As a licensed physician assistant (PA), you've invested heavily in your career—both time and money. You've gone to school for at least 6-7 years to earn a master's degree in an approved PA program. You've spent years building up your field experience. You've studied hard and passed the PANCE exam. And you've gotten licensed as a PA by your state's licensing board. Your entire livelihood rests on the validity of that professional license, which in effect, makes it one of your most prized possessions.
So imagine what can happen if someone files a complaint against you, and the licensing board informs you the status of your license is in jeopardy. Everything you've worked for now hangs in the balance, and the sense of uncertainty and dread may be overwhelming. Chances are, your mind is flooded with questions. What happens if you lose your license? What damage could this do to your career?
Attorney Joseph D. Lento has many years of proven experience helping licensed professionals with legal licensing issues in New Jersey, Pennsylvania, and New York. If you're facing a current threat to your physician assistant license, the Lento Law Firm has provided the following key information to help you stay informed and know what to expect.
What are the possible offenses that could result in my losing my PA license?
Physician assistants are held to high standards of performance and excellence—to the same extent, or almost the same, as medical doctors. Thus, a wide variety of offenses and issues could lead to a PA having their license revoked by the state licensing board. The most common charges that could lead to the loss of a license include:
- Fraud. Examples include overbilling patients or insurance companies, “upcoding” with incorrect insurance codes to get more money, billing for services not performed, etc.
- Inaccurate record-keeping. Safe health care requires accurate medical records. PAs can get in serious trouble if they keep inaccurate or sloppy records.
- Sexual misconduct. These allegations could include unwelcome sexual advances toward a patient or coworker, sexual harassment/assault, etc. In addition, starting any romantic relationship with a patient is unethical by AMA standards and could be grounds for losing your PA license.
- Substance abuse/addiction. Drug and alcohol abuse violates the rules of most licensing boards. A colleague who suspects that you are abusing drugs or alcohol has a professional responsibility to report it to the board.
- Abuse or neglect of patients. Any allegations of verbal, physical, or sexual abuse could endanger your license. Gross neglect and apparent unintentional abuse can also be grounds for revoking your license.
- Criminal convictions. Certain criminal offenses (e.g., DUI) could be considered a violation of your PA license. Your license could also be jeopardized if you fail to report to the board if you get a conviction.
- Inappropriate handling of medicine. Your license may be at risk if you prescribe or administer medicines inappropriately—or if you pilfer medications for your own use.
If I don't end up losing my license over an alleged offense, what other disciplinary actions may be taken?
Your PA license won't necessarily be revoked for every alleged offense. The licensing board can invoke other, lesser penalties based on the circumstances of your case. Some examples:
- Suspension of license. Your license may be suspended subject to further review and possible reinstatement.
- License restriction. Your permission to perform certain functions may be limited by the board, such as prescribing medicine or working in certain clinics.
- Fines. A monetary penalty may be imposed by the board.
- Continuing Medical Education (CME) The board may impose CME requirements to address an educational deficiency.
- Mandatory conditions. The licensing board may require you to fulfill certain obligations as a requisite for keeping your license (for example, mandatory treatment for substance abuse).
- Censure. The board can issue a private or public reprimand or censure for seemingly minor infractions.
These lesser penalties may be better than having your license revoked completely, but they can also cause career harm if they appear in your public records. Patients and potential employers frequently check with the board to see if a healthcare professional has been disciplined.
What are the steps for disciplinary action for physician assistants?
While disciplinary processes can vary from one state to the next, they generally follow the same basic path:
- Complaint. Most disciplinary actions begin with a formal complaint filed against you with your licensing board. Patients, coworkers, and other health care providers may all file complaints against you.
- Investigation. The board may interview witnesses, subpoena records, and ask you to provide a formal response to the complaint—all to determine whether the complaint itself is valid and warrants a response.
- Consent order. If the board finds sufficient evidence to discipline you, it may offer to negotiate a consent order with you—a binding agreement in which you voluntarily admit to wrongdoing and accept the board's determined consequences.
- Formal hearing. If a consent order is not reached or the charges are particularly severe, the board may move toward a formal hearing, which will take place either before the board itself or in court before an Administrative Law Judge.
- Final determination. The board (or the judge) will make a determination on your guilt and decide on appropriate action.
- Appeal. You have the right to file an appeal of any adverse action by the board. You would file this appeal with the appellate courts of your state.
While the disciplinary process is scary, bear in mind that at any point in the process, the board may opt to dismiss the complaint or to settle on a lesser disciplinary action. Having a professional license attorney representing you can greatly improve your prospects for a favorable outcome.
Why do I need an attorney's help if my license is at risk? How can an attorney help me?
One common misconception with PAs and other licensed professionals is that the licensing board is there to protect them. Actually, the board exists to protect the public. Thus, anytime someone files a complaint against you, the board is acting on behalf of the complainant to determine whether you are a risk to the public trust. In other words, even though the board may attempt to be unbiased in their investigation, the fact is you're going into the investigation at a disadvantage, and the burden of proof may be on you (not the board) to prove you deserve to keep your license.
Of course, you have the legal right to represent yourself in any professional license dispute—but you'll be taking a great risk with your license if you do so. Anything you say to the board could be used as evidence against you and actually weaken your claim of innocence. For these reasons, and because your very livelihood depends on it, it's best to have professional legal counsel to defend your license.
What type of attorney is best for professional license investigations or hearings?
Professional licensing falls in the category of administrative law—a specialized part of the law that not every attorney is familiar with. To ensure best results with any license investigation, you should hire an attorney with specific experience in professional license defense—preferably someone who has experience dealing with licensing boards within your state.
An attorney who is skilled in professional licensing will be familiar with the laws and regulations of your state. The attorney can review your case, gather evidence, and procure witness testimony on your behalf. They will also represent you in all official dealings with the licensing board. An attorney can negotiate for you to get better terms for your case, whether the complaint is dismissed or reduced in severity. A good attorney can negotiate a solution that will allow you to keep your license in most cases.
My superiors have suggested my offense is minor and will only result in a reprimand. Do I still require an attorney?
Even though your offense may be minor, it doesn't mean that the complaint won't have an impact on your career. Any disciplinary action taken by the licensing board can appear on your public record. Any patient or healthcare facility can look up your records and see if you were disciplined. Negative marks on your record can affect your ability to be hired by hospitals or other medical practices. It is highly recommended that you hire a professional licensing attorney whenever you face possible discipline from the licensing board. Often, the involvement of an attorney will result in a reduction in the severity of discipline—or in some cases, even a dismissal of the complaint.
An investigator from the state licensing board has contacted me or visited my home or workplace. Do I have to give them access or answer their questions?
You are required to cooperate in any investigation. Failing to do so could result in disciplinary action on its own. However, you can defer all questions to an attorney or insist on your attorney's presence. Don't feel pressured to let an investigator in your house or office unannounced. You could be held responsible for any statements you make or anything they discover. Instead, ask them for their card and tell them that your attorney will contact you.
Recently, I lost my physician's assistant license. Can a professional attorney help me reinstate it?
Yes. State licensing boards provide a way for you 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:
- Complete a reinstatement application
- Pay any reactivation and filing fees
- Send a detailed job history for all jobs performed while your license was inactive
- Send a written explanation of why you should be reinstated
- Show proof that you have met any conditions required for reinstatement (e.g., continuing education, treatment programs).
- Submit to any plan of action prescribed by the board. This may include a probationary period or supervision by another PA.
An attorney can help you with the reinstatement process and improve your chances of a smooth experience. An experienced professional license defense attorney will be able to provide sound advice and guidance on how your state reinstates licenses.
I have just been notified that a complaint has been filed against me. At what point should I hire an attorney?
The best answer is to get an attorney involved as soon as possible. Too many PAs wait until they have to face a hearing before consulting an attorney, and by that time, they are already on the defensive. It is better to hire an attorney early on in the process to help you resolve the complaint. This is partly because the board will often consider your initial responses to the complaints when deciding whether or not to proceed with the case.
Keeping your physician assistant license in good standing is essential for your career, and a single complaint or accusation has the potential to derail your future. Do not take unnecessary risks by trying to defend yourself or by taking a casual approach. A professional license defense attorney can effectively save your career. Joseph D. Lento, an attorney who is experienced in New Jersey, Pennsylvania, and New York license defense cases, has helped many PAs resolve complaints and other issues that could have put their licenses in danger. To discuss your case and to learn more about your options, call the Lento Law Firm today at (888) 535-3686.
