This is the first time I’ve applied for a new job since having my medical license was suspended by the Oregon and California medical boards. Credentialing after medical license suspension is a huge pain in the ass and requires a lot of juggling.
Filling out the credentialing application was unnerving, to say the least. Unfortunately the eventual outcome was an unfavorable “ineligible for credentials”. Credentialing after a medical license suspension can be a nightmare so let’s go through it.
My Medical Board Investigation Timeline:
- May 2017 – inciting event which led to investigation
- June 2017 – my employer investigated the matter
- August 2017 – my employer reported me to the medical board
- October 2017 – subpoenaed by Oregon Medical Board
- October 2017 – got a lawyer
- January 2018 – first interview before gang of investigators
- April 2018 – hearing before medical board members
- July 2018 – stipulated order signed with Oregon
- August 2018 – served 30-day medical license suspension
- September 2018 – terminated by all telemedicine companies
- November 2018 – starting everything over with California Medical Board
- Eventual California license suspension
- Investigation by Washington Medical Commission
- The ABFM (ABMS) suspended me for 30 days??
- Medical Board Hearing in front of a judge in CA
- Public reprimand by California
- Public reprimand by WA + fines
- $500 fine by CA for “false advertising”
- much, much, more
Job Application
I applied to this particular telemedicine company for whom I had worked in the past, American Well. It’s been a long time since I worked for them, so in order to restart I needed to get recredentialed.
I filled out the credentialing application and included all the relevant information regarding my medical board investigation. At the time of applying, I hadn’t yet been terminated from any positions. Though I later was, by Teladoc, Roman and Doctor on Demand.
On one page of the credentialing application alone I checked off yes to nearly 10 different questions:
- have you ever been investigated by a medical board? yes
- have you ever been investigated by an employer? yes
- have you ever resigned during an ongoing investigation? naturally
- do you have anything reported on you in any national database? proudly
- have you ever had a license suspension? yes
- have you ever lost any privileges? yeap
- have you been forced to pay a fine for any fault of your own? yes
- have you ever been found to be guilty of any dishonest conduct by a licensing or credentialing body? yeap
- have you ever been reprimanded by a medical board or licensing body? of course
- have you ever lost or had your board specialty designation suspended or terminated? yes
Felt like a criminal answering yes to all of these. But that’s the nature and purpose of an investigation and public reprimand – punitive and demeaning. It’s supposed to make credentialing after suspension much harder for a medical professional.
My first thought was “Shit, I wouldn’t even hire this guy!”
Credentialing committee response
The email response I got from the credentialing committee was quite professional. But I had no idea that Doctor on Demand had reported me to the National Practitioner Data Bank when terminating me.
The response above essentially says that I don’t meet the “eligibility criteria” because of my “privilege revocation by Doctor on Demand”. They listed the source as the NPDB.
It’s a tough situation for all parties. DoD is required to report any termination – no hard feelings there. But I was a per diem and didn’t need to be terminated.
But consider this, if I really was some kind of white coat criminal and DoD didn’t officially terminate me then they might catch a lot of heat. They are just protecting themselves, I get it. And I have since taken steps to protect myself.
The credentialing correspondent goes on to explain that the “eligibility standards” have been imposed upon this particular company by their “clients”.
The consequences
Unfortunately, even this credentialing rejection is reportable to the National Practitioner Data Bank, separate from everything else I have to report already. American Well must now report this to the NPDB.
It’s like I can see the toilet water swirl with my medical career floating against the bowl.
These are shitty consequences for someone like myself. But it makes sense when you think about the different safety nets to catch criminal doctors. It doesn’t feel good to be one of them but, hey, at least it’s an elite club.
One of the toughest things I recognize is keeping track of all the shit that has taken place. Each of these events is reportable and needs to be explained on your credentialing application. Whatever you leave out whether intentionally or unintentionally is considered perjury.
National Practitioner Data Bank
Who the hell is the NPDB? I had never heard of them until I went to the Professional Boundaries Course in San Diego. The NPDB was all the talk there. Now, it’s November 2019 and NPDB report is 18 pages long – 18 fucking pages.
When we were all sharing our stories, someone would eventually ask cautiously and quietly: “was it reported to the NPDB?”. Say yes and heads would shake like you were done for. Now I know.
The NPDB is a government run agency which requires that physicians and other white coats be reported for any potentially damaging information about them.
In fact, just last month, the NPDB updated their reporting guidelines and it’s now even stricter.
Self-query
Much like your credit report, you can request a self-query of the information included in your NPDB.
In order to verify you they will need access to your credit report. But since I have my credit reports frozen, they are unable to verify me online. I had to mail in a notarized letter to prove my identity.
Here is a good infographic for those of you interested in completing a self-query. If you’ve ever changed jobs or credentialed for new jobs, it’s a good idea to complete a self-query.
Reportable Instances
All sorts of events are now reportable under the new guidelines. You can review the lengthy guidebook on their website.
- leave of absence while under investigation
- withdrawal/resignation during a reappointment process
- resignation while under a “quality improvement plan”
- a broader definition of an “investigation”
- medical malpractice payment
- clinical privilege actions
- adverse professional society actions
- voluntary surrender of license
- peer review organization negative actions
- private accreditations negative actions
- exclusions from health care programs
- change in privilege with health plans related to fraud or competency
Credentialing after Medical License Suspension
Before you go slitting your wrists, remember that the National Practitioner Data Bank isn’t the final word when it comes to your career. There is still a lot that you can do for credentialing after a medical license suspension.
Yes, anything in the NPDB is likely going to be damaging.
Yes, it’ll make it more expensive and harder for you to get malpractice. Getting a job with a large medical group will be damn near impossible. You might lose insurance contracts or some insurers may refuse to credential you.
But there is always the street corner off of the freeway exit. Just kidding, panhandling is illegal. You can always open your own urgent care, or family medicine clinic, or pain medicine clinic, or start your own telemedicine company.
This kind of bullshit is expected in any profession, unfortunately. To capture the true criminals, there will always be a few unnecessary casualties. Get into wartime medicine mode and don’t give up.
You can also apply to smaller, private urgent cares and clinics. Ideally, start working for a friend or someone in your network. Having at least some employment history after your criminal acts will help improve your chances of future employment.
If I can make money without an active medical license then so can you. I earn a solid income doing healthcare consulting, selling products on my website, and consulting for other doctors who’ve gotten fucked by medical boards. Make it rain!
If you are freaking out, email me and let’s chat.
Finding Your First Job
I wrote this post back in November 2018. Now it’s November 2019 and I’m adding to this lovely post to let you know that it is possible to find work.
#1. Find a Recruiter
Recruiters are wonderful people. I know they can be annoying but they actually are all about building relationship and making connections.
Find a good one. Be honest. And let them hustle for you.
#2. Apply a Lot
Apply to a few jobs a week. No joke. And don’t give up. Keep applying.
Eventually you’ll ping someone who might be desperate enough or willing enough to work with you.
#3. Figure out Your Narrative
This is insanely important. I can’t even stress this enough. It’s too much to get into on this post. But you must know exactly what to say, how to describe it, and how to word it in your application.
You will need a lot of help with this. Be ready to shell out good money to have someone do this with you.
#4. Make Connections
Reach out to any doctor you know, even the ones from your past. Someone might be in a leadership role and be able to offer you a position.
#5. Reach out to Your Program Director
Your old residency program director will know all about these problems. Reach out to them and see what connections or suggestion they might have for you.
#6. Start Volunteering
You will meet great people volunteering. And you will make connections – you might find a lead.
Many healthcare volunteer organizations also hire physicians full-time or part-time. Maybe you can land a job through your volunteer gig.
#7. Start Your Own Practice
If nobody else will hire you, fuck them, be the one who’s going to do the hiring. Start your own practice. Whether and Urgent Care or a low-acuity Walk-in Clinic.
Or a Suboxone clinic. Or an aesthetic practice. Maybe even a low-income clinic.
#8. Strategize
You need someone with whom you can strategize. Whether it’d be a lawyer or a doctor like myself who’s an OG in this game. Don’t go at it alone. Repeating someone else’s mistake is idiotic.
#9 Pull on the Thread
One connection begets another. Like an STD, your first employment or volunteer gig will lead to another and another. Once you have whored yourself out there enough, everyone will have forgotten about your past.
#10. Be Honest
Don’t waste your own time by trying to hide your medical board investigation or malpractice history. Lead with it. It’ll be unexpected and yet refreshing.
If you don’t address it and they find it out on your application or from your NPDB, it’ll look worse.
16 replies on “Credentialing after Medical License Suspension”
Geez. This situation just keeps getting worse and worse. Do you know of any cases that have gone down this path and the doctor was able to salvage a career out of it?
It’s like once you are blackmarked you can never get back in. Even felons get a chance to be rehabilitated and become productive members of society. You almost have no action/corrective measure to at least say you “paid your time back to society” and can start over.
For drivers they have driver’s courses mandated by court to reduce fines/insurance rates. There should be some sort of required course (similar to say anger management or counseling) that says you completed it and are now cleared to practice again.
Sorry for your ongoing issues. Would this incident follow you to other countries (ie can you practice in another part of the world?)
Many of the docs in such situations work in low income clinics or open their own practice. Each situation is different so the wording is what can be a career killer.
It does affect you if you apply to other countries. In Spain, for example, they discouraged me from applying for a license there because with anything on your record they are likely to reject you. I could have still applied and they would have happily taken my money but I take the medical council’s word for it.
We’re now living this situation, is a nightmare!!! Or worse. I’ll try to email you, I couldn’t because I don’t have the MAIL app
It is – this is the point of the investigation, to limit the ability to get a job or at least drastically hinder it. But there is a light at the end of the tunnel if you navigate the process carefully.
So now, it’s all about gaming the system that rightfully drummed you out, just to survive, eh? It astounds me how entitled doctors can be; how lenient medical examiners bend over backwards to give doctors who have no business treating others chance after chance. Soooo, if they’re crafty enough, a drug addicted doctor can open a pain clinic. Brilliant. An incompetent doctor can continue to practice his incompetence on the disenfranchised. Right.
These are good points, thank you for bringing them up. Drug addiction in western medicine is considered a disease like hypertension or obesity or bipolar disorder. The goal is to not judge individuals because of their disease and instead support them. A person with hypertension can open a pain clinic and a person with addiction should be able to open a pain clinic. Of course, always under supervision. For example, individuals with seizure disorder can still get a driver’s license under close supervision of their doctor. It might seem more convenient at first to just pull the licenses of all people with diabetes, seizure disorder, or syncope or cardiac arrhythmias but then it becomes hard to draw the line as to how militant we want to be with our medical system. I suppose in the end there is no perfect way to make it fair to everyone.
Reality is once a state medical board marks you as a “bad” physician” you are labeled forever. In fact over 99 percent of cases a physician never can win as the process is not a fair and just review and due process is a mirage. Physician insurance is only limited in these matters and you are fighting against the board which has limitless financial resources since they have the entire State,’s money against you. All medical malpractice insurances have very limited funds to protect a physician and so financially you are doomed formed from the start. The boards and State only position is to win the case dispute the evidence of the case and the law. Physician malpractice insurance must change and have more money allocated to protect physician against these punitive and egregious medical boards who have an agenda of punitive actions and no real avenue for remediation or reintegration for a physician. We as physicians are treated worse than a criminal. No real representations no union like police or fireman whose unions protect them. When these things happen to physicians our profession and majority of colleagues abandon us. Many physicians then fall into despair and many have committed suicide. The process can only be changed by real malpractice insurance reform where the
majority of our insurance premium is used to fight these boards against their unfair legal pursuit on physicians to make the board look good to the public image with complete disregard for the physicians legal rights of representation or due process. What all physicians don’t realize is that we don’t need malpractice insurance against civil suits against our patients this will be at worst a monetary fine only we as physicians need protection against our own boards which will take away your freedom and livelihood. Physician suicide is real and destruction of physicians lives is real. We must have malpractice insurance reform so we can have a more money to protect our freedom and livelihood from these self serving and self righteous boards who have too much power and legal and financial weight to destroy physicians lives and take away their freedom and livelihood.
I hear you and it’s a difficult journey for physicians because most don’t even know what can lie hidden around the corner when it comes to a state medical board investigation. They have quotas to meet and they must pursue physicians in order to demonstrate that they are effective. I believe their intentions are good but the process is really sick.
However, it’s a common misconception to believe that there is a due process and you are innocent until proven guilty. This stems from the criminal court system in the US and has little in common with the administrative system. In the civil/admin cases you are guilty by definition when a complaint is filed against you and you must prove your innocence. Sadly, this actually makes sense when you think about it. If your own patient came and told you that your nurse cursed at them and called them a bunch of names, you wouldn’t tell the patient to prove it before investigating. You’d go to your nurse and ask if she did it. If the nurse doesn’t have a good aliby you’d have enough suspicion to proceed.
As far as malpractice coverage and reform – since this doesn’t fall in the scope of medical malpractice most insurance companies don’t have the underwriting appetite to put more money in it. And especially because most physicians don’t think it’s really that big of a deal they wouldn’t pay for it. Everyone caught in it of course will have wished they did.
Physicians medical boards must have evidence threshold at “clear and convincing ” evel which means probability should be greater than 90 percent certainly of error as a physicians livelihood and freedom are threatened they rarely meet this standard and convict doctors on the “preponderance” of evidence which is wrong and an abuse of power. In fact whereas, in a civil trial, a party may prevail with as little as 51 percent probability (a preponderance), those legal authorities who venture to assign a numerical value to “beyond a reasonable doubt” place it in the certainty range of 98 or 99 percent.
This is the level of a criminal trial In other words physicians trials are akin to criminal threshold of evidence but physicians are convicted on lower threshold of evidence which is not only wrong but an abuse of power by the State
Administrative law is abused by state medical boards and an abuse against a physicians rights and freedoms and Liberty and goes the very tenant of the constitution. The Medical Boards use their limitless financial resources to destroy a physician even if innocent. Physicians cannot win and since over 1000 physicians are destroyed every year and many commit suicide we must stand together and protect our colleagues and fellow physicians from such abuse power and demand malpractice insurance reform for more coverage a against medical boards so we have more financial resources to fight them. They will think twice before destroying physician on trivial preponderance of evidence threshold when a physician has millions of dollars in malpractice insurance to fight them. Until this reform is done in the insurance coverage many physicians lives are destroyed and lives are lost. Even one death of our colleagues because they have learned helplessness is too much. Dr. Mo , you are wrong that insurance cannot be changed. I implore you to demand this or physicians will continue to die. We were never trained to fight these legal battles we spent decades learning skills to help people but not fight these legal cases. We have no union iof brotherhood our profession and colleagues abandon us. We make mistakes but we all have right to reintegration. Boards fill quotas to justify their existence not for remediation of physicians . We all know of physicians who have died due to stress of investigation. The destruction of their careers and livelihood. We sit around and do nothing while physicians are dying. This is the true tragedy of theses kangaroo administrative courts and medical boards
It is a tragedy, indeed. I am hopeful that this platform I am offering for physicians is helping make a difference. Each person can only do so much and some cannot help in any way since they are already dealing with too much. Your points are valid and I am sure add important context to the bigger problem.
Medical board discipline is a real career killer! Currently serving a 5yr California Med Board probation for a DUI and allegations of self prescribing a controlled substance (weight loss medication). Let me start of by saying, I am not an alcoholic or a drug abuser. The DUI was an isolated event and even the medical board expert psychiatrists that evaluated me agreed I do not have a substance abuse issue. The board could care less, and here I am in their diversion program testing almost weekly and doing AA/ support groups for the last few years. It would all be OK, had not my career been totally derailed by this! I lost my job, was asked not to renew my hospital priviliges by the hospital, and many insurance companies dropped me as a provider. I was lucky to land a clinic job in my speciality but I have been unsuccessful in gaining meaningful employment. Financially I am dying. AND there is nothing I can do about it, since I am an ****** and without hospital priviliges for the last 2 years my chances are very poor. How to proceed? Times I feel like just quitting medicine, but my love and passion for my profession is what keeps me going. I am a DAMN GOOD and RESPONSIBLE physician. Yes, I had issues in my personal life which led to the DUI, but I did not practice medicine impaired nor did I hurt any patients. Sobriety is a lifelong committment that I have embraced but even when this is all said and done and probation is completed, where will I be? Answering yes to all the liability questions on every application! oh yeah, my license was suspended 30 days also part of the discipline order , total bullshit since the diversion program took me out of work for 6 months anyway! It’s all punitive! The board does not care of our current state or competence to practice. I would argue I am much much safer than a lot of “undiagnosed” physician out there!
Thank you for sharing this difficult journey you had and still have. From the number of comments here and how many physicians are turning to me for advice and the lag time to get credentialed in a new state it’s apparent that the disciplinary process is broken. We don’t have much control over getting investigated and even the punishments are out of our hands. We can only relinquish to the powers and pursue what’s meaningful to us. My 30-day license suspension was a disaster and the aftermath has left me still picking up the pieces. I don’t and likely will never have the career I once had. But the salvation in this is that I’ve grown as a person, definitely learned from some of my mistakes, and I have recognized the strengths I have as a person practicing medicine which has little to do with being a doctor. My medical school and residency trained me for the automaton insurance-based healthcare system which is the bane of everyone’s existence. It’s the last thing I want to be a part of.
The practice of medicine has many aspects to it, the least of which is getting hired by a medical group to practice the kind of medicine which got us in trouble in the first place. I can’t give you advice on here obviously but I think pursuing your own cash pay practice or reimagining what it means to be a healer for patients might be a more sustainable career.
Great Thread.
Would contacting each insurance company credentialing contact by email/phone and explaining the situation via an attestation letter make any difference? Espeically if it is only a temporary suspension of your license. Let me know what you think. Thanks!
I don’t see the need to contact the insurance companies if it’s a temporary suspension. But if you have something in your contracts that stipulates that you must contact the insurance company it would be good to do that.
Agree, hospitals hide behind peer review immunity and it if often triggered by CMO’s or CEO”s who selectively pick cases out of hundreds or thousands and say it is for patient care when it is really due to CEO’s using the system to get ride of people they don’t lke