Complaints and Discipline Against California Physicians and Nurses
Trends, follow the trends if you are concerned about what type of conduct can lead to Medical Board, Osteopathic Board or Nursing Board action against health care professionals.
The medical and nursing professions in California are subject to rigorous oversight, primarily by the Medical Board of California (MBC) and the Board of Registered Nursing (BRN). While these bodies protect the public, the sheer volume of complaints they process each year can be surprising. Let's break down the types of complaints that lead to disciplinary action and the various measures licensing boards use to enforce professional standards. However, the boards themselves are political and members are appointed by politicians. This does not mean that they are corrupt but it does mean that they will direct their limited resources in specific directions. Remember the opioid "crisis" where pharma was targeted with lawsuits claiming that they promoted opiates for profit and ignored patient concerns? That same time period led to major actions against prescribing doctors and MD's were forced to "taper" patients to less pain relief protocols at risk of losing their license. Later apologies by the Medical Board of California did not undo the harm to patients who lived unnecessarily in pain and to physicians who had to undergo investigation and prosecution.
The Medical Board of California: A Look at Physician Complaints
The most recent data we can rely on is from 2023–2024, Close to 10,000 complaints were reviewed but formal disciplinary actions were under 400. Most of the complaints got round filed. Patient complaints, employee complaints are often very personal and do not relate to qualifications. These do not pass the initial review.
Top Categories of Discipline Against Physicians
When a complaint does result in formal discipline, it typically falls into one of these serious categories:
- Gross Negligence or Incompetence: Repeated or severe errors in care that significantly fall short of the accepted standard of care, covering diagnosis, treatment, or surgical procedures.
- Inappropriate Prescribing: This includes over-prescribing controlled substances, writing prescriptions without a proper medical examination, or prescribing to known addicts without legitimate medical justification. Opioids are still a major issue but off label uses, non-FDA approved therapies are also in the forefront.
- Unprofessional Conduct: A broad category encompassing issues like patient abandonment, failure to maintain adequate medical records, violating patient confidentiality (HIPAA), or excessive rudeness.
- Sexual Misconduct: Any violation of sexual boundaries with a patient, such as inappropriate touching, harassment, or pursuing a sexual relationship.
- Drugs/Alcohol Impairment or Self-Abuse: Practicing medicine while impaired by substances or engaging in personal substance abuse that directly impacts patient care safety.
- Criminal Conviction: Being convicted of any crime considered substantially related to the practice of medicine (e.g., fraud, assault, drug trafficking). But consider this. If you are arrested for DUI (Driving under the Influence) and plead guilty to a reckless driving WITHOUT any reference to alcohol abuse, the boards will still want to interview you. Domestic Violence is a major trigger and again, even if you are found to be in the "right" an initial arrest for domestic violence will likely trigger a board inquiry.
- Fraud: Serious misconduct like billing fraud, insurance fraud, falsifying medical records, or misrepresenting professional credentials.
- Unlicensed Activity: Practicing without a current, valid license or allowing unlicensed individuals to provide medical services.
Types of Disciplinary Actions Against Physicians
The MBC utilizes a variety of escalating measures to enforce standards:
| Action Type | Description |
|---|
| Public Reprimand / Censure | A formal, public letter placed on the permanent record, but which does not restrict the ability to practice. |
| Probation | Allows the physician to continue practicing, but under strict, monitored conditions (e.g., practice restrictions, drug testing, further education, or monitoring). |
| License Suspension | Temporary deactivation of the license for a set period (e.g., 30 days to several years). |
| Interim Suspension Order (ISO) | An immediate, temporary revocation if patients are deemed to be in imminent danger, pending a full hearing. |
| License Revocation | Complete and irreversible loss of the right to practice medicine in California. |
| Revocation with Stay | The license is technically revoked but the action is immediately paused (stayed) if the physician strictly adheres to demanding probation terms. |
| Surrender of License | Often done voluntarily in lieu of further disciplinary proceedings; treated the same as a revocation. |
Physicians may also be ordered to pay for the Board’s investigative and enforcement costs (often exceeding $10,000) and/or referred for criminal prosecution if the conduct involved a felony.
RN Oversight: Discipline by the Board of Registered Nursing (BRN)
The California BRN oversees over 500,000 active Registered Nurses (RNs) and receives approximately 7,500–8,000 complaints annually. Similar to the MBC, only complaints with sufficient evidence progress to formal discipline. The nursing board is tough. They are dedicated to supporting a trend to increased responsibility and authority for nurses as a way to help ease our healthcare crisis. As part of this important task the board is taking discipline seriously as a way to both protect and elevate the standing of the nursing profession.
Common Disciplinary Actions Taken by the BRN:
- Public Reproval: A formal reprimand on the nurse’s public record; it does not restrict the license.
- Probation: Allows the nurse to continue working under conditions like workplace monitoring, drug testing, therapy, or prohibition from certain settings (e.g., no solo agency work).
- Suspension: License is deactivated for a defined period; the nurse cannot practice nursing in California during this time.
- Revocation: Permanent loss of the California nursing license.
- Voluntary Surrender: Relinquishing the license, usually to avoid a contested hearing; treated similarly to revocation.
The Intervention Program
The BRN offers a confidential Intervention Program (formerly Diversion) for nurses dealing with substance use disorders or mental health issues. This alternative-to-discipline pathway is voluntary and, if completed successfully, protects the nurse's public disciplinary record, focusing on safe treatment and a return to practice. The Medical Board and Osteopathic Board are behind the Nursing Board in this respect and the BRN program is truly worthy of respect.
TOP LEGAL HELP
Daniel Horowitz leads a team of medical lawyers who fight to protect your license, reputation and career. If you are under scrutiny or potentially exposed to board action, call 925-283-1863 to make an initial appointment with one of our medical lawyers.
