As a Doctor of Osteopathic Medicine (DO), you've invested a great deal of time, energy, and money into your career. You have spent years in medical school and residency training to learn a specific patient-centered approach to medicine. You have sat for the grueling COMLEX-USA exams. You have paid a dear price to become licensed to practice in your state and to be board-certified through either the American Osteopathic Association or the American Board of Medical Specialties. You have built personal and professional relationships with your patients, colleagues, and other health care professionals.
And yet, after all you've worked for, your entire career could be jeopardized by a single complaint or allegation of wrongdoing to the state medical board. The complaint doesn't even need to be substantiated; it can simply lead to an investigation that could end in your suspension or revocation of your license. If you find yourself in this undesirable position, what can you do to save your career?
Joseph D. Lento is a highly experienced attorney with a track record for success representing osteopathic physicians and surgeons in New Jersey, Pennsylvania, and New York who are at risk of losing their medical license. The following answers to common questions can help you be informed and prepared.
What Offenses Can Cause Me To Lose My Medical License?
A wide variety of offenses and issues could lead to DOs losing their professional licenses, as determined by the medical board in your state. (In New Jersey, it's the New Jersey State Board of Medical Examiners; in Pennsylvania, the State Board of Medicine; and in New York, the medicine division of the Office of the Professions.) The most common offenses that could lead to the loss of a license include:
- Fraud. Examples include overbilling insurance through "upcoding," accepting kickbacks, billing patients for services not performed, falsifying diagnoses, etc.
- Inaccurate record-keeping. Accurate medical records are critical to patients' health. Doctors can get into serious jeopardy for keeping sloppy records, or worse, altering or falsifying records.
- Substance abuse/addiction. Drunk driving among doctors violates the rules of most medical boards. A colleague who suspects that you are abusing drugs or alcohol has a professional responsibility to report it to the board--especially if you observed under the influence while at work.
- Sexual misconduct. These allegations could include unwelcome sexual advances between a doctor and a patient or between coworkers in a medical facility. The AMA also considers any romantic relationship between a doctor and a patient unethical.
- Abuse or neglect of patients. Any allegations of verbal or physical abuse could endanger a physician's license, as well as accusations of gross neglect.
- Criminal convictions. Some criminal offenses could be considered a violation of your medical license. Furthermore, your license could be affected if you do not report a criminal conviction to the board.
- Inappropriate dispensation or administration of medication. Examples include keeping sloppy inventories, prescribing medicine inappropriately, or pilfering medications for your own use.
What Happens With the Medical Board When I Am Accused of Wrongdoing?
While board disciplinary processes can vary somewhat from one state to the next, they generally follow the same basic path:
- Complaint. Nearly all disciplinary proceedings begin when someone files a complaint against you with the medical board. Complaints may come from patients, colleagues/coworkers, other practitioners, health care entities, or insurers. A court clerk may also report a conviction for a criminal offense to the medical board.
- Investigation. The board must investigate complaints to determine whether they have merit. The board can subpoena records and request that you give written testimony in answer to the complaint. They may also call witnesses. If there is insufficient evidence to validate the complaint, the inquiry may end here.
- Consent order. If the board uncovers significant evidence of wrongdoing, they may seek to negotiate a consent order with you as an alternative to calling a formal hearing. A consent order is an agreement between you and the state in which you admit to wrongdoing and agree to the board's recommended sanctions. If the evidence against you is compelling, a consent order may be a good idea, especially if it provides a path for you to keep your license or at least have it reinstated.
- Hearing and formal complaint. In the event that a consent order is not reached, or the charges are particularly severe, the board may file a formal complaint with the state. A hearing will take place before an Administrative Law Judge, who will decide on any disciplinary actions against you, including the revocation or suspension of your professional license.
- Appeal. The appellate courts of your state have the power to review an adverse decision against you. However, these courts will only review the case for errors. Reverse decisions are very rare at this stage.
Keep in mind that at any time during this timeline, the board could decide that the complaint is not meritorious or that there isn't enough evidence to bring formal action against it. A professional license attorney can help you improve your chances of dismissing the complaint.
What Are the Other Penalties I Could Face, Other Than Losing My License?
Your medical license may not be revoked for every alleged offense. The medical board can implement other, lesser sanctions or penalties that will allow you to keep your license to practice. Some examples of sanctions include:
- License suspension. A board could suspend your license for a specific period, subject to further review.
- Fines. A monetary penalty may be imposed by the board.
- License restrictions. Your permission to perform certain functions may be limited by the board, such as prescribing certain medications or working in certain clinics.
- Continuing Medical Education (CME) The board may impose CME requirements if they believe the violation was caused by an educational gap or deficiency.
- Probation or supervised practice. Probation means that the board will keep an eye on your progress for a period of time to make sure you are meeting the requirements for maintaining your license active. They may also require you to work under the supervision of another physician for a time.
- Reprimand. The board may simply issue a formal reprimand or censure to be placed in your file.
These other penalties are certainly preferable to having your license revoked completely, but they can still cause damage to your career because disciplinary actions become a matter of public record. If a patient or healthcare facility checks your credentials online, they will see any disciplinary actions that have been taken, and this may impact their willingness to work with you.
What Type of Attorney Should I Use To Defend My Medical License?
Although you can hire any attorney you wish, not every attorney will have the knowledge and experience needed to defend you successfully in front of the medical board. Your best option is to hire an attorney who has specific experience in administrative law and professional license defense.
What Can a Professional License Attorney Do To Help Me?
A skilled license defense attorney will be familiar with the laws and regulations of your state regarding your medical license and will know how the disciplinary process works. Serving as your official legal representative in all dealings with the licensing board, the attorney will review your case, develop a winning defense strategy, gather evidence, and procure witness testimony on your behalf. Your attorney can also negotiate at multiple points in the disciplinary process to have your complaint dismissed or the penalties reduced. In short, hiring an experienced attorney gives you a much better chance at having a favorable outcome—particularly one that enables you to continue your practice.
Mine Was a Minor Offense That Will Likely Result in a Minor Penalty. Do I Still Need an Attorney?
Even though your offense may seem minor, it doesn't mean that the complaint won't have an impact on your career. The board of medicine may still revoke your license even for seemingly minor offenses--and even if you are correct that the penalty will be minor (like a fine or a reprimand), remember that any disciplinary actions against your license become a matter of public record. Any patient or healthcare facility can look up your records and see if you were disciplined. In the field of medicine, professional reputation is everything, and disciplinary actions can affect your ability to be hired by hospitals or other practices, as well as make it difficult for patients to trust you to care for them. If the recommended penalty is indeed minor, an attorney may be able to intervene to have the complaint dropped so your record stays clean. It is highly recommended that you hire a professional licensing attorney whenever you face possible discipline from the medical board, no matter how minor the offense.
An Investigator From the Medical Board Has Contacted Me or Visited My Home or Workplace. Do I Have To Give Them Access or Answer Their Questions?
While you are required to cooperate in any investigation into your license, that doesn't mean you have to let an investigator into your home or practice unannounced. Don't give in to the pressure to let them in, as you may inadvertently say or do something that hurts your case. Instead, ask them for their card and tell them that your attorney will contact them.
Recently, I Lost My License to Practice. Can a License Defense Attorney Help Me Get My Medical License Reinstated?
Yes. State medical boards provide a way for doctors to request reinstatement of a suspended or revoked license. While the process for reapplication is different from one state to the next, it may include all or some of these requirements:
- Completing a reinstatement application along with a written explanation of why your license should be reinstated
- Paying any applicable filing fees.
- Submitting to a psychiatric evaluation to demonstrate that you are competent to practice medicine.
- Providing a detailed job history for all jobs performed while your license was inactive.
- Showing proof that you have met all conditions required by the board for reinstatement (e.g., continuing education, treatment programs).
- Agreeing to any action plan proposed by the board as part of your reinstatement.
An attorney can help you with the reinstatement process to help these move along smoothly, including filing your paperwork, monitoring your application status, and negotiating with the board for the best possible terms.
What Happens to My Patients if My License to Practice Is Suspended or Revoked?
If you are notified of an investigation into your medical license that could result in license suspension or revocation, the best approach is to hope for the best while preparing for the worst. You want to do everything possible to ensure your patients continue to get the treatment they need and deserve, not only because it's the right thing to do, but also because it may help build loyalty with your patients so that if you do have to suspend your practice, they are more likely to return to you when you start practicing again.
If you don't have a referral network with other osteopathic physicians, begin developing one now. If you feel comfortable, inform your colleagues about the allegations against you and inform them that you might be sending them some patients if your practice is suspended. You don't need to inform your patients unless you actually do have to close your doors, but you always want to have somewhere else to send them.
I Have Just Been Notified of an Investigation Into My Medical License. How Soon Should I Get an Attorney Involved?
The best course of action is to get an attorney involved as soon as possible. Don't wait until a formal hearing to hire legal representation because, by that point, the board will already have built a case against you. The sooner you hire a professional license defense attorney, the better your chances of getting the complaint resolved early in the process with the best possible outcome.
As an osteopathic physician or surgeon, your medical license is your most prized possession because your entire livelihood hinges on it. If your license is in jeopardy because of possible disciplinary action, don't take unnecessary risks by trying to represent yourself or by taking a casual approach. Hiring a professional license defense attorney could very well save your career.
Attorney Joseph D. Lento has plenty of experience with license defense cases in New Jersey, Pennsylvania, and New York. He has helped many doctors resolve complaints and other issues that otherwise would have threatened their license to practice. Contact the Lento Law Firm at (888) 535-3686 today to discuss your case and your options.