Physician Defense Against Patient Abandonment Disciplinary Charges

Physicians accused by their state medical board's disciplinary officials of patient abandonment face considerable disciplinary risk. Don't take your state medical board's investigation and allegations lightly. Instead, retain the Lento Law Firm's premier Professional License Defense Team the moment you learn of the allegations so that our highly skilled and experienced attorneys can help you achieve the quickest, surest, and best outcome to those misconduct allegations. Patient abandonment is a serious disciplinary charge. Get the premier attorney representation you need. Call 888.535.3686 or complete this contact form now.

State Medical Board Disciplinary Authority

You obtained your license to practice medicine through your state medical board. You must maintain that license in good standing to continue with your medical practice and employment. Your state medical board not only has the authority to issue your medical license but also to revoke it for patient abandonment or other misconduct. The Connecticut Medical Examining Board is an example.

The Connecticut Medical Examining Board operates under the authority of Connecticut Statutes Section 20-8a to issue, regulate, and discipline medical licenses for practice in the state. Section 20-13c expressly authorizes the Medical Examining Board to suspend or revoke a license for misconduct. The grounds for license discipline include any “illegal, incompetent or negligent conduct in the practice of medicine,” which would clearly include patient abandonment. Indeed, another Connecticut Statute, Section 17a-412, expressly requires physicians to report patient abandonment by other physicians or medical professionals for discipline and redress.

Georgia's medical practice laws provide an even clearer prohibition on patient abandonment. Georgia Statutes Section 43-34-8 states the grounds for physician license discipline. Those grounds expressly include when a physician “[m]istreated or abandoned a patient or his or her records....” Do not doubt your state medical board's disciplinary authority. Instead, retain our attorneys to defend and defeat those charges.

State Medical Board Disciplinary Procedures

When facing patient abandonment or other disciplinary charges, you have constitutionally protected property and liberty interests in your medical license, guaranteeing you due process. Due process generally means fair notice and a fair hearing before an impartial decision maker. You must, though, invoke those protective procedures, which are not always self-executing. Our skilled and experienced attorneys are responsible for doing so on your behalf and for your best disciplinary outcome.

Ohio's medical disciplinary procedures are an example. Ohio Statutes Section 4731.23 requires the Ohio State Medical Board to appoint an attorney hearing examiner to conduct contested disciplinary proceedings. The statute further details the hearing examiner's obligations to hold hearings, take evidence, record proceedings, issue declarative rulings, and otherwise provide the constitutional due process required when the State Medical Board seeks to terminate a physician's license. Final decisions of the hearing examiner may be subject to appeal to the Ohio State Medical Board and to civil court review under the state's Administrative Procedure Act. We can help you invoke and strategically pursue and enforce your equivalent procedural rights in your state of licensure.

State Medical Board Disciplinary Sanctions

Your disciplinary charges alleging patient abandonment may result in a wide range of progressive sanctions all the way up to license suspension and revocation. The range of sanctions that your state's medical board may impose can be daunting, but it also can give our attorneys grounds to argue for remedial measures or private sanctions that do not disrupt your medical practice, leave a record of discipline, or damage your reputation and relationships. Georgia's medical practice laws once again provide an example. Georgia Statute Section 43-34-8 authorizes the Georgia Composite Medical Board to take any of the following disciplinary actions:

• license probation;
• fine for violations;
• imposing a public or private reprimand;
• imposing costs of the proceeding;
• required additional examination;
• required additional education or training;
• required counseling, treatment, or examination;
• license limitation or restriction;
• license suspension;
• license revocation.

Definition of Patient Abandonment

The definition of patient abandonment can be critical to the outcome of your disciplinary charges. Many of the state statutes, rules, and regulations authorizing discipline for patient abandonment do not define the term. In general, patient abandonment involves a physician improperly terminating the physician/patient relationship. Consider, then, each of these separate elements of patient abandonment. First, a physician/patient relationship must exist. If the person claiming abandonment was not your patient, then abandonment should not be an authorized disciplinary charge. Second, the physician must have terminated the relationship. If the physician continues to serve the patient, the patient terminates the relationship, or a guardian, facility, employer, or other person or entity terminates the relationship, the physician has not committed patient abandonment. Third, the physician's termination of the patient relationship must have been improper, by abandonment, rather than within the proper customs, standards, rules, and practices of physicians.

Additional Elements of Patient Abandonment

In practice, disciplinary officials may require other elements before pursuing a charge of patient abandonment. They may, for instance, require that the physician's abandonment of the patient has been at a critical stage of the patient's need for medical examination and treatment. Abandoning a patient who suffers a chronic condition not likely to suddenly worsen without medical care or improve with medical care may not warrant disciplinary charges. Disciplinary officials may, in the same vein, consider whether the patient suffered harm from the physician's abandonment. Disciplinary officials may also consider whether the physician's abandonment was sudden and complete, cutting off all communications. If, instead, the physician gradually withdrew while continuing some care, such as medication review and orders, or continued to maintain patient contact and communications, disciplinary officials may decide not to pursue charges. Patient abandonment can, in other words, reflect a gray area rather than be black and white, clear-cut in every case.

Examples of Patient Abandonment

The above definition of patient abandonment should help you understand what your state medical board's disciplinary officials must prove to establish their disciplinary charge and sanction you for misconduct. However, examples of patient abandonment can still vary widely, depending on peculiar circumstances. Consider the following examples of patient abandonment to further appreciate your discipline risks and how we may be able to successfully defend your charges:

• a physician suffers an impairment, illness, injury, or other condition burdening the physician's pursuit of medical practice and causing the physician to suddenly step aside, without arranging for substitute medical care for current patients, when the physician could have continued with their care while making those arrangements, and one or more patient suffers a medical reversal as a result;
• a physician suffers the death of a spouse, parent, child, or other close family member, a separation and divorce proceeding, the destruction of the physician's home by fire, or other extraordinary event, causing the patient to suddenly turn all attention away from medical practice, leaving patients without needed care and causing preventable adverse medical events;
• a physician leaves for vacation or a professional conference for an extended period without arranging for coverage, leaving patients without needed medical examination and treatment, with some patients suffering worsened conditions as a result;
• a physician grows angry or frustrated with a patient and decides without informing the patient or others not to continue with needed examination and treatment, resulting in a serious medical event or reversal;
• a physician has a dispute with the hospital or other care facility and decides not to continue to exercise privileges at that facility, leaving the physician's patients at that facility without medical care and causing one or more of those patients to suffer preventable adverse medical events;
• a physician has a dispute with the physician's employer and determines to terminate the employment in favor of working for another medical practice, leaving the physician's hospitalized patients without an attending physician and causing one or more patients to deteriorate for lack of continued medical care;
• a physician has a dispute with medical supervisors, physician colleagues, or nurse subordinates, and the physician accordingly abandons patients so as not to come into contact with those other healthcare professionals, leaving the patients without medical care and resulting in adverse events.

Factors Triggering Patient Abandonment

You can see from the above examples that certain factors can be common triggers to patient abandonment circumstances and events. Those triggers may influence disciplinary officials in their decision to charge, resolve charges voluntarily without punitive sanction, or pursue severe sanctions through contested hearings. For example, if the trigger for a patient abandonment charge is the physician's sudden unanticipated injury, illness, or other burdensome event like the death or severe injury or illness of a close family member, disciplinary officials may look with sympathy and compassion on the physician's plight and may forgo disciplinary charges or minimize or eliminate sanctions. By contrast, if the trigger for a patient abandonment charge is the physician's vacation or a dispute with colleagues, facilities, or employers for which the physician is responsible, then disciplinary officials may pursue charges more aggressively and seek greater sanctions. We can help you evaluate triggers and charges to strategically present your best defense.

Factors Affecting Patient Abandonment Charges

The outcome of patient abandonment charges may similarly depend on related factors present or absent in each individual case. Our attorneys will help you identify those factors to ensure that we acquire and present the appropriate evidence for exoneration or mitigation of the charges. Those other factors potentially exacerbating or mitigating the disciplinary charges and sanctions may include:

• whether patients suffered an injury and, if so, the severity of the injury;
• whether the accused physician had prior incidents of abandoning patients or instead had a long and sound record of patient medical care;
• whether the physician promptly corrected or sought to correct the patient abandonment before disciplinary officials brought the charges or others acted to force the physician to do so;
• whether the physician had unexpected and unpreventable personal grounds distracting attention from medical practice and patient duties, such as sudden illness, severe injury, or a close family member's death or severe injury;
• whether the physician's patient abandonment disrupted the operation of the hospital or other facility in which the physician practiced; and
• whether the physician's patient abandonment embarrassed other medical or healthcare professionals and subjected the medical profession to public scorn, embarrassment, or contempt.

Types of Patient Harm from Medical Abandonment

As just indicated, the type and severity of harm that patients suffer from the accused physician's alleged abandonment can also heavily influence the outcome of the disciplinary charges. Patient harm can also lead to medical malpractice claims and the civil liability of the physician's facility, employer, colleagues, subordinates, or others, further influencing the disciplinary charges. We can help you evaluate whether your patients suffered harm from your alleged abandonment and, if so, the extent of the harm and the potential effect on your disciplinary charges. We can also make your best case for showing that harm did not occur despite contrary allegations or that harm was minimal. Physician abandonment of patients can lead to the following types of harm:

• the inability of patients to gain admission to hospitals, clinics, or other medical care facilities for needed care, resulting in worsened medical conditions;
• the inability of patients to obtain medical examination for the diagnosis of critical emerging conditions, leading to the worsening of those undiagnosed but treatable conditions;
• the inability of patients to obtain medical treatment for their ongoing disease processes and diseased conditions, leading to the worsening of those conditions;
• the inability of patients to obtain medications that would slow, reverse, and heal their ongoing development of medical disease or to adjust medications, resulting in disease worsening under preventable conditions;
• the inability of patients to obtain hospital, psychiatric facility, rehabilitation facility, or other facility discharge, causing the patient to incur additional medical expense, lost employment income, and delayed enjoyment of life; and
• heart attacks, aneurysms, strokes, seizures, and other sudden and grossly injurious medical events due to the physician's abandonment and the patient's inability to obtain other critical medical examination, consultation, medication, and treatment.

Defenses to Patient Abandonment Charges

Keep in mind when facing your state medical board's disciplinary charges that allegations are not the same as findings of patient abandonment or related misconduct. Do not ignore the charges, assuming that sanctions are your accomplished fate. Instead, your state medical board disciplinary officials may expect you to come forward with reasonable explanations. Indeed, they may hope that you do so, recognizing the considerable value of your medical services to your patient, employer, facility, and community. They may also prefer to avoid the time and effort of a formal disciplinary proceeding. We can bring these collateral interests to bear in your defense. Otherwise, your defense to patient abandonment disciplinary charges may depend on one or more of the following showings, depending on the available evidence:

• you were not the patient's physician but have been misidentified as such when other physicians were responsible for the patient's care;
• you were no longer qualified by specialty, skill, education, or experience to serve the patient in the patient's peculiar, changing, and emerging medical needs, and you reasonably informed the patient, facility, and your employer of that circumstance;
• you did not abandon the patient but instead continued to offer your care, which the patient refused;
• others terminated your privileges, employment, or practice so that you were no longer in a position to lawfully examine and treat the patient, of which you or others informed the patient;
• your employer, colleagues, or facility were responsible for notifying the patient of your withdrawal, by their agreement and your circumstances;
• you were unable because of disease, injury, or other incapacity or impairment to continue to treat your patients, of which you informed the patients and for which your employer, facility, or others were responsible for arranging substitute medical care;
• the complaining patient did not need continued medical care and had no emergent, urgent, or treatable medical condition that could benefit from continued medical care;
• the patient's legal guardian, power of attorney for healthcare, or other legal representative terminated your medical care of the patient, whom you would otherwise have continued to serve.

Procedures Defending Patient Abandonment Charges

When a state medical board charges a licensed physician with patient abandonment or other misconduct threatening the physician's medical license, the physician generally has constitutional rights to due process to protect the physician's property and liberty interests in medical practice. Your state medical board must recognize those due process rights and very likely does so through its enacted administrative rules, regulations, and procedures. The Texas Medical Practice Act provides an example. Section 164.004 of the Act guarantees that the accused physician in a disciplinary proceeding will have due process. Related sections of the Texas Medical Practice Act and other rules and regulations of the Texas Medical Board detail those mandated procedures. As a physician's constitutional rights require, those procedures ensure fair notice of the charges and a fair hearing before a qualified and impartial decision maker.

Other common procedural rights in physician disciplinary proceedings include an opportunity to request and attend informal resolution conferences, the right to review the disciplinary official's investigation report, a right to discover the medical board's evidence against you in order to prepare for the hearing, and the right to present your evidence and cross-examine witnesses at the formal hearing. You should also have a right to appeal an adverse decision from the hearing officer or hearing panel to the state medical board or, if the board was the hearing panel, then to a civil court or other independent body for review and reversal based on substantial errors in the proceeding.

The Role of the Defense Attorney

Our highly skilled and experienced defense attorneys can help you invoke the above procedural protections, which are generally not self-executing. You will need our strategic intervention and representation to ensure that you gain the greatest defense benefit from the available protections. We can, for instance, help you evaluate the notice of charges, identify and acquire defense evidence to those charges, and present that evidence at informal resolution conferences to advocate and negotiate for charge dismissal under remedial relief rather than punitive sanctions. If officials insist on proceeding with discipline, we can invoke your formal hearing right to present your testimony and other defense evidence at the hearing. We can also cross-examine adverse witnesses.

If you have already lost your formal hearing, we can invoke your procedural rights to an appeal to the full state medical board or to civil court or the other appeal tribunal your state's laws, rules, and regulations authorize. If you have already lost your appeal, we may be able to seek civil court review and relief based on constitutional violations, statutory violations, conflicts of interest, bias, prejudice, or failures in the evidence. Do not give up. Instead, retain us to exhaust all available avenues until you find appropriate relief. Your medical license and career are worth it. You have far too much at stake to do anything other than retain our best available defense representation.

Premier Physician License Defense Available

If you face patient abandonment disciplinary charges, your state medical license, physician employment, and medical practice are at risk. Do not retain unqualified local criminal defense counsel. Do not leave your professional future in the hands of representatives who lack the strategic skill and administrative law experience you need for your best outcome. Unqualified legal counsel may do your matter more harm than good.

Instead, retain the Lento Law Firm's premier Professional License Defense Team. You need our attorneys' sensitive, strategic, and effective representation. The law, rules, customs, and procedures for an administrative license proceeding differ from criminal law and court rules, conventions, customs, expectations, and procedures. We know how best to investigate, prepare, and present your best administrative license defense. Call 888.535.3686 or complete this contact form now to retain our premier license defense services. Delay could cost you significant opportunities and procedures through which to favorably resolve your case.