Applying for an Ohio medical license…things to know

Applying for a medical license in Ohio is an important step in your career that should not be taken lightly. When you apply for an Ohio medical license, you should know that every aspect of your application will be reviewed under a magnifying glass. The Medical Board takes the application process very seriously and will not grant you a license until the application is complete and every piece of the application has been reviewed.

It is also important to note that EVERY response that you submit to the Board will be reviewed and if any inconsistencies or questions are raised after reviewing your application, the application process will be stopped and you will be asked for further information to supplement your application. Once you submit an application in Ohio you will most likely not be permitted to withdraw the application once it is submitted.

As it is your application, you should also personally complete the application. I have had people tell me that they have had their office manager, spouse or parent complete an application on their behalf. This is a mistake. You are solely responsible for your responses. Any incorrect responses will be held against you. No one knows the details of your professional experience and history better than you.  Does your office manager know that you were arrested while in college for underage drinking? Do your parents know that you were placed on probation in your residency program? Probably not. So, complete the application yourself.

Be open, honest and accurate on your application. If you were suspended from your residency program don’t put on the application that you were “on vacation”.  Be honest. Read the application carefully and if you have any questions about any of the questions, seek the advice of experienced legal counsel to help you prepare your application.

As always, if you have any questions about this post or about the State Medical Board of Ohio in general, please feel free to contact me at (614) 486-3909 or by email at beth@collislaw.com.

Did you move? Notify the Medical Board of your change of address

If you hold a medical license in the State of Ohio, you are required to notify the State Medical Board of Ohio of any change in your address. This can be done in a number of ways:

1) Go to the following link:http://med.ohio.gov/pdf/OnLineChangeOfAddress.pdf

2) Contacting the CME/Records section of the Medical Board at 614-644-1464 and providing the Board with your change of address; or

3) Go on-line to www.license.ohio.gov and choose the “change address” option to change your address on-line.

Once you change your address, check back to the Board website after about 72 hours to verify that your change of address was properly recorded.

Why is it so important to make sure the Medical Board has your most up to date contact information? If the Board has any questions or concerns that need to be addressed by you, it will send the information to your “address of record”. If you are the subject of an investigation or if you are subjected to a random CME audit, the letters of inquiry will be sent to your address of record.

It is important to note, you are generally provided with a short period of time (generally 30 days) to respond to Board inquiries. Failure to respond may result in an adverse action against your license. For example, in a disciplinary proceeding, if you are notified by mail that the Board proposes to take a disciplinary action against your license for an alleged violation of the Medical Practice Act, under Ohio Revised Code Chapter 119, you have thirty (30) day from the date the notice was MAILED to you to request a hearing. If you fail to request a hearing in a timely manner, the Medical Board will take a disciplinary action (including possibly a suspension or revocation of your license) without considering your side of the story.

In addition, if the Medical Board takes a disciplinary action against a licensee and the Board is unable to provide the licensee with a copy of the final Adjudication Order (ie. if the Board does not have your current address) then the Board is required to PUBLISH the disciplinary action in your local newspaper.

It only takes a minute. You should check with the Board at www.license.ohio.gov to verify that the Board has your current address. If it doesn’t, please follow the prompts listed above to update your address with the Board.

As always, if you have any questions about this post or about the State Medical Board in general, please feel free to contact me at (614) 486-3909 or email me at beth@collislaw.com.

On probation with the Medical Board? Beware .. there is a new sheriff in town

Physicians who are on probation with the State Medical Board of Ohio related to alcohol or chemical dependency or abuse are generally required to submit to monitoring conditions during probation, including submitting to random urine drug tests, attending weekly AA meetings, completing 104 aftercare sessions, attending quarterly Board appearances,  and having a physician monitor their practice.

In the past, as long as a physician on probation did not have a positive alcohol screen, i.e. illegal substance or prescription medication without  a valid prescription, the Board generally did not always require perfect compliance with all other probationary terms. Again, generally,if a physician failed to submit a quarterly declarations of compliance or failed to attend all required AA meetings, the Board would customarily  address the issue at their quarterly meeting or would send the physician a “friendly” letter advising them that they were not in compliance and requesting that steps be taken to ensure compliance.

Under the direction of former Board Member, Mr. Albert, the Board rarely charged a probationer with failure to comply with the terms of their Consent Agreement, unless they tested positive for drugs or alcohol.  Most recently, however, the Board has taken a much stricter position on probationers who are not 100% in compliance with ALL the terms in their Board Orders or Consent Agreements.

Recently, the Medical Board issued a Notice of Opportunity for Hearing to a physician who had been on probation with the Board since 2005.  Despite the fact that all of the physician’s urine screens were negative, the Board proposed to discipline the physician for allegedly failing to comply with the following terms of the physician’s Consent Agreement: failure to submit quarterly reports to the Board in a timely manner; failure to submit AA logs to the Board; failure to seek Board approval for required courses and for a monitoring physician. Despite no evidence of relapse, the Board voted at its June meeting to revoke this physician’s medical license for failure to be 100% in compliance with the Board’s Order or Consent Agreement.

If you are under probation, please beware. The terms and conditions of Board Orders or Consent Agreements are mandatory. Failure to strictly comply with all terms and conditions of the Board Order or Consent Agreement can serve as the basis for further Board disciplinary action.

As always, if you have any questions regarding this post or the State Medical Board in general, please feel free to contact me at 614-486-3909 or email me at beth@collislaw.com.

Do you really need to wear your scrubs everywhere?

I usually try to write on topics related to the State Medical Board of Ohio and issues or problems that can lead to discipline by the Medical Board. Occasionally, however, I will write on a topic that I just find curious for medical professionals. Today, the issue relates to why many medical professionals wear their scrubs out of the hospital?

I have tried to figure out the whole, scrubs as casual wear issue. It makes sense to see medical professionals around the hospital or on the hospital grounds in their scrubs. I don’t find it unusual to see health care professionals grabbing a quick-lunch in their scrubs. However, the wearing of scrubs has gone way beyond that.   Is the rationale for wearing the scrubs that “I could be called to the hospital at any minute, so I need to be prepared?” This might be it. However, yesterday, I saw someone cutting their grass in their scrubs! I hope they don’t wear that same outfit into the hospital if they are immediately called in for an emergency.

My father was a practicing anesthesiologist for over forty years. He left the house before 6am in a suit and tie and returned late each evening in a suit and tie. I can’t say that I ever saw him in scrubs. He certainly never went to dinner or cut the grass in scrubs.

Now, some may ask, “who cares what medical professionals wear”?  While I agree that we live in a much more casual society than even 20 years ago, I do believe that it decreases the level of professionalism and respect for the profession when medical professionals are constantly wearing their “hospital uniform” outside of the work setting. Just something to consider.

(Wearing scrubs out of the hospital, even to cut your grass will NOT lead to discipline by the State Medical Board of Ohio.)

As always, if you have any questions about this post or about the State Medical Board in general, please feel free to contact me at 614-486-3909 or email me at beth@collislaw.com.

Medical Board Investigators Carry Guns Now?

I recently learned that Ohio Medical Board investigators now carry hand guns while on the job. I had heard that the Board was considering allowing their investigators to carry firearms, but recently I learned first hand that an investigator had entered a private medical practice carrying a firearm.  I find this practice intimidating and unnecessary.

Isn’t it intimidating enough when an investigator appears in the medical office or hospital, often unannounced, flashes his credentials and demands to speak with the physician (who is most often seeing patients) and then requests to immediately see and take original patient files? My question is, why must they also carry a firearm?

I went back to the Board’s minutes to review the Board members’ rationale for this decision. In August 2011, the Board reviewed the issue of investigator safety. Of course, I found that this new aggressive move by the Board comes down to the heightened investigation of pain clinics in Ohio. The argument was that pain clinic waiting rooms may be filled with patients, who may be also carrying weapons.  The Board members were advised, on occasion, investigators were confronted with people hanging around the parking lots and “drinking alcohol” and on one occasion an investigator’s car was blocked by another car and they could not leave the parking lot. http://www.med.ohio.gov/pdf/Minutes/2011/08-11minutes.pdf

Based on concern for the safety of the investigators, the Board members approved a policy that would require investigators to undergo a minimum of 40 hours of training at the Ohio Peace Officers Academy and obtain re-certification annually.

I would never want to put the lives or safety of the Medical Board investigators at risk. However, we have a trained police force available in Ohio that investigators can call at any time for assistance. In addition, if the investigator has reason to believe that they are going into a dangerous area, they can always alert the local police in advance and even have an officer accompany them to their appointment. However, to allow an administrative board investigator to carry a firearm after simply 40 hours of training into all medical offices for all appointments is intimidating and unnecessary for the overwhelming majority of investigations conducted.

As always, if you have any questions about this post or about the State Medical Board in general, please feel free to contact me at beth@collislaw.com or call me at 614-486-3909.

The truth..the whole truth and nothing but the truth

In order for your attorney to provide you with the best possible counsel, you have to tell them the truth .. the whole truth and nothing but the truth. This seems obvious, however, I find clients (or often potential clients) either don’t tell me the truth or fail to tell me the “entire story.”   The only way to effectively work with an attorney is if you tell them the entire story. It is the attorney’s job to work their way through all the information and determine what is important and what is not important information in your case.

Most of my clients are medical professionals. They have been trained to take a patient’s history and physical. They know the importance of getting the entire story from the patient. The approach the physician takes when treating a patient is largely determined by the information obtained directly from the patient.  This is exactly the same scenario in working with an attorney. If you don’t tell the attorney the truth and the ENTIRE story … their ability to help you is limited.

In addition, you should be readily forthcoming with the information for your attorney. You can’t expect your attorney to cross-examine you to get the story out or to make assumptions based on the limited information that you have provided to them.

If you are not comfortable telling your own attorney the entire story, then you need to find another attorney who you are comfortable telling the entire story. In addition, if you fail to tell your attorney your entire story, you run the risk of the information coming out in a deposition or on cross-examination, which could leave your attorney blindsided and unable to assist you.

The truth is always the best policy, especially when working with your own attorney.

As always, if you have any questions about this post or about the State Medical Board of Ohio in general, please feel free to email me at beth@collislaw.com or call me at 614-486-3909.

Do you have balance in your life?

Doctors …. do you have balance in your life?

In the past, I have written about the three main areas where the State Medical Board in Ohio takes disciplinary actions against physicians: (1) for submitting false information to the Board, (2) for violating a professional boundary with a patient and (3) for issues related to drugs or alcohol (see previous post entitled, “What the Medical Board Really Cares About – Sex, Drugs and Lies”).  Recently, I looked at many of the cases before the Medical Board to determine if there are similar warning signs or red flags that may have been present before a complaint is filed with the Board. What I found is that in many instances the physician had been living a life that is out of balance.

Physicians are trained to look for signs of health (or disease) in their patients, however, too often they do not look for those warning signs in themselves. I often see that the complaint with the Medical Board is just the “final straw” in a year (or years) of a physician living an unbalanced life.  I find that, in many cases, physicians are overworked, overweight, stressed out, and living meaningless and angst filled lives. Many are taking medications to help them sleep and then other medications to help them get through their work days. Many eat out too often, haven’t seen the inside of a gym in ages (or ever), and are living meaningless, spiritless lives.

In terms of boundary violations, they rarely happen  to physicians who are in loving, supportive marriages or relationships. Many times, a physician will find themselves immersed in a Medical Board investigation when they are also in the middle of an ugly divorce or professional partnership that has taken a turn for the worst.

As physicians, you worked hard in school to put yourself in a position where you would have choices. Choices about where you work and what type of work you would like to engage in on a daily basis. Now is the time to exercise those choices and put yourself in a work environment that you find interesting, fulfilling and enjoyable.

I recently read that in tough financial times many people start to step back from their jobs (or job searches) and consider what they can do to make their overall lives better. Many have found that by spending more time with family and friends, exercising more often, and taking “control” of their lives they have found the energy and spirit to be more successful in work or in their job searches. Despite the tough economy, gym memberships were up in 2011 and many more people participated in Weight Watchers and other programs to improve the overall quality of their lives.

Doctors … look at your lives. Are you healthy, happy and fulfilled? If not, now if the time to reclaim your life and the direction of your professional career.

As always, if you have any questions about this post or about the State Medical Board of Ohio in general, please feel free to email me at beth@collislaw.com or call me at 614-486-3909.

Physician/patient relationship = power imbalance

The State Medical Board of Ohio addressed two cases at its March meeting concerning the physician-patient relationship.  http://www.med.ohio.gov/pdf/Agenda/Agenda%20-2012/03-12agenda.pdf

In one case, the Medical Board suspended the license of a physician for 180 days after a hearing based on the finding that the physician had engaged in a sexual relationship with an indigent patient after providing the patient with “free” medical care and “free” medicine. From the physician’s perspective, she honestly believed that she was providing a medical service to the patient that he could not otherwise afford and that she should not then be “punished” for providing this care.   The physician did not comprehend that having a personal (read: sexual) relationship with the patient violated the physician/patient relationship.  Regardless of the fact that the medical care provided to the patient without charge, a physician-patient relationship was created.  The Board suspended the physician’s license for 180 days for the boundary violation.

In the second case, the State’s attorney offered for Board approval a Consent Agreement  for a physician who had engaged in a sexual relationship with a patient, which proposed to impose no active suspension on the physician’s license. The rationale given by the State’s attorney for no suspension was the fact that the patient was also the corporate attorney for the medical practice and therefore the legal staff did not believe that there was the same imbalance of power between the physician and the patient that usually leads to physician discipline. The state’s attorney argued that the physician and attorney/patient were on a more even footing.  The state’s attorney argued there was no imbalance of power and consequently no suspension should be imposed on the physician’s license.

The Board members did not agree with this argument. In a rarely seen move by the Board, the proposed Consent Agreement, was rejected by the Board.  While this is a very unusual fact pattern, it clearly shows the Board believes strongly about the inherent imbalance of power in a physician-patient relationship.

As always, if you have any questions about this post or about the medical board in general, please feel free to call me at 614-486-3909 or email me at beth@collislaw.com.

What the Medical Board really cares about – sex, drugs & lies

Today is the State Medical Board of Ohio’s monthly Board meeting. It is always scheduled for the second Wednesday of the month. Decisions on disciplinary actions are always scheduled on the 1pm docket. It is a  cattle call. All disciplinary actions are deliberated and final decisions are voted on in open session. Members of the public, including medical students, and the press are welcome to and do attend.

The first question I am always asked by physicians is “What will get me in trouble with the Medical Board”.  While the Medical Board can discipline a licensee for a wide range of things, there are three areas that seem to be of their highest concern: Sex, Drugs and Lies.

Sex. The Board typically takes disciplinary action against a licensee who has sex with a patient. However, the Board is also concerned with boundary violations with patients. Have you employed a patient in your office or loaned money to a patient or signed a car note or credit card application for a client? The line in the sand between a doctor and a patient should be clear. There should be no overlapping of a doctor/patient relationship and a personal relationship.

Drugs. Nearly half of all disciplinary actions handled by the Medical Board each year involve impaired physicians. Physicians who have been diagnosed with drug or alcohol problems. The Medical Board is also very concerned about the prescribing habits of physicians. Has the physician prescribed to the mother of a patient as opposed to the patient because only the mother has insurance? Has the physician prescribed a controlled substance to a family member?  Has the physician prescribed a drug to a patient for other than legitimate medical purposes?

Lies. The Medical Board does not like to be lied to. If you complete an application and fail to give clear, concise and accurate information to the Board, you will likely face a disciplinary action. Similarly, if you are the subject of discipline by another state and fail to tell the Ohio Board, you will likely be subject to discipline in Ohio not just for the “sister state discipline” but also for failing to disclose the action to the Ohio Board.

At the Board meeting today, the Board will consider final discipline in four cases. One involves practicing below the standard of care in the prescribing of medications to four patients that also resulted in felony and misdemeanor convictions; two cases relate to alcohol abuse or addiction and relapse and one involves an inappropriate sexual relationship with a patient. http://www.med.ohio.gov/pdf/Agenda/Agenda%20-2012/03-12agenda.pdf

Off to the meeting….

As always, if you have any questions about this post or about the State Medical Board of Ohio, feel free to email me at beth@collislaw.com or call me at 614-486-3909. I look forward to your questions.

Prescribing for self and family members – never a good idea

On Friday, I am scheduled to speak to a group of third year medical students in Ohio about the Medical Board disciplinary process. I have given this talk several times, but for this particular group of students I thought I would look up some recent Medical Board disciplinary actions and try to highlight an area that might not be an obvious violation to most physicians.  One area that often surprises physicians is the prohibition against prescribing for self and family members.

The standard of care requires physicians to be able to use detached professional judgment in treating patients. This can not be done when prescribing to yourself or for a close family member.   The Medical Board in Ohio has a specific rule that prohibits the prescribing of controlled substances by physicians to themselves and to close family members. http://codes.ohio.gov/oac/4731-11-08

Physicians may only use controlled substances to treat a family member in an emergency situation. However, even in these instances, the physician needs to take the same care with the family member that they would with any other patient. The physician must conduct a physical examination and maintain a clear written medical record.  Physicians may not prescribe controlled substances to themselves. The physician may obtain an over the counter Schedule V controlled substance for personal  use, but must follow all state and federal laws that a non-physician would be required to follow.

Physicians may prescribe to family members in an emergency situation. However, when prescribing to a family member, the prescription must be for a short period of time until the patient can schedule an appointment with their regular treating physician. Prescriptions with multiple refills for family members are not considered for an “emergency” basis and will violate the Board’s rule.

Physicians have been disciplined by the Medical Board of Ohio for prescribing controlled substances to family members that have been initially prescribed by other doctors, for prescribing medications with multiple refills, and for failing to take and maintain an adequate medical record.

Although, OAC 4731-11-08 specifically addresses controlled substances, the Medical Board also does not approve physicians writing prescriptions to family members for non-controlled substances, such as birth control pills unless the physician has conducted a physical examination and also maintained a medical record.  The AMA has also addressed this issue in AMA Ethics Opinion 8.19, which discourages the treatment of self or family members. http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion819.page

It is never a good idea to prescribe to yourself or to family members. You and your family members should always seek treatment from your own treating doctor.

As always, if you have any questions about this post or any other questions about the State Medical Board of Ohio, feel free to send me an email at beth@collislaw.com or call me at 614-486-3909.