Licensing/career advice

[HeneryHill]

I apologize if this is the wrong place to post this. Im a first-time licensee applicant. After waiting for 7 months I received notification that the State medical board will grant me a license on probationary status for two years to include monitoring and treatment secondary to EtOH use (self-referral to detox while still in training 3.5 years ago). Along with the probationary status and monitoring, they are going to make it public discipline with reports to FSMB and NPDB. Im wondering if anyone else has dealt with a similar situation and what kind of lasting effect it had on your career, especially with employment or future licensing in other states.

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[PikminOC]

I apologize if this is the wrong place to post this. Im a first-time licensee applicant. After waiting for 7 months I received notification that the State medical board will grant me a license on probationary status for two years to include monitoring and treatment secondary to EtOH use (self-referral to detox while still in training 3.5 years ago). Along with the probationary status and monitoring, they are going to make it public discipline with reports to FSMB and NPDB. Im wondering if anyone else has dealt with a similar situation and what kind of lasting effect it had on your career, especially with employment or future licensing in other states.

Depends on how it affects being able to panel with insurance

 

[BulgeDaTwine]

I apologize if this is the wrong place to post this. Im a first-time licensee applicant. After waiting for 7 months I received notification that the State medical board will grant me a license on probationary status for two years to include monitoring and treatment secondary to EtOH use (self-referral to detox while still in training 3.5 years ago). Along with the probationary status and monitoring, they are going to make it public discipline with reports to FSMB and NPDB. Im wondering if anyone else has dealt with a similar situation and what kind of lasting effect it had on your career, especially with employment or future licensing in other states.

I’m sorry for this.
Let this be a reminder to all that the medical board does not work for you, the physician; rather, their mandate is discipline under the auspices of “protecting the public” and they do have quotas.

So - you self referred yourself to detox and now the medical board wants you to submit to monitoring and treatment again, 3.5 years later? Do I have that right?

Did you have any aggravated incidents associated with your prior alcohol use? Car accidents, dui, did you use alcohol at work affecting patient care…. Assuming you did NOT, your next step is to get a substance abuse evaluation right now. The aim is to get a professional to evaluate you and hopefully conclude that your problem was isolated, that you fully rehabilitated, and that you represent now, no more risk than the average doc. Pay for it, submit to their exam and interview. If this independent evaluator concludes what I described above, then get your lawyer to submit that with a formal request/statement to forgo the reporting and rehab process. Agree to two years probationary status. Make the case that any further action or requirement by the board is without precedent, heavy handed, and unnecessary.

Good luck.

 

[HeneryHill]

So - you self referred yourself to detox and now the medical board wants you to submit to monitoring and treatment again, 3.5 years later? Do I have that right?

Did you have any aggravated incidents associated with your prior alcohol use? Car accidents, dui, did you use alcohol at work affecting patient care…. Assuming you did NOT, your next step is to get a substance abuse evaluation right now. The aim is to get a professional to evaluate you and hopefully conclude that your problem was isolated, that you fully rehabilitated, and that you represent now, no more risk than the average doc. Pay for it, submit to their exam and interview. If this independent evaluator concludes what I described above, then get your lawyer to submit that with a formal request/statement to forgo the reporting and rehab process. Agree to two years probationary status. Make the case that any further action or requirement by the board is without precedent, heavy handed, and unnecessary.

I self refered to detox while still in training. I ended up on a 5 year monitoring contract which at this point I have completed over 3 years of. So I've been monitored the whole time. Once training was complete I applied for licensure in a different state (where I'm originally from). Never any incidents related to EtOH. No accidents or DUIs. All use was isolated to personal time and NEVER during professional hours (classroom or clinical). I have had a 2 evaluations completed in the last year, both from Board certified MDs in the respective state of application.

 

[BulgeDaTwine]

I self refered to detox while still in training. I ended up on a 5 year monitoring contract which at this point I have completed over 3 years of. So I've been monitored the whole time. Once training was complete I applied for licensure in a different state (where I'm originally from). Never any incidents related to EtOH. No accidents or DUIs. All use was isolated to personal time and NEVER during professional hours (classroom or clinical). I have had a 2 evaluations completed in the last year, both from Board certified MDs in the respective state of application.

I wish you luck. You should fight. Capricious acts by the board like this are exactly why more docs don't seek help. What state?

 

[DetroitERDO]

I wish you luck. I’m not sure what to say except get a great lawyer to help you in this matter.

 

[cyanide12345678]

Yes. Please get professional legal advice.

This is not the time to save money and get advice from doctors on an online forum.

Your most valuable asset is under question. Get a lawyer.

 

[medninja]

I’m so sorry you’re going through this. It’s plain wrong.

Yes, get a lawyer. Also contact the Center for Physician Rights(CPR) — Google it. These stipulations on your license likely violate the Americans with Disabilities Act. You need a lawyer with some expertise and they can help find one in your state.

The abuse that boards and PHPs foist on doctors is a travesty. It’s a system without oversight. Authority with impunity inevitably breeds corruption and injustice. I’m not a religious man, but I hope the Old Testament has some truth when it comes to these vultures. You’re lucky they’re not shipping you off for a BS “assessment” in KS which would invariably find you need tens of thousands in further inpatient rehabilitation.

One of my good residency friends suffered the same abuse. He’s dead. This isn’t your fault.

It seems like there’s some change underway to increase oversight. Even ACEP now had an article a while back lambasting PHPs. The stresses and high profile suicides during the pandemic shined a very unfavorable light on the illegality of board license screening questions and routine flouting of ADA law.

 

[VA Hopeful Dr]

I’m sorry for this.
Let this be a reminder to all that the medical board does not work for you, the physician; rather, their mandate is discipline under the auspices of “protecting the public” and they do have quotas.

So - you self referred yourself to detox and now the medical board wants you to submit to monitoring and treatment again, 3.5 years later? Do I have that right?

Did you have any aggravated incidents associated with your prior alcohol use? Car accidents, dui, did you use alcohol at work affecting patient care…. Assuming you did NOT, your next step is to get a substance abuse evaluation right now. The aim is to get a professional to evaluate you and hopefully conclude that your problem was isolated, that you fully rehabilitated, and that you represent now, no more risk than the average doc. Pay for it, submit to their exam and interview. If this independent evaluator concludes what I described above, then get your lawyer to submit that with a formal request/statement to forgo the reporting and rehab process. Agree to two years probationary status. Make the case that any further action or requirement by the board is without precedent, heavy handed, and unnecessary.

Good luck.

I know my state doesn't, and I find it very difficult to believe that this is a widespread thing.

That said I do agree with getting a lawyer and trying to not have the public reprimand/reporting part. That does seem a bit heavy handed.

 

[medninja]

I know my state doesn't, and I find it very difficult to believe that this is a widespread thing.

That said I do agree with getting a lawyer and trying to not have the public reprimand/reporting part. That does seem a bit heavy handed.

It’s more than just a bit heavy-handed and every aspect of this is difficult to believe. There’s a person behind this who’s dedicated years of their life to this calling, so much so all their proverbial eggs are in the clinical medicine basket. They then do the seemingly “right” thing and ask for help for a problem that they developed and are punished for it, jeopardizing their ability to feed themselves and their family. Their private medical records are published and they’re placed in the stocks in the public square for us to judge. Oh, and don’t forget that the PHP behind it all isn’t bleeding them dry financially all along as they work helping others.

I don’t know if there are quotas but the outrageousness of it all wouldn’t have me doubting it. It’s a sickening thing that I’d wish on no one. Honestly, many doctors make a rational, if utterly perverse, decision to simply forego the help they routinely provide their patients. They are better off for it.

 

[VA Hopeful Dr]

It’s more than just a bit heavy-handed and every aspect of this is difficult to believe. There’s a person behind this who’s dedicated years of their life to this calling, so much so all their proverbial eggs are in the clinical medicine basket. They then do the seemingly “right” thing and ask for help for a problem that they developed and are punished for it, jeopardizing their ability to feed themselves and their family. Their private medical records are published and they’re placed in the stocks in the public square for us to judge. Oh, and don’t forget that the PHP behind it all isn’t bleeding them dry financially all along as they work helping others.

I don’t know if there are quotas but the outrageousness of it all wouldn’t have me doubting it. It’s a sickening thing that I’d wish on no one. Honestly, many doctors make a rational, if utterly perverse, decision to simply forego the help they routinely provide their patients. They are better off for it.

It is well known that some states are much stricter than others. Might be worth looking into other more lenient states.

 

[GonnaBeADoc2222]

I have nothing to say except I'm sorry and lawyer lawyer lawyer.

 

[Brigade4Radiant]

Yeah the medical board is mideval for any substance abuse nurses and NP/PA don't have to deal with crap like this

 

[HeneryHill]

I wish you luck. You should fight. Capricious acts by the board like this are exactly why more docs don't seek help. What state?

Colorado

 

[HeneryHill]

Yeah the medical board is mideval for any substance abuse nurses and NP/PA don't have to deal with crap like this

PAs certainly deal with the same. They are more or less held to the same standard as MD and DOs. I think there is variation for NPs as there is typically a separate board for nursing, but I digress.

 

[HeneryHill]

I’m so sorry you’re going through this. It’s plain wrong.

Yes, get a lawyer. Also contact the Center for Physician Rights(CPR) — Google it. These stipulations on your license likely violate the Americans with Disabilities Act. You need a lawyer with some expertise and they can help find one in your state.

The abuse that boards and PHPs foist on doctors is a travesty. It’s a system without oversight. Authority with impunity inevitably breeds corruption and injustice. I’m not a religious man, but I hope the Old Testament has some truth when it comes to these vultures. You’re lucky they’re not shipping you off for a BS “assessment” in KS which would invariably find you need tens of thousands in further inpatient rehabilitation.

One of my good residency friends suffered the same abuse. He’s dead. This isn’t your fault.

It seems like there’s some change underway to increase oversight. Even ACEP now had an article a while back lambasting PHPs. The stresses and high profile suicides during the pandemic shined a very unfavorable light on the illegality of board license screening questions and routine flouting of ADA law.

IM incredibly sorry for your loss. Im Ive heard the horror stories of physicians and other providers that have taken their own lives secondary to these issues. I can honestly relate. I did the whole evaluation thing in FL. I will look into the CPR. Thanks.

 

[Kryptocoin]

Some doctors use an alias/assumed name and pay cash when entering treatment programs to avoid situations like this. I agree with others, lawyer up.

 

[miacomet]

OMG this is insane. Colorado is making psychedelics legal because people "need" them yet you can't self-refer for detox?

1. Lawyer, lawyer, lawyer
2. Call the Lorna Breen heroes foundation
3. Get all the support you need
4. Fight this.

NP in my state had a DUI. Nothing happened. Nothing. Just monitoring, now has a great career making more than any of us.

 

[Brigade4Radiant]

OMG this is insane. Colorado is making psychedelics legal because people "need" them yet you can't self-refer for detox?

1. Lawyer, lawyer, lawyer
2. Call the Lorna Breen heroes foundation
3. Get all the support you need
4. Fight this.

NP in my state had a DUI. Nothing happened. Nothing. Just monitoring, now has a great career making more than any of us.

Yeah NPs and nurses can get caught with fentanyl and nothing happens they will go to the next travel assignment

 

[CajunMedic]

I'm dealing with the aftermath of being attacked by a patient and defending myself. I can't echo enough, find a lawyer that specializes in medical board affairs. It will be expensive, but worth it.

 

[Brigade4Radiant]

Also with any case regarding the medical board for any complaint you need a lawyer and don’t try to handle it yourself any communication can be used against you.

Medical boards ARE NOT YOUR FRIENDS

 

[miacomet]

Also with any case regarding the medical board for any complaint you need a lawyer and don’t try to handle it yourself any communication can be used against you.

Medical boards ARE NOT YOUR FRIENDS

No one is our friend
Not patients
Not insurers
Not hospitals
Not nurses
Not PAs
No one

 

[RustedFox]

No one is our friend
Not patients
Not insurers
Not hospitals
Not nurses
Not PAs
No one

Yep.
This is a tough place to be in, mentally.
I was there for a good long bit.

 

[miacomet]

Yep.
This is a tough place to be in, mentally.
I was there for a good long bit.

Who is your friend now?

 

[RustedFox]

Who is your friend now?

My dog.

The more you get away from EM, the better the mindset becomes.

 

[TooMuchResearch]

I'm dealing with the aftermath of being attacked by a patient and defending myself. I can't echo enough, find a lawyer that specializes in medical board affairs. It will be expensive, but worth it.

The board is trying to **** you because you didn't want to get injured to murdered?

 

[CajunMedic]

The board is trying to **** you because you didn't want to get injured to murdered?

Not yet, They've just now called me to meet with the investigator, 6 months after the incident. Admin threw me under the bus after the incident

 

[GonnaBeADoc2222]

Not yet, They've just now called me to meet with the investigator, 6 months after the incident. Admin threw me under the bus after the incident

I think if I'm ever assaulted by patient I'll just curl into a ball and let them pummel me and then sue the hospital for my (and my kids) retirement plan.

 

[HemeOncHopeful19]

I think if I'm ever assaulted by patient I'll just curl into a ball and let them pummel me and then sue the hospital for my (and my kids) retirement plan.

In that case the hospital will claim you should’ve defended yourself

 

[medninja]

I think if I'm ever assaulted by patient I'll just curl into a ball and let them pummel me and then sue the hospital for my (and my kids) retirement plan.

I sadly agree. I can’t but help think, though, that this strategy is akin the average, miserable patient’s mentality: show up, provide a half-glut hx, have issue diagnosed if not fixed, either way offload any responsibility of figuring it out or fixing it on “the system,” with an expectation for compensation if this plan fails.

I still enjoy the stoic pt insists on Tylenol for their flail chest, but this job is turning me into a dude with endometriosis, not to mention my preexisting POTS, IBS, migraine d/o and fibromyalgia. Perhaps, my shriveling self will find it in me to fight back, against my financial better interest.

 

[dozitgetchahi]

I apologize if this is the wrong place to post this. Im a first-time licensee applicant. After waiting for 7 months I received notification that the State medical board will grant me a license on probationary status for two years to include monitoring and treatment secondary to EtOH use (self-referral to detox while still in training 3.5 years ago). Along with the probationary status and monitoring, they are going to make it public discipline with reports to FSMB and NPDB. Im wondering if anyone else has dealt with a similar situation and what kind of lasting effect it had on your career, especially with employment or future licensing in other states.

Did you have a good licensing lawyer when this process started? Do you have one now?

If not, call one stat. If you had one before, call a different one. This is the type of outcome that may not have happened with good legal representation. You need professional legal help from someone who may be able to fix this.

Also, never ever ever interact with a medical board or PHP without legal representation. You should view state boards and PHPs as if they were the cops (and in some states, they’re administered under the state atty general and basically are law enforcement) - anything you say can and will be used against you. They’re not on your side by any means, and often times they’re corrupt to some extent, and there’s a lot of politics going on behind the scenes that you may not be aware of.

 

[Sagafemina]

Fully agree with the above. CO has one of the most longstanding and aggressive PHPs and a fully complicit licensure board, and this needs to be challenged directly and effectively. If you already have two clean evaluations, and 3.5 yrs of documented sobriety, and no infractions, there is no justification for any more treatment, and at the most 1.5 more yrs of monitoring. There is also no justification for discipline or reporting, either of which will permanently follow you throughout your career.

A person with AUD, or a past h/o same, is by definition a person with disability under the ADA. This kind of demand is a violation of your civil right to full participation in a title II program, namely CO medical licensure. See Medical Licensing Boards, Physician Health Programs, and the Lack of ADA Compliance: an Opportunity for Plaintiff Lawyers

I would encourage you to contact CPR, and also to make a complaint to the DOJ immediately (CPR can help you do this). DOJ is actively looking for cases to pursue, as a result of a letter by 3 Senators that they are not doing enough to protect docs with disabilities 3 US Senators Demand DOJ Investigate Medical Boards . Unfortunately, DOJ's process is not prompt enough to enjoin this demand, and not sufficient to extract you, although if they DO take your case it could be groundbreaking. If you make a complaint to DOJ it will be directed to the appropriate lawyers within the civil rights division of the DOJ.

You need a lawyer that is fearless, and familiar with ADA and Section 504 of the Rehab Act on which the ADA is based. If your lawyer is not acutely aware of how directly these apply to your case, you may need to get someone to advise them. Prompt action is of the essence.

 

[HeneryHill]

Fully agree with the above. CO has one of the most longstanding and aggressive PHPs and a fully complicit licensure board, and this needs to be challenged directly and effectively. If you already have two clean evaluations, and 3.5 yrs of documented sobriety, and no infractions, there is no justification for any more treatment, and at the most 1.5 more yrs of monitoring. There is also no justification for discipline or reporting, either of which will permanently follow you throughout your career.

A person with AUD, or a past h/o same, is by definition a person with disability under the ADA. This kind of demand is a violation of your civil right to full participation in a title II program, namely CO medical licensure. See Medical Licensing Boards, Physician Health Programs, and the Lack of ADA Compliance: an Opportunity for Plaintiff Lawyers

I would encourage you to contact CPR, and also to make a complaint to the DOJ immediately (CPR can help you do this). DOJ is actively looking for cases to pursue, as a result of a letter by 3 Senators that they are not doing enough to protect docs with disabilities 3 US Senators Demand DOJ Investigate Medical Boards . Unfortunately, DOJ's process is not prompt enough to enjoin this demand, and not sufficient to extract you, although if they DO take your case it could be groundbreaking. If you make a complaint to DOJ it will be directed to the appropriate lawyers within the civil rights division of the DOJ.

You need a lawyer that is fearless, and familiar with ADA and Section 504 of the Rehab Act on which the ADA is based. If your lawyer is not acutely aware of how directly these apply to your case, you may need to get someone to advise them. Prompt action is of the essence.

Had an attorney from The Health Law Firm out of FL. It clearly wasn’t much of a help.

Do you know how to file a complaint with the DOJ?

 

[Sagafemina]

Please READ the links in the above post.

You need local counsel that has dealt successfully with this CO board and PHP. Here's a list of EMPLOYMENT lawyers,
though not all would be PROFESSIONAL LICENSURE DEFENSE. You want to choose one of the ones designated "employee", and interview them as to their record of success in getting such requirements lifted from CO licensees, and whether they think they can get injunctive relief for you from these requirements using Section 504 of the Rehab act, or in any other way call the bluff of the entity.

A DOJ complaint could be earth-shattering for ALL potential licensees in your situation if they take on your case, but such will not happen quickly.
Here is the DOJ online complaint form: Contact the Civil Rights Division | Department of Justice
The blog post above details some suggested wording for such a complaint, focusing primarily on licensure questions.

Your situation is a bit different, but the principles are the same. And presumably your difficulties DID begin with licensure questions?

You are a qualified person with a disability under the ADA as someone with an AUD in remission.
You have met the essential eligibility requirements for medical licensure in CO
You have evidence that you have successfully rehabilitated yourself from two independent medical examiners,
and have (?) 3.5 yrs of monitored sobriety.
You have no healthcare or other incidents of any kind related to your former alcohol use on your record.
You truthfully reported all of this on your application for licensure in CO.

You have been ordered to do "x" by "y agency" (quote and attach documentation) in order to obtain even probationary licensure with years more required monitoring,
and you have been (threatened/told that you will be) disciplined and reported to FSMB and NPDB by "y or z" agency, which will taint you throughout your career (if a threat, what are the conditions)
(if the threatening entity is the PHP, be sure to state that you came to their attention ONLY by virtue of your application for licensure with the CO medical board and that the COPHP is exclusively contracted to that licensure board )
and (if true) that you will be required to pay for "x", a surcharge that is not imposed on other applicants for licensure
which you believe subjects you to discrimination on the basis of speculations, myths or stereotypes regarding your disability,
that you are seeking local counsel, and that you believe this may be a pattern or practice of this agency and
you would welcome the opportunity to discuss this issue, with some urgency.

Hope this helps; it is all that I can do, the rest is up to you.

 

[southerndoc]

It's really sad how getting treatment, counseling, etc. for a substance use disorder or mental health issue is a permanent scarlet letter against a physician in the eyes of the state medical boards.

 

[HemeOncHopeful19]

It's really sad how getting treatment, counseling, etc. for a substance use disorder or mental health issue is a permanent scarlet letter against a physician in the eyes of the state medical boards.

I think the issue is often more that it’s a permanent license to fleece them for money / fees for the PHP

 

[Brigade4Radiant]

Had an attorney from The Health Law Firm out of FL. It clearly wasn’t much of a help.

Do you know how to file a complaint with the DOJ?

Mostly when you’re in residency attorneys cannot do much for you because you still have to train and also you’re under the program Director and your training hospital. Did you have any contact with the medical board before returning an attorney?