cases, no. Medical malpractice cases are typically heard in civil court cases for monetary damages (which is why doctors carry malpractice insurance). Only if the alleged victim can prove that you intentionally tried to cause harm or committed extreme negligence could you lose your license—and those behaviors are usually characterized as patient abuse rather than malpractice.
What other penalties could I face other than losing my license?
Not every alleged offense will result in having your medical license revoked. Depending on the circumstances and the available evidence, the medical board may choose to invoke other types of penalties or sanctions as an alternative to costing you your license. Examples may include:
- License suspension. The board may opt to suspend your license for a specified period of time, subject to further review
- License restriction. The board may limit your permission to perform certain functions, such as prescribing medicine or working in certain clinics.
- Fines. The board may impose a monetary fine.
- Continuing medical education (CME). If the board believes the violation occurred due to an educational deficiency or gap, they may impose CME requirements to fill the gap.
- Imposing conditions. The board may require you to perform certain actions as a condition of keeping your license or avoiding other penalties.
- Probation. Probation means the board will monitor your progress for a specified length of time to ensure you're fulfilling the requirements for keeping your license active.
- Reprimand. For seemingly minor infractions, the board may opt to issue a private or public reprimand or censure of your actions.
While these other penalties might be preferable to having your license revoked entirely, they can also cause career damage if they appear in your public records. Patients often check the records to see if a doctor has been disciplined, and such marks may weaken your trust levels with the public.
What is the process for physicians facing possible disciplinary action?
Specific disciplinary processes may differ from state to state, but they tend to follow a similar basic path as follows:
- Complaint. Most disciplinary actions begin with the registering of a complaint against you to the board. Complaints may come from patients, colleagues/coworkers, other practitioners, health care entities, or insurers. A court clerk may also report a criminal conviction to the medical board.
- Investigation. The board conducts an investigation to determine if there is any validity to the complaint. The board may subpoena your records and ask you for written testimony, and you are expected to cooperate. In some cases, the matter can be resolved at this stage without further action.
- Inquiry. If the board is not satisfied with your written answers or level of cooperation during the investigative phase, they may ask you to appear at an inquiry to answer questions personally.
- Consent order. If the board determines that disciplinary action is in order, they will often seek to negotiate a consent order as an alternative to filing formal charges. A consent order is a legally binding agreement between the state, the board, and you, in which you collectively agree upon a set of prescribed sanctions. While the sanctions may be unpleasant or inconvenient, this option is often preferable at this stage, especially if it includes a path to restoration of full licensure.
- Formal complaint and hearing. If a consent order cannot be agreed upon, or if the alleged charges are especially egregious, the board will file a formal complaint against you with the state. At this point, a hearing will be held in front of an Administrative Law Judge who will decide on disciplinary actions against you—up to and including the revocation of your professional license.
- Appeal. You have the right to appeal an adverse decision to the appellate courts in your state, but be advised that these courts only review the case in the lower courts for errors, and reversals are rare at this stage.
Bear in mind that at any point along this timeline, the board may determine that the complaint against you is either without merit or lacks sufficient evidence to take formal action against you. Involving a professional license attorney early in the disciplinary process can greatly improve your chances for a dismissal of the complaint.
Why do I need an attorney if my medical license is in jeopardy?
Many doctors fail to understand what is at stake when a complaint is filed against them. They may also wrongly assume that the board exists to protect them or that they can get the board to see it their way if they just explain the situation correctly. The truth is, the board is there to protect the public, not the doctors, and in many cases, the burden of proof is on the doctor to demonstrate the falsehood of the claims.
Your medical license is not just an agreement with the medical board; it constitutes a legal agreement with the state, and any action the board takes to revoke your license is a legal action. You are a doctor, not a lawyer. When you attempt to represent yourself in these matters, you risk getting in over your head or facing unfair discipline simply because you don't understand how the system works. It's not unlike trying to represent yourself in court when facing criminal charges. Your odds of a fair outcome are greatly increased when you have an experienced attorney representing your interests and defending your rights.
What kind of attorney do I need to help defend my medical license?
Professional licensure falls under the category of administrative law. You can technically hire any attorney willing to help, but when it comes to your license, it's not advisable just to hire an attorney who's a friend because they will give you a good rate, or use an attorney because he/she has helped you with other matters like a divorce or even a malpractice suit. Your best advantage comes from hiring an attorney with specific knowledge and experience in administrative law—someone who understands how the licensing boards operate in your state and someone who has experience arguing before an Administrative Law Judge.
Does hiring an attorney make me look guilty to the board?
Absolutely not. State licensing boards don't expect doctors or other licensed professionals to be experts in administrative law, and they are fully accustomed to engaging with attorneys. Hiring a lawyer in no way suggests to the board that you are guilty—rather, it suggests that you are taking the matter seriously.
What can an attorney do to help me?
An experienced medical license attorney will have a thorough understanding of administrative law and the rules of licensure in your state. The attorney can review the facts surrounding the complaint against you, help you compile evidence and gather witnesses on your behalf, and represent you in an official capacity in interactions with the licensing board to ensure your side of the story is heard and understood. Your attorney can also negotiate on your behalf for better terms, either for dismissal of the complaints or for lesser sanctions. In a majority of cases, a good attorney will be able to negotiate a resolution that allows you to keep your license.
Can't I just call the board and explain the situation? This complaint is just a misunderstanding.
The issue may indeed be due to a misunderstanding, but it is a potentially critical mistake to assume the board is your friend and you can just “explain” things to them. The state medical board exists to protect the public against bad doctors, not to protect doctors from the public. Once a complaint has been filed, it's safe to assume that any information you volunteer to the board may be used against you. We strongly advise that you never reach out to the board or provide information without the counsel of a skilled attorney.
It's been suggested to me that the complaint against me will only result in a reprimand or other minor sanction. Do I still need an attorney?
Just because your offense is considered minor, don't assume the complaint couldn't do damage to your career. Disciplinary actions taken by the medical board are a matter of public record, and any patient or healthcare facility can look you up and find out if you have been disciplined by the board. A physician's professional reputation is everything. A professional record marred by sanctions can make hospitals and other practices less likely to hire you, and it can make patients reluctant to trust you with their care. For these reasons, it's highly advisable to hire a professional license attorney anytime you are facing possible discipline by the medical board. More often than not, the attorney's involvement will result in lesser actions being taken or the complaints being dismissed altogether.
I've been contacted by an investigator working for the medical board, or an investigator has shown up at my work or home. Am I required to let them in or answer their questions?
No, you are not—nor should you. While you are expected to cooperate with any investigation (and failing to do so could work against you), you have the right to defer all questions to your attorney or insist that your attorney be present. Do not be pressured to allow an investigator into your home or practice unannounced. Assume that anything you say could be used against you. Instead, ask for their card and inform them that your attorney will contact them. You are legally cooperating at that point without putting yourself at a disadvantage.
I recently lost my license to practice. Can a professional license attorney help me get it reinstated?
Yes. State medical boards have a mechanism in place for a physician to apply for reinstatement of a license that has been suspended or revoked. The reapplication process differs from state to state, but the process may include any/all of the following requirements:
- Filling out an application for reinstatement
- Paying filing fees and/or reactivation fees
- Submitting a detailed work history of all jobs held while your license was inactive
- Submitting a written explanation for why you should be reinstated
- Providing proof that you have completed any prescribed conditions for reinstatement (e.g., continuing education, treatment programs)
- Submitting to a psychiatric assessment to affirm fitness to practice
- Submit to a prescribed Plan of Action for reinstatement, which may include a probationary period and supervision by a monitoring physician
Having an attorney help with this process can greatly improve your chances for a smooth reinstatement of your license. A good license attorney will have a solid working knowledge of your state's reinstatement process to make sure all the conditions are met without missteps. The attorney can also:
- Oversee the processing and filing of paperwork and fees;
- Follow up with the board to monitor the status of your reinstatement;
- Negotiate the best terms for your reinstatement Action Plan; and
- Help you present the most compelling argument for why you should be reinstated.
In cases where there is evidence that your license was wrongfully suspended or revoked, an attorney can also present this evidence on your behalf during the reinstatement process to negotiate for the removal of unfair terms.
How will a disciplinary investigation affect my practice? How do I address it in terms of marketing, recruiting, etc.?
Unless your medical license has already been revoked, suspended, or temporarily suspended pending a hearing, you are still a licensed physician and free to practice as normal. You should also feel free to continue with any advertising or marketing strategies you currently employ, and if you are recruiting additional help, you should continue doing so. Don't assume your practice will be shut down unless your attorney advises you that license suspension/revocation is imminent. An investigation is merely that—an investigation—and remember that there are many possible disciplinary outcomes that do not involve losing your ability to practice. There's no need to allow your business to drop off by reducing your marketing and recruiting unless you're facing the worst-case scenario.
What Do I Tell My Patients, Employees, or Colleagues Who Ask About My License Investigation?
If word gets out that there has been a complaint against you and that the medical board is investigating, you may have concerns that your professional reputation may already be at risk. While this is a legitimate concern, you should also take into account that licensure investigations are more common than you think. State medical boards receive many complaints each year, and they have an obligation to review all of them.
If a colleague or someone in your care/employ asks you about the complaints against you, your first priority is to conduct yourself professionally. Do not speak in derogatory terms about the complainant or the board, and resist the urge to “explain your side of the story.” These responses not only come across as defensive, but they also may create more problems for you later on. It's okay to acknowledge that you are under investigation and that you are cooperating with the board to resolve the misunderstanding, but keep the details to a minimum. In the meantime, assure the person that unless the board tells you otherwise, you intend to continue providing the best care to your patients in an upright, professional manner.
What Becomes of My Patients if My License to Practice is Suspended or Revoked?
If your attorney advises you that license suspension or revocation is a distinct possibility, your best strategy is to “hope for the best and prepare for the worst.” In terms of your patients, if you intend to seek a reinstatement of your license, you want to take all precautions to make sure they continue to receive the best care in your absence. Not only is this the right thing to do—but it also may build loyalty, increasing the chances that these patients will return to you when you begin practicing again.
To that end, your best option is to establish a referral system with other trusted physicians within your area of practice. If you feel comfortable doing so, advise these colleagues of the complaints against you and advise them that you may be sending them some of your patients if your practice is suspended. There's no need to tell your patients unless the board suspends or revokes your license—but in the event that this happens, you always want to have somewhere to send them.
I've just received notice of a complaint against me. At what point in the process should I hire an attorney for my medical license defense case?
Typically, the sooner you involve an attorney, the better. Many doctors, unfortunately, wait until they are facing a hearing before consulting with an attorney, not realizing that by the time things reach the hearing stage, the board already has ample reason to believe you should face sanctions or have your license revoked. Hiring an attorney early in the process affords more chances to get the complaint resolved during its early stages, in part because your initial responses to the complaint often affect the board's decision as to whether to move the case forward.
If you have been informed of a complaint, investigation, or accusation against you that could jeopardize your medical license, your entire livelihood could be at risk. You don't want to take unnecessary chances by trying to represent yourself or taking a casual approach to the charges. Hiring a professional license defense attorney may very well save your career. Attorney Joseph D. Lento is well versed in medical license defense cases in New Jersey, Pennsylvania, and New York and he has helped many physicians resolve complaints and other issues that would otherwise have put their licenses at risk. Contact attorney Joseph D. Lento and the Lento Law Firm at (888) 535-3686 today to discuss your case and your options.