The Washington Medical Commission, aka the Washington Medical Board, just like any state medical board, can request that a physician appear in person for questioning or for other housekeeping reasons. This is often called a personal appearance.
I have now had 2 personal appearances before state medical boards ever since my medical board investigation ordeal began. In this post I’ll talk about my experience with the Washington Medical Commission.
Check out this PDF which shows the WA medical board’s investigation process.
I wasn’t the only physician there that day. There was a gang of us outside of the conference center. Everyone waiting, dressed in suits and ties. Some angry, some rather pleasant, some catching up on charting.
The personal appearance is often announced well in advance. So, you know that you’re coming up for one. And when you’re appearing before the Washington Medical Commission you’ll be in a room with about 15 other people.
A personal appearance could be requested because you’re under investigation or towards the end, when you’re requesting to terminate your stipulated order. This latter reason is why I had to appear before the Washington Medical Board.
I negotiated the terms of my stipulated order myself. Sorry, but I’ve been rather disappointed with the work that lawyers are willing to put into our medical license cases. And they are in bed with the medical boards, so naturally they don’t want to bite the hand that feeds them.
Washington Medical Commission Members
Ever since I started my investigation process with the WMC, I’ve had nothing but pleasant exchanges. From the emails to the phone calls to them helping me meet all of the requirement before my personal appearance.
They have 2 different committees and you’ll be assigned to one or the other. But there is only 1 lawyer for both and when when you appear before the medical board, you’ll be meeting the whole crew.
I counted about 10 different medical board members. Most were MD’s. There was an MD/JD and 2 non-physicians.
Obviously, if you’re being asked to appear before the medical board, you better have your story ironed out. You might need to bring some supportive documents, and you can have a lawyer present.
The narrative is the key. And saying less is always better. The room is intimidating enough and saying too much just opens you up to more questions. If you come across as inconsistent, well, that just makes you look bad.
You’ll have the attorney for the Washington Medical Commission state a brief history of your case or reason for your appearance.
Questioning by Each Member
Then, the lead for the medical boards will start by asking you some basic questions such as where you studied, where you’ve practiced, and where you are practicing now. Sometimes, rarely, they’ll have you tell what happened in your particular case in your own words.
One by one, each member will ask their own set of questions. And it’s all rehearsed. They will have read through all of your records and so you’ll need to be prepared.
Questions in my case were:
- what have you learned from this case and how will you practice differently moving forward?
- how has this even affected your career prospects?
- what did you learn from the professional boundaries course you took?
- how could we better educate doctors to prevent this from happening?
- where do you see yourself working in the future and where are you working now?
- how would have handled this case differently if you could go back?
Your Written Statement
The California Medical Board and the Oregon Medical Board, by comparison, won’t read your chart fully. At least that’s what happened with me. Even though I had sent in a statement before I met with those medical boards, they didn’t know shit about my case.
So, your written statement to WA is critical and you’d be wise to spend a lot of time on that to really create a beautiful narrative. Nearly every member commented on how great my statement was, as well as the essay I had to write separately.
The board can make a decision on the spot. They will ask you to leave the room while they review everything. And right there they could dismiss the case or terminate a stipulated order or hang you – whatever.
That’s why it’s important to be prepared. It can make your life so much easier. But it’s also possible that they will need to gather more facts before deciding on your case.
If you anticipate what they will ask and have that information ready, you could have a far less drawn out case.
In my case, they asked me to step outside while they would consider terminating my stipulated order. I waited 5 minutes and they pulled me back in to tell me that they terminated my stipulated order. Sweet.
Which means that all of my dealings with the Washington Medical Commission is over.
The Medical Board Apologizing
I felt it was a bit odd that 3 different medical board members apologized for this investigation and the ensuing stipulated order and all of the shit that’s now written into my NPDB.
Not doubting their sincerely; I genuinely believe that they wish all of this didn’t have to happen. But if you have to apologize for something, maybe don’t do it…?
They expressed praise that I handled the situation well. And that I was professional throughout the entire process. They commended me on my professional history of volunteering and teaching students.
I guess, I wished that the medical board would have said something along the lines of,
Hey, we know you meant to do the right thing, and we commend you for stepping in and getting that patient the care she needed. But you didn’t go about it the right way and that is why we had to punish you.
Or maybe I should just be happy that I’m done with this and learn from my mistakes and move on.
One extra thing that I learned about my case, which I didn’t know before, they considered my case an ethical case, not a clinical case. This came out as they were narrating my case to the rest of the board members.
The MD/JD on the team mentioned how the patient-doctor relationship is such a fine line and is difficult to pinpoint. Which to me really means that the medical board just hasn’t done a good enough job of delineating it – not like I get to decide on that.
The reason I mention this is that if you can get some insight into your particular state medical board, as in how they handle such cases, ethical ones for example, you’ll be able to better address it.
A clinical case, for example, might not be a big deal to one medical board but a more conservative one may wanna hang you by your gonads for an ethical case.
Done with WA
I’m done with the Washington Medical Commission but I’m not done with WA. As in, I feel a sense of dedication to WA now because they treated this physician with a lot of respect.
I gave up my Oregon medical license because that medical board is unprofessional and impossible to deal with. They had no motivation to even investigate the case; nor could they communicate properly with me.
It feels fabulous being done with the Washington portion of my entire saga. I still am dealing with CA and OR isn’t all done with, yet. OR refuses to close my case even though I’m not renewing my medical license.
As for the future, we’ll see. If I don’t see any patients in WA, I won’t be able to keep my medical license there. So, unfortunately, I’ll have to come up with some sort of solution.
I still see a few WA patients through DialCare telemedicine but it’s like a handful of patients per month. Their volumes might be too low for this to count.
Maybe I’ll start an Urgent Care in WA and staff it with an NP/PA and do all of the telemedicine work for it from Spain.
2 replies on “Washington Medical Commission Personal Appearance”
What you did in this case is very mild, very benign. An attorney early on and a very contrite response would have easily won you this case, it would have never gone beyond a preliminary investigation (I think..). You did something probably everyone has done, but of course when they shine a light on it, they found something slightly illegal with treating a friend as a patient. The big thing in your case was just your initial reluctance to cooperate, the perceived “arrogance” with them. I don’t think it was arrogance, but once they detected noncooperation, they went to town on you. Anything other than contrite, humble, and total cooperation results in them over punishing you. In your case, it’s just a class case of starting on the wrong foot with the board- unless you drop on your knees and cooperate, they’ll attack you. I firmly believe had you been ultra-cooperative, they’d have dropped it 100%
I don’t agree that they would have dropped it. Once a case is picked up by the medical board they will do something with it – a public reprimand at the very least. I have published stats of how many cases are picked up and how many are dropped and how many result in no decision at all … it’s somewhere on this website.
But you are 100% correct that my lack of cooperation made things far more difficult on myself. But let’s not forget that the nurse lied about me threatening her and Kaiser Permanente lied to the medical board that I was a “problem employee”. In fact, KP is the one who reported me to the medical board. KP claimed that I was a no-call no-show many times in 2015 even though I was a medical director at the time.
I also don’t agree that dropping to your knees is adequate. In fact, the opposite is true, you need to take the case very seriously and get legal representation and you need to go toe to toe with the medical board. If they know that you won’t be an easy target they will be less likely to try to punish harshly.
A great example was California – I went toe to toe with them and they took me to court which I attended and fought them on every ridiculous allegation. The lawyer was spitting fire before the judge, that’s how mad she was. But she had nothing, obviously. And the judge ruled 100% in my favor.
Imagine, I get a 30-day license suspension and a $5,000 fine in one state and a public reprimand letter in another – that’s the kind of joke medical system we are caught up in as physicians.