Are You at Risk? (What are the Hot Button Issues for Medical Board Accusations?)
Medical Board's Annual Report
The Medical Board of California's annual report gives a statistical breakdown of areas of complaints and board action. The short version is that alcohol issues (which in our experience arise out of DUI (Driving Under the Influence) arrests and criminal conduct (mostly fraud complaints) are a significant area of concern to the board. Opioid prescriptions are a close competitor. However Gross Negligence in medical practice is the # 1 factor.
Learn More: What Constitutes “Gross Negligence” to the Medical Board?
Learn More: Drug Issues and the Medical Board
Learn More: Medical Board Criminal Investigations
Reportable Malpractice Awards
Reportable malpractice awards commonly cluster in surgery, obstetrics (OB), emergency room (ER), and general practice areas. With few exceptions, any medical malpractice judgment, arbitration award, or settlement exceeding $30,000 must be reported, even if multiple attorneys are included under a single settlement amount.
Learn More: What Malpractice Awards are Reported?
Your Decades of Training Only Grant You a “Privilege” to Practice Medicine
Medical board accusations serve as a stark reminder that practicing medicine is a privilege, not a right.
In less than a year, an Accusation can strip you of your ability to practice medicine.
Malpractice Settlements
A malpractice claim settled in your name can result in a listing in the National Practitioner Data Bank (NPDB), even if you were merely one of many defendants. You might have thought the medical malpractice lawyer was protecting you, but in reality, they were protecting the insurance company. And guess what? The insurance company wasn’t reported to the NPDB—you were. Any settlement is reportable to the NPDB. Various state medical boards have exemptions from reporting if the settlement is under a certain dollar limit.
Levels of Medical Board Adverse Decisions
- Accusation: The document stating the charges the Board has filed against the physician. This shows on your record even as it is being adjudicated.
- Decision: The document describing legal and factual findings and disposition of the charges filed in the Accusation and identifying any conditions or limitations imposed on the physician's license. This is a permanent mark on your record. It can be appealed to the Superior Court.
- Suspension Orders: Issued by either a Superior Court judge or administrative law judge to suspend or limit a physician's practice immediately. When a doctor is arrested for a felony there is a petition that the Attorney General can file on behalf of the Medical Board to have the court restrict or suspend the doctor's license. There are some serious technicalities that arise from this petition which can be used to assist in the criminal case.
- Public Letter of Reprimand: A form of discipline that can include a requirement for specified training or education. The key word is “Public” and patients must be informed of the Reprimand.
- Citation: A sanction that usually includes a fine imposed by the Board for technical violations of the law. Note: Citations are not considered disciplinary action and are only available for three years after the citation has been resolved. This is often considered a victory and depending on the wording of the citation it may have little or no effect on the doctor.
What is an 805 Report to the Medical Board of California?
An 805 report is a mandatory filing to the Medical Board of California, as stipulated under the California Business and Professions Code. This requirement is supported by several legal precedents, including:
Who Must File an 805 Report?
The following entities are required to file an 805 report when certain disciplinary actions are taken against healthcare providers:
- Peer Review Bodies
- Hospital Administrators
- Designated Persons
When is an 805 Report Required?
An 805 report must be filed for medical disciplinary causes or reasons when:
- Privileges, Memberships, or Employment: These are revoked or restricted.
- Applications: Applications for privileges, memberships, or employment are rejected or denied.
Purpose of the 805 Report
The 805 report serves to inform the Medical Board of California about disciplinary actions taken against healthcare providers, such as physicians, surgeons, or nurse practitioners. This ensures that the Board is aware of any potential issues related to the professional conduct and competence of these individuals.
Navigating Peer Review Suspensions and Medical Board Reporting in California
When a physician faces a peer review suspension, it can trigger medical board reporting. Here are the key points to understand:
Summary Suspension: Medical staff can suspend a doctor without a formal hearing. Typically, this occurs behind closed doors through the Medical Executive Committee (MEC) or another authorized entity (such as the Chief of Staff).
Reporting Obligation: California law mandates that within 15 days of a summary suspension, a medical board report (known as an “805 Report”) must be filed. This report informs the Medical Board of California about the disciplinary action taken against the licentiate.
Negotiation Window: During the 14-day summary suspension period, negotiation is possible. Physicians may explore alternatives to reportable termination or resignation. Performance Improvement Plans (PIPs) and other non-terminating options may be offered, but they come with their own considerations.
Right to Contest: Physicians always have the right to contest adverse actions through a peer review committee.
Expert Legal Advice: Most summary suspensions and 805 reports do not lead to medical board action. The contents of the 805 matter and we strongly recommend seeking expert legal counsel during this critical 14-day period.
The MEC and medical staff policy makers expect physicians to retain legal representation. Hospital administration and Organized Medical Staff rely on legal advice. We know man of the Medical Staff attorneys and they are excellent at their jobs. Don't try to “do it yourself”. The individual physician should also have the best medical license representation just as the MEC has the best medical staff lawyers to protect their interests.
Unfair Discipline and Reporting: The Long-Term Impact on Physicians
Decades of dedication can unravel swiftly, leaving physicians vulnerable to unfair discipline and reporting. Even if you maintain your medical license, the repercussions can haunt your career indefinitely. Here are the key points to consider:
Ancillary Penalties: Beyond the immediate consequences, physicians may face ancillary penalties. These include reporting to the National Practitioner Data Bank, public databases, and the medical board website. Such reporting can have lasting effects on your professional reputation.
Self-Reporting Obligations: Keep in mind that self-reporting requirements kick in when you apply for privileges, change jobs, or seek business loans or malpractice insurance.
Navigating these challenges requires vigilance and strategic decision-making. Seeking legal advice can help protect your rights and mitigate the impact of unfair discipline and reporting
The Medical Board of California Telegraphs Its Hot Button Disciplinary Issues
Medical license lawyers know that the most common California Medical Board Accusations can be reviewed on their Accusation Filed Web page. We subscribe to this list and review each Accusation. This means that an attorney for doctors is part lawyer and part political pundit. Sometimes the politics are easy to anticipate. When lawyers and Attorney Generals started targeting opioid pharma companies, we knew that individual doctors would be next. We proactively reached out to our doctor clients and warned them of the upcoming tidal wave of discipline.
Medical license lawyers know that the most common California Medical Board Accusations can be reviewed on their Accusation Filed Web page. We subscribe to this list and review each Accusation. This means that an attorney for doctors is part lawyer and part political pundit. Sometimes the politics are easy to anticipate. When the lawyers and Attorney Generals started targeting the opioid pharma companies, we knew that individual doctors were next. We reached out to doctors who were already clients and warned them of the upcoming tidal wave of discipline.
There are trends that you can note with consulting a medical lawyer. As we said, Opioid prescriptions were a hot topic. Sexual misconduct is another major area of inquiry. Failures of patient care are not uncommon and the Horowitz Medical team includes a lawyer/doctor (Dr Mark Ravis) and paralegal chiropractor (Michael Yates) to review quality of care issues - in house. We can then consult with top medical experts to assemble the proper defense team.
Medical Board Consultants Will Judge You
The Medical Board employs consultants who are heavily influenced by board directives and political considerations regarding what constitutes standard practice for physicians. This approach can be biased. While some consultants are true experts who exercise independent judgment, many do not.
Learn More: What is a Medical Board Consultant?
Sources of Complaints to the Medical Board
Complaints to the Medical Board often originate from various sources, including other physicians, disgruntled employees, and patients. Ongoing investigations of other physicians may involve your office, possibly as a referral source, or some of your patients. Opioid complaints frequently come from insurance companies and pharmacies. If you receive a warning letter from either, contact an attorney immediately.
Common Sources of Complaints
- Other Physicians: Colleagues may report concerns about your practice.
- Disgruntled Employees: Former or current employees might file complaints.
- Patients: Dissatisfied patients can lodge complaints about their care.
- Insurance Companies and Pharmacies: These entities often report opioid-related issues.
Immediate Action Required
If you receive a warning letter from an insurance company or pharmacy, contact an attorney immediately to protect your rights and respond appropriately.
Other Triggers for Board Investigations
- Suspensions and Denials of Privileges: These actions can prompt board investigations.
- Criminal Convictions: Any criminal conviction or the filing of a felony indictment can trigger an investigation.
- National Issues: Topics like opioid prescriptions, Durable Medical Equipment (DME), genetic testing, and remote chart reviews often lead to investigations due to their national publicity.
State Variations
There is little consistency between states regarding medical board complaints, except on widely publicized issues like opioid prescriptions and DME fraud.
For expert legal advice and defense, contact Daniel Horowitz at (925) 291-5388.
Arrests & Convictions
Criminal charges can lead to an immediate petition by the medical board (to the court) for suspension of your license. The criminal process is slow and convoluted. As physician lawyers certified as criminal defense specialists we look past the criminal case and act to protect your license as we conduct a criminal defense.
How the Criminal Process Works
Criminal convictions always result in board examination. DUI's, domestic incidents and drug cases are frequent triggers for discipline but any criminal conviction will be examined.
DUI Conviction and the Medical Board
As an example, some states are very harsh on substance abuse by MD’s. Others look for a treatment option as the first choice. But beware agencies that administer these programs. Once you enter their world of supervision, they own your soul.
Drug Issues and the Medical Board
Negligent Acts
Recent Medical Board Accusations have focused on repeated negligent acts or gross negligence. The Accusations are public record even though there has been absolutely no judicial review of any of the allegations. A medical malpractice judgment or settlement (above $ 30,000) is reportable to the board and all judgments are listed in the NPDB. An Accusation can be filed without any malpractice action ever being filed. It gets filed when the board has suspicion of negligence (repeated or gross).
See Repeated Negligent Acts Accusation against Dr. Alan Krystal
See Gross Negligence Accusation against Dr. Douglas Abeles
See Gross Negligence Accusation against Dr. Stan Poulos
Current Medical Board Issues
False Medical Board Accusations
When is a Medical Malpractice Settlement Reported to the Board?
When Does a Doctor have to Self Report an Arrest?
