For healthcare providers, reputation is currency: a glowing review from a patient can be a ticket to long-term success, while a complaint or allegation that casts doubt on your fitness to practice or bedside manner can be stressful, upsetting, and detrimental to your career and livelihood. The Department of Health Professions (DHP) is a state agency that regulates healthcare providers in Virginia, and one of its key functions is to respond to complaints of provider malfeasance. The DHP investigates complaints filed by patients or other aggrieved parties.
A notice of a complaint may be one of the most unwelcome items that will ever hit your inbox. If you receive a notice from the DHP, do not panic. And do not ignore the notice. The DHP’s mission is to ensure patients are safely and competently treated by licensed healthcare professionals. In undertaking that mission, the DHP enforces certain standards of practice. Their jurisdiction is broad: they regulate more than 380,000 healthcare professionals across 62 professions. So an investigation that is likely very personal to you may be more routine for the DHP.
An investigation does have the potential to seriously impact your career, and a bungled attempt to defend yourself can yield disastrous consequences for your license, your job, and your career. While evidence uncovered during the investigation process may be confidential, the final determination will likely be public. If an Order is entered, it will usually set forth the underlying facts, the Board’s findings, your alleged violations, and any penalties or limitations placed on you. The Notice and Order will usually be public and disciplinary action will likely be reported to other entities, including the National Practitioner Databank. While you may be able to appeal a Board’s decision, appeals are rarely successful and the stain on your professional reputation will likely persist.
Therefore, it is vital to understand the investigation process and your rights, and to manage the process well. Although it may be tempting to try to immediately persuade the DHP investigator of your position in an effort to exonerate yourself, what you say, provide, and do can be used against you so resist the urge to make a statement, commit to a version of events, provide documents or other evidence, or jump to your own defense. Your interests would be well-served by consulting a healthcare lawyer, one familiar with the DHP and disciplinary process. If you unwittingly testify against yourself or provide damaging or misunderstood evidence, it can be very difficult to try to undo the harm.
If you are a Virginia healthcare provider and you are facing an investigation, here is what you can expect from the process.
Gathering Evidence
First, the DHP will assign an investigator to gather evidence related to the complaint against you. Throughout the process, investigators may work with state, local, and federal law enforcement agencies. The evidence against you will likely take several forms, from documentation to interviews.
The Investigative Report and a Board’s Decision
After the initial investigation, the DHP investigator will summarize his/her findings in an investigative report, which will be forwarded to the relevant board for consideration. The board will review the report and evaluate the case to determine whether there is probable cause to believe there has been a violation of a law, regulation, code section or standard of care. The DHP reportedly encourages boards to make a decision within 250 days from the date of the complaint, but it frequently takes longer.
After reviewing the evidence and making a determination, the board will notify you whether the matter is being closed at that phase or if it will continue through the process. The specifics vary by case and by board.
Boards have broad discretion in enforcing DHP standards and their disciplinary actions run a gamut from dismissal to license revocation. A few examples of dispositions include the following measures:
- Case closure: In some cases, a board may find insufficient evidence of a violation and close a case.
- Consent order: A consent order is mutually agreed upon between the board and the healthcare provider. It may resolve a case without in lieu of a hearing and is typically a public record.
- Reprimand: A board may choose to publicly reprimand a practitioner. This is considered disciplinary action and is usually public record.
- Monetary penalty: You may be ordered to pay a fine or other costs and fees associated with the investigation.
- Imposition of terms and conditions: The boards may take a variety of corrective actions including requiring continuing education courses, a proctor, future chart reviews, remedial action, or participation in a program such as the Health Practitioner’s Monitoring Program.
- Limitation of practice privileges: The board may limit or revoke certain privileges specific to your practice.
- Suspension or revocation: If a violation is determined to be severe enough, a board may suspend or revoke a license.
- Case dismissal: Boards may dismiss a case at an informal fact-finding conference or a formal administrative hearing if you are exonerated or it finds insufficient evidence of a violation.
Seeking Legal Counsel to Protect Your Professional License
Healthcare providers often find themselves quick to make statements, engage investigators, or provide documentation, only to later regret doing so. If you face an investigation, resist the urge to immediately share your side of the story, especially without thoughtful preparation and consultation with an attorney. Contact an experienced healthcare attorney before responding to DHP. Responding to a complaint may feel urgent and rushed, but you are not obligated to respond to the DHP without the guidance and benefit of legal counsel. The stakes can be high and the results long-lasting so before you hastily respond, consult a healthcare attorney experienced in helping clients navigate Virginia DHP investigations.