What kind of behavior may cause having your License revoked?

[Sivastraba]

We all know that you can get your license revoked if you are incompetent in diagnosing and treating your patient.

However, what about the gray zone areas?
Lets say you had a fight with someone out of your work and they pressed criminal charges. Or you had an incident with a police officer?

Does anyone have a list of things that could be considered a reason to have a license revoked? Does this vary from state to state.

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[f_w]

We all know that you can get your license revoked if you are incompetent in diagnosing and treating your patient.

Few if any medical licenses are revoked for incompetency.

Here are the main reasons for license action:
- dipping into the Fenta cabinet
- fondling patients
- fondling staff
- lying about stuff on your application (e.g. some past patient fondling incidents that you 'forgot' to mention).
- showing up drunk to see patients (or as the South Carolina statute so aptly puts it: 'Doctor may not attend patient under the influence of Wiskey')

Lets say you had a fight with someone out of your work and they pressed criminal charges. Or you had an incident with a police officer?

When you apply for a license (just filled out 3 applications), they will typically ask for convictions and arrests during the last X (usually 5) years. If you have a criminal history, you may have to appear in front of the board and make your case as to why you deserve to be entrusted with patients if you can't keep your cool with a peace officer.

Does anyone have a list of things that could be considered a reason to have a license revoked? Does this vary from state to state.

- Look into your states statutes.
- Review your state medical board minutes to see what type of stuff they act on.
- If you do have those kinds of troubles, consider consulting an attorney with experience in defending physicians in medical board procedings.

 

[LADoc00]

No1 reason for a medical license to revoked is poor record keeping. No joke. Failure to document phone calls, notes etc.

usually there is something else that causes the record keeping to be scrutinized ie- you are sleeping with your patients or RXing mad pot to people, but they end up nailing them on the recording keeping.

Sad but true.

 

[michaelrack]

Treating family members or office staff, especially in no chart is kept or if controlled substances are involved.

 

[primadonna22274]

I know 2 docs who pulled a gun on a partner doc (separate events, separate states). Both had board action but both are still licensed and practicing. Ended that relationship with said partner though.
(I don't think anyone was actually shot...but still.)

 

[f_w]

Treating family members or office staff, especially in no chart is kept or if controlled substances are involved.

And again, the record keeping and controlled substance issues are what is going to get you, not so much the fact that you where treating people you know.

 

[f_w]

I know 2 docs who pulled a gun on a partner doc (separate events, separate states). Both had board action but both are still licensed and practicing. Ended that relationship with said partner though.
(I don't think anyone was actually shot...but still.)

Well, I guess they figured that 'all options are on the table' when it comes to re-negotiations of the partnership agreement.

 

[primadonna22274]

yikes

Well, I guess they figured that 'all options are on the table' when it comes to re-negotiations of the partnership agreement.

 

[NPR]

I'm not a huge Scrubs fan (since I feel the star of the show is a huge tool) but this is one of the few clips that made me laugh out loud.

And one that left unchecked, could progress to activities that would lead to licenses being revoked.

[YOUTUBE]http://www.youtube.com/watch?v=aGDn6XPc6Fo[/YOUTUBE]

 

[OldPsychDoc]

I'm not a huge Scrubs fan (since I feel the star of the show is a huge tool) but this is one of the few clips that made me laugh out loud.

And one that left unchecked, could progress to activities that would lead to licenses being revoked.

Yep. That'd do it.

 

[Strength&Speed]

Treating family members or office staff, especially in no chart is kept or if controlled substances are involved.

treating family members? even without narcotics? hasn't the majority of physicians done this before?

 

[deleted109597]

treating family members? even without narcotics? hasn't the majority of physicians done this before?

Yep. It is still against the rules, but most boards don't care as long as you avoid the Schedule II's.

Some states consider altering the medical record as a reason for losing your license.

Sleeping with the patients is a big no-no.

Gross negligence can also do it. Incompetence, unfortunately, isn't commonly a reason.

Having a DUI probably won't cause you to get an already held license revoked, but it can make getting a new one pretty hard to get. Other crimes are similar.

 

[Strength&Speed]

while i don't disagree with you, I find it somewhat comical that sleeping with patients will get your license revoked more than incompetence. seems like one is a bit more damaging to society, but whateva

Yep. It is still against the rules, but most boards don't care as long as you avoid the Schedule II's.

Some states consider altering the medical record as a reason for losing your license.

Sleeping with the patients is a big no-no.

Gross negligence can also do it. Incompetence, unfortunately, isn't commonly a reason.

Having a DUI probably won't cause you to get an already held license revoked, but it can make getting a new one pretty hard to get. Other crimes are similar.

 

[LADoc00]

while i don't disagree with you, I find it somewhat comical that sleeping with patients will get your license revoked more than incompetence. seems like one is a bit more damaging to society, but whateva

Actually the boards DO take into account whether the said patient is hot or not. Similar to the website "Rate my Rack", they have a point system to decide these things.

 

[exPCM]

http://www.michigan.gov/mdch/0,1607,7-132--188631--,00.html

http://www.foxnews.com/story/0,2933,371643,00.html

http://www.macombdaily.com/stories/061408/loc_local05.shtml

http://www.goerie.com/apps/pbcs.dll/article?AID=/20060913/NEWS02/609130347&SearchID=73256739247736

 

[anon-y-mouse]

One of my attendings does this: He has a "donated medical services" file with charts for friends/colleagues/etc. for whom he prescribes. He doesn't do any painkillers whatsoever (they can always find something to ding you about re: a full workup), but has no problem writing for Ambien 10mg #30 prn insomnia or Alprazolam 2mg #30 prn anxiety, in addition to basic antibiotics/creams/etc. while fully documenting the problem, counseling about usage, abuse, etc. and follow-ups. If I as a medical student can manage someone's garden variety anxiety (not chronic) or insomnia, I don't think any licensed physician who has gone through all licensing exams would have any problems doing so. There's nothing that says a doctor-patient relationship conflicts with a friendship, and obviously he's not writing for hardcore painkillers or digoxin or stuff like that.

 

[milktoast]

Actually the boards DO take into account whether the said patient is hot or not. Similar to the website "Rate my Rack", they have a point system to decide these things.

be quiet. being a pathie you can sleep with all the patients you want. I don't think they'll revoke your license for reading their hematology smear then banging them, i hope.

 

[primadonna22274]

I like that idea. That's a good one. I might just steal it.
L.

One of my attendings does this: He has a "donated medical services" file with charts for friends/colleagues/etc. for whom he prescribes. He doesn't do any painkillers whatsoever (they can always find something to ding you about re: a full workup), but has no problem writing for Ambien 10mg #30 prn insomnia or Alprazolam 2mg #30 prn anxiety, in addition to basic antibiotics/creams/etc. while fully documenting the problem, counseling about usage, abuse, etc. and follow-ups. If I as a medical student can manage someone's garden variety anxiety (not chronic) or insomnia, I don't think any licensed physician who has gone through all licensing exams would have any problems doing so. There's nothing that says a doctor-patient relationship conflicts with a friendship, and obviously he's not writing for hardcore painkillers or digoxin or stuff like that.

 

[f_w]

I like that idea. That's a good one. I might just steal it.
L.

Once you are a medicare provider, 'donating' medical services kicks off a whole number of other issues. Doesn't matter as a resident, does matter once you are out on your own.

 

[primadonna22274]

OH gee. I already am a Medicare-credentialed provider (NPI and UPIN and all that jazz) as a PA. Um....ugh.
Which is why I really don't like to "donate" services. I don't hand out scripts to my family. I don't call in flexeril for my girlfriend (felt bad about that one...and she and I haven't really had the same relationship since, but probably coincidental).
People in the office (MAs, lab techs, EMS workers who corner me in the ED) don't get it. They don't see what the big deal is in having to have a documented visit etc. they think I'm too stingy...probably partly true, but it's my license, not theirs.
What to do??

Once you are a medicare provider, 'donating' medical services kicks off a whole number of other issues. Doesn't matter as a resident, does matter once you are out on your own.

 

[Samoa]

As far as I can tell, medicare only objects if you bill them for the services, and waive the copay for a patient who would otherwise be able to pay. And also if you provide free care in return for referrals.

So if you're a specialist writing a prescription for a PCP (who could potentially refer patients to you) you might get in trouble, but not likely the other way around. Unless you (if you're a surgeon) get free care from a PCP, and then send them all your patients for medical clearance. Otherwise, as long as you keep good records, and don't bill the insurance company if you didn't bill your friend or family member, you are practicing within the law.

Whether you're practicing ethically is another matter.

 

[Ypo.]

I guess I don't understand why it's unethical to provide free medical advice. I know it's taking a risk, especially if undocumented (mainly because of the lawsuit happy culture we live in), but I do think there are circumstances that make it acceptable. In the old days doctors used to give medical services in exchange for a bushel of apples...

I understand that treating your family can be bad because it can cloud your judgment. But I know of several physicians practicing in small towns who regularly get called by members of their church and who get treated off the books. The physicians would never bill an insurance company for it, and they would never prescribe prescription narcotics. But I know of one physician who did give a patient valium during a mental breakdown. Some of these people would not get any medical care otherwise. I don't think the line is always black and white, especially in small towns.

 

[Arch Guillotti]

One of my attendings does this: He has a "donated medical services" file with charts for friends/colleagues/etc. for whom he prescribes. He doesn't do any painkillers whatsoever (they can always find something to ding you about re: a full workup), but has no problem writing for Ambien 10mg #30 prn insomnia or Alprazolam 2mg #30 prn anxiety, in addition to basic antibiotics/creams/etc. while fully documenting the problem, counseling about usage, abuse, etc. and follow-ups. If I as a medical student can manage someone's garden variety anxiety (not chronic) or insomnia, I don't think any licensed physician who has gone through all licensing exams would have any problems doing so. There's nothing that says a doctor-patient relationship conflicts with a friendship, and obviously he's not writing for hardcore painkillers or digoxin or stuff like that.

That attending is a *******. Writing for any controlled substance for someone who is not your patient is one of the stupidest things you can do.

 

[Samoa]

This is actually true, and I'd avoid writing for any controlled substance for a friend or family member, regardless of schedule. The difference in jail time and monetary fines between inappropriately prescribing vicodin and ambien is qualitatively insignificant.

 

[Tired]

That attending is a *******. Writing for any controlled substance for someone who is not your patient is one of the stupidest things you can do.

They are your patient the moment you see them for a medical reason. Keeping documentation on these encounters satisfies the basic requirements for a physician-patient relationship. There is no law or rule that says you have to see only strangers and only in a medical clinic. As a physician, it is completely within your rights to prescribe any pain medication (including controlled substances) to anyone you see for a medical reason.

That being said, the question is really if you want to subject yourself to scutiny should these actions ever be questioned. And you have to question whether or not you can be truly objective, and adhere to standards of care, when treating people you are close to.

 

[Strength&Speed]

That attending is a *******. Writing for any controlled substance for someone who is not your patient is one of the stupidest things you can do.

i would have to agree that treating a friend/family member with alprazolam for anxiety is an exceedingly bad idea.

 

[dragonfly99]

From lists of docs who had their license revoked or restricted in my state, it seems most were for some sort of misuse or misprescribing of controlled substances and/or a substance abuse problem on the part of the docs.

However, having said that, I know someone who had license withheld temporarily for being a "disruptive physician". This didn't involve any kind of criminal charges or physical altercation. The person was a trainee and argued too much and just ran afoul of the wrong person. The person was a great student, a talented doc and it was very unfortunate. The higher-ups had an extreme reaction to a situation that could have been taken care of in a much less punitive manner. Moral of the story: be careful what you do when you are a trainee. Do not run afoul of nurses or attendings.

 

[f_w]

Local doc just got an emergency suspension of his license. The charges are:

- leaving pre-signed and dated triplicates for schedule II drugs in his office so his PAs (who are not allowed to prescribe schedule II in our state) can take care of his chronic pain patients in his absence.
- having a drawer full of leftover schedule II and III drugs in his office that he received from patients he had prescribed to.
- instructing his office manager to give out an envelope with several pills of a schedule III drug to a patient without issuing a formal prescription (initial complaint on the search warrant mentioned methadone, now it was supposedly one of the combination analgesics).
- instructing his office manager to discard all the drugs in his drawer coincidentally ON the day a search-warrant was sworn for his office....

He operates a chain of urgentcares that he mostly staffs with FNPs and PAs. The places have become very busy, not so much with classic urgentcare patients but more with the chronic pain and disability crowd. If you believe the medical board and DEA he is the local 'candyman', if you believe his patients he is a cross between mother Theresa and Jesus of Nazareth.

 

[secretwave101]

I know someone who had license withheld temporarily for being a "disruptive physician". This didn't involve any kind of criminal charges or physical altercation. The person was a trainee and argued too much and just ran afoul of the wrong person. The person was a great student, a talented doc and it was very unfortunate. The higher-ups had an extreme reaction to a situation that could have been taken care of in a much less punitive manner. Moral of the story: be careful what you do when you are a trainee. Do not run afoul of nurses or attendings.

This is unbelievable. Stalin would be proud.