Medical malpractice is a constant worry for physicians. But a complaint submitted to their licensing board may pose a more serious risk to a practitioner’s career.
Physicians should immediately seek legal assistance and begin considering a license defense when they receive a phone call, letter or other notice of a medical board complaint. Complaints and investigations may ultimately restrict their ability to practice or harm their professional reputation.
Consequences may ultimately include revocation or suspension of a physician’s ability to practice, reprimands, probation, and monitoring. Board discipline may also cause other related problems such as:
- Suspension of DEA registration
- Termination of hospital privileges
- Loss of board certifications
- Exclusion from participation in preferred provider organizations
- Loss of third-party payer enrollment
- Exclusion from government programs such as Medicare and Medicaid
Adverse actions against physicians must be reported to a national database, the National Practitioner Data Bank. Hospitals must consult this database before granting or renewing staff privileges.
Medical boards also report public disciplinary actions to the Federation of State Medical Boards. The FSMB is a national clearinghouse, and its members include all of the nation’s state medical boards. Information in these reports, and mandatory self-reporting, may lead to reciprocal discipline in other states where a physician is licensed.
Licensing complaints to licensure boards typically involve these allegations:
- Professional ethics violations
- Failure to provide treatment
- Patient mismanagement
- Violating patient boundaries
- Inadequate communication
- Over prescription of drugs, especially opioids
Understanding and dealing with patients’ needs and expectations may help prevent complaints. These other steps are recommended:
- Having proper training, supervision and use of support staff and allied professionals
- Learning about patient’s needs and trying to accommodate them
- Clearly communicating with patients and answering their questions
- Being courteous and respectful
- Reducing and delays and sharing information about time frame problems
- Having proper and complete medical records and billing documentation. Forms may be helpful
- Avoiding inappropriate language in medical and billing records
- Thoroughly documenting informed consent
- Having a formal policy to address and resolve complaints without admitting fault
With an attorney’s assistance, physicians should immediately respond to complaints. Their malpractice insurance may provide coverage.
Nonetheless, physicians should never ignore a complaint or alter or destroy records. Physicians should share all information with their attorneys so they can adequately respond to the complaint. Lack of information, even if it is damaging, can impair the attorney’s ability to respond and engage in a defense.
The physician should never contact the complaining party directly because this may cause further complications. Legal representation should be sought immediately to deal directly with the medical board and with other individuals concerning the complaint.