Lessons From the Board of Medicine
by Ron Pace, PA-C

I recently had the pleasure of attending my first Board of Medicine meeting. It was held in Orlando and I went as the FAPA representative just to observe, listen, and learn. And of course I had to be on the alert for any issues that might affect the PA profession in Florida.

Each of the members of the Board appeared to be well prepared for their meeting and it went quickly. They did not do committee work at the Board level. Each member was expected to have read the details on each case being presented, and were advised by the Chair if they had not done so, they should recuse themselves on any particular case with which they were not familiar. Also, if anyone on the Board had any suggestion of a conflict of interest in a case they would recuse themselves from that issue.

One of the first things I noted was that if you are to appear before the Board, have a lawyer with you. Those that did seemed to do better with their cases. But make sure you have a good lawyer and one that does not have a reputation to live down. One lawyer who appeared with his client was apparently well known to the Board and not in a positive way. One of the Board members commented on how this lawyers' clients always seemed to be able to remember some details that they were not able to remember prior to retaining this particular lawyer. It was a rather testy situation for a moment.

Above all, be honest on your application in all respects. Trying to make it appear that you were unaware of things when there are documents in the file to prove or even suggest otherwise is not a good move. One physician responded "No" to the question about ever having been on probation. The question on the application is general and not specific. At one time during his residency he had been placed on academic probation for a short period. There were contradictory documents on the issue in his file and his attorney tried to convince the Board that he was never really officially told that he was on probation. His record was otherwise exemplary and there were no other problems. He was fined $5,000 and had to resubmit for licensing and pay fees and costs as well. Now he will have a mark on his record forever. If he had said yes and explained it in detail with his application, then nothing else would have been said and his license issued without challenge. But because there was the impression that he was less than honest and possibly trying to hide something the result was much different. And there were several cases along this line, and the result was the same each time.

If you are appearing to explain yourself regarding a specific complaint, make sure you are familiar with each and every document in your file on that case that to which the Board members have access, and all the ones in your office dealing with that case that the Board does not have in front of them. I can guarantee you that someone on the Board will be so informed. One physician who did a wrong site surgery was asked when he did the correct surgery if the patient had been billed for both. He replied that he would be surprised if that had occurred since his office staff knew not to do so. He was asked if he had personally looked at the bill prior to appearing before the Board and he stated no that he had not done so. He was admonished that it would have been prudent for him to do so. Now his case is continued until he can prove to the Board that this has been done.

If you are ever convicted of Medicare fraud don't even think of asking for a Florida license. They have a zero tolerance policy for such issues. Even if it was in another state and the time frame is not considered either. This one physician was applying for a license to work with the correction department and his license application was denied. One Board member even commented he did not understand why the prison system would have even considered offering this doctor a position.

They tried to maintain the same standard for everyone and rarely changed a previous decision. One thing I noted is that this Board is very cognizant of its' responsibilities to protect the health and welfare of Florida citizens in its' deliberations on matters. A couple of lawyers tried to play the card of financial hardship for their clients but the Board did not buy into that all. It was not even taken into consideration in the cases I saw adjudicated. The message I received was that you are responsible for your actions and the consequences and if they have a financial impact on you, then so be it. One physician took his case to a hearing previously, lost the case and as a result he had some sixteen thousand dollars in fines and costs levied on him and was seeking to get them reduced. Sorry, pay up he was told. One physician who lost his license because of alcohol and drug abuse claimed he was destitute because without a license he could not earn a living. Sorry, he was told. He would have to fulfill the prior agreement and only then consideration to giving him back a restricted license would be in order. He was bluntly told that he himself had created the problem by abusing drugs and alcohol and that it was his responsibility and his alone.

They do not like to take up issues or cases that they have not had time to review in detail. One doctor had a job offer and was in danger of losing the offer if they could not grant him a license at this meeting. He was told, sorry, we will review your case in the usual manner and then consider licensure. There was some discussion on this but a couple of Board members strongly objected into being rushed into making a decision with having time to adequately review the file. So it was voted down.

They have their legal counsel and Executive Director present at the Board meeting and frequently seek their opinions and counsel on issues. They plan to send Board members to the Florida Medical Association meeting and monitor each reference committee meeting also. They appear to have a good working relationship with their Board staff and use their experience and knowledge.

I would have to give them a grade of 98% on this meeting. The only reason they did not get a 100% is that the refreshment table was behind ropes and had a sign that read "For Board Members Only." And after having arisen at zero dark thirty to be there, I could have really used a good cup of coffee, no actually even a bad cup of coffee would have been nice. By the way, the PA Council Report was approved and accepted with minimal discussion.

And lastly, I guess the most important lesson I learned from this experience is that you do not EVER want to put yourself in a position where you are summoned to appear before the Board of Medicine for consideration of disciplinary action, no way, no how.