Failing to Act Appropriately to the Initial Letter
"Some physicians don't reply or reply late," says IDFPR's Brian Zachariah. "But this is your livelihood, your career."
Robin advises, "Take it seriously and respond as quickly, openly, and honestly as possible."
The best scenario is to be able to end the issue right then, notes Allan Tobias, MD, JD, a healthcare consultant and lawyer in Walnut Creek, California. "A nice letter with an attorney consultation explaining the situation" can quash a potential investigation immediately. Do not fail to respond to the letter in the allotted time.
Trying to Represent Yourself
Does a doctor who tries to represent him- or herself have a fool for a client? Afraid so.
"Get an attorney," advises Zachariah. "Way too many physicians represent themselves."
Neville M. Bilimoria, a healthcare lawyer at Duane Morris LLP in Chicago, says, "Too many times, doctors go in on their own and then call me [when they're] in worse trouble."
Consider a New Jersey gynecologist who received a letter from her state board. She immediately called her malpractice insurer. She had removed a 6-cm mass from the right pelvic area of a patient who'd said she'd had her left ovary removed 10-15 years ago.
But the patient had misremembered; in fact, it had been her right ovary that had been removed years before, and the pathology report of the mass was granulosa cell tumor, low grade, with cancer potential, which the patient then said was what she'd been told a decade earlier.
"I told her it will come back, and she needed to be followed by a gynecologic oncologist forever," the gynecologist told her. "She didn't like the diagnosis, or hearing that."
Not long after, the patient claimed that another hospital had said that she still had the mass, which the gynecologist surmised was the material she had inserted to stop the bleeding, which had not yet resorbed. The patient claimed the gynecologist hadn't performed the appropriate surgery.
"I guess I could be faulted for not requesting her previous records," says the gynecologist, "but she had the operation she should have had."
The malpractice insurer's lawyer sent a letter to the board with all the relevant records, and the gynecologist reported, "Two months later, I got a letter saying, 'Your case has been dismissed.'"
Still, the episode took its toll.
"I felt violated as a doctor. I gave good care and had a good rapport with the patient. It was an unjust accusation, and it made me feel depressed. It was very important for me to know that nothing I did was outside the standard of care."
The gynecologist's malpractice insurer provided the attorney; other insurers allot funds for a client doctor to hire an attorney, so it's good to check with your insurer to see about coverage.
Who Should Represent You?
But even if the insurer provides an attorney, you're better off with your own advocate, says Zur. "The insurer's attorney is concerned about the bottom line; your attorney is concerned about you," he says.
In addition, the attorney should have very specific experience.
"The burdens of proof and standards of evidence are different from those of malpractice cases," says Zachariah. "You need an attorney who specializes in board complaints and regularly appears before boards."
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Cite this: 4 Things Not to Do at a Medical Board Hearing - Medscape - Mar 13, 2014.