Unless you have done something absolutely appalling, it’s a sinking feeling to find out that your medical license has been revoked. It doesn’t happen overnight so you probably knew it was coming but you are still left with having to figure out the next steps.
Letter from the Medical Board
I got a certified letter from the medical board that they have decided to revoke my medical license and impose a $10k financial penalty plus any financial cost they incurred conducting their investigation.
When the medical board reaches their final decision they will send you a certified letter with that decision. A more structured document will be included which will include the wording that will enter your public record. In my case it’s the events surrounding the investigation.
The document that was mailed to me concluded with their justification for reaching their particular verdict of revoking my license and the sanctioned fines.
Though it is a final decision of the medical board, I still have the right to a hearing which I must request within 30 days of their certified letter. If I don’t reply to them then it becomes a default judgement and they will proceed with their intended actions.
The letter from the medical board will often contain a date by which you need to reply to the medical board to request a hearing.
During this hearing my lawyer and I can try to negotiate the details of the judgement. There isn’t a whole lot of room for negotiations because this isn’t an appeal – just a hearing.
The wording of the public statement from the medical board is a common item to address during the hearing. For example, they might want to use a word such as “theft & deceit” and we may ask to change it to “unprofessional conduct”.
I can also contest the medical board’s decision during this hearing but I would have to cite something substantial. In my case, we will likely cite that the facts the medical board has from my ex-employer are erroneous and manufactured.
Depending on which state you practice in, there is some room to bring statement of facts from involved individuals to make your case.
Requesting Records From The Medical Board
In order to prepare for the hearing your lawyer will request all the facts that the medical board investigation team has collected. This will include interviews of involved individuals, testimonies, and employment records.
Having the medical board change such a drastic decision is a longshot but if there are obvious flaws and errors in the facts of the case then it can give me a chance to keep my medical license.
After The Hearing
The board usually gets back to you within a few weeks after the hearing. Depending on your bargaining tools they might alter their final judgement and comply with some of your requests.
Otherwise they can stick to their original decision to revoke your medical license and that’s when your license would need to be forfeited. You still have an option to appeal the medical board’s decision but you won’t have a medical license in the meantime.
I discussed the appeal process in previous posts. I have the option to appeal their decision after it goes into effect by having my lawyer file the appeal with the medical board.
The appeal process would involve me hiring my own investigator, subpoenaing records, conducting interviews, putting together a case, and meeting with the medical board once again.
After the first round of appeals before an administrative judge I have the option of appealing to a higher court. This is the 2nd and final appeals options.
Regardless of the ruling of the higher courts, the medical board can still overrule the higher court’s decision and still maintain for my license to be revoked. This is an interesting veto power that the medical board maintains.
A Revoked License isn’t Permanent
Once your license is revoked then you have a 3 year minimum waiting period before you can petition for your license to be reinstated. This varies from state to state but it seems to be commonplace.
This process is lengthy, tedious, and of course lucrative for the lawyers involved. You and your lawyer would gather character witnesses, statements from employers, CME certificates, volunteer letters, remediation course letters, and psychiatric evaluations in order to put together a case to petition the medical board to reinstate your medical license.
You can then request that your license get reinstated. This might be a contingent license or you might have your medical license reinstated fully. Obviously it all depends on the medical board and the potency of your petition.
Decision To Appeal
Whether you decide to immediately appeal the medical board’s decision or you decide to wait 3 years before asking for your medical license to be reinstated, you must continue and begin the following actions:
- get CME credits
- perform community/volunteer work
- take remediation courses
- get multiple psych evaluations
- get character witnesses
- have a lot of fucking money
None of this is cheap and regardless of the cost estimates your lawyer gives you, it will likely be far more.
Not only will you have to see a psychiatrist, take remediation courses, take CME courses, and travel for some of these courses, but you’ll also have to pay your lawyer, pay an investigator, pay for a notary, etc.
Whatever money you’ll lose directly will be compounded by your inability to earn an income.
Nothing is Guaranteed
Just because you initiate an appeal doesn’t mean the judgement will be overturned. The medical board can make the final decision unless you decide to sue the medical board which would require celebrity money.
Even if in the end you win the appeal and the medical board changes their mind, you are still out of the money and time you spend appealing. It’s not like the medical board will apologize to you and use taxpayer money to reimburse you.
Debt & Income & Principalities
I figure there are 3 different types of situations when a physician will decide to fight the medical board:.
1. Principalities. You are butthurt to the level of N and you are not willing to take it lying down. Call it justice, call it principles, call it ego, call it a loss of identity … you’re going to fight this until you run out of money.
2. Mega Debt. If you have a massive mortgage then you can always sell the house and rent. But if you have a hefty student loan balance then nobody will forgive that debt even if you lost your medical license.
3. Need For Income. If you have no other way to earn an income and cannot fathom doing anything other than medicine then you’re likely going to spend anything and everything that you have to get your medical license back.
Your Tainted Medical License
Finally, before you decide to fight to get your medical license back on an appeal it’s important to understand that you will have one fucked up personal record.
In the eyes of malpractice insurers, employers, and future malpractice cases you are the ex-con of medicine.
Just because you have your medical license back doesn’t mean you can get a job. And once you have a job then you might be looking over your shoulder every minute.
Should the unfortunate day come when you finally get sued as a physician then your medical board investigation will be brought up in court and you’ll have to defend that as well.
There is absolutely nothing different about you as an individual right before and right after having your medical license revoked. You are a unique person with your unique group of friends, a good lifestyle, interesting hobbies, and goals.
However, if your identity was caught up with being a physician then you are going to have a tough time accepting the new circumstances.
You’ll likely already have gone through the blame stage and are trying to deal with acceptance. The problem is that these medical board investigations are meant to constantly provide new disruptions – often making you relieve old emotions.
Find your routine again, whether it was reading at a cafe or hanging out with friends and family or going to the gym. Everything will likely feel more tasteless because your medical license is on your mind.
Take a trip and get the fuck out. Change your environment when you’re in a rut, not to escape problems but to bolster your senses and lighten your perception of the situation.
Feelings of despair, suicide, impending doom, anxiety, insomnia, worry, blame, and other emotions are perfectly normal. Our society makes you feel like a criminal for having such thoughts – nothing wrong with them, just a way for your body to cope. Be patient and take that gun out of your mouth.
I don’t know if this is a good analogy but I have been thinking of a revoked medical license as going bankrupt. I then think about all the successful entrepreneurs who have fought their way back up from a bankruptcy to eventual success.
It sucks giving up your $100-$500/hour income but you obviously have a skill that’s highly valued by society. There are many ways of coming back from this kind of legal disaster, it’s just a matter of how you’ll do it. You can consult, teach, lecture, write, edit within medicine or start a completely unrelated business.
Whether you decide to pursue the matter or not it’s important to get solid legal advice. You’ll need to find the kind of lawyer who has dealt with the medical board before. This lawyer will have to have filed petitions, conducted investigations, and been present with clients during hearings.
The decisions are up to you but your lawyer can give you great advice and give you a good sense of what to expect. A competent lawyer will also have experience with the many emotional turmoils his/her client deals with – my lawyer did a fantastic job with that.
A good lawyer will also have connections – inside connections in the medical board. They can find out the ‘progress’ of your case because they know the lawyer(s) on the opposing side.
There are annual nerdy lawyer meetings where they are invited to speak to medical boards or have representatives do that. This further gives them inside information that can benefit you. You can find out if your lawyer’s law firm is part of such meetings.
Word of Mouth
Lawyers, like doctors, aren’t found on Yelp. You’ll need a word of mouth referral. Start talking to your lawyer friends and some older physicians – ideally someone who has dealt with the medical board in the past.
Once you get the referrals it’s helpful to sit down with the lawyer. Unfortunately ‘vibes’ and ‘first impressions’ aren’t reliable metrics but you will need to work with this person a lot over the next few months/years so it should be someone whom you can sit across for hours at a time.
Employment & Finances
As soon as you have something like a medical board investigation on your hands it’s important to go into emergency financial lockdown. Do it even if you think you have a slam-dunk case as I thought I did.
Legal fees, conferences, consulting fees, and unnecessary CME’s will eat up your savings quickly.
Money gives you options – option to suffer through the bullshit or cut the rope. Should you sit through more medical board investigation hearings just to be berated and belittled? If you have enough money and other sources of income then you can make the decision that’s right for you.
You’ve read my blog, you know all the different things that I do to earn an income. I realized a long time ago that I have a target painted on my white coat – it’s just that most shots had missed the target so far.
If you are on good terms with your medical group then ask for a position within the organization where you don’t need to use your medical license. For this matter it’s best to reach higher than HR and contact organizational leaders.
Have some good recommendation letters, a list of skills that you might have, and be prepared to take a pay cut but at least you’ll have less financial stress.
There are plenty of medical groups who have moved their physicians from direct patient care into management positions once they lost their medical licenses.
If you choose to share the progress of your case with family and friends then you’ll get a rainbow of different opinions. Each person often is telling you what they would do for themselves if they were in your shoes. They aren’t giving you an objective opinion.
However, most of us have that one aspy friend who can separate the facts from emotions quite well and that’s probably a good person to run things by.
Your decision to appeal or not to appeal, to fight or to just walk away is a personal one that nobody can make for you. Staying and fighting your revoked medical license means having to spend a lot of money. Can you be okay with the potential outcome or will you beat yourself up? Are you the uber-conservative cautious type? Then maybe it’s better for you to stay and fight. Are you confident that you’ll land on your feet regardless? Then maybe cutting your losses makes the most sense.
Medical License in Other States
I hope that you have multiple state medical licenses in order to protect yourself from a revoked medical license. If you don’t then you’ll have a hard time applying for one during a medical board investigation.
The common practice by other states is to take the same action as your investigating medical board, namely to revoke your license. Your state’s medical board will disseminate their final decision of a revoked medical license to all the other states through a national database and you’ll soon be corresponding with other medical boards in other states where you are licensed.
To appeal each state’s decision or negotiate with them you’ll likely need a lawyer in that particular state unless you decide to do it yourself, in which case you can keep your current lawyer and have them help you draft your appeals process. But they won’t be able to represent you and they won’t know the legal scene in the other state as well.