I just got back from Oakland after my medical board hearing. I got destroyed. It wasn’t a hearing before the medical board as I wrongfully assumed, it was a full-on courtroom with a presiding administrative judge and the medical board attorney. I had no place being there without a lawyer. More on that in another post.
I learned something interesting during the hearing which I think is worth sharing with readers. As you know, claiming to be ‘board certified’ has certain conditions associated with it. In order to claim you are board certified you have to meet the criteria set forth by your state’s Business and Professions Code.
You aren’t taught this in medical school, nor in residency. Your CME’s don’t discuss this and your board certification exam doesn’t review it. It’s on you to know it so read on.
Board Certified in California
I was board certified by the ABMS up until December of last year. I have decided to let my board certification under the ABFM lapse and decided to go with NBPAS for my board certification. I have several reasons why I decided to go this route which I’ve shared on this website before.
During the hearing, the California medical board attorney asked me on the witness stand if I was board certified and I said yes. She then proceeded to point out to the administrative judge why I was, in fact, not considered to be board certified.
The California medical board adheres to the Business and Professions Code regarding claiming to be board certified. Specifically, section 651(h).
Apparently this was a recent amendment – January 1st, 2019, just 2 months ago. Prior to this you could petition the California medical board to recognize your non-ABMS board specialty. Though I’m not sure if they would recognize NBPAS even if you petitioned prior to this amendment.
ACGME Postgraduate Training
Take a look at #2 in the screenshot above and it reads as though you would be considered board certified and could claim it if you completed an ACGME accredited postgraduate training program.
Alternative to Claiming to be Board Certified
If you choose to get out from under the ABMS it doesn’t mean that you can’t claim a board certification in California with an alternate credentialing body. It’s just that you can’t use the word ‘board certified’.
It’s like a ™ which can only be used with a particular product. This is important to California because they recognize that the public assumes something about a physician who claims to be board certified. And that’s that the physician is routinely tested and held to a high standard.
This is rather fair. If you’re going to be in charge of licensees then it’s important that you safeguard the grammar to prevent any confusion. They aren’t prohibiting you from using other verbiage to describe your non-ABMS affiliations.
California lets you claim to be a ‘diplomate’ or ‘member’ or ‘approved by’ to indicate that you have an affiliation with a particular specialty. You can even say that your expertise is in Family Medicine or Internal Medicine. I’m not sure if you can say you are a specialist in those specialties.
NBPAS in California
I looked through the NBPAS FAQ section and found that they highlight their lack of penetration with California and Texas. Again, you can still practice in California but you cannot use certain terminology regarding your board certification status or board specialty.
If you have your own medical practice then it’s important that you consult with an attorney who is familiar with this. If a state has this kind of a law then you have to assume that there are similar laws which may not be on your radar.
In fact, I was looking through the California medical board website and there are a lot of different rules regarding what you can claim as a physician in advertising and other patient-facing claims. It’s rather interesting but unless you have a ton of free time it can be hard to read through all of it.
Board Certification in Other States
I hold a license in OR and WA as well. I am allowed to claim to be board certified in those states because I am not restricted to the ABMS (parent company of ABFM) for a board specialty designation.
Online Patients
This creates a bit of an issue when seeing online patients and needs to be addressed. I just don’t know by whom. Can I say I’m board certified to another person because I’m board certified in another state? What if that person is from CA? How would I know they are from CA?
If you have an online profile and a patient from California can access it then it’s on you to address that. I will look through my many online profiles and see if and where I am making that claim because I’m in enough trouble and don’t need more.
Potential Solution
Don’t claim to be board certified. It doesn’t help you in any way if you’re a family medicine doctor. The average patient is intelligent enough to have sought you out and can determine for themselves if you are capable and competent.
You can say that you attended a Family Medicine residency. Or that you are affiliated with the NBPAS who recognizes you as a Family Medicine physician. Even this you need to run by a lawyer if you have your own practice or see patients across multiple state lines.
Employers
What about an employer or an affiliate company who advertises you as being board certified and does business across multiple state lines? Such is the case which came up for me during my California medical board hearing.
If they are advertising you to be a board certified physician to their clients or patients in other states then they are the ones violating the Business and Professions Code. This doesn’t mean that you can play dumb to this. If you know about this then you should document that you have taken steps to point it out to that medical group or entity.
I don’t think the medical board will be vindictive in such cases. If you are found to have made such a claim erroneously and there isn’t any sign that you did it intentionally I would expect that they will point this out to you and give you a chance to correct it.
4 replies on “Physicians Claiming to Be Board Certified in California”
Sorry about the California board. Seems to be one of those states that lets nurses run wild while torturing physicians….
Not sure I agree with that assessment. I’ve had my ass saved by my nurses on more occasions than I can count. But because of this shitty power dynamic which exists in medicine a nurse has no recourse with a physician and will take out their anger the only way they know how which might be through escalating the case legally.
Doctors are no better. I’ve had colleagues complain about me to my chief – 2 pediatricians, 1 gynecologist, 1 neurologist – instead of coming to me directly. Each of those cases actually had valid reasons why they disagreed with my management and in one of the pediatric cases I was, in fact, dead wrong. But why escalate? Why not communicate with each other.
In my career I have reported 1 PA and 2 nurses to their supervisors but that was after I addressed the issues with them multiple times and they couldn’t or wouldn’t make any changes. It was always in the role of a medical director which, unfortunately, puts you in more of these reporting instances.
As much as I would like to hate the guts of this nurse for making up all of the lies she did, my actions got her fired. I feel fucking shitty about that but this was just one ugly mess of a case.
Dr. Mo,
I think you have previously addressed (and you noted above you would have more on it) the need for physicians to always have an attorney when dealing with the medical board, but it is worth mentioning frequently. Since I can’t speak to all medical boards (thankfully), it still seems from all I read and hear that the medical boards are more or less a quasi-law enforcement agency always poised to hammer away at their physicians. The only exception is those physicians with substance abuse problems who seemingly get multiple chances. I’m not downplaying the challenge of substance abuse, just that our medical boards frequently crucify their own for the silliest things.
My other thought is why in the hell would any doctor want to put up with that kind of shit to practice in California? What kind of radar picks up on petty things like your situation AND goes to the length of having you appear before the board? I don’t know all of the details, but it sounds like that could have been handled over the phone. Board appearances (and investigations to get to that point) should be reserved for issues where the subject physician could harm or has harmed the public (patients).
We should start a Go Fund Me or formal defense fund for physicians to stand up and bring claims/counterclaims against rogue medical boards in the most public ways. At the same time, impressing our state politicians to legislatively reign in the ridiculous power the medical boards have in making hell for the lives of physicians.
We worked too hard to get in and out of medical school. Studied and trained for years at low wages only to get out and be strapped with regulations, credentialing bullshit, staying up to date and trying to make a living for us and our families who have also sacrificed.
Keep up the good fight.
Exactly as you said dude, don’t handle any of this without a lawyer unless you have a legitimate reason not to. The lawyer I worked with in Oregon was an awesome human being. He genuinely sat me down and told me why what I did was wrong. Never judged me. Let me be as blunt and honest as possible and before we concluded our relationship he asked me what I learned and what I would do differently. So don’t think all lawyers are shitty – I’ve had the exact opposite experience. And once you have a lawyer guys, be 100% honest. Even if you are confused what’s fact and what’s not, you’re the quarterback, not your lawyer. You need to let them know all the facts and let them figure out a strategy.
As for us putting up with this shit … I messed this case up and should have never gone to this hearing. I’m working on a long post to highlight this. A patient without a surgeon in the OR is akin to a doctor in a courtroom without legal representation. Don’t do it. My intention was to get a stipulated order – that’s what I assumed I was showing up to. Instead it was a full on administrative hearing before an ALJ. Fuck me. Their attorney chewed me up, spit me out.
My biggest contention with the process is, as you highlighted, the medical board wants to paint us as criminals. They want us to be guilty. I can speak for anyone else’s case but at least in my case I haven’t been able to just accept my mistakes, apologize for them, show the medical boards what I’m gonna do to correct them and move on. No. Instead I’m this criminal and danger to the public which is absolutely ridiculous. I am comfortable being punished – I’m not a child who’s gonna go crying. Punish me for what I did wrong. I get a fine if I’m overdrawn in my checking. I get an interest tacked on to any underpayments to the IRS. I have to pay a fine for speeding and I’ll get a DUI if I drive drunk.
But if it went beyond that then it would no longer make sense. The bank can’t fine me and close my account and ruin my credit report. If the medical board wants blood then why waste money and resources on a process. Just terminate the licensee as soon as anything goes wrong. Don’t give them a chance to redeem themselves.
As for the go-fund-me page. This is the GFM page for doctors right here. You guys call me and vomit out all of your own medical board issues. And I feel for you deeply because I know it hurts. And you guys share some terrible and secret shit with me and you share some very dark thoughts. And it’s not easy for me to hear it because every time I do I’m reliving my own shit. But I’m sharing with you everything that I’m going through and sharing with you guys that there is a way out and that you can fight back and that it’s not the end of the world. You can find other ways of living without being dependent on your income in medicine. You can do a lot with your experience as a health professional in medicine.
I also recognize that some of my writing could make some of you guys jaded. So let me highlight something really big and important: the Washington medical board fined me $100 which was only the cost recovery for having to deal with this case. They didn’t terminate my license, didn’t suspend it, didn’t do anything else. They accepted and acknowledged that I’m deeply sorry for the mistakes I made and accepted that my intention was in the right place – I wanted to help the patient but I fucked up in the execution.
So let’s not hang all medical boards just because I had a shitty experience.
Finally, as for addiction, exactly like you said, it’s a fucking disease. Let’s stop punishing people for having a disease. As a recovering fattist who would blame my patients for being obese and having consequences from the disease I realize how difficult certain health conditions are. I’m embarrassed that I even had those view points back in the day but I’ve learned. No physician who has alcohol or benzo or opioid addiction should be punished irreversibly. They should get support, supervision, love, attention, and slowly integrated back into clinical medicine.