What to Do When Facing a Medical Board Investigation

You have been notified that your state medical board requests your medical and billing records from your office or from your hospital.

You have been advised that you need to appear for an interview with representatives from your state medical board.

Investigators from your state medical board show up at your office and demand to be allowed to inspect the premises.

What is your next step?

In all three cases, the answer is the same. Call a lawyer.

Physicians who believe they have done nothing wrong and will have not problem answering questions from the medical board investigators may be right. But, it is always better to be safe than sorry later. Legal representation is vital, even in preliminary stages of an investigation; even if the complaint has arisen from a mentally disturbed patient or a former employee or staff member who is disgruntled.

While a vast majority of cases will be settled without an accusation, trying to deal with the situation alone is just like walking into a police station where you are the prime suspect in a murder case and refusing the help of an attorney. No one would ever do that without a well-prepared attorney at their side.

Every state has different regulations, but most boards look for patterns of conduct that may be considered dangerous for the consumer. Most do not focus on an isolated incident or isolated complaint. It can happen, so never think that a single complaint wil go un-noticed. More times than most people realize, investigations may occur based on a single complaint.

Illegal conduct, dishonesty, psychological or physical problems are common reasons that physicians come to the attention of the medical board. Also, gross negligence, repeated negligent acts or extreme departure from established standards of care are also reasons people have come to the board’s notice.

The two things that send up red flags the quickest are sex offenses and lies. Sexual offenses may involve overt conduct such as having sex with a patient, but it can also be interpreted as inappropriate conversation. Physicians are cautioned to always act with the utmost propriety so that there will never be a misunderstanding.

Coding errors or revision on charts may the interpreted as lying. A history of record keeping that is above reproach and extreme honesty in dealing with patients, staff and insurance companies will go a long way in protecting the physician should an isolated incident occur.

The best advice is to practice medicine in such a way that nothing is ever questioned. If something does occur that causes an investigation, the call a lawyer.