If you’re a physician practicing in the US, you know that state medical boards exist. Do you know what they do, though? And more importantly, do you know what steps to take if they contact you regarding a complaint? Let’s explore that today by looking at your initial steps in responding to a letter of complaint from your state’s medical board.
1) What Do State Medical Boards Do?
In the United States, there are 70 state or territorial medical boards (SMBs). These boards interact with one another under the umbrella of the Federation of State Medical Boards, however each SMB operates independent of the others and is regulated by the laws of the state or territory it serves. Some are complete entities unto themselves, others are part of the state’s Department of Health. SMBs often include a mix of physicians and members of the general public, frequently appointed by the governor.
In every case, the state medical board has a role in licensing physicians to practice medicine, and in some states, they also license other practitioners such as physician assistants, acupuncturists, massage therapists, and chiropractors. Processing applications and verifying credentials for licensure and re-licensure is only the beginning of their work, though.
What many physicians don’t realize is that the primary function of the SMB is not to serve the medical community. Rather, all SMBs exist “to protect the public from the unprofessional, improper and incompetent practice of medicine,” according to the Federation of State Medical Boards. Among other tasks, they’re charged by the legislature to investigate complaints, discipline physicians who violate the law, and may mandate certain types of evaluation of a physician or other healthcare professional’s fitness for practice.
Before you respond to any complaint from your SMB, you must first understand that their first duty is to protect the public from the inadequate or unethical member of the medical profession.
2) A Letter of Complaint
In general, a complaint to a SMB will initiate an investigation. At that point, the complaint may be dismissed. If it is not, the physician(s) identified in the complaint will receive a letter of complaint, to which they will be expected to respond.
In some states, physicians may also come under the scrutiny of their SMB when a medical malpractice lawsuit results in a payout, whether by means of settlement or jury verdict. In fact, I have learned over time that it is not uncommon for physicians who thought a legal case was finally behind them to be surprised by correspondence from their SMB. Your defense lawyer should be able to tell you whether this may occur in your state or not.
In either case, what should you do if you receive a letter from your SMB raising a concern regarding your practice?
Above all, you simply must take this correspondence seriously! Even if the complaint strikes you as silly or baseless -- perhaps even especially if it does -- you MUST recall that the SMB has the power to restrict or even terminate your license to practice medicine in that state or territory. And the actions of one state medical board will almost certainly have ripple effects on the future views of other SMBs.
Do not act hastily. Stop, take a deep breath, and respond in a professional manner.
3) Find an Excellent Lawyer
Every now and then, stories surface regarding physicians who responded hurriedly to a letter of complaint from their SMB, perhaps by phone or e-mail, only to find themselves increasingly embroiled in a tangled mess.
It’s easy to see how it could happen. Reasonable Physician -- someone like you or me, say -- receives a letter of complaint. Confident in their competence and integrity, they communicate directly with the SMB, certain that things will sort themselves right out. They do not, however, and in fact, matters only get worse. While this is a worst-case scenario, for this reason, I’d suggest that you treat responding to any SMB communication beyond ordinary license renewal matters with the seriousness you would bring to a malpractice lawsuit.
First, find an excellent lawyer well-versed in dealing with the state medical board, and do it immediately.
Medical malpractice insurance frequently includes coverage for the costs of your legal defense before the SMB, as they would with an allegation of malpractice. So, as a first step, I recommend you notify your insurance carrier, your direct supervisor, and the risk manager at your institution. They can tell you whether your policy covers matters like the one you face. If so, the carrier will usually assign an appropriate lawyer to your case.
Even if your malpractice insurance will not cover defense for the particular type of complaint you confront, they may be well equipped to provide you with names of lawyers in your region experienced with this type of action. If you will be paying the lawyer directly, you may wish to set up meet-and-greets with two or three, and then choose among them. Let them know in advance that you plan to meet briefly with several lawyers prior to contracting with one of them, and you may find that there is no charge for these introductory conversations.
Once you’ve found the lawyer you need, allow them to guide you each step of the way. The cost will not be negligible, but it will be small by comparison with the years of potential income and quality of reputation you aim to preserve..
4) Protect the Medical Record
If the concern relates to the care of a particular patient, it is imperative that you protect the medical record as well as billing or other records relating to the patient’s interaction with you or your staff. As always, do not allow fear to drive you to mess with a medical record! Nothing reflects poorly on a physician’s integrity more quickly than a perception that records have been destroyed or altered. Even a record with gaps or errors is far better than an altered record.
5) Mind Deadlines Closely
Understandably, a letter of complaint from the state medical board is enough to make many physicians want to go and hide under a rock. Unfortunately, time spent hiding is time wasted.
Letters from the SMB will almost always define a deadline for response which you will not want to miss! All the more reason to find strong legal counsel immediately, and respond as a team. Stay on top of communications from the SMB and move through the process with consistency and integrity.