The medical board investigation process can be exhausting but it will often culminate in a medical board interview where you are asked to present before the medical board members for a hearing. This post is about preparing for the medical board interview from information I have gathered from my lawyer and what I’ve already been through.
Intentions of the Medical Board
The medical board isn’t there to protect us physicians but instead the public. We are considered guilty until proven otherwise. This isn’t a statement made from a bitter heart but based on what lawyers and other experts have shared with me about the medical investigation process.
Unfortunately, there is some logic to this method because the medical board doesn’t do audits of its licensees and always assumes that if a physician isn’t complained about then they are a physician in good standing.
Once a complaint comes in and makes it past the complaint department, thus deemed worthy of going to the investigative committee, it is assumed that this physician must be a bad seed and everything possible about them should be pursued.
It’s flawed, of course. If you have ever diagnosed, prescribed, or done a physical exam on a friend or family member then you would be in the same shoes as myself, having to appear before the medical board, spend thousands of dollars on courses and lawyers and have your record smeared permanently.
Our US culture is big on punishment, big on justice and huge on retribution. That same sentiment carries across to our physicians. It allows the public and those tasked with protecting the public to sleep easy at night, knowing that guilty individuals are jailed or punished before the public.
The medical board investigation process is supposed to be intimidating, laborious, lengthy, complex, and expensive. The process is supposed to label me a bad seed and hopefully hurt me career wise either through lost income or getting fired.
All that said, it’s also supposed to hopefully prevent me from making such a mistake in the future.
Medical Board Interview Request
I shared with the readers that I got tricked by the medical board once thinking that I was going to appear before them but instead ended up in front of 3 investigators – that should have never happened. Read your letters carefully and consult a lawyer if you need to.
You don’t need to retain a lawyer for the entire process. You can sit down with a lawyer on an hourly basis at $300/hour and just discuss the process, ask questions, and gain guidance.
You can even call or email your investigator to find out exactly who will be present during the interview that’s scheduled for you. If the interview is with investigators then you have the right to either refuse that interview or ask them to send you their questions in writing and that you’ll wait to appear before the medical board members for your interview.
If it’s a legit interview then you will appear before the members of the medical board which might be the Investigative Committee. You will also have a discovery letter in which you will be told exactly what you are being accused of. Expect this to arrive in the form of certified mail.
The date and time can be negotiated and you’ll probably get a couple of weeks to a month advance notice for this medical board interview request.
Medical Board Interview Setting
Back to the punitive process. The setting in which you’ll appear before the medical board will be intimidating or at least uncomfortable.
It’s common for the medical board members to be seated on a higher podium while you’re sandwiched in the back by the investigator(s).
Expect there to be a court secretary who will record everything either by typing it out and/or recording your voice.
The process might take 1-2 hours and there may be technical problems. The board members may discuss things among themselves. You may get very warm in the room or very cold.
It’s best to not request a bathroom break so plan accordingly.
Meeting with your Lawyer
This is a good time to meet with your lawyer because the facts which are included in the discovery letter can give you a glimpse into what the main concerns are.
While reviewing my discovery letter my lawyer and I realized that they are going after multiple other factors which weren’t in our radar initially. This makes the case slightly more complicated but at least we can prepare for it.
I am a big DIY-er but I’ll be the first to admit that I never anticipated all the shit that my lawyer was able to identify. Granted, he is very good at what he does but I admit my naiveness.
Prepare a Letter
For the most part of the investigation process you will likely only have a basic idea as to what is being investigated and you will know very little about what the investigators know.
Now that you had a certified letter inform you of the medial board interview date and you received the discovery letter, you have a better idea what you will be asked about.
This is a good time to prepare a well-written letter to the medical board. I might write a post on this topic alone because it’s quite involved and it can be quite advantageous to do so.
The letter should address the following 3 factors:
- the exact situation you were involved in
- what you did wrong and what you have learned
- how you will behave and change moving forward
Prepare for the Oral Portion
Some topics are worth writing in your letter to the board but some things the medical board will keep up their sleeve and you may need to be ready for.
Such unanticipated blows are common during a medical board interview even though they would never fly in a real courtroom where all facts have to shared with each side.
Honesty should obviously be the cornerstone of your defense. This isn’t the courtroom where you can mask some facts and hide behind legal speak. Be honest because it will make the punishment hopefully less severe. Whatever the situation was, whatever you said before, it’s irrelevant and you should focus on coming clean to the medical board interview committee.
However, that doesn’t mean that you should be excessively honest. It still is helpful to use the right wording and set the context in order to give the medical board members, who are after all human, some insight into why you did or said what you did.
It’s a good idea to come up with a lot of possible questions and figure out how you can answer them.
As for your lawyer, they cannot say much during a medical board interview. They can be present in the room and they can protect you if the board gets verbally hostile but they can’t step in and rephrase what you’ve said.
However, your lawyer can use signals such as clearing their throat or asking you if it’s hot in the room to give you a clue that you are drowning with your answer. This should reset your mind get your guard back up.
Expect the medical board interview to be bipolar, switching from kind and inviting to accusatory and inflammatory. One member might try to get you to let your guard down while another will try to attack you, hoping that you will crack.
Remember, you are guilty, that’s why you are appearing before the medical board. The medical board interview serves the purpose of having you come clean. To squeeze the facts out of you and hopefully paint you as an evil and conniving individual.
Enroll in Relevant Courses
When you are preparing your letter to the medical board it’s also a good time to consider enrolling in any relevant courses which will help expedite the process on the back end.
If you are appearing before the medical board because you prescribed antibiotics to your father without charting anything then it’s a good idea to take a Professional Boundaries course and a Medical Charting course.
The medical board will likely make you do it anyways so it’s a good idea to have it ready.
Even if you don’t complete the courses until after the medical board interview, at least you won’t have to trade even more emails or letters with the medical board in the future to get these things done.
Set your Demeanor
How you come across when you talk and your body language is important. This is a good thing to practice with a lawyer friend who has some courtroom experience.
Sit with an open body language facing the medical board members. Have your hands crossed in front of your body but not on your lap and now around your face.
Sit comfortably but don’t slouch and don’t lean back too far. Don’t lean too forward either. Neutral, open, receptive.
Make eye contact with whomever addresses you but no need to hold it. Let them know you are addressing them.
It’s important to answer firmly without being emotional. Use the fewest words possible and address only the question that’s asked of you.
Your State of Mind
After doing a lot of research and talking to different experts the conclusion I have made -and I hope it works for you as well – is to appear before the medical board with a state of mind that reads something like: “I have made a mistake, I have learned from my mistake, I am ready and willing to discuss it in any level of depth demanded of me.
“I have moved on from the angry and blame phase to the acceptance phase and am preoccupied with how I can prevent something like this from happening in the future.
I’m ready and willing to talk about the details and demonstrate exactly why what I did was wrong and what I have learned from it.”
Don’t go in bitter. Yes, the process isn’t kind to doctors and you are dealing with a whole lot of other things such as possibly having lost your job and being left without an income.
Don’t blame the medical board. You wouldn’t have a medical license in that state if it wasn’t for the medical board. The public demands this process and it’s a necessary evil. Doesn’t mean that it’s fair – it just is what it is.
Don’t be mad at yourself. Definitely don’t go blaming yourself. You are human and you’re a physician – these are 2 hard things to balance. If you are obviously guilty then admit your fault and take solace in knowing that you’ll never repeat that mistake – I know I won’t. Don’t get caught up in negative thoughts, blaming yourself and being mad at yourself – you are taking proactive steps to remedy the situation.
Don’t think you are a victim. It would be detrimental to you if you went in thinking that you are a victim. You aren’t. You are there because something you did didn’t sit well with someone and you are there to answer for it – it’s the process that we as a nation have chosen for our physicians. It’s helpful to accept it. As my Professional Boundaries course instructor said: “Everyone but you gets to decide if a professional boundary violation occurred.”
Develop some zen. I think it’s good to develop some zen about the situation before you appear before the medical board. You accept the situation and you aren’t mad at any of the members involved. This process will end and those who accused you and the investigators will move on to the next case.
Don’t be vindictive. If you are having vindictive circulating thoughts up in that cerebrum of yours it’s a good time to pay them less attention. You may want to tell off the person who reported you. You may want to punch the investigator in the face for verbally attacking you. You may want to sue person X… no matter what it is, it’s good to let it go. Wait until you are done with this process and if you still feel strongly about such retaliatory actions then pursue them.
I think I have finally gotten to a point where I have realized that the best thing I can do is learn something from this process so that I don’t end up before an investigative committee in the future.
In my mind I have forgiven the nurse who reported me to the medical board and for the wild accusations she made. Hopefully she won’t do that to another physician in the future.
I forgive the medical board for making this process punitive and realize that it’s their intention to make it a costly process for a physician. I also realize that they aren’t singling me out – this is what happens to every physician unfortunate enough to have to appear before the medical board.
I have also identified the things that I have done wrong and what kind of mindset I had that led me to do what I did. I have worked on that mindset and won’t let that happen again.
At the same time I don’t want to be beat down or feel defeated after this process is over. For that reason I maintain that what I did was wrong but that it’s not necessary to be punitive when it comes to disciplining physicians. We are a self-motivated group and most of us are very well-intentioned.