Medical Boards, officially known as state Departments of Licensure and Discipline, play a crucial role in safeguarding public health by ensuring doctors and other licensed healthcare professionals adhere to professional standards. Their mandate is to protect the public from practitioners who are unskilled, impaired, or unethical. While this protective function is vital, it’s important to acknowledge that well-intentioned clinicians can sometimes find themselves facing board investigations.
These investigations can arise from various sources. Patient complaints, disputes with fellow doctors – including professional rivals – or even concerns initiated directly by the Medical Board itself can trigger scrutiny. Furthermore, malpractice lawsuits or mandatory reporting of adverse events in patient care can also lead to a Board looking into a clinician’s practice.
Many clinicians find the process of a Medical Board investigation to be shrouded in mystery. Lack of clarity about the Board’s operations, the composition of its members, the appointment process, lines of accountability, and the implications of Board decisions can be deeply unsettling. Without proper understanding, physicians may inadvertently complicate their situation. Seeking legal counsel is often recommended to navigate this complex terrain effectively. Depending on the specifics of the complaint, professional liability insurance might cover some of the associated legal costs.
It’s critical to remember that Medical Board procedures vary from state to state. Generally, any individual can file a complaint against a physician for almost any reason, and Boards are obligated to review each complaint. Some states even permit anonymous complaints, which can range from serious allegations to minor issues. Notably, there is typically no time limit for filing these complaints.
Understanding the gravity of these investigations is essential. Disturbingly, research has linked Medical Board scrutiny and evaluations to increased risk of physician suicide. Dr. Pensa highlights a 2014 study revealing that nearly 5% of physicians referred to the Tennessee medical board for fitness-for-duty assessments attempted or completed suicide. The effectiveness of Medical Boards in identifying genuinely dangerous doctors has also been questioned, as illustrated in a John Oliver segment on ‘Last Week Tonight’, which presented a critical view of state medical boards’ performance in this area.
The task entrusted to Medical Boards is undeniably challenging. Dr. Pensa advocates for greater transparency, accountability, and feedback mechanisms within these organizations, given their considerable authority and the far-reaching consequences of their decisions. Legislative changes are likely necessary to bring about such reforms, as Medical Boards typically operate as governmental or politically affiliated bodies.
In a podcast episode featuring Guillermo Beades, Esq., Dr. Gita Pensa offers an insightful introduction to Medical Board investigations and complaints. Mr. Beades, a healthcare law expert, regularly educates clinicians on these matters through teaching and publications, including an article in Medical Economics. Guillermo J. Beades, Esq., a Partner at Frier Levitt, specializes in healthcare litigation and co-leads the firm’s Insurance Defense Group. He represents healthcare professionals in a wide array of legal matters, including administrative, civil, and criminal cases. Mr. Beades possesses extensive experience in proceedings before state licensing boards and Medical Boards (such as NJ BME, OPMC), federal healthcare agencies (like OIG, CMS, DEA), and state healthcare agencies (e.g., NJ Medicaid Fraud Division, NY OMIG). His practice encompasses representing healthcare professionals and organizations in areas such as credentialing disputes, administrative disciplinary actions, Medicare audits, hospital fair hearings, and pre and post-payment reviews.
