February 26, 2024 • 36 mins
The rules appear uneven. The outcomes seem almost random. But what happens when a doctor, a dentist, a nurse, etc., makes a mistake...or is negligent? Can they practice or do they go to jail? In this episode, you are going to hear some wild stories...
If you are a professional...what do you do? If you are a consumer, how do you protect yourself?
Bob explores the razor-thin line between human error and negligence in the healthcare industry with professional license lawyer and industry expert David Williams. We take you on a journey through the complexities of healthcare licensing, where the fate of professionals hinges on the decisions of regulatory bodies.
The contrast between an Arizona dentist who maintained his practice despite a history of complaints, and a Tennessee nurse facing severe penalties for a single mistake sets the table for our conversation.
We tackle the arduous process healthcare workers endure to obtain and retain their licenses, and the psychological warfare they face under the scrutinizing eyes of licensing boards. Our guests shed light on the self-corrective mechanisms within the industry, revealing the delicate balance between upholding patient safety and supporting the well-being of medical practitioners.
What do you do if you are a practitioner and you have a complaint? Make a mistake? How can consumers protect themselves, report mistakes?
Listen now.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Attorney Bob Sewell (00:00):
It's a phrase from popular movies.
It's also a question that comesup in our daily life.
The question is is that evenlegal?
We talk about the things thatdrive you crazy, the things you
won't believe and the things youneed to know and understand.
I'm attorney Bob Sewell, andthis is the podcast.
Is that Even Legal?
(00:20):
Let's get started.
Today's guest on the show isDavid Williams.
David Williams is an attorneythat practices in the area of
administrative licensing andprofessional defense.
David is an expert in the fieldof administrative licensing.
(00:43):
Dave, welcome to the show.
Thanks, bob.
I want to tell you a story, twostories actually, and they just
opposed against each other.
They seem odd.
I'll be honest with you.
The first story is a story of adentist in Arizona.
This dentist has a history ofbeing he's having his hands
(01:09):
slapped if you will by theArizona Board of Dentistry.
He was working on a patient, forexample, and an instrument
dropped on the throat of hisclient.
He was working on the patient.
He gave the patient fivedifferent types of sedatives and
medicines and during theprocess of his procedure, the
(01:36):
patient dies.
And then, after he begins,after when he's supposed to be
being disciplined and he's notsupposed to be practicing, he
goes and practices anyways andhe ends up getting some
complaints based on puttingthese people at risk for his
(02:01):
poor professionalism.
On the other hand, we have anurse and this nurse is out in I
think she was in Tennessee and,through a series of unfortunate
events, she is administeringthe wrong medication.
(02:29):
This is not a person who is anevil person, is not a person
who's going out and trying to dobad things.
We're talking about a nurse andwe all know these nurses are
overstressed, they're pushed tothe max.
There's not enough of them andin the heat of the moment she
(02:50):
grabs the wrong medication, sheadministers the wrong medication
if I got the facts right andthe guy dies, she ends up losing
her license.
All right, fair enough.
But then she takes it one stepfurther, or the state takes it
one step further and theycriminally prosecute her and
(03:13):
she's found guilty of criminalnegligent homicide.
Frankly, I'm flabbergastedbecause on the one hand, we got
some guy who's out thereviolating the terms of his
sanction from the dental boardand he kills someone when he's
(03:40):
practicing, and on the otherhand, we have someone who
doesn't have a history ofmisconduct and now she's being
charged with criminal negligenthomicide and found guilty of it,
even losing her livelihood.
David Williams (03:55):
It just seems outrageous.
Yeah, these are two extremes ofit.
These are two opposite ends ofextreme situations.
So the case with the nurse outof Tennessee.
She was working as a nurse andshe's working under the
authority of a prescribingphysician.
There was an order put in for asedative medication because the
patient was going to have aclosed MRI scan and instead of
(04:19):
giving her the sedative, thenurse actually gave her a
medication that actually causedparalysis and it caused that
patient to stop breathing as shedied.
That nurse, setting aside hererror like she made an error,
but she did the right thing asfar as she reported her error to
her supervisors there was aninternal investigation at the
(04:40):
hospital where she worked.
Then there was an investigationby her licensing board in the
state of Tennessee that issuedher a nursing board license and
then she lost her license, shelost her job.
There was actually a lawsuitthat was filed that resulted in
an out of court statement to theperson who passed away.
But then the state of Tennessee, a local district attorney,
(05:00):
criminally prosecuted her andthat case raises a whole number
of questions because you don'twant to criminalize a medical
error and by doing that, if youcriminalize a medical error,
what you're doing is you'rescaring nurses, or scaring
health professionals in general,not to acknowledge when a
mistake is made, because we onlylearn from our mistakes in
(05:22):
these situations.
Now you've got the opposite endof the spectrum with this
Arizona dentist who had ahistory of some sort of prior
discipline from the Arizonadental board of examiners and
still was practicing unsafely,which resulted in the death of a
patient, and then, rather thanimmediately taking this dentist
(05:42):
license, they put him on arestricted practice, but then he
violated those terms again.
So you have almost two extremeswhere you have lax regulation,
not enough regulation from oneentity and over-regulation on
the other.
So how do you reconcile that?
And I think before you canreconcile that, bob, I think you
(06:04):
have to understand how peopleget licenses generally for
health professionals and thenhow do those licenses get
regulated.
Attorney Bob Sewell (06:16):
So let me just start there, ok, well, OK,
yeah, before you go there, Iwant to go there, I do, but I
just want to say it is offensivein many respects because I have
to be licensed right and anyprofessional who practices knows
no professional practicesperfect at whatever they do.
(06:38):
They know it's not possible.
We're not perfect.
We will do things that we knowlater that there's better ways
to do them, it's just the way itis.
It's called a practice rightand I spent three years of my
law school, four years ofundergrad.
(06:58):
Nurses spend four years ofundergrad and sometimes we have
people with masters in nursingand you have doctors who spend
four years of undergrad, fouryears of residency, four years
of med school, then four yearsof residency or less or more,
and you spend all this time, allthis money, and we have to be
(07:26):
perfect.
That's what I feel like andwe're getting set in gas.
And it's outrageous that nursewho was criminally charged
outrageous.
David Williams (07:44):
Yeah, it is absolutely outrageous.
So that's the tension that'sbuilt into a system where you
give people the privilege ofhaving a professional license
that lets them serve the public.
Now keep in mind this everyperson that seeks medical care
is seeking and is putting theirtrust in the hands of a trained
(08:07):
professional.
They are putting their life inthe hands of someone to treat
whatever medical ailment theyhave, whether it's a root canal,
a heart procedure, whatever thething is, and so you put your
life in the hands of someone.
You want to ensure that thatperson knows what they are doing
, that they're properly trained,that they're credentialed, that
(08:28):
they've gone through a reviewprocess to make sure that they
are competent to be able toprovide the medical services
that you are putting your lifein their hands.
So in most states, every statehas a licensing process for a
health professional, and so Ipractice in Arizona, and Arizona
has different licensing boardsfor different health
(08:49):
professionals.
In fact, in Arizona we haveover 30 different regulatory
boards that cover anything fromlicenses for a barber to an
acupuncturist, to healthprofessionals, and before you
can get a license, you have tobe trained.
You have to go get a formaleducation through medical school
or chiropractic school ordental school, nursing school,
(09:09):
and then you have to take alicensing exam, and then you
have to go and pass a backgroundcheck, and then you get a
license that's issued by yourstate licensing board.
And then the purpose, though,of these boards is not to
protect the professional.
They are there to protect thepublic from the professional,
(09:30):
and so their mission, in everystate that licenses a health
professional specifically, theirgoal is to regulate their
profession, and the stateactually allows the
professionals to generallyregulate themselves.
They basically appoint to theselicensing boards doctors and
people who work in that area toregulate themselves, and so
(09:53):
those boards regulate theirprofession to ensure that the
people that work in theirprofession are qualified,
competent and safe to practiceFor the health seeking public.
Now, that's the way it'ssupposed to be.
What is scary is you have thesetwo extreme situations where the
system broke down, and, withrespect to the nurse, the system
(10:15):
did what it was supposed to do,like she lost her license,
there was compensation to thefamily, and then the hospital
where she worked implementedchanges.
You had the extreme situationof a prosecutor that decided
they were gonna criminalize thatprocess, which I think is
completely in error and blowsthe system up, because the
(10:37):
licensing system is built uponrecognition of errors.
We are not trying to create aperfect situation where people
don't have a problem andproblems never occur.
What you want to do, through aregulatory system that allows
you to practice, is to create asystem where you can recognize
an error and you can correct it,either by and we could talk
(11:01):
about this in a few minutescorrecting that error by maybe
retraining the physician, givingthat health provider some
education, having them comeunder a tutor like a
professional practice manager,or maybe you pull them out of
the practice for a while, yoususpend their license and don't
let them practice.
So the system is designed to beself-correcting.
In the Arizona dentist example,the system did not self-correct
(11:25):
, and that's the problem.
So let me, before we kind ofget into that, though, in order
to understand why the systemkind of had these extreme
results, you kind of need tounderstand how the system works.
So let me sort of start there.
So, like I said, every personthat generally works in a health
profession has to have aprofessional license issued by a
(11:46):
professional licensing board,and the way these, like these
physician, these healthpractitioners, are governed is
they are governed when acomplaint comes in.
So something happens thattriggers an investigation by
that licensing board, usuallyfrom a complaint by like a
patient that's been harmed, orfrom another professional, like
(12:08):
another doctor that practiceswith a health professional that
made an error, or a hospitalreports them or a lawsuit was
filed.
And then there's a report fromsomething called the National
Practitioner Data Bank.
So a complaint gets filed andthen a licensing board opens an
investigation.
They gather facts, they bringthe health professional in to
provide testimony or evidenceand from there they then undergo
(12:34):
a process to correct thathealth professional.
And that process can involve alot of different things.
It could involve justre-educating the doctor or the
physician or the healthprofessional, making them do
some continuing education.
You could limit their practicefor a period of time, you could
(12:55):
put them under a practicemonitor for a probationary
period, you could suspend theirlicense for a period of time or,
in really bad examples wherethere's really no way that they
can be rehabilitated, you takeaway their license.
And that is very scary.
That licensing complaintprocess is very scary for a
(13:17):
health professional because youjust identified.
They go to school, they spendhundreds of thousands of dollars
in their undergraduateeducation, their graduate
education to get a degree thatthey stick on the wall, and now
suddenly, because of some issuethat comes up sometimes
rightfully or wrongfully, theyrun the risk now of losing their
income and their ability toprovide for themselves and their
(13:40):
family, and so that is a veryscary thing for a health
professional, but at the sametime, that's needed because you
have the medical seeking publicthat wants to ensure that the
people that they're gettingservices from are safe to
practice.
So the system, like I said, issupposed to balance itself out.
Attorney Bob Sewell (13:59):
But let me challenge you on that Now, and
I'm not saying that we shouldget rid of these.
There's a portion of me thatagrees with everything you're
just saying.
That is so we can have a safepractice.
There's another portion of methat says come on, dave, it's
practically a rubber stamp toget the license, and then they
(14:20):
only discipline you afterthere's a problem arises.
Right, it's only after there'sa problem that you get any sort
of discipline.
It doesn't train them to be agood doctor.
There, it is right, I mean.
So is it really helpful to thepublic?
David Williams (14:43):
It is, and so it's helpful to the public on a
couple of different levels.
One is let me take like amedical board Generally.
A medical board you have to be,you know.
You have to go through all ofyour professional training.
You have to go through medicalschool and then you have to go
do your residency and then youhave to get your specialization
and you have to pass yourcertification boards and then
you have to pass the licensingexam for that particular, you
(15:07):
know, to obtain your medicallicense.
So there's a lot of educationand on the job training that
goes into that.
Then every medical, every healthprofessional that has a license
anywhere across the country,even lawyers, have to do this.
They have to have continuingongoing education every year,
every two years, to keep theirlicense, and so if they don't
(15:28):
continue their educationalprocess then they can run the
risk of having their licensetaken from them.
And then the third way thatit's self-correcting is when a
complaint comes in and acomplaint is investigated and
validated.
Then there could be some sortof ramification, some sort of
what we call discipline againstthat practitioner's professional
(15:51):
license.
So there are those things thatare built into it.
But, frankly, for the licensedprofessional going through a
complaint investigation is avery, very stressful process
because on the extreme theycould lose their professional
license and their way of earningincome.
So it's very eye-opening for alot of my clients, especially
(16:16):
some of my clients that you know.
You sometimes get a God complexwhen you're a health
professional and you sometimesthink that you are error-proof
or bulletproof and it's a very,very humbling process to have
yourself sort of put under amicroscope by your peers through
a complaint process and it'svery stressful for a lot of them
and that in and of itself thatprocess is sometimes all the
(16:40):
education a professional needsbecause they are now very
self-aware that their futureincome opportunities could be
put at risk.
Attorney Bob Sewell (16:51):
You know you help a lot of healthcare
professionals over the years.
Do they?
Are they repeat customers orare they one and done?
Tell me that they're one anddone.
Yeah, most of them are one, anddone.
David Williams (17:05):
Most of them are one and done and in fact, like
in the health area, let me juststay with like a doctor, for
instance.
You sort of see certain fatpatterns that develop as you do
this long enough.
But most of these are one anddone.
You typically see a complaintarise when there's a what we
(17:27):
call an adverse event.
You know there's a.
Somebody makes a medical error,you know they.
Something happens during asurgical procedure.
There's a failure to diagnose,there's a medication error, like
the Tennessee example.
Maybe there's a failure toprescribe medication.
There's a they don't getinformed consent from the
(17:47):
patient.
The patient doesn't understandthe ramifications of a procedure
.
Or you know, you get theextreme situation where somebody
drops a screw down your mouthduring a dental procedure, like
the Arizona example.
So you see certain fact patternsthat happen from from what I
call practice related issues.
That's where the majority ofcomplaints come from.
But you also see complaintscome about because physicians
(18:10):
deal with substance.
There's they might havesomething that affects their
fitness to practice, likethey've had a medical.
They've had an injury, like aback injury, and they start
taking meds and pain meds and sosuddenly they become addicted
to a pain medication and so nowthey start dealing with
substance abuse issues you have.
Sometimes you'll see situationswhere there's opiate issues or
(18:33):
sometimes you even getinappropriate contact with a
patient, you would be surprised.
There's actually been aheightened awareness, especially
coming out of the Me Toomovement, of physicians that are
inappropriately touching orinappropriately being involved
with a patient, which thenobviously compromises their
medical judgment.
(18:54):
If you're dating your patient,but some people just lose their
sense of sense of balancesometimes.
So you see a lot of these kindof similar fact patterns when
you deal with healthprofessionals.
But on the most part, medicalcomplaints that come in while
there are, you know there arehigh numbers sometimes most of
(19:17):
them do not result in a takingof the physician's license,
because the majority of thetypes of complaints that come in
are things that can be dealtwith through rehabbing or
educating the healthprofessional so that they know
not to do that, or putting inplace certain guardrails like a
(19:37):
mentor or a practice monitor ormaking them go through some sort
of retraining process.
Nine times out of 10 solvesthose problems, so you don't get
the reoffender.
Attorney Bob Sewell (19:50):
So let me ask you I'm a healthcare
professional, bob, so I became adoctor and, of course, because
it's me, I am a fantastic doctor.
Okay, and, anyways, I become adoctor.
I never want to have to talk toyou, I never want to have to
(20:11):
hire you.
Okay, what am I going to do?
What am I going to?
What type of?
How am I going to go about mypractice?
That's going to make so I don'tneed you, bro.
David Williams (20:23):
Well, I think the first thing is education,
making sure that you've put inbest practices and being on top
of cutting edge things.
So, if you're in a fieldbecause most people that work in
a particular health field aregenerally specialists, at least
in the medical area, in nursingthat's more of a generalized,
obviously medical fieldchiropractic, naturopathic
(20:44):
medicine, some of theseintegrative kind of like
non-medical, what I would say,non-traditional medical
practices, what I would say istwo things education, making
sure you're staying on top ofthe new trends, things like that
, being involved in the medicalcommunity, what you serve, and
then following up and trying tomake sure you've implemented
(21:07):
best practices.
Are you taking care of yourself?
First of all, are you doing thethings to take care of yourself
on a personal level?
Are you?
Do you have guardrails in placewhen you're in your practice,
whether it's a hospital, adoctor's office, a private
office?
Are you taking care of yourstaff?
Do you have good systems inplace?
On the business side, are youdoing your medical billing
(21:28):
correctly?
Are you?
Do you have a good officemanager, things like that?
So it's more like what am Idoing on the personal level to
take care of myself?
What am I doing in theprofessional world in my own
professional development.
And then what do I have systemsin place around me?
If I run like my own practice,or I have a team around me that
makes sure that my practice isfiring on all, on all pistons.
Attorney Bob Sewell (21:50):
Oh right, I mean that makes some perfect
sense to me, because if I'mdistracted with all the business
aspects of my practice you knowI have a bunch of HR concerns
and you know a doctor istypically a great, great at
medicine but they're notnecessarily trained in how to be
a business manager, how to runa business.
So if I'm dealing with allthese business issues that are
(22:11):
not in my wheelhouse, I'm notgoing to be able to focus.
And on the healthcare I'mproviding, you know, and so that
makes perfect sense to me toeliminate the distractions,
focus on what I do best.
David Williams (22:27):
Yeah, and I think also you have to look at
there's two different, probablytwo different people that are
two different people that arelistening to us today, that are
gonna be listening to us.
There are the non-professionalsand then there are the
professionals.
So let me talk to the, let mespeak to like the general person
right now.
If you're going to a doctor andyou have concerns about that
doctor and you feel like there'sbeen a problem, sometimes you
(22:51):
can go talk to a lawyer, but themedical licensing process for
that professional is there toprotect you.
So if you're concerned and youthink that doctor did something
wrong, first talk to yourmedical provider and raise
concerns, ask questions and bean active consumer of your
medical care, be involved inmaking informed decisions and
(23:13):
then, if you feel like somethinghappened, talk to the physician
, make sure you get yourquestions answered.
If you think that there wassomething wrong and then if you
don't feel like you're gettingyour questions answered, then go
seek redress, either by hiringa lawyer and honestly, most
medical problems never turn intoa lawsuit and make you millions
of dollars.
That's not the point.
But if you want to seek redress, you can also file a complaint
(23:36):
with that doctor or healthprofessionals licensing board.
So there are ways that you, asthe medical seeking public, can
take care of yourself.
Now, if you're the healthprofessional and you get one of
these complaints, the firstthing I would always advise you
to do is talk to a.
There's two people you shouldcall.
Talk to a lawyer, find a lawyerthat practices in this area and
seek their advice.
The second thing you need to dois call your insurance broker,
(23:59):
cause most likely, you have somesort of medical liability or
professional liability insurancethat you need to make your
insurance carrier aware of, andthey may actually have a lawyer
available to you to talk to forfree, or they may hire a lawyer
to help you through that processand then talk to that lawyer
about the process and make sureyou understand what you're
(24:20):
getting involved with, and letyour lawyer be your advocate
through that complaint licensingprocess.
Attorney Bob Sewell (24:29):
Yeah, I'm gonna challenge you a little bit
about that.
I think you're 100% right.
But there's been a lot ofstudies on who gets sued by
their patients.
Okay, who gets the complaints?
It's the unlikeable doctor whogets the complaints generally.
(24:51):
It's the guy who is arrogant,who is boring, who is mean,
who's not compassionate.
They get the complaints.
It tends to end to be.
The people who complain tend toend up having a personal
difficulty with the professionalrather than necessarily
practice the difficultygenerally speaking.
(25:13):
But if the doctor is humorous,they find, or is encouraging
patients to talk to them and askquestions, and they're helpful
and they're prompt and theyapologize if something went
wrong.
Hey, I'm sorry about that,that's not how this was supposed
(25:33):
to go.
They tend to have lesscomplaints, less likely to be
sued.
Do you think this is wisecounsel?
David Williams (25:45):
Yeah, I think so .
And here's what I think you'regoing to find is the reason you
have a complaint filed against ahealth professional through
their licensing board.
Nine times out of 10 is becausethere was a failure to
communicate.
The doctor or the healthprofessional did not see this
from the perspective of thepatient and they did not
(26:07):
proactively address the concernsof the patient during that
process.
And that can happen for a lotof reasons, like doctors get
busy, they have too big of ahigh patient load, like there's
a bunch of reasons why sometimescommunication breaks down.
But nine times out of 10, mostcomplaints come about because
there's a breakdown in thedoctor-patient relationship on
(26:28):
the communication level.
And so if you are a physicianlistening to this, making sure
that you are adequately talkingto your patient, don't talk
medical to them, talk regular,talk to them, you know.
Talk to them, not at them, andlisten to their concerns.
And if you could do that mostof the time, you will calm that
(26:49):
patient down, because thatpatient's just scared.
They're just scared thatsomething's happening and they
don't understand what's going onin their own body and they're
looking to you, mr Doctor, mrsDoctor, as the person that's
going to help them through thisprocess and so not only are you
a medical professional, butsometimes you have to be part
therapist also and you have tobe able to listen and empathize
(27:10):
and be empathetic to thatpatient.
And if you are, a lot of timesyou can work through these
situations.
And that happens with everylicensed professional.
That's not just a doctor, Imean.
That even happens with lawyers,like clients that get mad at us
and our legal profession ninetimes out of 10, they get mad
because we haven't communicatedto them adequately, help them
(27:33):
understand where they're comingfrom, and so it all breaks down
really to a relationship Are youthere to take care of the
people that are being entrustedto your care?
And if you are, then nine timesout of 10, you're going to
float through this very smoothly.
And then, for the one-offsituations where something
extreme happens, recognize wherethere's a problem, seek help
(27:55):
from a legal professional ifyou're a doctor and the health
professional and get ahead ofthat process instead of being
the surgeon that does their ownsurgery on themselves.
That's where I see a lot ofpeople screw up is that they try
to do this themselves.
They don't recognize, they'renot humbled through the process,
they get defensive, and that'swhere the doctor or the health
(28:15):
professional makes mistakesthrough the investigative
complaint process.
Because they don't recognizetheir error, they don't seek
legal help and they try to do itthemselves and they try to
minimize what actually happened,versus taking it very seriously
, recognizing their licenses onthe line even if it's a minor
complaint that their licensecould potentially be on the line
and being proactive and workingthrough an attorney to get
(28:38):
ahead of that process.
And if they do that nine timesout of 10, it's going to work
out in their favor.
I mean, work out in their favoris a better result versus them
doing it themselves.
Attorney Bob Sewell (28:47):
David, you know I'm going to close the loop
on a couple different thingshere.
The first thing is when amedical professional gets that
letter or that phone call fromthe board and they say we're
concerned about your conductwith regard to whatever patient.
David Williams (29:09):
When do they call so?
Attorney Bob Sewell (29:12):
um, they call a view.
David Williams (29:13):
I should say yeah, I would say the sooner
they can.
There's two people they shouldcall at the beginning of this
process the minute you getcontacted by your licensing
board and typically it's goingto become a letter that says,
hey, a complaint's been filedagainst you and we want you to
provide a written response.
That's what starts theinvestigative process, the
investigative complaint process.
The minute you get contacted,there are two calls you should
(29:35):
make.
You should call a lawyer first,somebody that knows what
they're doing and that's notyour, not your.
You know your next doorneighbor who you got a referral
from, but find somebody who'squalified in this area.
The second person you shouldcall is your insurance broker.
Okay, and then, if you work ina hospital setting, the third
person you should probably callis you need to report it up your
chain of command.
If you work in a medical office, medical practice, um, but
(29:59):
those are really the three callsyou need to make.
You need to call your lawyer,you need to call your insurance
broker and you probably need toreport it up your training
command, depending on theenvironment, the medical setting
and what you work.
Um.
Once you get involved with alawyer early, then we are more
able to help you navigate thatprocess sooner and the
investigative process looksdifferent based upon what
(30:19):
particular licensing board andin what particular state.
But generally here's what itlooks like A written complaint
comes in um.
That medical board will sign asan investigator who will go and
gather facts, gather themedical records, talk to the
patient, talk to the familymembers.
If there's other witnesses,they may talk to them.
And then they will reach out tothe medical professional, the
(30:39):
licensee, and then seek theirinput and typically they'll ask
you to provide your records,your charts, um provide a
written response and then thatmedical investigator, that
investigator, will gather all ofthat information.
They may want to interview themedical professional, um, and so
obviously you would want tohave a lawyer with you during
that and then eventually thatthat once the investigation
(31:02):
phase is completed, then it willbe considered by the entire
medical board or the medicallicensing agency, um, on how to
resolve that complaint.
And at least in Arizona, um, amedical compli a a a a
professional's license, can onlybe disciplined if they engage
in a very specific term calledunprofessional conduct and they
(31:23):
have to buy.
An unprofessional conduct has abunch of different scenarios by
which something can rise tounprofessional conduct.
But what the medical board orthe licensing agency is looking
at is is what happened here?
Does that rise to the level ofunprofessional conduct?
It doesn't fit within one ofthese enumerated categories of
unprofessional conduct.
And if it does, how are wegoing to resolve that?
(31:46):
And so once the medical board orthe licensing agency considers
that, then they can dismiss it.
They can require the, theprofessional, to have some
education.
They can, they can take somewhat we call non-disciplinary
steps which don't doesn't affectthe license of the professional
or um.
They can take some actionagainst the license, put them on
probation, make them do someordered um continuing education
(32:09):
under under, you know, under auh, somebody who's going to
watch over their practice um,have a practice monitor, suspend
their license and there's awhole bunch of things.
Now you also would have dueprocess rights around all that.
Maybe you have anadministrative hearing, but
ultimately the medical agencyhas to figure out how to resolve
that complaint.
And getting a lawyer involvedearly to help you navigate that
(32:33):
process is how you do it.
And that's really what I do inmy practice is helping medical
professionals or healthprofessionals work through that
process and hopefully educatingthem about it and helping them
hopefully get a positive outcomeon the back end.
Attorney Bob Sewell (32:47):
That makes sense to me.
The reason why is if you're amedical professional, you're
trained in medicine.
You're not trained in advocacyand lawyers.
Jobs are to package the storyand why the story is supposed to
work out favorably of favor ofclient or make the story in.
You know, show the story in thebest light.
(33:08):
That's in the best light infavor of our client.
So that makes perfect sense tome.
We want you're going to helppeople package, package
themselves more palatably forthe board.
One question I'm a consumer andI don't want to pick the doctor
(33:29):
that has 1000 complaintsagainst them.
Is there a way for me to knowthat doctor or medical
professional has complaintsagainst?
David Williams (33:37):
them?
Yes, and it depends.
It depends a lot on the statein which you're looking for them
.
But if you go to that localstate agency, licensing agency
or state regulatory board, go totheir website.
You can typically type up anddo a search for the doctor
you're looking for and if thatdoctor has been disciplined, had
(33:58):
action actually taken againsttheir license.
That's typically availableonline for a period of time.
Some states limit it to likefive years, some states go back
20 years.
It just depends upon which thestate.
It will not tell you if acomplaint's been filed.
It will only typically show youinformation on whether that
physician's been disciplined.
The other place you can look atit and it's kind of a you know
(34:20):
what the default for a lot ofpeople do is.
There's websites like healthgrades or Yelp or Google reviews
that give at least information,that give you a little bit more
information about thatprofessional and then also
realize sometimes you're limitedby your insurance plan and sort
of where you can go andsometimes your insurance plan
will also provide a grade or areview or a assessment of the
(34:45):
doctors in that health plan.
So there's a couple ofdifferent resources you can go
to.
You can go to the state license, the state licensing board.
You can kind of look online anddo your own research or you can
even look at kind of how thatperson is graded by your
insurance carrier.
So that's usually a good way toget your questions answered.
Or, you know, maybe sometimeseven seek a second opinion from
a physician If you don't feelcomfortable at the end of
(35:08):
meeting with that physician.
For, like, this is fornon-emergency issues, but you
don't feel comfortable, youalways can go talk to another
doctor.
You are not locked into thatparticular doctor.
And so what I would tell themedical public is be active in
your medical care, be educatedabout your medical care, don't
just be a passive consumer.
Be an active consumer of yourmedical care.
(35:31):
And if you do that nine timesout of 10, you're going to be
fine.
Yeah this is good advice, Dave.
Attorney Bob Sewell (35:36):
Dave, thanks for coming on the show.
David Williams (35:38):
Thank you very much.
I really appreciate you havingme, and this is a fun topic to
talk about.
Attorney Bob Sewell (35:42):
If I am a medical professional, I need to
get your services.
How do I contact you?
David Williams (35:48):
You can contact me on my website at
wwwDavisMilescom, or you cancontact me through my email
address atdwilliamsdwilalimascom.
Talk to you in a day.
Attorney Bob Sewell (36:04):
Thanks.
Thank you very much.
Have a great day.
Thanks for listening to.
Is that Even Legal?
Remember this isn't legaladvice.
If you have a legal questionfor yourself, reach out to an
attorney.
Remember that we're fun, we'relovable and we are here to help
you, To my listeners in 62countries across the world.
If you have something you wantto explore, email us at
(36:27):
produceratevenlegalcom and don'tbe shy about leaving a review
for this podcast on yourfavorite podcast forum.
See you next time.
It's a phrase from popular movies.
It's also a question that comesup in our daily life.
The question is is that evenlegal?
We talk about the things thatdrive you crazy, the things you
won't believe and the things youneed to know and understand.
I'm attorney Bob Sewell, andthis is the podcast.
Is that Even Legal?
(00:20):
Let's get started.
Today's guest on the show isDavid Williams.
David Williams is an attorneythat practices in the area of
administrative licensing andprofessional defense.
David is an expert in the fieldof administrative licensing.
(00:43):
Dave, welcome to the show.
Thanks, bob.
I want to tell you a story, twostories actually, and they just
opposed against each other.
They seem odd.
I'll be honest with you.
The first story is a story of adentist in Arizona.
This dentist has a history ofbeing he's having his hands
(01:09):
slapped if you will by theArizona Board of Dentistry.
He was working on a patient, forexample, and an instrument
dropped on the throat of hisclient.
He was working on the patient.
He gave the patient fivedifferent types of sedatives and
medicines and during theprocess of his procedure, the
(01:36):
patient dies.
And then, after he begins,after when he's supposed to be
being disciplined and he's notsupposed to be practicing, he
goes and practices anyways andhe ends up getting some
complaints based on puttingthese people at risk for his
(02:01):
poor professionalism.
On the other hand, we have anurse and this nurse is out in I
think she was in Tennessee and,through a series of unfortunate
events, she is administeringthe wrong medication.
(02:29):
This is not a person who is anevil person, is not a person
who's going out and trying to dobad things.
We're talking about a nurse andwe all know these nurses are
overstressed, they're pushed tothe max.
There's not enough of them andin the heat of the moment she
(02:50):
grabs the wrong medication, sheadministers the wrong medication
if I got the facts right andthe guy dies, she ends up losing
her license.
All right, fair enough.
But then she takes it one stepfurther, or the state takes it
one step further and theycriminally prosecute her and
(03:13):
she's found guilty of criminalnegligent homicide.
Frankly, I'm flabbergastedbecause on the one hand, we got
some guy who's out thereviolating the terms of his
sanction from the dental boardand he kills someone when he's
(03:40):
practicing, and on the otherhand, we have someone who
doesn't have a history ofmisconduct and now she's being
charged with criminal negligenthomicide and found guilty of it,
even losing her livelihood.
David Williams (03:55):
It just seems outrageous.
Yeah, these are two extremes ofit.
These are two opposite ends ofextreme situations.
So the case with the nurse outof Tennessee.
She was working as a nurse andshe's working under the
authority of a prescribingphysician.
There was an order put in for asedative medication because the
patient was going to have aclosed MRI scan and instead of
(04:19):
giving her the sedative, thenurse actually gave her a
medication that actually causedparalysis and it caused that
patient to stop breathing as shedied.
That nurse, setting aside hererror like she made an error,
but she did the right thing asfar as she reported her error to
her supervisors there was aninternal investigation at the
(04:40):
hospital where she worked.
Then there was an investigationby her licensing board in the
state of Tennessee that issuedher a nursing board license and
then she lost her license, shelost her job.
There was actually a lawsuitthat was filed that resulted in
an out of court statement to theperson who passed away.
But then the state of Tennessee, a local district attorney,
(05:00):
criminally prosecuted her andthat case raises a whole number
of questions because you don'twant to criminalize a medical
error and by doing that, if youcriminalize a medical error,
what you're doing is you'rescaring nurses, or scaring
health professionals in general,not to acknowledge when a
mistake is made, because we onlylearn from our mistakes in
(05:22):
these situations.
Now you've got the opposite endof the spectrum with this
Arizona dentist who had ahistory of some sort of prior
discipline from the Arizonadental board of examiners and
still was practicing unsafely,which resulted in the death of a
patient, and then, rather thanimmediately taking this dentist
(05:42):
license, they put him on arestricted practice, but then he
violated those terms again.
So you have almost two extremeswhere you have lax regulation,
not enough regulation from oneentity and over-regulation on
the other.
So how do you reconcile that?
And I think before you canreconcile that, bob, I think you
(06:04):
have to understand how peopleget licenses generally for
health professionals and thenhow do those licenses get
regulated.
Attorney Bob Sewell (06:16):
So let me just start there, ok, well, OK,
yeah, before you go there, Iwant to go there, I do, but I
just want to say it is offensivein many respects because I have
to be licensed right and anyprofessional who practices knows
no professional practicesperfect at whatever they do.
(06:38):
They know it's not possible.
We're not perfect.
We will do things that we knowlater that there's better ways
to do them, it's just the way itis.
It's called a practice rightand I spent three years of my
law school, four years ofundergrad.
(06:58):
Nurses spend four years ofundergrad and sometimes we have
people with masters in nursingand you have doctors who spend
four years of undergrad, fouryears of residency, four years
of med school, then four yearsof residency or less or more,
and you spend all this time, allthis money, and we have to be
(07:26):
perfect.
That's what I feel like andwe're getting set in gas.
And it's outrageous that nursewho was criminally charged
outrageous.
David Williams (07:44):
Yeah, it is absolutely outrageous.
So that's the tension that'sbuilt into a system where you
give people the privilege ofhaving a professional license
that lets them serve the public.
Now keep in mind this everyperson that seeks medical care
is seeking and is putting theirtrust in the hands of a trained
(08:07):
professional.
They are putting their life inthe hands of someone to treat
whatever medical ailment theyhave, whether it's a root canal,
a heart procedure, whatever thething is, and so you put your
life in the hands of someone.
You want to ensure that thatperson knows what they are doing
, that they're properly trained,that they're credentialed, that
(08:28):
they've gone through a reviewprocess to make sure that they
are competent to be able toprovide the medical services
that you are putting your lifein their hands.
So in most states, every statehas a licensing process for a
health professional, and so Ipractice in Arizona, and Arizona
has different licensing boardsfor different health
(08:49):
professionals.
In fact, in Arizona we haveover 30 different regulatory
boards that cover anything fromlicenses for a barber to an
acupuncturist, to healthprofessionals, and before you
can get a license, you have tobe trained.
You have to go get a formaleducation through medical school
or chiropractic school ordental school, nursing school,
(09:09):
and then you have to take alicensing exam, and then you
have to go and pass a backgroundcheck, and then you get a
license that's issued by yourstate licensing board.
And then the purpose, though,of these boards is not to
protect the professional.
They are there to protect thepublic from the professional,
(09:30):
and so their mission, in everystate that licenses a health
professional specifically, theirgoal is to regulate their
profession, and the stateactually allows the
professionals to generallyregulate themselves.
They basically appoint to theselicensing boards doctors and
people who work in that area toregulate themselves, and so
(09:53):
those boards regulate theirprofession to ensure that the
people that work in theirprofession are qualified,
competent and safe to practiceFor the health seeking public.
Now, that's the way it'ssupposed to be.
What is scary is you have thesetwo extreme situations where the
system broke down, and, withrespect to the nurse, the system
(10:15):
did what it was supposed to do,like she lost her license,
there was compensation to thefamily, and then the hospital
where she worked implementedchanges.
You had the extreme situationof a prosecutor that decided
they were gonna criminalize thatprocess, which I think is
completely in error and blowsthe system up, because the
(10:37):
licensing system is built uponrecognition of errors.
We are not trying to create aperfect situation where people
don't have a problem andproblems never occur.
What you want to do, through aregulatory system that allows
you to practice, is to create asystem where you can recognize
an error and you can correct it,either by and we could talk
(11:01):
about this in a few minutescorrecting that error by maybe
retraining the physician, givingthat health provider some
education, having them comeunder a tutor like a
professional practice manager,or maybe you pull them out of
the practice for a while, yoususpend their license and don't
let them practice.
So the system is designed to beself-correcting.
In the Arizona dentist example,the system did not self-correct
(11:25):
, and that's the problem.
So let me, before we kind ofget into that, though, in order
to understand why the systemkind of had these extreme
results, you kind of need tounderstand how the system works.
So let me sort of start there.
So, like I said, every personthat generally works in a health
profession has to have aprofessional license issued by a
(11:46):
professional licensing board,and the way these, like these
physician, these healthpractitioners, are governed is
they are governed when acomplaint comes in.
So something happens thattriggers an investigation by
that licensing board, usuallyfrom a complaint by like a
patient that's been harmed, orfrom another professional, like
(12:08):
another doctor that practiceswith a health professional that
made an error, or a hospitalreports them or a lawsuit was
filed.
And then there's a report fromsomething called the National
Practitioner Data Bank.
So a complaint gets filed andthen a licensing board opens an
investigation.
They gather facts, they bringthe health professional in to
provide testimony or evidenceand from there they then undergo
(12:34):
a process to correct thathealth professional.
And that process can involve alot of different things.
It could involve justre-educating the doctor or the
physician or the healthprofessional, making them do
some continuing education.
You could limit their practicefor a period of time, you could
(12:55):
put them under a practicemonitor for a probationary
period, you could suspend theirlicense for a period of time or,
in really bad examples wherethere's really no way that they
can be rehabilitated, you takeaway their license.
And that is very scary.
That licensing complaintprocess is very scary for a
(13:17):
health professional because youjust identified.
They go to school, they spendhundreds of thousands of dollars
in their undergraduateeducation, their graduate
education to get a degree thatthey stick on the wall, and now
suddenly, because of some issuethat comes up sometimes
rightfully or wrongfully, theyrun the risk now of losing their
income and their ability toprovide for themselves and their
(13:40):
family, and so that is a veryscary thing for a health
professional, but at the sametime, that's needed because you
have the medical seeking publicthat wants to ensure that the
people that they're gettingservices from are safe to
practice.
So the system, like I said, issupposed to balance itself out.
Attorney Bob Sewell (13:59):
But let me challenge you on that Now, and
I'm not saying that we shouldget rid of these.
There's a portion of me thatagrees with everything you're
just saying.
That is so we can have a safepractice.
There's another portion of methat says come on, dave, it's
practically a rubber stamp toget the license, and then they
(14:20):
only discipline you afterthere's a problem arises.
Right, it's only after there'sa problem that you get any sort
of discipline.
It doesn't train them to be agood doctor.
There, it is right, I mean.
So is it really helpful to thepublic?
David Williams (14:43):
It is, and so it's helpful to the public on a
couple of different levels.
One is let me take like amedical board Generally.
A medical board you have to be,you know.
You have to go through all ofyour professional training.
You have to go through medicalschool and then you have to go
do your residency and then youhave to get your specialization
and you have to pass yourcertification boards and then
you have to pass the licensingexam for that particular, you
(15:07):
know, to obtain your medicallicense.
So there's a lot of educationand on the job training that
goes into that.
Then every medical, every healthprofessional that has a license
anywhere across the country,even lawyers, have to do this.
They have to have continuingongoing education every year,
every two years, to keep theirlicense, and so if they don't
(15:28):
continue their educationalprocess then they can run the
risk of having their licensetaken from them.
And then the third way thatit's self-correcting is when a
complaint comes in and acomplaint is investigated and
validated.
Then there could be some sortof ramification, some sort of
what we call discipline againstthat practitioner's professional
(15:51):
license.
So there are those things thatare built into it.
But, frankly, for the licensedprofessional going through a
complaint investigation is avery, very stressful process
because on the extreme theycould lose their professional
license and their way of earningincome.
So it's very eye-opening for alot of my clients, especially
(16:16):
some of my clients that you know.
You sometimes get a God complexwhen you're a health
professional and you sometimesthink that you are error-proof
or bulletproof and it's a very,very humbling process to have
yourself sort of put under amicroscope by your peers through
a complaint process and it'svery stressful for a lot of them
and that in and of itself thatprocess is sometimes all the
(16:40):
education a professional needsbecause they are now very
self-aware that their futureincome opportunities could be
put at risk.
Attorney Bob Sewell (16:51):
You know you help a lot of healthcare
professionals over the years.
Do they?
Are they repeat customers orare they one and done?
Tell me that they're one anddone.
Yeah, most of them are one, anddone.
David Williams (17:05):
Most of them are one and done and in fact, like
in the health area, let me juststay with like a doctor, for
instance.
You sort of see certain fatpatterns that develop as you do
this long enough.
But most of these are one anddone.
You typically see a complaintarise when there's a what we
(17:27):
call an adverse event.
You know there's a.
Somebody makes a medical error,you know they.
Something happens during asurgical procedure.
There's a failure to diagnose,there's a medication error, like
the Tennessee example.
Maybe there's a failure toprescribe medication.
There's a they don't getinformed consent from the
(17:47):
patient.
The patient doesn't understandthe ramifications of a procedure
.
Or you know, you get theextreme situation where somebody
drops a screw down your mouthduring a dental procedure, like
the Arizona example.
So you see certain fact patternsthat happen from from what I
call practice related issues.
That's where the majority ofcomplaints come from.
But you also see complaintscome about because physicians
(18:10):
deal with substance.
There's they might havesomething that affects their
fitness to practice, likethey've had a medical.
They've had an injury, like aback injury, and they start
taking meds and pain meds and sosuddenly they become addicted
to a pain medication and so nowthey start dealing with
substance abuse issues you have.
Sometimes you'll see situationswhere there's opiate issues or
(18:33):
sometimes you even getinappropriate contact with a
patient, you would be surprised.
There's actually been aheightened awareness, especially
coming out of the Me Toomovement, of physicians that are
inappropriately touching orinappropriately being involved
with a patient, which thenobviously compromises their
medical judgment.
(18:54):
If you're dating your patient,but some people just lose their
sense of sense of balancesometimes.
So you see a lot of these kindof similar fact patterns when
you deal with healthprofessionals.
But on the most part, medicalcomplaints that come in while
there are, you know there arehigh numbers sometimes most of
(19:17):
them do not result in a takingof the physician's license,
because the majority of thetypes of complaints that come in
are things that can be dealtwith through rehabbing or
educating the healthprofessional so that they know
not to do that, or putting inplace certain guardrails like a
(19:37):
mentor or a practice monitor ormaking them go through some sort
of retraining process.
Nine times out of 10 solvesthose problems, so you don't get
the reoffender.
Attorney Bob Sewell (19:50):
So let me ask you I'm a healthcare
professional, bob, so I became adoctor and, of course, because
it's me, I am a fantastic doctor.
Okay, and, anyways, I become adoctor.
I never want to have to talk toyou, I never want to have to
(20:11):
hire you.
Okay, what am I going to do?
What am I going to?
What type of?
How am I going to go about mypractice?
That's going to make so I don'tneed you, bro.
David Williams (20:23):
Well, I think the first thing is education,
making sure that you've put inbest practices and being on top
of cutting edge things.
So, if you're in a fieldbecause most people that work in
a particular health field aregenerally specialists, at least
in the medical area, in nursingthat's more of a generalized,
obviously medical fieldchiropractic, naturopathic
(20:44):
medicine, some of theseintegrative kind of like
non-medical, what I would say,non-traditional medical
practices, what I would say istwo things education, making
sure you're staying on top ofthe new trends, things like that
, being involved in the medicalcommunity, what you serve, and
then following up and trying tomake sure you've implemented
(21:07):
best practices.
Are you taking care of yourself?
First of all, are you doing thethings to take care of yourself
on a personal level?
Are you?
Do you have guardrails in placewhen you're in your practice,
whether it's a hospital, adoctor's office, a private
office?
Are you taking care of yourstaff?
Do you have good systems inplace?
On the business side, are youdoing your medical billing
(21:28):
correctly?
Are you?
Do you have a good officemanager, things like that?
So it's more like what am Idoing on the personal level to
take care of myself?
What am I doing in theprofessional world in my own
professional development.
And then what do I have systemsin place around me?
If I run like my own practice,or I have a team around me that
makes sure that my practice isfiring on all, on all pistons.
Attorney Bob Sewell (21:50):
Oh right, I mean that makes some perfect
sense to me, because if I'mdistracted with all the business
aspects of my practice you knowI have a bunch of HR concerns
and you know a doctor istypically a great, great at
medicine but they're notnecessarily trained in how to be
a business manager, how to runa business.
So if I'm dealing with allthese business issues that are
(22:11):
not in my wheelhouse, I'm notgoing to be able to focus.
And on the healthcare I'mproviding, you know, and so that
makes perfect sense to me toeliminate the distractions,
focus on what I do best.
David Williams (22:27):
Yeah, and I think also you have to look at
there's two different, probablytwo different people that are
two different people that arelistening to us today, that are
gonna be listening to us.
There are the non-professionalsand then there are the
professionals.
So let me talk to the, let mespeak to like the general person
right now.
If you're going to a doctor andyou have concerns about that
doctor and you feel like there'sbeen a problem, sometimes you
(22:51):
can go talk to a lawyer, but themedical licensing process for
that professional is there toprotect you.
So if you're concerned and youthink that doctor did something
wrong, first talk to yourmedical provider and raise
concerns, ask questions and bean active consumer of your
medical care, be involved inmaking informed decisions and
(23:13):
then, if you feel like somethinghappened, talk to the physician
, make sure you get yourquestions answered.
If you think that there wassomething wrong and then if you
don't feel like you're gettingyour questions answered, then go
seek redress, either by hiringa lawyer and honestly, most
medical problems never turn intoa lawsuit and make you millions
of dollars.
That's not the point.
But if you want to seek redress, you can also file a complaint
(23:36):
with that doctor or healthprofessionals licensing board.
So there are ways that you, asthe medical seeking public, can
take care of yourself.
Now, if you're the healthprofessional and you get one of
these complaints, the firstthing I would always advise you
to do is talk to a.
There's two people you shouldcall.
Talk to a lawyer, find a lawyerthat practices in this area and
seek their advice.
The second thing you need to dois call your insurance broker,
(23:59):
cause most likely, you have somesort of medical liability or
professional liability insurancethat you need to make your
insurance carrier aware of, andthey may actually have a lawyer
available to you to talk to forfree, or they may hire a lawyer
to help you through that processand then talk to that lawyer
about the process and make sureyou understand what you're
(24:20):
getting involved with, and letyour lawyer be your advocate
through that complaint licensingprocess.
Attorney Bob Sewell (24:29):
Yeah, I'm gonna challenge you a little bit
about that.
I think you're 100% right.
But there's been a lot ofstudies on who gets sued by
their patients.
Okay, who gets the complaints?
It's the unlikeable doctor whogets the complaints generally.
(24:51):
It's the guy who is arrogant,who is boring, who is mean,
who's not compassionate.
They get the complaints.
It tends to end to be.
The people who complain tend toend up having a personal
difficulty with the professionalrather than necessarily
practice the difficultygenerally speaking.
(25:13):
But if the doctor is humorous,they find, or is encouraging
patients to talk to them and askquestions, and they're helpful
and they're prompt and theyapologize if something went
wrong.
Hey, I'm sorry about that,that's not how this was supposed
(25:33):
to go.
They tend to have lesscomplaints, less likely to be
sued.
Do you think this is wisecounsel?
David Williams (25:45):
Yeah, I think so .
And here's what I think you'regoing to find is the reason you
have a complaint filed against ahealth professional through
their licensing board.
Nine times out of 10 is becausethere was a failure to
communicate.
The doctor or the healthprofessional did not see this
from the perspective of thepatient and they did not
(26:07):
proactively address the concernsof the patient during that
process.
And that can happen for a lotof reasons, like doctors get
busy, they have too big of ahigh patient load, like there's
a bunch of reasons why sometimescommunication breaks down.
But nine times out of 10, mostcomplaints come about because
there's a breakdown in thedoctor-patient relationship on
(26:28):
the communication level.
And so if you are a physicianlistening to this, making sure
that you are adequately talkingto your patient, don't talk
medical to them, talk regular,talk to them, you know.
Talk to them, not at them, andlisten to their concerns.
And if you could do that mostof the time, you will calm that
(26:49):
patient down, because thatpatient's just scared.
They're just scared thatsomething's happening and they
don't understand what's going onin their own body and they're
looking to you, mr Doctor, mrsDoctor, as the person that's
going to help them through thisprocess and so not only are you
a medical professional, butsometimes you have to be part
therapist also and you have tobe able to listen and empathize
(27:10):
and be empathetic to thatpatient.
And if you are, a lot of timesyou can work through these
situations.
And that happens with everylicensed professional.
That's not just a doctor, Imean.
That even happens with lawyers,like clients that get mad at us
and our legal profession ninetimes out of 10, they get mad
because we haven't communicatedto them adequately, help them
(27:33):
understand where they're comingfrom, and so it all breaks down
really to a relationship Are youthere to take care of the
people that are being entrustedto your care?
And if you are, then nine timesout of 10, you're going to
float through this very smoothly.
And then, for the one-offsituations where something
extreme happens, recognize wherethere's a problem, seek help
(27:55):
from a legal professional ifyou're a doctor and the health
professional and get ahead ofthat process instead of being
the surgeon that does their ownsurgery on themselves.
That's where I see a lot ofpeople screw up is that they try
to do this themselves.
They don't recognize, they'renot humbled through the process,
they get defensive, and that'swhere the doctor or the health
(28:15):
professional makes mistakesthrough the investigative
complaint process.
Because they don't recognizetheir error, they don't seek
legal help and they try to do itthemselves and they try to
minimize what actually happened,versus taking it very seriously
, recognizing their licenses onthe line even if it's a minor
complaint that their licensecould potentially be on the line
and being proactive and workingthrough an attorney to get
(28:38):
ahead of that process.
And if they do that nine timesout of 10, it's going to work
out in their favor.
I mean, work out in their favoris a better result versus them
doing it themselves.
Attorney Bob Sewell (28:47):
David, you know I'm going to close the loop
on a couple different thingshere.
The first thing is when amedical professional gets that
letter or that phone call fromthe board and they say we're
concerned about your conductwith regard to whatever patient.
David Williams (29:09):
When do they call so?
Attorney Bob Sewell (29:12):
um, they call a view.
David Williams (29:13):
I should say yeah, I would say the sooner
they can.
There's two people they shouldcall at the beginning of this
process the minute you getcontacted by your licensing
board and typically it's goingto become a letter that says,
hey, a complaint's been filedagainst you and we want you to
provide a written response.
That's what starts theinvestigative process, the
investigative complaint process.
The minute you get contacted,there are two calls you should
(29:35):
make.
You should call a lawyer first,somebody that knows what
they're doing and that's notyour, not your.
You know your next doorneighbor who you got a referral
from, but find somebody who'squalified in this area.
The second person you shouldcall is your insurance broker.
Okay, and then, if you work ina hospital setting, the third
person you should probably callis you need to report it up your
chain of command.
If you work in a medical office, medical practice, um, but
(29:59):
those are really the three callsyou need to make.
You need to call your lawyer,you need to call your insurance
broker and you probably need toreport it up your training
command, depending on theenvironment, the medical setting
and what you work.
Um.
Once you get involved with alawyer early, then we are more
able to help you navigate thatprocess sooner and the
investigative process looksdifferent based upon what
(30:19):
particular licensing board andin what particular state.
But generally here's what itlooks like A written complaint
comes in um.
That medical board will sign asan investigator who will go and
gather facts, gather themedical records, talk to the
patient, talk to the familymembers.
If there's other witnesses,they may talk to them.
And then they will reach out tothe medical professional, the
(30:39):
licensee, and then seek theirinput and typically they'll ask
you to provide your records,your charts, um provide a
written response and then thatmedical investigator, that
investigator, will gather all ofthat information.
They may want to interview themedical professional, um, and so
obviously you would want tohave a lawyer with you during
that and then eventually thatthat once the investigation
(31:02):
phase is completed, then it willbe considered by the entire
medical board or the medicallicensing agency, um, on how to
resolve that complaint.
And at least in Arizona, um, amedical compli a a a a
professional's license, can onlybe disciplined if they engage
in a very specific term calledunprofessional conduct and they
(31:23):
have to buy.
An unprofessional conduct has abunch of different scenarios by
which something can rise tounprofessional conduct.
But what the medical board orthe licensing agency is looking
at is is what happened here?
Does that rise to the level ofunprofessional conduct?
It doesn't fit within one ofthese enumerated categories of
unprofessional conduct.
And if it does, how are wegoing to resolve that?
(31:46):
And so once the medical board orthe licensing agency considers
that, then they can dismiss it.
They can require the, theprofessional, to have some
education.
They can, they can take somewhat we call non-disciplinary
steps which don't doesn't affectthe license of the professional
or um.
They can take some actionagainst the license, put them on
probation, make them do someordered um continuing education
(32:09):
under under, you know, under auh, somebody who's going to
watch over their practice um,have a practice monitor, suspend
their license and there's awhole bunch of things.
Now you also would have dueprocess rights around all that.
Maybe you have anadministrative hearing, but
ultimately the medical agencyhas to figure out how to resolve
that complaint.
And getting a lawyer involvedearly to help you navigate that
(32:33):
process is how you do it.
And that's really what I do inmy practice is helping medical
professionals or healthprofessionals work through that
process and hopefully educatingthem about it and helping them
hopefully get a positive outcomeon the back end.
Attorney Bob Sewell (32:47):
That makes sense to me.
The reason why is if you're amedical professional, you're
trained in medicine.
You're not trained in advocacyand lawyers.
Jobs are to package the storyand why the story is supposed to
work out favorably of favor ofclient or make the story in.
You know, show the story in thebest light.
(33:08):
That's in the best light infavor of our client.
So that makes perfect sense tome.
We want you're going to helppeople package, package
themselves more palatably forthe board.
One question I'm a consumer andI don't want to pick the doctor
(33:29):
that has 1000 complaintsagainst them.
Is there a way for me to knowthat doctor or medical
professional has complaintsagainst?
David Williams (33:37):
them?
Yes, and it depends.
It depends a lot on the statein which you're looking for them
.
But if you go to that localstate agency, licensing agency
or state regulatory board, go totheir website.
You can typically type up anddo a search for the doctor
you're looking for and if thatdoctor has been disciplined, had
(33:58):
action actually taken againsttheir license.
That's typically availableonline for a period of time.
Some states limit it to likefive years, some states go back
20 years.
It just depends upon which thestate.
It will not tell you if acomplaint's been filed.
It will only typically show youinformation on whether that
physician's been disciplined.
The other place you can look atit and it's kind of a you know
(34:20):
what the default for a lot ofpeople do is.
There's websites like healthgrades or Yelp or Google reviews
that give at least information,that give you a little bit more
information about thatprofessional and then also
realize sometimes you're limitedby your insurance plan and sort
of where you can go andsometimes your insurance plan
will also provide a grade or areview or a assessment of the
(34:45):
doctors in that health plan.
So there's a couple ofdifferent resources you can go
to.
You can go to the state license, the state licensing board.
You can kind of look online anddo your own research or you can
even look at kind of how thatperson is graded by your
insurance carrier.
So that's usually a good way toget your questions answered.
Or, you know, maybe sometimeseven seek a second opinion from
a physician If you don't feelcomfortable at the end of
(35:08):
meeting with that physician.
For, like, this is fornon-emergency issues, but you
don't feel comfortable, youalways can go talk to another
doctor.
You are not locked into thatparticular doctor.
And so what I would tell themedical public is be active in
your medical care, be educatedabout your medical care, don't
just be a passive consumer.
Be an active consumer of yourmedical care.
(35:31):
And if you do that nine timesout of 10, you're going to be
fine.
Yeah this is good advice, Dave.
Attorney Bob Sewell (35:36):
Dave, thanks for coming on the show.
David Williams (35:38):
Thank you very much.
I really appreciate you havingme, and this is a fun topic to
talk about.
Attorney Bob Sewell (35:42):
If I am a medical professional, I need to
get your services.
How do I contact you?
David Williams (35:48):
You can contact me on my website at
wwwDavisMilescom, or you cancontact me through my email
address atdwilliamsdwilalimascom.
Talk to you in a day.
Attorney Bob Sewell (36:04):
Thanks.
Thank you very much.
Have a great day.
Thanks for listening to.
Is that Even Legal?
Remember this isn't legaladvice.
If you have a legal questionfor yourself, reach out to an
attorney.
Remember that we're fun, we'relovable and we are here to help
you, To my listeners in 62countries across the world.
If you have something you wantto explore, email us at
(36:27):
produceratevenlegalcom and don'tbe shy about leaving a review
for this podcast on yourfavorite podcast forum.
See you next time.
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