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Downside to Multiple State Medical Licenses

In a previous post I mentioned the benefits of having multiple state medical licenses. I still believe that there is an advantage to having multiple state medical licenses. However, I wasn’t aware of all the risks when I wrote that post in April of 2018. I hadn’t yet dealt with the Oregon medical board and haven’t had to pay thousands of dollars to multiple lawyers in various states.

Having multiple state medical licenses is becoming the norm. Most medical groups are expanding to nearby states and adding telemedicine to their repertoire of care. In order for their physicians to manage these patients, these medical groups are making it easy for their docs to get licensed in multiple states.

And many physicians maintain their medical licenses from residency even if they move to a new state for their attending jobs. This adds an extra expense but it also means having a lot more of an administrative headache, should you have any medical license issues.


 Dealing with multiple medical boards

Imagine you are sued in Texas by a patient. You happen to have a medical license in AZ and CA and NM. You have to report your malpractice suit to each medical board within a specific time frame. Once a final judgement is reached, you have to once again notify these states.

Each state can then, and often will, open their own investigation into the matter. If you, for example, prescribed opioids to a patient who then overdosed and died in the ICU, you will have to deal with the lawsuit and also the administrative side of an investigation by the medical board.

Since this happened in Texas, you’ll first deal with the Texas medical board and have to report an open investigation to all the other medical boards. AZ, CA, and NM will then open their own investigations into the matter. So, you’ll be dealing with a malpractice lawyer for the case in Texas and you will need to hire a lawyer to deal with the medical board for TX and a lawyer for each of the other states.

If Texas suspends your medical license for 30 days then you will not be allowed to practice any medicine, anywhere in the US. It doesn’t just apply to Texas. Eventually, the other states will also suspend your license after they perform their own investigations. For each state you will serve a 30-day suspension – that’s 4 states, or 120 days in total.


Terminating your medical board license

Once you are sued or once you have an active medical board investigation, you cannot terminate your medical licenses in the other states. Well, you can, but it will look poorly on your records. Not only will it be reported as “licensee terminated his/her license during active investigation” but you will still have to deal with that state’s investigation. Refusing to do so can result in criminal charges.

If you’re going to terminate your excess medical licenses, this is the time to do it. Do this before you have a lawsuit or before a nurse or coworker complains about you to your primary state medical board.

The shitty thing is that even after you terminate your medical license in other states, those states can still open cases against you if they feel it’s necessary. Imagine you get investigated by AZ for having sex with a patient, and you terminated your medical license in CA 5 years ago. But because you once saw patients in CA, CA has the right and likely will still open an investigation against you in order to determine if any patients in CA could have been potentially harmed.


Medical Boards Don’t Represent You

Medical boards are definitely not representing you. They are licensing you, only so that they can regulate you. The IRS isn’t your friend either. I have gotten audited multiple times by the IRS, never have they said that I overpaid – and never have they won in any of those audits. Still, they ain’t my homie.

Patients are learning that the best way to create a huge headache for their physician is to report them to the medical board. Sure, if it’s one drug seeking patient complaining about you, the medical board isn’t gonna care. But imagine that person having their friend call as well – 2 complaints, now that won’t be ignored.

Once the case against you is opened, the medical board will want heads to roll. Looking through medical board audits, their completion rate is over 80%. Meaning, 70%+ of cases which are opened end in judgement against the physician. I’ve read much higher numbers but 70% is bad enough.

If anyone or anything comes your way from the medical board, you must, must, must get a lawyer before dealing with it. That includes a medical board investigator who might walk into your clinic unannounced to question you. Be cooperative but you have the right to a lawyer and that’s the exact right you should be exercising.

The investigator will ask you: “Why doctor? Do you have something to hide?” You may want to dick slap them but instead, the appropriate response is: “I am unfamiliar with the medical board investigation process and want to be as cooperative as possible but also want to make sure that I am protecting my rights as a licensee. When would be the best time for me to connect with you after I have had a chance to discuss this matter with my lawyer?”

4 replies on “Downside to Multiple State Medical Licenses”

Thanks for the post, always interesting getting your take on it. But despite your warnings, I’m looking into getting other state licenses for telemedicine. Since I’m overseas, I think it is the best work I can get. JustAnswer drives me nuts with their policy of giving refunds even when you gave the best answer that anyone could give. And you can only spend so much time trying to convince someone they didn’t get HIV from licking a stripper’s breast before you start to lose your mind.

I’ve been looking at the Interstate Medical Licensure Compact, have you heard anything about anybody going through that? It looks like a good way to go for telemedicine, but none of the telemedicine companies I’ve asked about it seem to know very much about it.

It’s just an expedited process for licensure. Not much else to it and I don’t believe all the states are fully participating yet. But yes, I know several docs who have used it.
I don’t think having multiple state medical licenses is bad. It’s more important that you take steps to decrease the risk of a lawsuit or a medical board case.
That said, I’m slammed with emails and phone calls from doctors who find my blog on the first page of google when they search for “medical board investigation”. This is very concerning.

Do all the medical boards communicate with eachother? If I get sued in one state and it’s a fake lawsuit, do I really need to report it to everyone else?

There is no such thing as a fake lawsuit unfortunately. I suspect you mean to say that it doesn’t have much of a basis. The state medical boards don’t necessarily communicate though that’s changing soon with the FSMB. However, at least the states I’m licensed in, require me to disclose any malpractice suit within a number of days of receiving that suit. Usually most physicians don’t report it and wait until their renewal when you are asked about it. I recommend having your lawyer make that decision with you.

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