Medical Justice provides consultations to doctors facing medico-legal obstacles. We have solutions for doctor-patient conflicts, unwarranted demands for refunds, online defamation (patient review mischief), meritless litigation, and a gazillion other issues. We also provide counsel specific to COVID-19. If you are navigating a medico-legal obstacle, visit our booking page to schedule a consultation – or use the tool shared below.
“Can Medical Justice solve my problem?” Click here to review recent consultations…
all. Here’s a sample of typical recent consultation discussions…
- Former employee stole patient list. Now a competitor…
- Patient suing doctor in small claims court…
- Just received board complaint…
- Allegations of sexual harassment by employee…
- Patient filed police complaint doctor inappropriately touched her…
- DEA showed up to my office…
- Patient “extorting” me. “Pay me or I’ll slam you online.”
- My carrier wants me to settle. My case is fully defensible…
- My patient is demanding an unwarranted refund…
- How do I safely terminate doctor-patient relationship?
- How to avoid reporting to Data Bank…
- I want my day in court. But don’t want to risk my nest egg…
- Hospital wants to fire me…
- Sham peer review inappropriately limiting privileges…
- Can I safely use stem cells in my practice?
- Patient’s results are not what was expected…
- Just received request for medical records from an attorney…
- Just received notice of intent to sue…
- Just received summons for meritless case…
- Safely responding to negative online reviews…
We challenge you to supply us with a medico-legal obstacle we haven’t seen before. Know you are in good hands. Schedule your consultation below – or click here to visit our booking page.
Last month I met two physicians who had more than one medical license. Each had over 40 medical licenses. They were both active in telemedicine and had a staff to assist with applying for and maintaining those licenses. Physicians who work locums and travel frequently also carry double-digit numbers of licenses. For these two groups, they use their licenses. They use these documents to earn a living. To them, it’s the cost of doing business.
What about the rest of us?
Most of us stay put. We work in the same location for decades. Yet, many keep our legacy licenses. We know it is easier to keep a license than to re-apply and start afresh. Who knows? We may move again.
Keeping a legacy license has its costs. These licenses must be renewed. You pay a fee every one to two years. Many states impose CME obligations. The CME obligation in your legacy state may be more onerous than in your work state. And regulations in one state may be more lenient than another. Some states frown on your prescribing a Z-pak for your child. Other states don’t seem to mind. The rules across all 50 states are not the same.
Many say the following.
“I may move back.”
“I just joined a group and signed a non-compete. If it doesn’t work out, I’ll return to my old job.”
“I still own a house or rental property in the old state.”
“I’d like to keep my options open.”
“I’d like to retire where I started and work pro bono or at the VA, just to give back.”
This list is hardly exhaustive.
A cautionary tale. Make sure your out-of-state Board has your current mailing address. If you’ve recently moved, update your contact info on your profile on the Board’s website. Most states have some rule or regulation which mandates the licensee is obligated to provide a current mailing address and to check that it is accurate. Many of us will double-check this information at license renewal. I’d recommend doing it more frequently.
One talented surgeon has a wildly successful practice in the heartland. One of his patients had an unfortunate outcome. This led to a medical malpractice settlement for a modest sum. That state’s medical licensing Board learned of the settlement. The Board filed a complaint, and the surgeon agreed to accept a public letter of reprimand, the lowest form of discipline. His license was untouched, and he continued as before, with no restrictions. Not surprisingly, this was reported to the National Practitioner Data Bank.
This doctor had a second medical license in a west coast state. He had not practiced there for over 25 years. He planned on retiring there. He still owned a house close to the beach.
The west coast Board of Medicine filed a reciprocal complaint based on the letter of reprimand.
For unknown reasons, the second state Board had the wrong mailing address. It was not even an old address. It was a wrong address. The letter never made it to its target. The west coast Board of Medicine never received a response. It eventually revoked the surgeon’s license, the most onerous discipline it could deliver. The surgeon never learned of this until after it was a fait accompli.
This license revocation, in a state where this doctor left years ago, affected the surgeon’s employment in the state where he WAS working.
This heavy-handed action seemed manifestly unjust. Kafkaesque.
The take-home point.
If you plan to keep a license in more than one state, be aware that all Boards need your up-to-date mailing address. Be aware in most states, if you have been disciplined, lost clinical privileges, or been arrested, the clock is ticking for your obligation to notify the Board. Every state is different. That’s why this can become quite messy if you own double-digit numbers of licenses.
Do you really need the headache? Maybe. Check that the Boards have your current mailing address (above and beyond your email address). Also, be aware of reporting obligations and timelines if something ugly takes place, such as your being disciplined or arrested, losing clinical privileges, or the like.
What do you think?
Medical Justice provides consultations to doctors facing medico-legal obstacles. We have solutions for doctor-patient conflicts, unwarranted demands for refunds, online defamation (patient review mischief), meritless litigation, and a gazillion other issues. We also provide counsel specific to COVID-19. If you are navigating a medico-legal obstacle, visit our booking page to schedule a consultation – or use the tool shared below.
“Can Medical Justice solve my problem?” Click here to review recent consultations…
all. Here’s a sample of typical recent consultation discussions…
- Former employee stole patient list. Now a competitor…
- Patient suing doctor in small claims court…
- Just received board complaint…
- Allegations of sexual harassment by employee…
- Patient filed police complaint doctor inappropriately touched her…
- DEA showed up to my office…
- Patient “extorting” me. “Pay me or I’ll slam you online.”
- My carrier wants me to settle. My case is fully defensible…
- My patient is demanding an unwarranted refund…
- How do I safely terminate doctor-patient relationship?
- How to avoid reporting to Data Bank…
- I want my day in court. But don’t want to risk my nest egg…
- Hospital wants to fire me…
- Sham peer review inappropriately limiting privileges…
- Can I safely use stem cells in my practice?
- Patient’s results are not what was expected…
- Just received request for medical records from an attorney…
- Just received notice of intent to sue…
- Just received summons for meritless case…
- Safely responding to negative online reviews…
We challenge you to supply us with a medico-legal obstacle we haven’t seen before. Know you are in good hands. Schedule your consultation below – or click here to visit our booking page.
Learn how Medical Justice can protect you from medico-legal mayhem…
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Jeffrey Segal, MD, JD
Chief Executive Officer and Founder
Dr. Jeffrey Segal, Chief Executive Officer and Founder of Medical Justice, is a board-certified neurosurgeon. Dr. Segal is a Fellow of the American College of Surgeons; the American College of Legal Medicine; and the American Association of Neurological Surgeons. He is also a member of the North American Spine Society. In the process of conceiving, funding, developing, and growing Medical Justice, Dr. Segal has established himself as one of the country’s leading authorities on medical malpractice issues, counterclaims, and internet-based assaults on reputation.
Dr. Segal was a practicing neurosurgeon for approximately ten years, during which time he also played an active role as a participant on various state-sanctioned medical review panels designed to decrease the incidence of meritless medical malpractice cases.
Dr. Segal holds a M.D. from Baylor College of Medicine, where he also completed a neurosurgical residency. Dr. Segal served as a Spinal Surgery Fellow at The University of South Florida Medical School. He is a member of Phi Beta Kappa as well as the AOA Medical Honor Society. Dr. Segal received his B.A. from the University of Texas and graduated with a J.D. from Concord Law School with highest honors.
In 2000, he co-founded and served as CEO of DarPharma, Inc, a biotechnology company in Chapel Hill, NC, focused on the discovery and development of first-of-class pharmaceuticals for neuropsychiatric disorders.
Dr. Segal is also a partner at Byrd Adatto, a national business and health care law firm. Byrd Adatto was selected as a Best Law Firm in the 2021 edition of the “Best Law Firms” list by U.S. News – Best Lawyers. With decades of combined experience in serving doctors, dentists, and other providers, Byrd Adatto has a national pedigree to address most legal issues that arise in the business and practice of medicine.
I still have 4. Used to moonlight a great deal in various states since early on, there were precious few of us doing neurointervention. My travel agent used to deliver stacks–literally–of airplane tickets to my office. I’m down to 4 now, places where I’ve practiced and may again.
There are places where it’s far from worth it to maintain a license if not practicing. The two biggest that come to mind are Florida and, unsurprisingly, California. Both are seriously expensive, have onerous requirements, and make what I consider to be ridiculous demands. I allowed both of those to lapse years ago.
Florida, for example, requires all physicians, regardless of their practice, to pay into the bad baby fund. What it translates to is that you either get a good, healthy baby or a consolation prize. Maybe they’ve repealed it; if not, they should.
Just about all states allow licensure by reciprocity, BUT…they pretty much all want you to have taken a licensing-level exam of one or another sort within the previous 10 years. When I got my radiology boards, it was a one-time thing, so I’ve never had to re-up my certification. That’s changed in recent years so radiologists have to recertify q10 years or so. Still, it’s a pain in the behind to get a license in a new state.
I’m keeping my 4, even though I’m retired. Ya never know….
Thanks for covering this topic that is not well known and certainly not understood. Holding licenses in multiple states is hazardous (if not treacherous) for all of the reasons you state and more. I practice telemedicine, and as you know the “instate” requirement for patients of telemedicine providers was relaxed due to exigency during Covid. Now, states are actively rolling back the rules despite the fact that many patients (especially fragile ones with complex diseases or mobility issues) have come to rely on telemedicine across state lines. See, e.g.https://bit.ly/telemedicinethreatened
Why is this happening? the Federation of State Medical Boards (FSMB) and individual states have long defined the location of medical practice as where the PATIENT is located. Boards do this, they claim, because their job is to protect the safety of THEIR STATE’s patients through disciplinary channels. But as you illustrated, Jeff, NOTHING STOPS ANY STATE FROM DISCIPLINING ANY DOC WHO IS LICENSED THERE. So this argument (we can’t discipline you if you’re not in our state) is spurious. The real reason is more likely the most universal one: because they can require multiple licensure and extract mega$ from docs who wish to provide services across state lines.
FSMB claims to have addressed this problem through their Multistate Licensure Compact. Yes, this reduced (very slightly) the administrative burden of applying for multiple licenses. But FSMB craftily incorporated a MOC requirement into the Compact, no doubt at the urging of ABMS (many regulatory types participate in both organizations). And the Compact did almost nothing to reduce the burden of complying with all of the varied regulations in each state as was mentioned above.
There is a simple and logical solution, and that is to redefine the location of medical practice as where the DOCTOR is located. But to apply an oft plagiarized aphorism “never try to convince (xxx) of anything, if their salary (or budget) depends on their not being convinced.”
A major point worth making here is that when you have any issue with one board, such as a board complaint, whatever action is taken or whatever investigation is opened, you’ll have to report that to all the other state medical boards. For someone who had to actually do that, let me tell you that it is beyond overwhelming even with 3 state medical boards. I was getting a letter what felt like every week for nearly 3 years trying to communicate with the state medical boards. I’m not sure why they don’t use electronic forms of communication but I have some ideas why.