A Board complaint can evolve into an investigation. An investigation can evolve into charges being filed. Once filed, your license is at risk.
The Medical Board may offer an agreement in lieu of a hearing. The agreement would stipulate terms and conditions.
The ostensible carrot is that you’d be bargaining for a certain outcome with terms you can live with.
On the other hand, you’d be foregoing a chance at exoneration.
The risk associated with taking that chance can be substantial.
As with a surgical procedure, you need to weigh the risks, benefits, and options of a hearing versus a stipulated agreement.
There is no perfect answer, just trade-offs.
Let’s go through a few terms that may be proposed.
You may be offered a probation period of five years. With negotiation, you may be able to bring this number down to four years. If you lose at the hearing, you may be stuck with five years.
You may be offered a prohibition of solo practice. Such a term might look like this:
SOLO PRACTICE PROHIBITION. Respondent is prohibited from engaging in the solo practice of medicine. Prohibited solo practice includes, but is not limited to, a practice where: 1) Respondent merely shares office space with another physician but is not affiliated for purposes of providing patient care, or 2) Respondent is the sole physician practitioner at that location.
If Respondent fails to establish a practice with another physician or secure employment in an appropriate practice setting within 60 calendar days of the effective date of this Decision, Respondent shall receive a notification from the Board or its designee to cease the practice of medicine within three (3) calendar days after being so notified. The Respondent shall not resume practice until an appropriate practice setting is established.
If you do practice by yourself, this term might be the kiss of professional death. It may not be feasible to join another practice.
With negotiation, you may be able to remove this solo practice prohibition. If you lose at the hearing, you may be stuck with having to find a “new partner” just to be able to practice.
No doctor comfortably stomachs a disciplinary action of probation. But choosing a negotiated settlement must be weighed against the alternative. Meaning, what could happen if you lose at a hearing.
By the way, in a number of states, for example, California, even if you win at a hearing (which is adjudicated by an Administrative Law Judge), the Medical Board is not obligated to accept the judge’s ruling. They may still impose the disciplinary action of their choice.
If they do, you can then appeal in court. But this takes time, costs money, and you may be stuck with a practice restriction until you are cleared, if you even are.
Ultimately, the decision to accept a stipulated agreement will depend upon what you are able to negotiate for, the stage of your career, and what practical restrictions are imposed, if any.
What do you think?
By the time you are presented with the “possibility” of a negotiated settlement with a practice board, you have already lost the game. People who attend and graduate medical school/residency must be aware that this shadow is one that will follow you throughout your practice years. Despite your best efforts to try to avoid this, a number of highly qualified and successful physicians find themselves in this situation.
Medical Justice presents the gamble very well. By the time the process is concluded, you may no longer have the option to continue practicing medicine, even after spending hundreds of thousands of dollars/depression and lost night’s sleep.
But there is another alternative not discussed here: Planning in advance for the very real possibility that your practice career may be much shorter than you anticipated. The answer is in your investments and bank accounts.
This requires an honest, deep discussion with your spouse; and planting the idea that you have to prepare for retirement at a much earlier age. Fortunately, some physicians have a very high personal income. You can parlay that income into very conservative living, much less expensive cars, smaller house, infrequent vacations and asking your children to attend a state university.
This is painful for many spouses, who believe that their elevated personal status is part of the equation of being married to a physician. Some may refuse outright and continue over-spending.
There is real value in planning for a forced early retirement. You have options that are not available to those physicians who expected to work a full length career in medicine. A well planned and almost complete nest-egg gives you choices that other physicians do not have. Continued employment as a physician may be impossible. But you may be able to obtain a teaching certificate and find employment as a public school teacher.
When your medical board enforces a draconian action against you, you will have the option of saying: “No. I will not comply.”
Michael M. Rosenblatt, DPM
I completely agree with above. You are not always judged either by people with your specialty.
I agree with Mike. Mike exhibits excellent ” out of the box” thinking. But, his suggestion would be a hard sell.
I suggest working to prevent that State Board Complaint from happening. Give careful thought of why a patient, co-worker, or another would be motivated to write or even call the Medical Board and complain about you. And, it does not even have to be about you. It could be generated by the person at the front desk. She must be mindful of the patient on the line and be aware and respectful of the conversation. Being pre-occupied or being rude is the kiss of death not for the employee but for the doctor.
It is worse if a doctor is employed by a group. He/she is faced with some horrible co-workers whom he did not hire, can not train, and can not fire, yet in the mind of the patient, the doctor is responsible so the complaint is called in.
There are other reasons why a complaint could be generated.
While it is impossible to guarantee that a complaint would not be generated, one can greatly lower the risk.
Richard B. Willner
The Center for Peer Review Justice
http://www.PeerReviewJustice.org
There are few other things to consider.
1) Some physicians now just do telehealth via phone or video conference call.
Is that considered solo practice? Typically this doesn’t even involve an office.
2) Aside from retirement, there is another option. Change careers. It is not easy. It involves hard work. But it is doable. It helps if one has an interest in business or technology, or law. There is life after medicine. So many physicians do not even have hobbies, nor any plans for what they want to do in retirement. Hobbies can be turned into businesses. It takes thought, creativity, and determination. Some physicians who never went through residency went to work for investment houses evaluating medically related investments. There really are lots of other choices.
Let’s talk money. Very few careers outside of medicine can provide the very high pay that physicians achieve. Exceptions are in financial careers and management of hedge funds. AI generated incomes for general surgeons can be from 500k-900k/year. Pediatricians and non-surgical careers get much less but are still substantially higher than the general population. Any accredited financial advisor can present/set up a lower spending standard over a period of 10-12 years that would produce a good retirement base in the event of forced withdrawal from medicine. This would not represent “skinflint living” and still allow for repayment of student loans.
It requires that the physician avoid very high tax states and elevated cost of living areas. This would exclude virtually all Blue States. For example, California is now entering years of financial catastrophe. No physician attempting to plan for early retirement would even consider it.
Some physicians come from upper-class families who paid most of their educational costs. Those people certainly have a head start. Dr. Willner correctly describes the difficulties in “selling” a lower standard of living to spouses of physicians. The march for elevated social status is a difficult obstacle. But not all spouses of physicians (male or female) are addicted to social status. Reality counseling might help.
I still believe a very successful retirement base can be set for between 4-6 million dollars net worth. This early retirement base can vastly reduce legal fees when you decide to say NO to your medical board. Avoiding 500-900K in legal fees will vastly improve your retirement base.
We also have to include the possibility of legal charges against you and risks of Federal prison. The Stark Laws represent clear and lasting risk to all physicians. You need to be very aware of them. Perhaps in the future, they can be repealed. But that will require the strangle hold of Leftism be remediated.
Ah, good memories coming back. I did end up going to a hearing and the attorney for the CA board told the judge that my license should be terminated because I’m a threat to the public. At the time I had a blog which was anonymous and the attorney introduced it without notifying me – I had no way to prep. Fortunately, the attorney was so aggressive and belligerent that she got told a few times by the ALJ to calm down. The whole thing was a blur but it seemed like it went in my favor. I did get a $500 fine for falsely representing myself as a board-certified physician. A few months prior, the state medical board had passed some rule about only ABMS counting as a board certification, not my beloved NBPAS.
I learned a lot and definitely grew from the experience. I wish I could say it made me a better doctor but I’m not sure that was the intention of the process.
I’ve made it a habit to now run everything by Dr. Segal and have gotten my money worth 10x over by being a member of Medical Justice.