Anyone can file a complaint with the BOM. Complaints can be filed by patients, patients’ family members, other healthcare providers, employees, former employees, or competitors. Increasing awareness of this fact and the complaint process has likely led to an increase in the number of BOM complaints filed. Disciplinary action can include a reprimand, monetary penalty, restrictions on a physician’s license or practice, continuing medical education, monitoring, probation, license suspension or license revocation. There can be other adverse consequences to BOM discipline as well. These can include a report to a physician’s professional liability carrier, managed care plan, health insurance plan, or a report to the National Practitioner Databank. A physician’s livelihood and reputation can be affected and destroyed. Therefore, it is important to respond properly to a complaint. But many physicians make crucial mistakes when notified of a complaint against them. Here are some suggestions about what to do, and what not to do, when faced with a Board of Medicine complaint.
DON’T DENY THE COMPLAINT OR TAKE IT LIGHTLY
Physicians sometimes dismiss the complaint as a reflexive action. They may want to deny that a complaint has been filed or think the allegations are without merit. A doctor may be offended or frustrated at being wrongly accused of unprofessional conduct. He often assumes that if he just explains his viewpoint the matter will be favorably resolved. But physicians are well-advised to take all BOM complaints seriously. Physicians should treat any formal complaint as serious and take immediate and thoughtful action, including by planning a respectful and thorough response.
PROMPTLY CONSULT WITH COUNSEL
It is important to find an attorney who is familiar with Virginia’s licensing board procedures. Sometimes physicians believe they can handle the matter themselves, and they can, but it is not advisable. A physician knows how to practice medicine, and may be an excellent healthcare provider. But that does not mean he/she is equipped to defend himself in a licensing board proceeding, where administrative and legal matters are involved. In most cases it is better to have someone else help defend the physician than to have the target doctor as his own and only advocate. Importantly, many physicians seek counsel late in the process, when they have already done significant damage to their defense and cause, which could have been avoided with earlier legal advice.
If you know an attorney who has handled these types of cases, call him/her immediately. If you do not know one, ask colleagues, physician organizations or your insurance company for referrals. Understandably physicians are not anxious to broadcast that a complaint has been filed but pride should not get in the way of obtaining legal counsel. When you obtain counsel, promptly provide her with all pertinent information and documents so she can be fully informed and prepared.
NOTIFY YOUR MALPRACTICE INSURER OR EMPLOYER
Facing a BOM complaint can be daunting, and even embarrassing. A physician may want to avoid notifying even those who could help him, which is a mistake. First, the malpractice carrier or employer may provide coverage or pay for assistance, including experienced counsel to represent the physician before the BOM. Second, under many malpractice insurance policies, physicians have a duty to promptly notify the carrier of any claim or potential claim which might require coverage. (Physicians may also be required by contract, bylaws, etc. to notify their employer). Failure to provide such notice can jeopardize coverage. Therefore, it is often in a physician’s best interest to notify the appropriate parties, including his malpractice carrier.
- Review your insurance policy to determine whether you have coverage for board complaints or a duty to notify. If so, notify your carrier as soon as possible. Request any legal or other assistance which may be available under your policy or employment.
- Be Careful if You Handle the Matter Yourself
- If you do elect to represent yourself in your complaint, a few notes of caution. Do not contact the complaining party or the patient about the Complaint.
- Do not miss deadlines set forth in the complaint or correspondence. If there is a deadline for responding, submit your response timely.
- When responding, do not respond angrily or emotionally. Respond to each allegation thoroughly. Be candid and forthright. Do not needlessly admit fault. Respectfully inform and educate the BOM about your practice and the procedure/case at issue.
- Do not alter or destroy any medical record related to the Complaint or the patient(s) referenced in the Complaint.