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Insight: When You Get a Notice from the Board


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twisted pipes

Insight: When You Get a Notice from the Board

By John Puleo, Esq., Hamrock & Tocci

Related to: Emergency Medicine, Primary Care, Nursing, Obstetrics, Surgery

Physicians generally do not want to get a letter from the Board of Registration in Medicine. Being anxious upon receiving one is a fairly predictable reaction. Like many state administrative agencies, the Board of Registration in Medicine exists largely in a world somewhat peculiar to itself, with a seemingly complex system of processes, regulations, and procedural rules that can appear at times confusing and intimidating. But if you know how the Board works, it can take some of the concern out of receiving notice from them.

The Board’s complaint process is almost always initiated by a patient and handled by the Board’s Complaint Committee. The Data Repository Committee is responsible for investigating and handling reports that are filed pursuant to statutory mandate. A letter from either committee to a physician, requesting the physician’s perspective on any given matter, is likely to look identical and to provide little or no information to the physician about the nature of the inquiry being made. The subtle differences between the two, however, may determine the extent of the physician’s subsequent duty to report the matter during later re-credentialing.

Generally speaking, any correspondence from the Complaint Committee is likely to regard a matter that has formally been opened by the Board as a “complaint,” and usually will include a reference line with a docket number. Correspondence from the Data Repository Committee, however, may often be a mere informal request for information before any formal “complaint” is docketed. The Data Repository Committee may consider the physician’s response and then close the matter on behalf of the Board without ever docketing a formal “complaint.” In those instances, even though the physician had been the subject of some investigation or inquiry, the physician could respond “no” on subsequent credentialing applications when asked whether s/he has been the subject of any complaints.

As you can see, navigating your way through what may be unfamiliar territory at the Board can be challenging. If you receive a letter from the Board related to your professional responsibilities, consult with your risk manager and/or CRICO/RMF representative for guidance. CRICO/RMF can provide you with advice and legal representation, and can help you communicate effectively with the Board.

Complaints and Discipline: How Much Do You Know? 

1. A hospital patient makes a serious but unfounded allegation of misconduct against a physician. The hospital and physician agree that while the matter is being investigated, the physician will not practice at the hospital. After three days of investigation, the patient withdraws her complaint, the matter is closed, and the physician resumes her normal practice at the hospital. Has the physician been “disciplined?

__Yes __No

Answer: As unfair as it may seem, the answer is “yes,” according to the regulations of the Board of Registration in Medicine, since virtually any restriction of a privilege constitutes discipline, even if it is only temporary and “investigative,” and even when the investigation is resolved in the physician’s favor.

2. In light of the above, the hospital dutifully files a “disciplinary action report” regarding the physician, with the Board. The Board then sends a letter to the physician, asking her to provide her perspective on the issues raised by the patient. The physician files her reply with the Board. The Board then determines that no further action is warranted and sends a letter to the physician informing her that the matter has been closed. Not long afterwards, the physician completes her re-credentialing application and is asked whether she has been the subject of any complaints filed within the renewal period. What is the correct response?

__Yes __No

Answer: As counter-intuitive as it may seem, the correct answer could be “no,” and may turn on whether the letter from the Board came from the Complaint Committee or the Data Repository Committee. 

December 1, 2008
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