I had a chance to sit down with a lawyer and discuss my medical board investigation case recently. The information he provided was quite insightful but to my dismay the process is much more complicated and costly than I expected. Needless to say, I should have sought out legal representation much sooner.
I was under the assumption that my work’s malpractice insurance covered me for such regulatory investigations. Unfortunately, my job lied to me and I resigned before being able to take advantage of it. I’ll write more about this as that story unravels.
Finding a Competent Lawyer
I was having drinks with my friend V. and her boyfriend who does some larger med-mal cases for hospitals. He was shaking his head when I was telling part of the story to him. He referred me to one of his colleagues who is familiar with medical board.
I trust both V. and her boyfriend because I consider them to be the competent type. I didn’t expect them to refer me to someone who couldn’t handle this.
Because this is a work-related compliance issue it’s not as straightforward to handle. It’s not like I killed a patient. Or that I reported to work intoxicated. Or dispensed opioids in return for a blowy.
Why Legal Representation?
I don’t have an answer for this. I think at this point I’m a bit panicked.
A few months ago when my head was on straight I didn’t care if lost my medical license.
Actually, a few months ago I never thought this small matter could result in me losing my medical license. But the story has morphed into something much more complicated. The medical board investigation interview blew my panties off.
I understand and take 100% responsibility for the situation. I should have never offered my clinical opinion to this colleague. By doing that I went down a deep rabbit hole.
But the questioning and the threat of losing my license over this by the investigators left me confused that perhaps there is something much bigger going on that I’m not seeing.
First Meeting With Lawyer
The first session with the lawyer felt informal which was great. I met him at his large corporate office and we sat down to discuss the details of the case. His first question was what the medical board was investigating me for.
I didn’t have a good answer to this very obvious question.
Now after sitting down with him I have a much better understanding of everything that’s going on and why I’m on the hot seat.
He was a bit shocked that I did the interview by myself but he was pleasantly surprised that I at least showed up. Apparently quite a few doctors freeze in their tracks and don’t even show up to the interview.
“Did you wear a tie?”
Of course. And even underwear!
“Don’t say of course. You’d be shocked what doctors do at these hearings and how dismissive they act towards the investigators.”
“Also, how come you don’t just use the lawyers from your employer?”
I asked my employer and they said they don’t represent their physicians for board related investigations.
“What? How is that possible? I don’t believe that. I’ll look into it.”
Next, he reviewed the initial inquiry letter from the medical board from which he deduced a lot more than I did.
I also gave him a synopsis of my answers during the interview. Overall, he said I didn’t do too bad during the interview but that I could have done major damage control at the letter-stage.
Initial Reply To The Medical Board
My initial reply to the medical board wasn’t great. According to my lawyer I should have de-escalated the situation, admitted fault, and provided relevant information to paint myself as an otherwise competent physician.
He will try to addend my reply to the medical board but he said it was likely too late.
The Investigation Interview
The interview didn’t go well based on how emotional the investigators were during the proceedings. He said that it’s not too uncommon for the investigators to pick on someone they don’t like; not just because I’m ugly …I don’t think… but because they have a hunch or something in my story doesn’t fit.
My lawyer believes that I could have done a better job of preventing further questioning by the investigators had I been represented by a lawyer. It’s less likely for investigators to use forceful tactics since they are more cautious around lawyers.
The Reason For The Investigation
- Patient-doctor confidentiality.
- Abusing position of power.
- Inappropriate use of resources.
Though all the above are potential factors, the investigators are only focused on my relationship with the patient. By relationship I am referring to the boundary of whether she was my patient or just a colleague.
That line got blurred because she didn’t pay a copay or get checked in to officially become my patient.
The lawyer was glad that I realized that what I did was wrong. He mentioned that most physicians he deals with have a hard time admitting to and accepting their wrongdoing.
The lawyer confirmed that I definitely could lose my medical license because of this which I admit I was shocked to hear. It’s not only unheard of but also quite possible based on how the interrogation went.
He was a bit worried because the kind of questioning the board subjected me to makes him wonder if there is more to the story or if they just don’t like me. That’s what he’s going to find out.
The Medical Board Process
My lawyer gave me a little 411 about how the medical board works. It goes in the following steps:
- Review the complaint and dismiss if not relevant/pertinent
- Assign investigator and send inquiry letter to doctor
- Decide if further information is needed and possibly meet with physician in person
- Present their findings to the medical board committee
- The committee will then meet with the physician for an interview
- A ruling will be decided on and forwarded to the physician
- The physician can choose to accept it or appeal the decision
There is no legal process for the medical board committee to follow and they don’t have to follow any specific rules when it comes to making their decisions. So they can vote to take my license away, have me pay a fine, or just get a slap on the wrist.
The Cost Of Legal Representation
Even though I earned $100/hour as a physician, I would be paying $300/hour to my lawyer to help represent me. It’s probably not too bad from an economic standpoint since the chance of such investigations are low.
I will be billed on a monthly basis and the first month will be the most expensive since my lawyer will be writing letter to the medical board and Kaiser Permanente.
I can’t stress the importance of having an emergency fund for just such situations. Remember, if you are in my shoes, you wouldn’t have an income to rely on.
Next, he will need to draw up a contract between him and myself to clarify HIPAA boundaries since we will be discussing an individual who had a medical procedure done.
He will need to reach out to various individuals and attempt amend my initial letter. He will need to find character witnesses and see what else the medical board is planning on doing in regards to my investigation.
Contesting The Board’s Decision
Let’s say the medical board says that I’m a bad physician and should lose my medical license or that they decide to fine me and recommend that I take various courses.
Either of these events would suck for me. The former obviously means that I can’t practice medicine and other states where I hold medical licenses would likely agree with that decision.
The latter wouldn’t be good because malpractice carriers will refuse to cover me and insurance companies would refuse to let me bill them.
Interestingly, malpractice insurance isn’t like auto insurance where you have to pay a higher premium in case of lawsuits or other such regulatory investigations.
The cost of contesting the medical board’s decision would be in the $40,000 range from my lawyer’s office. I would then have to pay the fees of the lawyers of the medical board which would be another $30,000. This isn’t including the costs leading up to the board’s decision.
If I then get a favorable judgement we’d be done. If not, then he would appeal the case to go to a legal court and that would cost another $80,000 after all fees to both parties.