Physicians often migrate from one state to another. Looking for greener pastures.
This is particularly the case when your current workplace loses its magic. Sometimes it IS better to leave and get a fresh start.
If you head to a different state, you’ll need a license to practice there. If you already have a license in that state—for example, you maintained one there since residency—great, you saved a step.
If not, you’ll need to submit a new application.
That often takes time.
What if you are under investigation by the medical board in the original state? What if a complaint was filed in the original state and an investigation was opened?
There will almost certainly be a question in the new application asking about prior discipline. And whether you are currently under investigation. All questions must be answered honestly. If you answer “Yes,” it is unlikely your application will just sail through unimpeded. These are the likely next steps:
- Requirement for a full explanation of the investigation.
- Request for a face-to-face interview with the Board—either by Zoom or in-person;
- Delay of a final decision until the original state has closed its investigation and rendered its conclusion.
- Provisional approval of application with restrictions; for example, requiring supervision, or probation… again, until the original investigation has finished.
Why is this so difficult? Can’t each state medical board make its own independent decision? In theory, yes. But say the investigation was based on a patient or hospital complaint. While the original state can subpoena records from practices and institutions within its own state, it lacks jurisdiction to obtain those records when housed in another state. They assume the original state does have access to those records and can perform a more thorough investigation. Plus, why expend internal resources when the job can be done at no cost elsewhere?
One word about Interstate Medical Licensure Compact (IMLC).
Via the Interstate Medical Licensure Compact.
Recognizing that physicians will increasingly practice in multiple states as a result of telemedicine, U.S. state medical boards in 2013 began actively discussing the idea of creating the Compact in order to help streamline traditional medical-license application processes.
The idea was embraced by a diverse range of state boards, and over the next several years the groundwork was laid for the creation of the Compact. With assistance from the Federation of State Medical Boards, a group of state medical board executives, administrators, and attorneys drafted a model compact – which was introduced publicly in the fall of 2014. State legislatures soon began adopting it, and in April 2017, the Compact became operational.
For a NEW application, there are several showstoppers.
- No history of disciplinary actions toward your medical license
- No criminal history
- No history of controlled substance actions toward your medical license
- Not currently under investigation
You have to self-certify before applying. And you have to confirm you understand the rules.
Is being under investigation in one state a showstopper for RENEWAL of IMLC? No. Renewal is treated differently than a new application.
Being under investigation is a disqualifying event only in the application process for a Letter of Qualification (LOQ) – IMLC Model Statute, Section 2, paragraph (k)(9).
Being under investigation is not a disqualifying event for renewing a license within the IMLC process.
So, what should you do if you want a new medical license in another state while under investigation?
- Hang on to your current job pending closure of the investigation.
- Investigate new professional opportunities (including locums) in a state where you currently hold a license, while you wait for closure of the investigation.
- Every state is different. Some states may allow your application to sail through once they have a detailed explanation on paper or via interview.
What happens if your initial application is denied? Is that reportable to the National Practitioner Data Bank (NPDB)?
State licensing and certification authorities must report to the NPDB denials of initial and renewal applications for licensure or certification for health care practitioners, entities, providers, or suppliers if they are adverse actions resulting from formal proceedings. For example, if, after a formal proceeding, a state licensing board denies a practitioner’s initial licensure application because the applicant misrepresented credentials, that is reportable.
However, state licensing or certification authorities should not report cases in which a health care practitioner, entity, provider, or supplier simply does not meet the threshold criteria for licensure or certification. For example, if a state licensing board determines that an applicant failed to meet the education requirements or failed to pass a required exam and denies the applicant’s license, the state licensing board should not report that action.
So, a key question would be whether “[the denial] is an adverse [action] resulting from formal [proceeding].”
What if you withdraw your new license application? Generally, not reportable to NPDB.
Investigations should not be reported to the NPDB. However, withdrawal of a renewal application for licensure or certification, or failure to renew, while the state licensure or certification authority is investigating the applicant is reportable. In addition, an applicant’s withdrawal, for any reason, of an initial application for licensure or certification is not reportable, even if the applicant is under investigation.
Being under investigation sucks. It freezes you in time. But there are better and worse ways to manage this zone of uncertainty while awaiting a licensing board’s decision.
What do you think?
