Doctors can often sense when trouble is brewing. They may be scrutinized more than their fair share. Multiple peer review events. Several “cup of coffee conversations” with leadership. Sometimes it’s better to leave sooner rather than later.
I’ve heard these recommendations made multiple times:
“Why Don’t You Take a Leave of Absence for 30 days? It’s not reportable to the state medical board or the Data Bank.”
“Why don’t you voluntarily avoid taking patients to the operating room for 30 days? It’s not reportable to the state medical board or the Data Bank.”
You get the gist.
Physicians have heard that if a hospital restricts your privileges for more than 30 days, it’s not reportable to the National Practitioner Data Bank (NPDB). And, for the most part, that’s true.
If a restriction is greater than 30 days, and the doctor was under investigation and the restriction over 30 days is a professional review action, then it’s reportable to the NPDB. So, conversely, if the restriction is lifted in 30 days or less, it’s not reportable. (Let’s not spend time on possible exceptions…)
So, the 30-day number is what doctors remember as being a critical juncture.
Importantly, that 30-day number matters if the hospital takes the action.
What if YOU voluntarily take the action? What if YOU take a leave of absence for 30 days or less? What if YOU agree to restrict your surgical privileges for 30 days or less?
If you were under investigation for competence or conduct that did or could affect patient care, it’s actually reportable to the NPDB. And to most state medical licensing boards.
Immediately.
The NPDB allows the facility 30 days to make the actual report. But the trigger for the report is immediate.
See Questions #22 and #23 in the NPDB 2018 Guidebook:
Is an agreement not to exercise privileges during an investigation, without actually surrendering the privileges, a resignation while under investigation that is reportable?
Yes, the agreement not to exercise privileges is reportable if other reportability conditions are met. NPDB regulations state that “acceptance of the surrender of clinical privileges or any restriction of such privileges . . .while under investigation” is reportable. An agreement not to exercise privileges is a restriction of privileges. Any restriction of privileges while under investigation, temporary or otherwise, is considered a resignation and must be reported.
Is a leave of absence while under investigation considered to be a resignation of privileges that is reportable?
If a leave of absence while under investigation restricts privileges, it is reportable. NPDB’s regulation states that “[a]cceptance of the surrender of clinical privileges or any restriction of such privileges” is reportable. To the extent a leave of absence restricts a practitioner’s ability to exercise privileges, it is considered a surrender that is reportable. If a practitioner can take a leave of absence without affecting his or her privileges, and his or her privileges remain intact during the leave of absence, the leave of absence is not reportable to the NPDB.
If you are being asked to take a leave of absence or restrict your privileges, first ask or confirm if you are under investigation, which would trigger immediate reporting to the NPDB. Assuming you voluntarily took the leave of absence or restricted your privileges.
There may be better options.
To be fair, some hospital personnel and leaders are just not aware of the reportability distinction. But sometimes their motive is malicious. To make you the bad guy, and the cause of your own future problem.
The alternative, of course, is for the hospital to take its own adverse action against your privileges. But if it does, you at least have a 30-day runway, and various due process rights are triggered.
Be cautious. Do your homework. And engage a knowledgeable attorney.
What do you think?
