Responding to Board Investigations

Facing a board investigation can be one of the most stressful times during a medical professional’s career. It is easy to become overwhelmed by the process and inadvertently commit an error that can negatively impact the outcome of the investigation. However, by understanding the process and having experienced guidance, medical professionals can navigate board investigations with the best possible outcomes. This is what to consider when facing a board investigation.

Why Board Investigations Occur 

Board investigations can happen for a variety of reasons. Medical boards investigate unprofessional conduct. Each state defines what constitutes unprofessional conduct within that jurisdiction. While there are differences from jurisdiction to jurisdiction, certain behaviors such as alcohol or substance abuse that affect professional performance, sexual misconduct or inappropriate relationships with patients, neglecting patient care, or failing to meet the accepted standard of care in the state, are considered unprofessional. Other examples include prescribing medications excessively or without a legitimate medical reason, providing false or misleading information during the license application process, conviction of a felony, engaging in fraud, maintaining incomplete or inaccurate medical records, and failing to fulfill continuing medical education requirements. 

What to Do When A Board Investigation Occurs 

A board investigation can be stressful and carry serious professional consequences for medical professionals and physician practices, so responding appropriately is critical. This is what a medical professional should do upon receiving notice of a board investigation:

Consult with A Medical License Defense Attorney

First and foremost, medical professionals should promptly contact an experienced medical license defense attorney as soon as they receive notice of a board investigation. Attorneys specializing in healthcare law and professional licensing matters have the expertise to carefully review the allegations, identify any weaknesses or inconsistencies, and develop a strategic response. They can assist in gathering relevant documentation, preparing witness statements, and advising on the best approach throughout the investigation or hearing. Engaging a knowledgeable medical license defense attorney early not only ensures informed decision-making but also significantly increases the likelihood of achieving a favorable outcome.

Clarify Allegations

When a board investigation begins, the first step is to clearly understand the specific allegations being made. Reviewing the complaint or notice in detail helps identify exactly what conduct or documentation is under scrutiny. Clarifying the allegations as soon as possible allows a provider to target their response to the specific issues under investigation, rather than addressing unrelated concerns or making assumptions about the board’s focus. By identifying exactly what conduct, documentation, or incidents are being questioned, time and resources can be spent gathering relevant evidence, organizing records, and preparing witness statements that directly address the board’s concerns.

Act Promptly 

Any notice from a licensing board or regulatory authority should be taken seriously and addressed promptly. Ignoring it, responding late, or failing to follow instructions can result in automatic or default findings against the provider, meaning the board may decide the case without considering the facts or explanations. Timely action allows the provider to submit evidence and have the opportunity to explain the circumstances.

Gather Documentation

Collecting comprehensive documentation is a critical step when responding to a board investigation. Every record that relates to the allegations should be reviewed and organized, including patient charts, treatment notes, lab results, imaging studies, medication logs, and any relevant correspondence. Billing records, appointment schedules, and prior communications with patients or staff may also be important, especially if the investigation involves claims of improper billing or procedural errors. 

How to Prepare for a Board Hearing

Preparing for a board hearing requires careful planning and attention to detail. This is what medical professionals should do to prepare for a board hearing:

Understand Board Procedures 

Each state licensing or regulatory board operates under its own set of rules regarding hearings, submission of evidence, timelines, and procedural requirements. These procedures can vary widely, from how complaints are filed to the standards of proof required, the format of testimony, and deadlines for responding to notices. Familiarity with these rules is essential to effectively participate in proceedings, preserve rights, and ensure that all responses and evidence are considered appropriately.

Know Rights and Responsibilities 

Medical professionals facing board proceedings have several important rights and responsibilities. Many boards allow legal counsel or other professional representation during hearings, so knowing when and how to engage an attorney or advocate can be critical for navigating complex procedures. Boards are generally required to provide timely notice of complaints, hearings, or disciplinary actions, and recognizing these rights allows individuals to respond appropriately and avoid default judgments. In addition, boards often require timely responses to complaints or requests for information, and failure to comply can result in penalties, automatic findings, or suspension of licensure. It is also essential to understand rules regarding confidentiality and disclosure, as sharing information improperly can compromise a case or lead to additional sanctions. Being aware of appeal rights, including how and when to appeal decisions, means that the medical professional is aware of how to challenge outcomes that may be unfair or incorrect.

Maintain Professionalism

Emotions can run high during board investigations, especially when facing allegations or disciplinary actions that may affect your career or reputation. It is crucial to remain composed and mindful of your tone, demeanor, and overall conduct throughout the process. Demonstrating professionalism conveys respect not only for the board but also for the process itself, signaling that you take the proceedings seriously and are committed to transparency and accountability. Maintaining a calm and respectful attitude, even when questioned aggressively or challenged, helps establish credibility and reinforces one’s professionalism.

Contact An Experienced Medical License Defense Attorney

Board investigations are a serious matter that can affect one’s medical license, career, and personal and professional reputation. Engaging an experienced medical license defense attorney early in the process is critical to protecting your interests because this attorney understands the nuances of state board procedures and common pitfalls. Having professional guidance provides peace of mind, allowing the provider to focus on patient care while the attorney manages the legal complexities of the investigation.