I’m into the second week of serving my medical license suspension and I’ve gotten a chance to reflect on the practice of medicine and seeing patients.
No part of me misses seeing patients though I suspect I will go back to it after the medical boards finish playing their games.
I am now busy dealing with California who will perform their own separate investigation and has already initiated a license suspension, separate from this one which I’m serving with Oregon.
Medical License Suspension
At least I am serving this suspension from Seville, Spain. This is a beautiful city with some of the friendliest humans I’ve met. It doesn’t hurt that the euro goes far here.
I’m writing this post from a cafe in the beautiful city of Cadiz. It’s the closest beach city to Seville, about a 2-hour drive or a 2.5-hour train ride.
I am not sure what the purpose of the medical license suspension was. I get that there is a protocol to be followed in medicine but I just don’t see how this punishment fits what took place in my situation.
Serving the license suspension has been fairly easy. All I need to do is wake up, have a cup of coffee, go to the gym, read books, and write for my blog. I got this!
What’s annoying is the uncertainty and dealing with the consequences of a medical license suspension. I have to exchange emails and letter with medical groups, CMS, and other state medical boards.
Not Seeing Patients
In these past 2 weeks I have done no clinical medicine whatsoever. No telemedicine. No replying to patient messages. No logging on to medical forums to discuss medicine. No clinical case reviews.
The toughest part about this – and maybe why I have never strayed too far away from clinical medicine – is that I don’t miss it. I miss the income but I don’t miss seeing patients online, and certainly not in the clinic.
I don’t miss replying to patients. I don’t miss getting a 1-star review for not giving a patient antibiotics. I don’t miss getting my performance reports from the telemedicine companies. I don’t miss wondering if I missed something important on a patient. Wondering whether I should have sent that one to the ER or given her precautionary antibiotics. If I was a dick for not refilling his blood pressure meds because he hadn’t had any blood tests in 2 years.
In the past I used to love the happy patients. Those who’d give me 5-star reviews or those expressing their appreciation.
Now, no, I don’t even miss that. It really has become a means to an end.
Secretly, I am searching on the inside to see if my interest in medicine can get reignited. I am hoping that not seeing patients will make me miss it; it never works.
There was a glimmer of hope when I first stopped working in the urgent care. For the first few months I missed seeing patients in person. Now, not even a bit.
The Medical Board’s Reach
You know what I used to fear the most? Causing medical harm to a patient. Not out of fear of a lawsuit but because I would feel so bad if the patient had to suffer from my mistake.
I’ve had my fair share of mistakes. I have 2-3 deaths under my belt which I believe resulted from me not having been thorough enough. I can live with those and I learned a lot from those – I can’t improve as a doctor without making mistakes.
I never got into trouble for any of those cases either because nobody ever filed a lawsuit or the because the charts were adequately defensively worded. But medicine isn’t practiced in a court of law, I know what I could have done better.
So I used to fear going to court for a bad patient outcome and from what I have learned it’s not the malpractice lawyers I have to worry about but the medical board. Malpractice cases are often settled out of court and there is very good precedence. And though never a pleasant experience, they have a beginning, a middle, and an end.
The medical board, on the other hand, doesn’t have to operate within the confines of the law. They will perform their investigations and finalize their judgement completely on their own terms.
Your only recourse is to sue or take the case up to higher courts. But the burden of proof is on you. The litigation expenses are on you. And whatever the final result, the medical board can veto it.
Consequences on Medicine
I asked the medical board what I would do in case there was patient follow-up which I needed to address. The answer was that it was my problem to deal with. Any manner of patient interactions would be considered noncompliance with my medical license suspension.
What if I had my own medical practice? What if I was a surgeon and needed to follow a complicated case? What if I was part of a research trial and had ongoing cases? What if my employer couldn’t find a replacement in time?
Not their problem. My problem. And likely the punitive intention of the punishment. Well-played, sir.
I really don’t think that the medical boards wants to be this punitive – or maybe I’m just being naive. After all, they are in the business of protecting patients from rogue doctors.
Their enforcement of their own rules is where the poor execution lies. Maybe they see no other viable options when it comes to disciplining doctors but this whole process is chaos.
I am not sure what the point of this medical license suspension is exactly, still scratching my head over it. To sully my reputation? To impose a financial burden on me? To stop me from causing 30 days worth of harm? To try to get me fired from a job? I’m not sure. Maybe all of the above or maybe none.
Reflecting on Medicine
There are times when you get to reflect on certain major things in your life, like a relationship, a marriage, a financial decision, and a career.
I’ve had time to reflect on my career as a physician both when I was working a busy 60-hour week and now, when I am not seeing any patients.
Just like a shitty marriage that you need to put behind you, I realize that I need to step away from the practice of medicine. But those of you who are physicians know how hard that is.
Selfishly, practicing urgent care medicine is easy as pie for me. Practicing defensive medicine to make it to the next day is second-nature. Therefore, giving up the income from something this rudimentary is painful.
So why can’t I just cut the cord? Cancel the medical licenses, sit back and enjoy my retirement?
I think a big part of it is fearing not having the income from medicine. Maybe I’m not convinced that I can live a comfortable life without that income – I’ll revisit this again in future posts. Or maybe I haven’t found something to do in which I feel as productive as practicing medicine.
I have to admit that I’m a very stubborn man when it comes to any such processes. Especially when I am not convinced that I’m fully in the wrong.
I still have a lot of things to deal with when it comes to Oregon and California and I’ll have to deal with Washington as well. I’ll then have some back and forths with a few of the telemedicine medical groups for whom I work.
But, eventually, say, sometime in the middle of 2019, all this will be a thing of the past. I’ll be right back to earning my usual income from medicine and maybe I’ll even do a little good here and there for some patients.
The most disheartening thing of all is that I really don’t have any more love left for medicine. Whatever was left, it got squeezed out of me by these medical boards. Doesn’t mean I won’t keep trying to keep some part of medicine in my life but the cards are stacked against me.