Regulation of Medicine

article

Responding to a Medical Board Inquiry

Executive Summary

A state medical board inquiry needs to be treated seriously. Each state medical board’s process for inquiries varies. However, you should always allocate the necessary time to carefully prepare and draft your response with the help of a skilled and knowledgeable attorney.      


Recommended Actions
  • Stay alert for medical board inquiries in the mail and email (including your junk email)
  •  Ensure that there is an office policy and staff are properly trained to flag medical board inquiries for your review, as time is of the essence.         
  • Ensure that your office keeps adequate documentation and medical records in case of an inquiry. 
  • Remember that most complaints come from upset patients and can involve a variety of issues regarding your professional activities.          


State medical boards were created to license and regulate the practice of medicine for a particular state. They also are responsible for responding to formal complaints against physicians and other medical professionals regulated by those boards. Not all complaints that medical boards receive from patients or other physicians warrant formal investigations, but some do. In the event you receive a letter from your state medical board, it is important that you respond appropriately and in a timely manner.        

     
Consider these two scenarios:

Two physicians, Doctor A and Doctor B, both receive letters from their state medical boards. Doctor A immediately notifies their malpractice insurance carrier. Doctor B sets the letter down and returns to seeing patients, forgetting about the letter for a week and then crafting a hurried and minimal response. Doctor A, however, has developed a well-thought-out response with the help of an attorney. For Doctor A, this is the end of the journey; the responses satisfied the medical board and no further actions are needed. Unfortunately, Doctor B receives a summons to appear for an interview, continues through the process without the help of legal counsel, and winds up with a suspended medical license.

Both scenarios are very real possibilities for practicing physicians.


If you receive a letter from your state medical board regarding a patient complaint or other inquiry, MagMutual recommends that you do the following:     

  • Treat any correspondence regarding a complaint or an inquiry from the board as a serious matter. Remember, you have devoted a great deal of time and effort to obtain your medical license. Any board complaint or investigation is a potential threat to your ability to practice medicine in your state.
  • Notify MagMutual immediately by sending a copy of the complaint to incidents@magmutual.com. After you report the matter, MagMutual can review and assign an attorney who is familiar with the board’s inquiry process in your specific state.
  • Write a thorough and detailed initial response. Your attorney will identify any irregularities that may exist in your documentation and help you draft an appropriate response. Your response could very well determine how the board decides to proceed.
  • Do not alter, add to or destroy any medical records, particularly those that may have been requested by the board. Those actions are grounds for discipline. Most likely, you will be required to send in the relevant records along with your response.
  • Update your assigned attorney and MagMutual about any correspondence you receive from the board. If an interview is requested, it is crucial that you prepare well ahead of time. 
    Although medical board processes may vary from state to state, timely and careful preparation, along with the guidance of a skilled and knowledgeable attorney, will allow you to achieve the best resolution to any inquiry.

Lessons Learned 
  • Collect necessary documentation related to the inquiry and compile everything in a safe location.
  • Communicate with the board in writing.
  • Keep copies of all responses to and from the Board during this process.
    Potential Damages: Failure to adequately respond can result in a provider facing serious disciplinary action, such as fines, license restrictions or even revocation.
Quiz

Answers are provided below

True or false?


Question 1: I can alter the medical records of a patient, particularly those that may have been requested by the Board.            
Question 2: I can take my time notifying MagMutual if I get a medical board inquiry.
Question 3: I do not need to consult with counsel before responding to an inquiry. 

Answers

Question 1: False. You may not alter, add to or destroy any medical records, particularly those that may have been requested by the Board. Those actions are grounds for discipline.
Question 2: False. Contact MagMutual immediately if you get a medical board inquiry so we can help guide you through the process. Any delay can hurt your chances of a thorough response. Some states have a very short timeline for submitting a response and will not allow for an extension.
Question 3: False. Your attorney will help identify irregularities in your documentation and will help ensure that you draft an appropriate response. Do not contact an attorney, however, before reporting the matter to MagMutual.           

03/22

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Disclaimer

The information provided in this resource does not constitute legal, medical or any other professional advice, nor does it establish a standard of care. This resource has been created as an aid to you in your practice. The ultimate decision on how to use the information provided rests solely with you, the PolicyOwner.