Attorney Beth Collis quoted in Medscape article on Medical Board investigations

Attorney Beth Collis, of Collis Law Group LLC, was quoted in a Medscape article titled “The Dangers of a Medical Board Investigation: How to Protect Yourself”. In the article Ms. Collis addresses the 9,000 complaints that the State Medical Board of Ohio receives each year. “Many are minor or frivolous, such as allegations that the doctor or his staff was rude to the patient or family, billing questions, being forced to wait too long for an appointment, etc. The Board generally doesn’t take action in these cases and may not even inform the doctor of them.”

Ms. Collis also addresses how it is necessary for physicians to respond to Board investigations or inquiries. Ms. Collis warns physicians against ignoring inquiries from the Board, or from talking to the Board without counsel. “No complaint is too minor. Too many physicians think they don’t need a lawyer and can just talk the Board investigators into dropping the complaint. Doctors may sincerely want to help but they don’t understand the rules and pitfalls. They are often too chatty and explain things that weren’t even asked.” Legal counsel is recommended for any physician in connection with any Medical Board investigation or disciplinary action.

Read the article, written by Mark Crane, by clicking on the following link: https://www.medscape.com/viewarticle/899247_2

As always, if you have any questions about this blog or the State Medical Board of Ohio, please feel free to contact one of the attorneys at Collis Law Group LLC at (614) 486-3909 or email me at Beth@collislaw.com.

Ohio Physicians: Timely open and respond to all letters from the Medical Board

Keep your address up to date

As a physician licensed to practice medicine in Ohio, you are required (under R.C. 4731.281) to maintain your current accurate mailing address with the State Medical Board of Ohio. You may update your address online at: http://med.ohio.gov/UpdateAddress.aspx

The address on file with the Medical Board will be the official address that the Board will use to contact a physician if they become the subject of an investigation, or if the Board proposes to take a disciplinary action against a physician.

Certified Mail

If the Medical Board takes an action against a physician, they will be mailed a letter outlining the charges to their address of record with the Board. Under RC 119.07, the Notice of a Board Order shall be given by registered mail, return receipt requested, and shall include the charges or other reasons for the proposed action, the law or rule directly involved, and a statement informing that the party is entitled to a hearing if the party requests it within thirty days of the time of mailing the notice.

If you receive a certified mail from the Medical Board, it is imperative that you open it!  If the Medical Board has mailed a certified letter to a physician, it will include important information and often requires an action to be taken by the physician within a short period of time.

For example, if the Medical Board issues a Notice of Opportunity for Hearing to a physician, the physician is only provided with 30 days (from the date of mailing by the Board) to request a hearing. Failure to timely request a hearing may result in a board-ordered sanction, and the physician would be provided with no means to defend their case. The sanction takes the form of a Final Adjudication Order under RC 119.

Failure to cooperate in an Investigation

Failing to respond to a subpoena request or to respond to Interrogatory questions sent from the Medical Board may also result in a disciplinary action taken against the physician by the Medical Board. R.C. 4731.22(34) provides that failure to cooperate in an investigation conducted by the Board, including failure to answer a subpoena or order issued by the Board, or failure to answer truthfully a question presented by the Board in an investigative interview, an investigative office conference, at a deposition, or in written interrogatories, will result in disciplinary action.

Publication notification

If you fail to accept delivery of certain notifications, the Medical Board has the authority to publish the notification in your local newspaper. If any notice sent is returned for failure of delivery, the agency either shall make personal delivery of the notice by an employee or the agent shall publish the notice once a week for three consecutive weeks in a newspaper of general circulation in the county where the last known address of the party is located. When notice is given by publication, a proof of publication affidavit, with the first publication of the notice set forth in the affidavit, shall be mailed by ordinary mail to the party at the party’s last known address and the notice shall be deemed received as of the date of the last publication.

Refusal of delivery by personal service or mail is not failure to deliver and service is still deemed to be complete. Therefore, it is important to keep your address up to date in order to accept all certified mail that is sent from the Medical Board. Be sure to carefully review all letters from the Board as they often include short timelines in which a response may be required.

If you have any questions about this post or the State Medical Board of Ohio, please feel free to contact one of the attorneys at the Collis Law Group LLC at 614-486-3909 or email me at Beth@collislaw.com.

Rich Doc/Poor Doc

In my practice of representing physicians who are under investigation by the State Medical Board of Ohio, DEA, local law enforcement, and/or their employer, I have seen many professionals struggle with multiple issues.  Recently, I have noticed  that far too many physicians are in disastrous shape financially.  Many physicians have poor money management and/or business management skills that have led them to entering into risky contracts or taking on jobs that they otherwise would have not considered.

Most physicians do not have the time, training, or education to be good money managers and, therefore, generally, many make poor financial decisions.  Many physicians enter the practice of medicine deeply in debt with student loans.  Many residents live beyond their means in the belief that once they complete their residencies, they will be given lucrative employment contracts.  Often, young physicians are so far in debt after completing their training, they are forced to accept work in undesirable practices to pay their debt.

Too often, physicians are also seen as “easy targets” for unscrupulous people.  I am always surprised to learn of highly educated physicians who enter into risky business dealings or fail to perform due diligence when purchasing property or entering into a business venture.

I have seen numerous instances in which physicians who are strapped with debt make unwise decisions as to where they will work and who they choose to associate themselves with in their medical practice.  Often, these physicians will seek ways to save money in their medical practice that leads to poor patient care or that is contrary to law.  Last year, the State Medical Board of Ohio disciplined a number of physicians who (in an effort to save money) purchased non-FDA approved medications from outside of the United States to administer to their patients.  These physicians did not realize that they were violating the law by purchasing these medications.  Nevertheless, these physicians were each subjected to disciplinary action by the Board.

I have also seen physicians continue to work for high volume practices in which they are constantly pushed to order expensive tests to ensure that the practice is highly compensated.  Often, these physicians tell me that they felt trapped in these jobs because the high salaries allow them to pay their debts.  I have also seen physicians take “moonlighting” jobs in areas outside of their specialty in an effort to repay debt only to find themselves investigated by the Board or DEA for practicing or prescribing outside of their scope of expertise.

The best way to have choices as a physician is to live within your means and to take the time and effort to do research before joining a particular practice or entering into a particular business dealing.  Physicians who are financially strapped risk making poor personal and business decisions that can lead to discipline by the Board or another agency.

A qualified accountant can be of assistance regarding your taxes.  A relationship with an attorney can be of benefit when researching a particular job or business venture.  A financial planner can offer guidance as to investments.   Utilizing these types of individuals allows you as a physician to do what you do best…to practice medicine.

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

Physicians’ Legal Obligation to Report to the State Medical Board of Ohio

Last week, the State Medical Board of Ohio issued a landmark decision in which the Medical Board permanently revoked the license of a physician for failing to report to the Medical Board allegations of sexual misconduct concerning the physician’s colleague.

Pursuant to ORC 4732.224(B), an individual licensed by the Medical Board who has reason to believe that a violation of any provision of the Medical Board’s statutes or rules has occurred shall report to the Medical Board. Although this law has been in effect for many years, this was the first time we are aware that the Medical Board has disciplined a licensee for failing to report a licensee under this law. It was also remarkable that the sanction imposed was a permanent revocation, which is the most serious sanction that can be imposed by the Medical Board.

An interesting factor of this case also rests in the subjective wording of the reporting statute, which provides that a licensee who “has reason to believe” that a violation of Medical Board law or rule has occurred shall report to the Medical Board. This subjective wording can make it difficult for a physician to know when they must report to the Medical Board allegations made against a colleague.  However, OAC 4731-15-01(D) provides guidance by indicating that “reason to believe” or “a belief” does not require absolute certainty or complete unquestioning acceptance, but only an opinion that a violation has occurred based upon firsthand knowledge or reliable information.

In this case, the Board’s attorneys argued that the physician’s failure to report to the Medical Board allegations of sexual misconduct concerning the physician’s medical partner with patients in the practice was a violation of the reporting statute. Despite the fact that the physician who allegedly engaged in misconduct was terminated from employment at the medical practice, the physician who failed to report to the Medical Board the alleged misconduct permanently lost his medical license.

Although there are certain exceptions to the reporting requirement in OAC 4731-15-01(B), those exceptions are limited and require a fact specific analysis in each individual case.

Under OAC 4731-15-01(E), a report required to be made must be made to the Medical Board within 48 hours. Under OAC 4731-15-01(G), each report must include (i) the name of the practitioner or other individual in violation, (ii) the violation which is believed to have occurred, and (iii) the date(s) of and place(s) of occurrence(s), if known.

This case is a cautionary tale to Ohio physicians. If you have reason to believe that another licensed professional is violating any of the provisions of the Ohio Medical Practice Act (ORC 4731 et seq and OAC 4731 et seq), you are required to report to the Medical Board.

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

 

 

Ohio Medical Board approach to physicians with mental health issues may have a chilling effect on physicians seeking treatment

Pursuant to Ohio Revised Code Section 4731.22(B)(19), the Medical Board in Ohio can suspend the license of a physician if it is determined that a physician has an “…inability to practice according to acceptable and prevailing standard of care by reason of mental illness . . .”.  This suggests that the Board must link a physician’s mental illness to an inability to safely practice medicine.  In fact, the Medical Board does not need to show immediate harm to the public or evidence of poor or substandard medical practice to limit or restrict a physician’s license if it is determined that he or she suffers from a mental illness.

Under the Ohio Medical Board statute, if the Board has reason to believe that a physician suffers from a mental illness that could affect their ability to practice medicine, the Board can order the physician to undergo a psychiatric evaluation with a Board approved psychiatrist (a psychiatrist selected and approved by the Medical Board). The evaluation, which generally runs between $2,500-$4,800, is at the expense of the physician. Generally, before the evaluation, the physician is required to sign a release form and submit his or her medical records, including mental health records, to the Board approved psychiatrist for review. After reviewing the physician’s medical records, the Board approved psychiatrist will evaluate the physician and make a determination. The evaluation may or may not include psychological testing and may or may not include the psychiatrist contacting family members, colleagues or co-workers to evaluate the physician’s “ability to practice.”

After the evaluation, the Board approved psychiatrist will make one of the following recommendations to the Board:

-physician may continue to practice medicine with no Board monitoring; or

-physician may continue to practice medicine as long as they enter into a monitoring agreement that requires them to maintain treatment with a psychiatrist or therapist and for the therapist to submit quarterly reports to the Board; or

-the physician is unfit to practice medicine and his or her license will be suspended until such time as s/he can provide the Medical Board with evaluations from two additional psychiatrists that s/he is fit to resume practice. These evaluations are, again, at the expense of the physician.

If the physician is required to enter into any type of monitoring agreement with the Medical Board, the agreement is a public document.  Such agreement typically includes the physican’s medical diagnosis and conditions under which he or she may continue to practice medicine. It is reported to the National Practitioner’s Data Bank and is accessible to the public on the Medical Board website.

Many physicians throughout the state have voiced strong opposition to the lack of confidentiality of the monitoring program, the onerous nature of the monitoring conditions and the chilling effect that curtails many from seeking appropriate medical care for fear that their confidential medical records would be reviewed by Medical Board Members or staff. (Confidential medical records are NOT released to the public. However, the physician’s medical diagnosis, monitoring conditions and name of their treating doctor is released to the public.)

Many individuals have been contacting the Medical Board with their concerns about the punitive way in which the Medical Board treats physicians who suffer from a mental health condition. Many individuals are also pushing for Ohio to institute a confidential program to monitor physicians. If you believe that physicians should be provided with a confidential monitoring program, I recommend that you contact the State Medical Board of Ohio and voice your concerns.

As always, if you have any questions about this post or the State Medical Board of Ohio in general, please contact one of the attorneys at Collis, Smiles & Collis, LLC at 614-486-3909, or by email to Beth@collislaw.com.

 

Physicians .. Do your CMEs or face Ohio Medical Board discipline

Each month I attend the monthly meeting of the State Medical Board of Ohio.  This past week, at the Board’s monthly meeting, I was stunned to hear that the Board had voted to accept the permanent surrender of four physician’s licenses for failure to comply with their Continuing Medical Education (CME) requirements! This means four physicians in the state of Ohio chose to permanently surrender their medical licenses for failure to comply with the Board’s CME requirements. While many of these physicians may be older doctors who no longer want to practice, I was saddened to hear that they chose to permanently surrender their licenses under such circumstances.

All physicians in Ohio are required to complete 100 hours of CME credits every two years. 40 hours of that 100 must be Category A approved hours and the remaining 60 hours can be completed by simply reading medical journals. There are many on-line or in person locations that you can obtain CME approved hours. You may contact your local medical association or the Ohio State Medical Association for approved credit hours.  https://www.osma.org/education/continuing-medical-education-requirements.

You are required to maintain documentation of your meeting attendance. Each year, the Medical Board conducts random audits and requests that selected physicians submit proof of completion of their CME hours.

Failure to respond timely to an audit can result in a Reprimand to your professional license. If you are unable to provide evidence that you completed the required CME credits during your two-year renewal period, the Board may issue for a first time offense a Reprimand and a fine ranging from $1000-$5000. The Board may also indefinitely suspend your medical license until you have completed all your CME hours.

For a second time offense, the Board can impose a sanction of a fine from $3000-$5000 and can suspend your license for an indefinite period of time ranging from a 60-90 day suspension.

Keep track of your CME credits. Keep copies of all meetings you attend and journals you read. It is not worth the risk of discipline to your professional license including a fine, Reprimand or Suspension for failure to complete your required CME hours.

As always, if you have any questions about this post or the State Medical Board of Ohio, you may contact any of the attorneys at Collis, Smiles and Collis in Columbus, Ohio, 614-486-3909.

Medical Residents, Be Advised

As July 1 quickly approaches and medical Residents prepare to start their residency programs, it is imperative that Residents know the limits of their Training Certificate. For instance, many Residents question whether they are authorized to prescribe non-controlled medication to family and/or friends pursuant to a Training Certificate. The answer is, no.

The holder of a Training Certificate is not authorized to write non-controlled medication prescriptions to family members and/or friends unless the care being delivered to the family member is under the auspices of the Residency Program for which the Training Certificate was issued.

Other restrictions also include, but are not limited to: the holder of a Training Certificate is not authorized to practice medicine, including writing prescriptions, except as may be required by or incidental to the holder’s Residency Program. In addition, the holder may not practice outside of the Residency Program hospital or facilities for which the Training Certificate was issued. Thinking of picking up part-time medical work an a hospital or office setting on weekends? You will need to have a full Ohio medical license to work outside of your training program.

Lastly, the Training Certificate may be revoked if the holder practices medicine, including writing prescriptions, outside of the Residency Program. Residents, don’t overlook formalities and be aware that there are limitations to follow while working under your Training Certificate!

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

Physicians .. have you read the rules?

The practice of medicine in Ohio is outlined by one statute section, Ohio Revised Code 4731, and one set of rules drafted by the Medical Board, Ohio Administrative Code 4731. This Code section and these rule outline the requirements to be licensed as a physician, podiatrist, massage therapist or physician’s assistant in Ohio and also define the scope of practice of medicine in Ohio. However, I am always surprised that most physicians with whom I speak have no idea that these laws and rules even exist.

Ohio Revised Code Chapter 4731 is the law governing the practice of medicine in Ohio. The Ohio Administrative Code is drafted by the Medical Board members and is reviewed and approved through a rule making process. Physicians in Ohio are required to know, understand and follow the guidelines established in these laws and rules.

These laws and rules can be found at the Medical Board’s website at: http://www.med.state.oh.us. You can also follow the following link to find these sections: http://codes.ohio.gov/orc/4731
or for the administrative rules go to: http://codes.ohio.gov/oac/4731

Pertinent sections of these laws and rules include:

Basis for disciplinary action can be found at R.C. 4731.22(B) which can be found at: http://codes.ohio.gov/orc/4731.22.

To learn more about licensing and continuing education go to: OAC 4731-10, which can be found at: http://codes.ohio.gov/oac/4731-10.

To learn more about prescribing of controlled substances go to: OAC 4731-11, which can be found at: http://codes.ohio.gov/oac/4731-11.

To learn more about the Medical Board’s hearing process go to: OAC 4731-13, which can be found at: http://codes.ohio.gov/oac/4731-13.

To learn more about the duty to report to the Medical Board go to: OAC 4731-15, which can be found at: http://codes.ohio.gov/oac/4731-15.

To learn more about what to do if you believe you suffer from  chemical dependency go to: OAC 4731-17, which can be found at:  http://codes.ohio.gov/oac/4731-17.

As practicing medical professionals in Ohio, you are required to know, understand and follow the laws  and rules in ORC 4731 and OAC 4731. Take the time to read the rules and, if you have questions, contact experienced legal counsel to assist you.

As always, if you have any questions about this post, please feel free to contact me at beth@collislaw.com.

Social media can be a dangerous pastime for medical professionals

You have probably seen the “news” reports in the past two days of a naked Prince Harry having a good time in Las Vegas. These clandestine photos were obviously taken when Prince Harry believed that  he was in a private setting. However, they were secretly released to the press and quickly went viral to the great embarrassment of the Royal Family.

You may wonder what this has to do with physicians and the medical profession? We are now in a world where virtually everyone is carrying a camera/video camera on their phones with the ability to take and upload photos and videos to the internet and to the world in moments.  Behaviour that professionals may have engaged in that they thought was private may now be published to the world.

I have not seen a case yet where the Ohio Medical Board uses video footage of a physician “acting badly” as evidence of impairment or inability to practice medicine, however, in my opinion it is just a matter of time. Physicians need to be aware that the Medical Board can take an action against a physician for their conduct, even if it is not related to the practice of medicine. You do not need to be “falling down drunk” at work to be disciplined by the Medical Board. A photo or video of you clearly impaired at a bar taken at 2am when you are scheduled for surgery at 7am could serve as the basis for discipline.

Social media can also be evidence of a boundary violation with a patient. Do you “friend” patients on Facebook? Do you have photos of yourself and a patient taken in social settings? These could all constitute boundary violations with patients.

Social media can be a wonderful tool to reconnect with old friends and to share photos with family members and friends. But, it can also lead to trouble for professionals if not used wisely. As physicians, your conduct needs to be professional 24/7.

As always, if you have any questions about this post or about the State Medical Board in general, please feel 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.