Navigating medical board complaints

Published on: 
Medical Economics Journal, March 25, 2020 edition, Volume 97, Issue 6

Avoid common mistakes by understanding the process.

Physicians plan and insure against the possibility of a medical malpractice suit. However, they often overlook another serious threat to their livelihood: a medical board complaint. Here are some common causes of complaints and the risks and process involved.

While most doctors are primarily concerned about a medical malpractice suit, a medical board complaint on its own can significantly disrupt your income - and even end a career. It is vital to have the right coverage at the right limits before a complaint is filed against you.

Unlike an actual medical malpractice suit, a patient can easily file a board complaint at little or no cost. The Federation of State Medical Boards (FSMB) provides significant guidance to physicians and medical boards in all 50 states. It also provides some very specific guidance to patients on when, and how, to file complaints against physicians.

Complaints can result in fines, reputational damage, license suspension or limitations and even complete license revocation. So, while the results may not be as devastating as a seven-figure lawsuit judgment against the wealth you have already amassed, it can take away your future ability to earn more. For many physicians, this is their biggest asset.

A medical board complaint may accompany or precede a more onerous medical malpractice lawsuit. Medical board complaint legal defense costs are not always covered by your medical malpractice insurance. It’s a policy specific question, and I advise physicians to make sure they know, at a minimum, the following important details about their coverage:

  • If they are actually covered for board complaint defense.

  • What the dollar limits of that coverage are. It may be a rider that only covers $50,000, for example.

  • If they have stand-alone coverage or if that coverage shares limits with another policy, thereby potentially reducing the coverage available for a resulting medical malpractice claim.

Causes of medical board complaints

According to the FMSB, medical boards sort and prioritize complaints, fast-tracking adjudication of those complaints that present the possibility of imminent patient harm.  Such claims logically include instances of physicians allegedly engaging in sexual misconduct with patients, deviation from the accepted standard of medical care in a state and practicing under the influence of drugs or alcohol.

Some causes common standard-of care complaints include: 

  • Failure to diagnose, also a leading cause of medical malpractice claims;

  • Inappropriately prescribing and monitoring opioids or other controlled substances;

  • Incorrectly prescribing medication;

  • Actionable violations of physician-patient confidentiality;

  • Inappropriate behavior that interferes with patient care, including interactions with others in the chain of care;

  • Failure to provide appropriate postoperative care; and

  • Failure to respond to a call from a hospital to help a patient in a traumatic situation.

Ike Devji, JD, has practiced law exclusively in the areas of asset protection, risk management and wealth preservation for the last 16 years.