Major Complaints Can Prompt Immediate Loss of License
One example of a medical board's immense power is its ability to temporarily suspend doctors' licenses if the board finds that they are an "imminent threat" to public safety. This action is sometimes triggered by complaints that would make headlines, such as improper prescribing of opioids from a pharmacist or sexual offenses.
Such cases are a dilemma for boards. Waiting for a hearing would ensure that the physician hasn't been falsely charged, but during that time, the physician might be a threat if he's guilty and the board would be accused of harboring a threat to the public safety. In these cases, the board is empowered to act immediately and temporarily suspend the physician's license before the hearing can be held.
But temporarily suspensions can create some Kafkaesque experiences for innocent physicians caught in this process. D'Souza says a temporary suspension in Texas can last for years. Meanwhile, the action has already been reported to the NPDB, and it's well nigh impossible to undo the listing. However, D'Souza says temporary suspension are very rare and getting rarer. According to Texas board statistics supplied by D'Souza, 13 such cases were allowed in 2014, down from 32 in 2011.
Chapman says the Michigan board provides for a similar action, called a "summary suspension," but the board is required to expedite a hearing. Viewing the seriousness of the charges, you might assume that the Michigan board has an open-and-shut case against these doctors. But Chapman, who has defended several of these cases, says he has always been able to overturn the suspension.
Public Pressure on Boards
State medical boards were conceived as a form of peer review wholly operated by physicians, who still serve without pay. Even a couple of decades ago, Wozny says, the Texas board was widely seen as running "a good-old-boys network" of physicians. "A physician would be privately reprimanded, and the public would never know," he says. But those cozy relationships, if they ever truly existed, have long gone.
Today, boards are increasingly seen as guardians of the public trust. Although boards are still dominated by physicians, they now have two or three nonphysician members—often attorneys involved in health law. All members are appointed by the governor, who has a political stake in a board decision that allows a suspected rogue physician to keep practicing. Such cases make headlines.
Boards are under increasing pressure to go after "bad doctors." In 1999, the consumer group Public Citizen began publishing yearly rankings that purportedly showed each board's effectiveness, based on its number of "serious actions" per 1000 physicians. The rankings were based on yearly data released by the Federation of State Medical Boards (FSMB). The federation protested about the way in which Public Citizen was using its data, but the rankings had a powerful effect, according to Lane, the medical claims consultant who used to work for the Georgia board. He recalls that some board executives around the country lost their jobs owing to low rankings from Public Citizen.
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Cite this: Leigh Page. The Black Cloud of a Medical Board Investigation - Medscape - Dec 23, 2015.