For physicians who have multiple state medical licenses, they have to deal with each state individually when it comes to a medical board investigation. If you’ve had a medical board investigation in NV and you have state license in TX and CA, you’ll have to go through the same process with each medical board.
After my initial 30-day license suspension, I’ve had to do a lot of quarterbacking to deal with the other state medical boards. If you have multiple state medical licenses as a medical professional, it’s good to read about my case so that you can be better prepared.
Washington Medical Board Investigation
After I got my medical license suspended and paid a fine to Oregon I received a letter from Washington that they wanted to open their own investigation into the matter. Their attorney just copy and pasted the same narrative Oregon used without doing any fact-checking and notified me that they were “looking into the matter”.
I got the initial letter maybe 2 months ago. Just a few days ago I received a letter from the Washington Medical Commission (the WA medical board) that instead of actually investigating the case they would agree to a stipulated order. A stipulated order just means that it shortcuts the legal process and brings both parties to an agreement – much like settling a malpractice case out of court.
The WA Medical Board didn’t interview me, didn’t interview my old employer, didn’t interview the nurse who was involved, and didn’t interview my colleague; they simply issued a proposed stipulated order based on facts which I disputed with Oregon.
This recent WA letter acknowledges that they received my statement where I explained my situation and disputed the facts which Oregon brought up. The fact that they didn’t believe that I did something so severe to warrant a medical license suspension is why WA has offered me this rather favorable proposed stipulated order. I’m incredibly grateful for this after what I’ve been through.
A stipulated order is a very nice way of quickly resolving the matter. It’s often something you can handle yourself and don’t need a lawyer. That said, if you care about your long-time career in medicine (I don’t) then it’s highly recommended that you proceed with a lawyer. Because your lawyer can still help tweak the terms and conditions of the stipulation.
It was a stipulated order which I signed with Oregon which resulted in a 30-day suspension, a fine, and ruining my spotless employment history.
Washington Proposed Stipulated Order
Here are the terms and conditions of the proposed stipulated order which the WA attorney offered me. Notice, there is no license suspension, unlike what Oregon offered me.
- mandatory compliance orientation through the WA medical board (by phone or in-person)
- a CME course on medical ethics and boundaries (similar to what I’ve already done)
- a 1,000 word written paper on the ethical implications of my actions
- regular personal appearances before the medical board as determined by the WA medical board (could be once a year or several times a year)
- $1,000 fine
Justification of Proposed Sanctions
The WA medical board has a few well-written paragraphs which explain why they offered me a stipulated order as opposed to opening up this case and doing an entire investigation.
They valued the fact that my professional record was clear. This, they believed, was important and why they didn’t want to open the entire case and were willing to agree to a stipulated order.
They also mentioned that I blurred the lines between a patient-doctor relationship and doctor-colleague relationship. And because I didn’t document anything on this patient, I exposed the patient to minor harm.
They also expressed appreciation for my personal statement where I expressed remorse for the mistakes I did in this case.
No matter how pissed I want to be, their explanation is fair. Agreeing to a stipulated order essentially means that they acknowledge everything I’ve done right and everything I’ve done wrong.
There isn’t a whole lot else I can say about this. By trying to expedite the test which I ordered for my colleague I put myself in harm’s way. It’s one thing to advocate for your colleague and another to step in and take over the responsibilities of a physician. Those blurred lines are what resulted in all these headaches.
Signing the Stipulated Order
If I agree to the terms and conditions of the stipulated order then all I have to do is sign it, accept my punishment, and then go through the entire process of enacting the terms. I don’t have the patience for that, nor do I want to be doubly punished for my actions.
Obviously, if your career is important to you and you don’t want to ruffle any feathers, the right move here is to agree to the stipulated order and perhaps offer some slight tweaks and see if the Medical Board will grant them.
In my case, I don’t wish to keep my medical license in Washington and made the stupid mistake of renewing it while I was going through my medical board investigation with Oregon. I should have let the license lapse. And even though WA would have still opened the case against me, the stipulated terms would have been much simpler – likely just some punitive words published about me in their medical board newsletter.
I will see if the Washington Medical Board will allow me to terminate my medical license. I would essentially give up my license voluntarily. Hopefully by doing so they wouldn’t hold me to the other terms and conditions of their proposed stipulated order.
In order to open such negotiations you have 2 options: you can either discuss your proposed changes to the stipulated order by phone with the medical board attorney or you can put it in writing through email or a letter. I have chosen to perform all of my communications with the medical boards through certified letters. I use OnlineCertifiedMail and love how easy it is to create, send, and receive a confirmation for the certified mail without having to ever go to a post-office.
The lawyer will review my proposed changes to the stipulated order and give me an idea if the medical board committee would accept it. If not, we will tweak it back and forth until it seems agreeable. Based on that, the attorney will take back whatever I’ve come up with in front of the medical board committee during their next meeting and notify me if it was accepted and when it will go into effect.
Don’t forget, you have to report this proposed stipulated order to all of the following:
- your current employer
- each of the other states where you have a medical license
- your medical specialty body
- your malpractice insurer
Yeap. For each of these entities you have to send a certified letter and report this event. And once you agree on the stipulated order you’ll have to notify them of the terms of the stipulated order.
I still have to deal with the California medical board so I have a lot of work ahead of me. I can’t help but feel frustrated about all this. It’s demoralizing and though it doesn’t change how I feel about the practice of medicine, it makes me want to light my credentials on fire.
It’s important to point out that you don’t have to deal with all of this yourself. You can hire a lawyer in each state to handle all of the communication on your behalf. You don’t even have to see that lawyer in person – it can all be done over email or on the phone.
I would expect that for each state you would likely spend around $3,000-5,000 to go back and forth for the stipulated order. If a state decides to do an official hearing and do their own investigation, expect to spend north of $10,000.