Common Causes Of Medical Board Complaints: Process, Risks, Threats

Last updated Dec 1, 2021 | Published on Sep 13, 2021

Table Of Contents:

Medical board complaint refers to the process of registering a complaint against any medical practitioner. A patient can complain to the respective state medical council or boards for unprofessional conduct and inadequate care by a physician or healthcare provider. If the patient is covered by medicare, they can file a complaint directly to medicare.

A patient may file a board complaint at little or no cost, whereas a real medical malpractice claim requires significant legal fees and time. The Federation of State Medical Boards (FSMB) offers significant assistance to physicians and medical boards in all 50 states. It also offers some very precise advice to patients about when and how to file complaints against physicians.

From there, the designated state medical board agency investigates any complaint against a physician and takes necessary action against them.

Medical Board Complaints

Medical boards will typically receive hundreds to thousands of complaints annually, depending on the size of a state’s physician population.  Complaints are prioritized according to the potential for patient harm. If an investigator determines imminent patient harm to a patient are typically “fast-tracked” to ensure appropriate action by the medical board.

Common Causes Of Medical Board Complaints

Medical board complaints often arise due to deviations from accepted standards of medical care. Some of the most common medical board complaint includes:

  • Failure to diagnose a medical problem that is found later.
  • Inappropriate prescription of medicine or other controlled substance.
  • Failure to provide tests and other medical services in a timely manner.
  • Violation of physician-patient confidentiality.
  • Inappropriate behavior that interferes with the terms of patient-care
  • Failure to respond to a call from the hospital to diagnose a patient in a traumatic situation.
  • Failure to provide appropriate postoperative care.

Other causes include practicing medicine under the influence of alcohol/ illicit substances, sexual misconduct and/or providing substandard care. It  is investigated by medical board staff. Disciplinary action resulting from a medical board complaint can include significant monetary damages, revocation, suspension of license, and reputational damage.

Process of Medical Board Complaints

The process involving medical board complaints can be tedious and long-drawn. A complaint is first assessed for jurisdiction and then set a priority for investigation by a designated medical board. Any indication of risk or imminent patient harm may allow the board to suspend or limit the physician’s license immediately.

The identity of the patient is either withheld or not informed to the physician. The respective state medical board identifies individuals and institutions involved in providing their statements.  The board conducts a review and determines if the patient’s medical care has been compromised.

It may summon experts to comment on the standard of care provided. The court’s ruling may settle minor or false complaints at this stage; otherwise, an informal hearing is called for. If the matter isn’t settled, a proceeding similar to a lawsuit with the formal presentation of witness and evidence is called for.

The board finally rules on the evidence provided. Disciplinary action imposed by the board is made available in the public domain through FSMB Physician Data Center. Patients can access this information at docinfo.org, a national online database of consolidated physician licensure and disciplinary information maintained by the FSMB.

Risks and Threats of Medical Board Complaint

Most physicians plan and insure against the possibility of a medical malpractice suit. Physicians tend to think that their medical malpractice insurance will cover legal defense brought about by a medical board complaint.

A medical board complaint can take a significant toll on the physician’s income and possibly jeopardize their career. A patient can file a board complaint with little or no cost, making it a favorable option for patients seeking redressal of grievances. Apart from guiding physicians and medical boards, the FSMB provides specific guidance to patients on the process of filing a complaint against physicians.

The Way Forward

A medical board complaint can accompany or precede the more vicious medical malpractice lawsuit. Acknowledging and addressing board complaints can help facilitate the damage that usually ensues in the process.

A good solution would be to enquire with your insurance carrier about the coverage provided. See if they cover board complaint defense, the dollar limits of the coverage, the amount covered by a rider, and whether it’s a stand-alone or shared coverage.  All of these factors can significantly reduce both monetary and reputational damages engendered by medical board complaints.

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