I recently completed my California Medical Board hearing and it was an eye-opening experience. Buckle down because this is going to be a long one. There should be a lot to learn from this and I’ve had some time to reflect on this recent experience.

This was an administrative hearing before an administrative judge where I, the medical board attorney, the court stenographer, and the judge were present. There was nobody else in the room. Such hearings are open to the public and anyone can sit in on these and the court transcripts are available to the public.

My Impression Before the Hearing

As a physician who has practiced for over 10 years in California and has busted his ass I expected that, from all of the states, California would be the most cooperative. I may have let my guard down because the Oregon Medical Board was rather fair – considering – about the whole process and Washington was super professional.

California is where I went to medical school and residency. That’s where I started moonlighting and that’s where I had my first job. I worked very hard in medicine because it was important to me and because I enjoyed the hell out of it.

It’s necessary to add here that I didn’t know this was going to be a hearing before an administrative judge. In my letter to the attorney I clearly demanded a stipulated order if that was available. Instead, I was scheduled for a hearing.

The hearing I had before Oregon was before the members of the Medical Board and so I assumed this was going to be the same.

When you feel like an illiterate person within your own career and can’t make heads or tails of it, that’s when you know something’s up.

Underestimating the Process

I assumed that during this hearing the judge would be stern and partial and the attorney for the Medical Board would be on a fact-finding mission. I assumed that the Medical Board would have a genuine interest in determining whether the physician they are dealing with is a white coat criminal or a good physician who made a mistake.

Instead, I left the hearing feeling like a criminal but I’ll discuss that later. Mistakes should be punished. Absolutely. That’s the punitive nature of our legal system. But I’m not sure if I enjoy practicing so much that I would be willing to go through this process again.

Admitting to Fault

At no point did I go into this thinking that I’m not guilty. Far from it. As I’ve written on numerous pages on this website I am 100% guilty. Many of you, in fact, disagree but that’s because you haven’t taken the professional boundaries course I’ve taken, you haven’t been lectured by the medical board, and you haven’t had your own attorney tear through your logic.

I should have never ordered a test on a colleague and I should have never put the nurse in a position to have to deny a request by a physician. I certainly don’t think that I’m a victim of the system. I mention all this because it’s what the Medical Board attorney accused me of, in front of the judge.

I wasn’t aware of certain rules and regulations and my mental paradigm of placing the patient above the Medical Practice Act bit me in the butt. I didn’t think through all of the consequences. I didn’t even know there was a Medical Practice Act in 2017. I didn’t think that getting an EKG on a colleague would automatically create a patient-doctor relationship which is why I never created a chart.

Medical Errors

As a physician I’m very comfortable making mistakes. The best doctors amongst us have made the most number of mistakes. Those who made it through our punitive system lived to tell about it and teach others.

It’s just that the mistakes we make now as attendings are often not as grave because we have learned the many pitfalls of medicine. We know what to look for and how to ensure patient safety. We have colleagues to turn to. We have medical journals and online forums to consult. In fact, this is why no bad outcome resulted from my rogue EKG order.

The Medical Board’s job is make sure that they don’t have licensees who are dangerous to the public. They have the power to reprimand a doctor, to punish them, to terminate their license, to put them on probation, or have them appear before the Board for a review.

Reason for a Hearing

To catch the new subscribers up, I had my medical license suspended in the state of Oregon for 30 days which resulted in rebound investigations in WA and CA. WA agreed to a stipulated order which I have signed with their Medical Board attorney. I will have a $100 fine to recover the expenses for the investigation.

The California Medical Board wrote me a letter saying that I had a right to a hearing or that I could agree to a stipulated order. I didn’t fully understand the letter because it was written in legal jargon. From what I understood I wrote a letter to the California Medical Board telling them that I’m open to a stipulated agreement but I didn’t want to miss the window to agree to a hearing if I had to.

I got no reply to this, no feedback from the California Medical Board attorney. I was just told that I had a few dates to choose from for the California Medical Board hearing. I picked a date and a time was assigned to my case. 9am.

Stipulated Agreement

What’s a stipulated agreement? It’s a proposed consent order, or a negotiated agreement, or a hundred different names depending on which state you’re licensed in.

When a case has already had an outcome in another state and the licensee has multiple state medical licenses it makes little sense to repeatedly punish the licensee for the same offence.

Instead, the medical boards in other states agree to save taxpayer resources and valuable court time by agreeing to a fair punishment which the medical board draws up, and which the licensee agrees to. This can then be slightly negotiated by the two parties and an agreed upon stipulated order is drafted which is then signed by both parties.

That’s what I wanted. A stipulated order. But, as I mentioned, the letter I received, though addressed to me, was written in a language only an attorney can understand. That’s a shame because I’m not an attorney. Though I have consulted attorneys throughout this process I didn’t retain one for California or Washington to represent me.

Imagine if every letter I sent to a patient was written in medical jargon and the patient had to hire a healthcare expert to translate it. No such scenario exists because we protect the consumer from this. Physicians aren’t a protected consumer group because … well, I don’t know why. Perhaps because we don’t put up much of a fight.

After a 13-year and $300k investment everyone knows that you don’t have much wiggle room. You’re not going to put up much of a fight. You stand to lose a lot more than anyone else who’s out to fuck you over.

A Medical Board Hearing

I appeared before the Oregon Medical Board March, 2018. The board members hadn’t even read the letter which I addressed to them. One of the members actually thought that the entire event in question took place at a …. bar….?

I have outlined the process of a Medical Board hearing in numerous other posts which you can refer to. Even though I have researched the shit out of this convoluted, circular process, I still wasn’t wise to my options.

I didn’t have to attend this California Medical Board hearing and definitely shouldn’t have. I certainly shouldn’t have appeared before a judge and an attorney without a lawyer. But I made my decision a long time ago that I was going to stand up to this process; I wasn’t going to spend another dime on a lawyer. After all, I’ve made my money from medicine. I’m financially independent and can stay retired indefinitely.

I love the practice of medicine and would be happy to practice it in any states that wants me. Oregon and California don’t seem to be on that list. Based on my track record it’s definitely their loss.

Justifying the Cost of Legal Representation

I have already spend over $15k for my Oregon case – probably closer to $20k. I have consulted lawyers for Washington and California and good California lawyers aren’t cheap. After being terminated from all my clinical jobs I couldn’t justify this expense.

Nor would it make sense to pay the same legal costs for each state when the event remains unchanged. If I was desperate for the income or desperate to portray an active physician status then I would have committed to those expenses. I had this sneaky suspicion that my case wasn’t going to go away anytime soon; and I was right.

Since this California Medical Board hearing, I have been contacted by the Oregon Medical Board and they have decided that my license should change from a full status to a telemedicine-only status. And I’m sure this isn’t the end of it.

I’m reluctant to terminate my medical licenses since that could be used by the medical boards as an excuse to note in my records: “Licensee surrendered medical license during active investigation.”

Anatomy of a California Medical Board Hearing

During a Medical Board hearing there is an administrative judge present and an attorney for the California Medical Board. There might be a medical expert and witnesses if your case has that level of complexity. There is also a court stenographer.

Then there is you and your lawyer. The judge sits at the front of the room and there are 2 tables for each side. Kind of like the divorce courts you see on TV.

Evidence and Discovery

Before the California Medical Board hearing both parties need to share with each other any witnesses and list of evidence which are called the exhibits.

During the medical board hearing you can contest whether any of the evidence should be included.

Administrative Judge

From everything that I had researched, a Medical Board hearing was supposed to be in front of the members of the medical board. Somehow I was wrong. Somehow I misunderstood my lawyer. The medical board hearing took place in a courtroom where I swore the oath and got grilled before an administrative judge by the California Medical Board attorney.

The administrative judge has no knowledge of the case until the information is presented to them. They reside over all sorts of administrative hearings for various boards – construction, traffic, medical, etc.

The judge assigned to me was incredible. She was calm, took her time to explain the proceedings to me, and gave me time to collect myself even when I had a frog stuck in my throat.

I was nervous as fuck up on that witness stand. Not at first. I really didn’t expect the process to be pejorative. My dumbass thought that the Medical Board just wanted to get the facts straight. Far from it.

Opting out of Legal Representation

The first few days after the hearing I felt a lot of animosity from the Medical Board’s representation during the hearing. The Medical Board attorney seemed to have taken it so personally. After reflecting on it and talking to my lawyer friends it might be because she was offended that I was representing myself.

I can’t tell you what I would if I could go back – I’m not there yet. I’m still grieving over the loss which took place in that courtroom.

The judge did so much to help me. She was patient and she explained what the process was like for a physician representing themselves. She couldn’t have been more gracious though I am sure she, too, wasn’t tickled by my decision.

I did hire a lawyer for Oregon. The result of that was a 30-day suspension. I’m not sure what to conclude from this; it’s sort of a wash. Financially it wasn’t a big hit because I was able to write off all of that on my taxes – the perks of being a sole proprietor.

My Oregon lawyer was fantastic. He was more concerned about me learning something from this and less concerned with boosting my ego and belittling the process. I learned a lot from him. But I would have been just as comfortable with my Oregon license being terminated.

With my abundant income sources from healthcare consulting and the ability to go practice medicine in other states, other countries, or do non-clinical medical work, what’s the purpose of fighting for the right to practice medicine? If the governing body which doles out licenses doesn’t want you to practice, it’s perhaps better to take the hint and move on.

The California Medical Board Hearing

As soon as I sat down and the attorney for the California medical board started talking I realized that I was in enemy territory. You feel it right away when you’re about to get roasted – it’s a 6th sense sort of a thing. It was one of those cartoon moments, a bubble went up in my head and I’m like, “oh, oh…”.

As my lawyer said it so well: “If someone is after the truth they will calmly and patiently ask you about the chain of events from your perspective. They will then fact check what you said. They will come back to you to fill in any gaps. It’s calm, it’s logical, and it’s not chaotic, not emotionally charged. On the other hand, if someone is out to get you then they’ll ask you leading questions and try to paint the worst possible image of you.”

I went through this when I appeared before the Oregon Medical Board. The lady across from me was so mad, she was red in the face. We’re not talking a rosacea flare but like anaphylactic red. Maybe it’s my personality to piss people off or maybe she had a close family member die because of a rogue EKG order… I’ll never know.

On the Stand

The judge asked me to take the stand so that the attorney could ask me questions about the case. She asked me if I wanted to take the stand. Of course I did! I had nothing to hide and the case couldn’t be more straightforward. And the case already had so much precedence in Oregon and Washington … what questions could possibly arise.

And since I was appearing before a judge and the Medical Board attorney, surely they must have already spoken to all involved parties. They must have interviewed my colleague on whom I ordered the EKG. They must have talked to the nurse who made up all of those lies about me. They must have talked to my supervisors to get a realistic picture of my performance as a physician. Right? Well…. maybe not.

On the stand I got the opportunity to tell the story from my perspective which is both similar to but also very different from the narrative which is included in the stipulated order I signed with the Oregon medical board. The overall facts are identical. But it’s a few subtle things which are different enough that allowed the attorney to zoom in on.

I led my story by admitting to what I did wrong. There is no arguing about what I did wrong. My lawyer in Oregon said what I did was wrong. My lawyer friends told me what I did was wrong. The professional boundaries course I took said what I did was wrong. And the Medical Practice Act clearly outlined why I was wrong.

Shockingly, even though I opened with this line, even though I explained why what I did was wrong, the California Medical Board attorney stated in her closing arguments that I was admitting to no fault and accepting no responsibility. English is my 3rd language, maybe that had something to do with it. Hard to say.

I went on to highlight that my intention for ordering this test on this person was because she had already put it off due to not being able to afford the test. This person wanted to stay far away from western medicine but her clinician had ordered the test and didn’t have an EKG machine to perform it for her. This patient needed someone to intervene on her behalf to get this test done.

Questioning

The attorney then tore me a new one. Each question was accusatory and she made every effort to tear up everything that I said. I would say one thing and she’d show that I had said something else before. I would agree to one thing and she’d show the court that I didn’t agree to something else.

As an intelligent human being you know when you’re outmatched. You also know when it’s not a factual game you’re playing but a play on words. I didn’t stand a chance against her and she was good, very good.

By the second or third question I surrendered peacefully. I was still standing up for myself but because I was shockingly outmatched, it only made sense to stick to the facts and just answer her questions.

The decision to surrender was a huge stress reliever because just 5 minutes before I could barely swallow my saliva. She seemed to get more and more agitated and kept interrupting me when I would talk. The whole case had really gotten her riled up.

Even the court stenographer had to tell the attorney to slow down on numerous occasions. The judge recognized it too but maintained a calm and professional demeanor. The judge maintained eye contact with me at all times and would nod when I was talking.

My Website

The attorney asked me if I had a website called urgentcarecare.com. I immediately said yes which took her by surprise. I think she was banking on me denying it. It took her a moment and she started asking questions about things I had written and comments people had made.

She had printed out a few pages from this website and used them out of context to demonstrate that I didn’t have any remorse for what I did. The irony of course was that for the one paragraph she found I had pages of me explaining why and how what I did was wrong.

The judge asked if I had any objection to those documents being entered into evidence. No, I didn’t object as long as everything else from the website was going to be included. Well, guess what, that was overruled.

I’m still trying to digest this. A part of me thinks that it makes sense that it should be admitted because it is something I wrote. And I think it will work against the attorney because the judge is still able to read the rest of my website and she’ll read the rest of the paragraphs in that individual post.

The attorney had to read through nearly 60,000 words to find the 2 paragraphs which could corroborate her argument. Her intention seemingly was to show that I don’t take any responsibility for what happened and that I blame others and not myself.

My Washington Medical Board Stipulation

A week before this hearing I had an email conversation with the California Medical Board and I forwarded them my signed stipulated agreement with the WA medical board. I did that because it was a rather favorable outcome and thought that it would demonstrate some precedence that I’m not a bad doctor.

I noticed that the attorney hadn’t included that piece into evidence. That was actually the very first thing that tipped me off that I was about to get skewered. Despite all the emotionality of injected in the hearing I remembered to bring that up to the judge – to which the attorney naturally objected.

I explained that I had signed it and the attorney for WA had signed it and so it was legit. The attorney argued that because it wasn’t yet adopted by the medical board it wasn’t final.

The California Medical Board attorney actually made a valid point. Once a licensee reaches a stipulated agreement with the attorney for a Medical Board, it still has to go before the Medical Board Committee for final approval. Of course, the attorney will never offer a stipulated agreement which the Medical Board Committee will reject.

Nevertheless, the judge agreed to include that into evidence which was a huge break for me.

Board Certification

The attorney next asked me if I was representing myself as a board certified physician. Of course I was. I’ve been a board certified family medicine physician since I finished residency.

Well, the attorney didn’t think so.

She asked if I was board certified with ABMS. Nope. I let that lapse in December of 2018, just 3 months prior to this hearing. She told the court that if a physician is not board certified with ABMS in the state of California then they aren’t considered board certified and can’t advertise themselves as such.

What?

Apparently California amended their Business and Professions Code to prevent the ability to have your non-ABMS board certification recognized by the California medical board. This is certainly a step in the right direction since the ABMS can no longer buy out the medical boards.

This rule went into effect January 1st, 2019 – less than 60 days before the hearing. It would have been pertinent by the attorney to bring this up since an administrative judge would need to know this before making their decision. In fact, by leaving this out, when the judge goes to review the facts, I’m certain that she’ll wonder why the attorney failed to mention that.

Even though I am board certified through NBPAS, California doesn’t recognize that as a valid board certification. It doesn’t mean that you can’t practice medicine in California, just that you can’t use the words “board certified” unless it’s specifically through the ABMS.

However, what the attorney failed to mention is the following:

Which states that I can claim that I specialize in Family Medicine and that my specialty is “approved by” or that I’m a “diplomate” of NBPAS.

Fortunately, Oregon does recognize NBPAS, so does Washington. Which means that I can continue to claim to be a board certified physician but not in California and not to California patients.

The reason she brought this up in the first place is that I am a medical expert on JustAnswer which the attorney cited as proof that I was falsely claiming to be a board certified physician. However, I don’t have any control of what states JA advertises in. If JA is breaking a rule then JA will have to deal with the consequences.

Again, if this was a fact-finding mission then this wouldn’t have been brought up in this setting because I am considered board certified for the purposes of JustAnswer. But it certainly made me look bad in front of the judge who is an administrative judge and doesn’t purely reside over medical board cases. I did my best to defend myself against that accusation but don’t think I succeeded.

My Reputations as a Physician

As for my reputation as a physician, my dear readers, it didn’t come up once. Years of doing the right thing and those anxious ridden nights, the panic attacks in the exam room, the phone calls from patients and nurses, the 14-hour shifts, none of that was brought up.

I have been volunteering in healthcare since 2002. That’s 17 years. I’ve worked at a free clinic in downtown LA. I’ve taken care of orphans in Mexico. I’ve volunteered and ran 2 different mobile health vans. I’ve seen homeless patients under the Burnside bridge. I’ve volunteered at a laser tattoo removal place. I’ve been a volunteer attending at 3 different free clinics run by medical students. I never stopped volunteering until the medical boar investigation stuff surfaced. Not once did any of that come up.

Look, I love that side of medicine so I did all the volunteering truly because I enjoyed it and not for a resume booster or a pat on the back. Certainly not as a way to get out of a medical board investigation.

The fact that I was a medical director didn’t come up. The fact that I have great patient satisfaction scores and a low prescription rate in the urgent care – none of that. I remember walking out of that room and wondering why the hell I did everything that I did.

I could have opened a concierge clinic in San Diego and milked that shit out of the system. I could have made $500k a year and written everything off against my income. I could have been giving out antibiotics like it’s candy. In regards to my career it would have made no difference.

Closing Arguments

During the closing argument the attorney for the medical board pointed out that I showed no signs of remorse for what I did. That I was unprofessional and dishonest. That I blame others and not myself and that I wasn’t properly punished by the Oregon medical board.

She said that I am still a danger to the public. That patients have to be protected from a doctor like me.

She suggested that the punishment should be as follows:

• probation
• supervision by another doctor to practice medicine
• for me to take another professionalism course, put on by the California Medical Board
• a documentation course

She didn’t mention anything about a license suspension or license termination. But she was talking so fast and she seemed so upset that it was hard to follow.

My closing arguments were weak as fuck. I didn’t highlight that I’ve been a solid physician and that I would be looking to continue seeing patients in the state of California. But more on that later.

I once again had to correct her that it wasn’t an Emergency Room but an Urgent Care and that I had perfect insight into what I did wrong and how I placed the patient in harm’s way by shortcutting the patient-doctor relationship.

How would an attorney for the California Medical Board not know the difference between an Urgent Care and an Emergency Room?

Practicing Medicine in California

Listening to the summary provided by the attorney made me realize that the California Medical Board has a very different impression of me than I have of myself. Now, the question is if this attorney truly represents the Medical Board or if these were personal attacks. Kind of like when a physician gets mad at a patient for not taking a medicine or for being a drug-seeker; like, if you’re taking your job personally, there’s something wrong.

State Licensing

I remember when I owned a mechanic shop in San Diego the California Bureau of Automotive Repair had a problem with me opening my shop in an industrial neighborhood. They initially rejected my license so I got on the phone and talked to a very friendly guy who explained that the zoning would prohibit me from opening a mechanic shop in that part of town.

I talked to him further and it turned out that there were only certain things which I couldn’t do on cars in that space. My shop was geared towards race cars so we didn’t do oil changes or brake jobs or tune ups. We were mostly working on suspensions and customizing engines and installing safety equipment for racing. He suggested that he come down for an inspection. The face-to-face encounter was an even more pleasant one. He granted me the city license and we agreed to revisit the issue if my line of work started shifting more towards general automotive repair. Done. Both parties happy. Both working together to bring a service to the consumers in California. That shop created 3 jobs and brought more tax revenue for the city.

Now, the California medical board hasn’t filed their final decision so I can’t make any assumptions. Maybe the attorney’s job is to paint me in as bad of a light as possible because she knows that the judge will be excessively lenient. Maybe the sum of all this is a fair system. Maybe I took it too personally and another attorney in the courtroom would have thought the medical board attorney to be quite fair and competent.

What I know for sure is that I don’t ever want to go to another Medical Board hearing for the years I have left on this earth. Is this the kind of environment I wish to practice in? No. If I treated my patrons of my clinical services the way the Medical Board treats their licensees, would that add more positivity to the world? Fuck no.

What I know is that I’m a great fucking doctor. I’ll leave the humbleness to rock climbing and playing racquetball. I worked my ass off to know what I know in medicine. I’ll always have a crush on the art of medicine but I’m fairly certain that I’m done with medicine as a career.

The California Medical Board Attorney

As much as I want to think that this attorney was pure evil and that she did everything possible to paint me bad, I have to be fair. So let’s explore the other side of this situation. This attorney gets one chance at this medical board hearing to make sure that a potentially harmful physician is adequately reprimanded.

This attorney carries the burden of protecting the public. That’s a huge responsibility. She has to do a ton of research about me, ask around, look up and stay up to date on legal code, and figure out whether I’m lying or telling the truth.

She has no idea that this is all that happened. For all she knows, I traded sex for that EKG. Maybe I’ve done this sort of thing thousands of times before. Or maybe there are other things about me which nobody has uncovered.

Imagine 5 years from now I come up in the news as having run a $1.2B medicare scam. How would she feel if she was the last attorney to try me and didn’t catch something like that?

Next, she has to assume that the other medical boards may have missed something big. We’ve all heard of doctors who go to practice in another state after they did something egregious in a previous state. That’s all on her too. It’s not like the medical board is going to have another attorney on the case or give her all the resources she needs to do her due diligence.

I think the reason I’m all butthurt about this is because she didn’t give me the benefit of doubt. But should she have? Looking over this fucking novel and reading what I wrote, I’m not sure she should have. I think she did the right thing to point out all the negatives in my case.

What I don’t agree with is that she gave me no credit – none whatsoever – for my insight into the case. It’s like the patient who knows that his diet isn’t ideal and that he doesn’t do a good job of controlling his stress. He’s not in denial. A physician lecturing him on his poor lifestyle habits would be absurd. Instead the physician will build on that base and come up with tips and tricks to add in a little more health and a little less harm.

Maybe this is how the process has to be to ensure a safety net. I don’t know. What I know is that I had no business being there without a lawyer. Had I known what this was, I would have not gone.

Surrendering my Medical License

The letter I received gave me the option to a hearing, a stipulated agreement, or to surrender my license. For any physician reading this, it’s important to understand the difference and know the consequences of each decision you make.

I’ve wondered whether I should have surrendered my medical license. But I would do that on my own terms, when I’m good and ready. Why surrender it because of a letter I receive in the mail. That makes no sense to me.

I should also mention that now that I attended this hearing, I can’t choose to surrender my medical license – at least from what I understand. The presiding administrative judge will make her recommendation to the medical board and they will decide what to do with that information. They can accept it, reject it, or continue the investigation.

Fortunately, my fate isn’t in the hands of the judge, nor the Medical Board. I’m in a ridiculously fortunate position to not need the income or title or prestige from medicine. In fact, if this medical board investigation didn’t happen I would have never branched out into healthcare consulting.

The Capstone

I left the California Medical Board hearing totally drained. I doubted myself a lot that day on the flight back home. Normal, I guess.

But there is a cherry on top. The capstone on this day was my ride back in my Uber. I got out of the hearing with only 1 hour to make it to the airport because the meeting got pushed back from 9 am to 1:15 pm.

The guy driving me was from Nepal. Young guy, soft spoken, a thick SE Asian accent. He asked me what I did and why I had no luggage. I told him that I was here for a medical conference and was hot-legging it back to PDX. He then asked me if he could run his dad’s health by me.

So me and this kid started rapping about his dad’s health. It was fucking magic. All that bullshit in the courtroom just melted away. His dad had some issue develop with his kidney and the kid had so many questions. We then started talking about his own health and his late-night snacking on garbage trying to stay awake to learn coding.

He ended by saying: “I think doctors are gods!”. How cute is that? Of course, I wish he didn’t have that impression of doctors because it makes us even less approachable and doesn’t empower the patient. But he said that and thanked me for talking about his dad and his own health. And that he was going to share all my feedback with his pops.

Even if you’re a billionaire you’re going to have difficulties and hiccups in life. Nobody is immune. Everyone, every-fucking-one, will have to battle something eventually and frequently. You just have to decide what is worth fighting for. Which battles do you want to tackle and which do you want to skip. You have no choice but to engage, my friend.

Many of you are going through your own Medical Board drama; far worse than mine. Some of you are dealing with malpractice lawsuits. Some are going through cancer and some are going through a divorce. Some are pissed that your neighbor keeps stomping around at midnight or that your cat conveniently misses the shitter whenever you leave out of town.

If medicine is your calling then fight for it. Don’t fight for it because it’s your income. You’ll only become bitter and hate yourself for letting yourself get degraded in a courtroom. If you want to see patients you have to fight to see those patients. It’s not a given. But it’s also not a privilege, as the Medical Boards like you to think. I disagree with that as much as I disagree with the sentiment that doctors are gods. Medicine is a job and being licensed is only a privilege in as much as the patients and medical boards are privileged by us agreeing to practice medicine.

I wish every physician in the US was aware of the Medical Board investigation process, the concept of the Medical Practice Act, and understand why shortcutting the system in any way is looked down upon.

But the fact is that we are put into awkward situations as doctors all the time. Nobody is there to protect us every time we are tempted to advocate for the patient even if we don’t do it properly. If what you do is of value to you then it should be worth fighting for. Whether you fight it yourself or with a lawyer or by moving to another country to practice medicine there, you get to choose your flavor of war.

Finally, for every State Medical Board such as California there is one like Washington. I don’t know what the verdict of California is yet but the process was dehumanizing. Maybe the outcome will be favorable, maybe they’ll request a death by hanging, we’ll see.