Today was the big day. I appeared before the investigative committee with my lawyer in tow.
Let me say that having a lawyer, having a good lawyer, makes all the difference. I can’t thank my lawyer enough who prepared me for this oral molestation which took place.
The Interview Room Setup
You walk into the room and there are 6 figures standing tall ready to shake your hand. I felt tiny. Everyone introduces themselves with forced smiles and we all sit down.
My lawyer knew the investigative committee’s counsel and so they exchanged a few words of familiarity and we got started.
My lawyer sat to my left with a notepad in hand. I sat on the long end of the oval table with 4 members of the investigative committee across from me, the lead investigator behind me, and the court reporter to my 2 o’clock further off to the side.
There were 2 male MD’s, 1 female board member, the board’s legal counsel, and me sitting at this table. My chair was low, a little hard for me to get my hands on the table and cross them but I managed, just as we practiced with my lawyer.
Nobody except the woman across from me had anything in front of them, She had a notepad and laptop. Everyone else was leaning back on their chair as if they were about to watch a presentation.
Starting the Interview
It was obvious that the female board member was going to be the lead interrogator. She started out very soft-spoken and calm and asked me about my medical education – this demeanor didn’t last long.
She wanted to know what the incidence was that brought me here. I started with a broad perspective of the events but was immediately interrupted by one of the MD’s, younger doc, who expressed confusion because he thought the entire event had taken place at bar with me and the patient discussing her medical case there.
Mind you – I had sent a revised and very detailed letter to the medical board explaining the entire event, how it happened, what I did wrong, what I learned, and how I could prevent it in the future.
Okay – odd that MD doesn’t even know the narrative – but let’s go with that. I stopped and let him speak and then started telling the story over again.
After we cleared this up the woman across from me jumped straight into the facts she had about me from my ex-employer. She was angry – I mean not calm at all – she got frantic, looking at the computer screen, talking with her hands, looking at me and looking around – I thought she was gonna blow her jugular. It was like watching a 5-yo rile herself up. I wanted to tell her to breathe but felt that may have hurt my chances at keeping this glorious medical license.
The story she had about the event was so different from what I had that quite honestly if I was in her shoes maybe I’d be upset as well. Though, this is what she does for a living so I’m not sure why she was taking it so personally.
I remained calm just as my lawyer taught me. I repeated the story and explained to her that the facts which she got from my ex-employer were completely inaccurate. She wouldn’t let up – she continued getting more agitated and that’s one of only two occasions where my lawyer stepped in and very firmly told her that I already answered that question and she needed to stop asking the same question.
I can’t share too many details because I am not allowed to share the details of my medical board investigation. I am trying to be vague enough but still give my readers a good idea as to what a medical board investigation process entails.
My records at this large medical group have been impeccable and no supervisor of mine has ever had anything but the best to say about me – at least to my face.
I always worked hard, I was known as one of the go-to docs in the Urgent Care and I never had unexcused absences, never came to work late, and never had problems with my supervisors.
I took on a Medical Director role for 2 years and this is where it gets interesting. During the interview this woman is reading off the information that my ex-employer had shared with the investigative committee and here are the 2 important facts which I’m trying to digest even as I write this post:
- According to that medical group’s HR and legal team I showed up to work late on several occasions and had unexcused absences multiple times, along with performance issues.
- I was also found to be at-fault by them for fraud/abuse and for intimidating a nurse upon which they recommended that I be terminated.
The facts provided my ex-employer aren’t true – in fact, they are doctored up which had me and my lawyer scratching our heads after the fact. I’ll get into that later some more.
Before I get back to the rest of the interview, when my lawyer and I were leaving the interview I turned to him and said that she obviously was making that stuff up to trap me which is what I was assuming during her questioning.
Nope. My lawyer assured me that because this was a recorded deposition with a court reporter present that she couldn’t make up any of those facts.
So, what does your medical group have about you in their records?
When you are on a fact-finding mission then you ask open-ended questions and delve down into the details prn. When your intention is to entrap someone then you ask leading questions and offer yes/no answer options until you trip them up.
“Wouldn’t you agree that you are guilty of doing xyz and that it was incredibly unprofessional?”
Umm, no! I recognize that the way I handled this situation wasn’t perfect but I had no secondary motivation and my intention was to help this person obtain the test which she had been putting off for months.
“We didn’t ask about your intentions! Answer the question! Are you or are you not guilty?”
I agree that I should not have ordered any test for this person unless she was my patient but I’m not going to admit to being guilty when you and I aren’t even on the same book, much less page.
During such questioning what I have learned is to stick to the story – the why’s and the what’s. Start with the why’s always, and finish with the what’s. Don’t admit to blanket guilt because you don’t know what their next question will be or how they might take that out of context and play that portion of the recording to the rest of the medical board during their final ruling.
They are welcome to ask me something concrete: “Do you agree that ordering that test was inappropriate because you weren’t her physician and didn’t document ordering or interpreting that test after doing so?”
But they didn’t – not once.
Before I Had a Lawyer
I was unprepared and assumed the investigators were there to find out the truth. For better or worse, I did a halfway decent job of sticking to the facts and didn’t mess things up too much for myself.
Before I had a lawyer I had no idea about some of the tactics these board members would try. For example, while they were going down the storyline of a particular matter suddenly the woman would jump in and ask something like “Were you drunk that day?” – the point, I’m guessing, was to catch me off-guard.
Or this one, “Would there ever be a circumstance when you might refer to this woman as ‘Ms.’ and use her last name?” (I still don’t get this one).
One person would be asking me about the check-in process at the Urgent Care and another would jump in “Did you have relations with this woman?”
It was chaos. And the tone they used, man… I didn’t mind their lawyer and the woman being harsh with me but that doctor dude… wow. Where was he getting off to be so condescending? His tone, his eye contact, his demeanor, his accusations, and that aura of passive aggressiveness. Why?
The Medical Questions
There were 2 MD’s on this interview panel. One was fairly friendly and benign and the other just an asshole.
Both doctors were trying to twist the facts around to show that I was a negligent physician. Neither had a grasp on the facts and I had to retell the story to them. I’m embarrassed that these are my colleagues in medicine.
They were so caught up on this test that I ordered. The test was a non-invasive test and they were preoccupied with the interpretation. I kept telling them that the woman in question wasn’t my patient, I didn’t order the test, I didn’t interpret the test.
The Angry Woman
The whole interview was only 30 minutes long but it felt like it was 5 hours. On 2 instances the angry woman was so agitated that other board members had to jump in to redirect the questions because she was just spinning herself into a frenzy.
About 15 minutes into the interview I started noticing how upset she was and how personally she was taking this and I felt a little bad for her. I don’t know, maybe she’d been in a similar personal situation and she was reliving something. Or maybe she was so convinced that I was lying and couldn’t help herself.
The point that I have a hard time digesting here is that I didn’t kill anyone. I didn’t sleep with the patient which the board obviously confirmed by talking to the patient. I didn’t profit from this interaction. And I have an impeccable record otherwise making it quite unlikely for me to be a threat.
And finally, and most importantly, I have fully admitted that what I did was wrong. Basically, other than me ordering a test and my ex-employer not being able to bill for it – which I realize is a break in the protocol and standards of outpatient care – there was nothing else that could have fueled this woman and this MD to lose their shit.
Attempts to Discredit
I can’t change the facts of the case. I can only demonstrate to the medical board what I have taken away, what I would do differently, and what I have learned from this experience.
I think it’s important for physicians to understand what they are walking into when they enter the process of a medical board investigation. Fact-finding is not at all what this about – it’s about the medical board trying to piece together a case of a bad doctor, that’s what they are after.
To an extent, they should be. Their job should be to identify any physicians who could potentially harm the public. Identify them, punish them, move on. But know when to let it go.
During this interview they attempted to make it seem as though I had a relationship with this woman – obviously a sexual one. They poked and prodded to find out if I ever dated a patient, if I ever prescribed meds to friends, etc.
Then they tried to discredit me further by saying that I must be an incompetent physician. The details as to why I will leave out of this post but it was absolutely bullshit.
Then they started attacking my clinical skills. They delved into my ability to do a proper exam on a patient and really dove in deep into the work I did at the other clinics and the telemedicine work I do.
The nurse who reported me to the medical board went all out. She made claims that I came to work drunk, that I had relations with the patient in question, that I watch porn at work, that I use illegal substances, and a few other things I won’t mention.
As physicians we are at the very top of the food chain. Even though we all know that there is no such thing any longer as ordering a nurse to do something, it’s still perceived as such when a physician and nurse interact.
Anytime you interact with someone who ranks below you it’s important to understand that you are likely going to be more vulnerable should an accusation be made against you. Especially if you are a male and the other person a female – that’s a double whammy.
The angry board member woman was reading something verbatim which my ex-employer supposedly had shared with the medical board. I don’t recall the details or wording but it was something to the effect that I was found guilty of having intimidated the nurse and that I committed fraud. And that they reprimanded me for this and fired me over it.
If these things are in fact true then my ex-employer is mandated to share that information with me before putting it in my file. I have the right to contest such facts leading to my dismissal an I’m entitled to know about them if I ask about it.
They have to either document a phone call to me, which they didn’t. They could have sent me certified mail to ask for my response, which they didn’t. Or they could have emailed me a secured document, which they didn’t.
After my lawyer and I debriefed we were both puzzled because as he mentioned, if he sent out his own investigators to interview the people involved and obtain the legal HR documents then my ex-employer wouldn’t have a leg to stand on.
This is easier said than done – I would have to pay out of pocket for the whole ordeal and go toe-to-toe with a large medical group.
The lies the nurse told are easily refuted by talking to the patient who was with me who will undoubtedly tell the same story as me – we were both there, she would have no reason to tell a different story.
I don’t understand my ex-employer’s angle – it seems either incredibly egregious or purely incompetent on their part. If they wanted to make me look bad then why doctor things up, why not just use the fact that I resigned during their investigation against me?
The Next Steps
It’s unlikely that I will interview before the full medical board – this was the investigative subcommittee interview which is likely my final interview. To me it’s all confusing but such is the process for a medical board investigation.
This investigative committee will take my information and present it to the full medical board. They will take everything they have and everything I offered and create a case which is finalized enough to be presentable.
If they can get it on the agenda then I’ll have a judgement ready for me soon. This judgement can be anything from a public reprimand, which wouldn’t go on my public record, all the way up to having my license terminated.
During the debriefing with my lawyer he commented that my chances aren’t looking that good. He suspects that the board’s judgement will be ugly, at best. Of course, nothing is set in stone and it’s hard to predict the outcome.
However, I am more optimistic than my lawyer because I was there when all this took place and I suspect that the investigative committee is going to take the facts which I have now shared with them for the 3rd time – but which finally may have clicked with them and actually set out to confirm or deny these facts.
Right now I look like a total liar because most of what I have said is the opposite of what the investigators and my ex-employer have shared with the medical board. If the investigative committee shares this file with the full medical board as-is then they’ll look incompetent. There are way too many discrepancies.
The investigative subcommittee can go back and fill in any gaps before taking the matter to the full medical board which is done in some cases.
When these facts are clarified and presented to the entire medical board later in the year, I think I will be held responsible only for the patient-doctor relationship which was never officially establish and not documenting on this woman.
Let’s say that the investigators don’t do any of this and take all this straight to the entire medical board and the board decides that I’m a liar. The board could:
- terminate my medical license indefinitely
- fine me up to $15,000
- suspend my license for 2 months
- require me to take a bunch of courses on professionalism
- report me to all the state medical boards
- limit my ability to order tests for a period of time
I’ve been practicing since 2006 and have kept a healthy portion of my income from medicine and I’ve never had a patient malpractice suit. These things make me feel that I’d be exiting out on top even if the board decided to suspend or terminate my medical license.
I am 100% guilty of ordering that test and shortcutting the system but it was done for good reasons. I can live with that. If I can’t practice medicine because of this then good riddance.
If that nurse got fired or reprimanded for performing that test which I asked her to do then that sucks – I feel bad for her and I feel shitty about that. But maybe we’re even for the lies she made up about me.
Fortunately, or unfortunately, my ex-employer dropped the ball on this whole situation. This isn’t how a large medical group handles such situations unless they are trying to cover something else up.
If I decide to go toe-to-toe against them then of course that would require further investigations, interviews, and taking that employer to court. From what my lawyer and I discussed, the fact that they didn’t share any of my employment records with me or my lawyer would be considered perjury.
The downside would be that even after we clear all that up, I would have to take that information back to the medical board, reopen the hearing, and have the board then give us a final judgement.
I learned a lot from this case and though I come away a bit jaded and disappointed about what my old medical group and the medical board has said and done, I am also humbled by this process that if I’m going to practice in the field of medicine then I have no right to shortcut the system.
Immediately that morning and even during the interview with the medical board I was doubting my lawyer’s approach to answering the board’s questions – I felt he was being to mechanical. What if it would be better to just be vulnerable and answer the exact questions they asked? Why not just spill the beans and tell them I fucked up and I’m ready to repent.
Looking back, I am glad I didn’t cave – I’m certain that without a lawyer I would have.
Now that I’ve had some time to reflect on this medical board investigation interview I am even more convinced that the board had no desire to uncover the truth. I don’t mean to sound jaded but they obviously didn’t read the final letter that I wrote them and they didn’t even have the facts straight.