The Medical Board issues licenses which it can deny, revoke, suspend, or place on probation. State attorneys file statements of issues and accusations for these Board actions. HMO exclusion, denial of hospital privileges, and insurance cancellation may occur when a license is denied, discipline occurs, or probation is imposed on a doctor or applicant.
In 2008-2009 the Board received 6,169 license applications. Most were granted. Six were issued with a Public Letter of Reprimand, ten with probation, and thirteen initially denied. Of the latter, four accepted denial without a request for an administrative hearing. Three went to hearing and were granted a license. Nine Statements of Issues (SOI) for denial were filed, but five of these were subsequently withdrawn. The Board lost the remaining four cases in administrative hearings.
The doctors in the latter cases were likely represented by experienced administrative law attorneys. According to the Board's most recent Annual Report, 99.900 physicians and surgeons are licensed in California (with 27,556 in Los Angeles alone). 6,437 complaints were reported, while 450 cases were referred to the Attorney General for civil prosecution. Another 27 cases were referred for criminal prosecution. This does not mean that the other 99,423 are safe.
Many of these complaints may still result in discipline because Board investigations often span more than a year. While the Board’s investigations remain confidential until an accusation is filed, each case represents potentially severe harm to a doctor’s career and livelihood. Most physicians have little or no contact with the Board except for payment of their licensing fees and submission of Continuing Medical Education (CME) credits. Many never consider a Medical Board license denial or complaint until it happens to them.
When it does occur, most want to know “What does this mean for my practice?”, “What are my legal rights?”, and “What happens next?” License applicants are questions by Board staff, who review the application and all records. They may request further documentation. This review can lead to denial when issues or problems arise. For physicians already licensed, investigators with badges, guns and Board-paid medical consultants may visit a doctor's office and ask pointed questions to which they already seem to know the answers. They may request records. Frequently these investigative interrogations are recorded. Ultimately, a formal Accusation may be filed by a Deputy Attorney General.
Being questioned by the Medical Board either on an application or a complaint can be intimidating, much like receiving a notice of audit from the IRS. If the Board is satisfied with your initial responses, the issues may evaporate. If suspicion lingers, however, formal action may result. When a Statement of Issues or Accusation is filed by the Attorney General's Office, the doctor must prepare to defend him or herself before an Administrative Law Judge. If admissions or other statements have already been made, the doctor may find it too late to marshal a successful argument for licensure or an effective defense to an Accusation.
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