1. Alesia
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    Alesia Pen names: AJ Connor, Carey Connolly Contributor

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    Reasons for an indefintely suspended or revoked medical license?

    Discussion in 'Research' started by Alesia, Oct 24, 2013.

    I know there are as many mistakes that can be made my medical staff as there are words in the dictionary, but what types could possibly lead to the physicians medical license being indefinitely suspended or revoked along with their hospital privileges? Would a simple big mistake do it, or would there need to be mitigating factors such as drug use involved?

    Some background info:

    This mistake would take place in an emergency room/trauma ward setting. I'm thinking the patient involved would be pediatric and said mistake would result in the death of the individual. I don't think blatant negligence would be a factor here, but if it helps, the MC is a young physician roughly 2-5 years out of med school. She also has a background as a medic in the U.S. military during the Iraq/Afghanistan conflicts before coming to work in a stateside hospital as an ER doc.

    Preferably I'd like this error to be something that can really sting her hard, beyond just being responsible for a child's death.
     
  2. Lewdog
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    Lewdog Come ova here and give me kisses! Supporter Contributor

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    What if a patient came in from an accident and the physician amputated the wrong leg? Later they found out that the Physician was drunk and had been sneaking drinks on the job.
     
  3. Duchess-Yukine-Suoh
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    Duchess-Yukine-Suoh Girl #21 Contributor

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    Drinking on the job, at all. You don't even have to do anything wrong, but you would still get your license revoked.
     
  4. Cogito
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    Cogito Former Mod, Retired Supporter Contributor

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    Mistakes usually involve malpractice insurance, not suspension or revocation, unless the physician's mistake involved a breach of procedure (including the hospital's policies), as well. Let's say the physician left a clamp on a blood vessel and closed the incision. The patient dies during recovery, and the forgotten clamp is deemed to have contributed to her death.

    Most hospitals require an inventory of all medical tools and supplies before closing to prevent this kind of problem, because with everything going on, it an easily happen. If the doctor performed the inventory, and there was a miscount that went undetected, the tragedy might be resolved with a settlement and a review of the procedures to prevent miscounts. But if the physician skipped the inventory, or waved off a count discrepancy without rechecking the surgical site, that could be grounds for suspension.

    That's an "ideal" situation. In a high profile mistake, like a prominent patient or a media blitz, even a mistake with no procedural violations could result in the doctor getting suspended to take the heat off the hospital.

    Revoking a doctor's license generally requires multiple violations, or something truly egregious. Or sensational in the news.
     
  5. Lewdog
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    Lewdog Come ova here and give me kisses! Supporter Contributor

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    Yes, something along the lines of the doctor that was treating Micheal Jackson.

    Unless you can make it so that the doctor committed inappropriate acts with patients while they were under anesthesia and gets caught.
     
    Last edited: Oct 24, 2013
  6. Alesia
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    Alesia Pen names: AJ Connor, Carey Connolly Contributor

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    LMAO. That's way out of her character, however being caught drunk on the job completely fits with this MC. That's part of why I asked about mitigating factors like intoxication. Say the physician while under the influence prescribed too much of/or the wrong drug, that could possibly do the trick?

    Another related question. How do like medical/hospital board reviews, hearings, whatever you call them work? Is the physician present and given a chance to plead their case, or is it a matter decided by a panel of higher ups based off medical charts where the Dr. is notified of the decision at a later date?
     
  7. Lewdog
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    Probably wouldn't happen because nurses would normally tell the doctor they are prescribing too much.
     
  8. GingerCoffee
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    GingerCoffee Web Surfer Girl Contributor

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    A drug or alcohol problem, inappropriate sexual acts involving a patient, gross negligence such as leaving the grounds when one was on duty, gross negligence such as mentioned above like the MD who gave Michael Jackson an anesthetic (that was enough) then leaving him unattended (that would have been a second offense worthy of suspension, falsifying data in a study, and practicing beyond one's scope of expertise are things off the top of my head that would result in suspension or revocation of a medical license.

    Medical mistakes would have to be outrageously bad, most errors are treated as a malpractice issue as noted above.
     
  9. Alesia
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    Alesia Pen names: AJ Connor, Carey Connolly Contributor

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    Just goes to show how my brain always goes toward the worst possible scenario with horrible deaths and whatnot. I found a site of Oregon state laws (I'm assuming they are the same in every state on this) that says an arrest can do it too. So at this point my mind is saying:

    MC goes out to the bar late one night and gets popped with a DUI on the way home. While the officer is searching her person, a small amount of a controlled substance is found in her pocket (prescription painkiller/morphine/possibly pot since she is known to smoke from time to time.) So now we have an M.D. behind bars for DUI and possession of a controlled substance... I should think that would lead to at the minimum an indefinitely suspended license and temporary revocation of hospital privileges.
     
  10. GingerCoffee
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    GingerCoffee Web Surfer Girl Contributor

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    Substance abuse in a licensed health care provider leads to a temporary suspension and drug monitoring when the license is reinstated. State laws can vary but probably only slightly when it comes to substance abuse. So a person who gets treatment and agrees to monitoring might only be suspended a month or two for a first offense.

    If you want to spice the soap opera up, we are all required by law to report a substance abusing colleague, so instead of arrest (which is also good, BTW), you could have someone turn the guy in.
     
  11. mammamaia
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    mammamaia nit-picker-in-chief Contributor

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    after a hearing by the proper in-house board, the hospital can only suspend or revoke physicians' hospital privileges, or fire them if they're on staff... it can't suspend or revoke a license to practice, since that's issued and controlled by each state...

    the AMA can suspend or permanently drop doctors from its membership, which will could make them unhireable by many hospital and/or unable to be allowed hospital privileges [meaning they can't perform surgery or tests there]...

    the state licensing board can suspend or revoke their license, without which they can't practice in that state and if they do, it could be a felony, depending on the state...

    and, as noted by others above, the conduct earning a permanent loss of license would have to be either a pattern of serious breaches, or a single one of such magnitude that the doctor is convicted of a major crime...
     
  12. Alesia
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    Alesia Pen names: AJ Connor, Carey Connolly Contributor

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    That's precisely why I was looking at a suspension of license at this point. She definitely will get her hospital privileges suspended or revoked since this incident occurs in chapter one or two and serves as the lynch pin to set the events of the rest of the novel in motion which will require her being unable to work.

    Now, she does have a big drinking problem and some minor substance abuse issues (pot smoking, recreational vicodin/morphine use, etc...) However, that being said, if she was popped for DUI/possession more than once, then we open the door to bigger legal issues such as jail time, probation, and so on and so forth. To move forward she needs to be fairly free of court problems (unless she just skips her court date that is.) The crux of the novel is the MC sort of running away and going on a massive US road trip after he life starts totally falling apart, so that could add some drama with being wanted in at least one state lol.
     
  13. Lewdog
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    I know it is just a television show, but I'm guessing they did their homework on the matter, but didn't House go back to work at the same hospital as a doctor with only a temporary suspension of his license after being busted for forging a prescription and substance abuse, and then serving time in prison?
     
  14. GingerCoffee
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    GingerCoffee Web Surfer Girl Contributor

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    The rest of what you posted is correct but the AMA is just a professional organization, they don't kick members out, to my knowledge, and I doubt any employer would care if an MD was or was not a member.
     
  15. mammamaia
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    mammamaia nit-picker-in-chief Contributor

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    sorry, but you're wrong... they certainly can...

    from the AMA website:
    and, if a doctor has been censured/suspended/ejected by the AMA i don't see it making sense for a facility where s/he's on staff to not care... certainly their legal dept. would be concerned that it could put them at risk of being sued by patients, if the doctor subsequently did anything questionable...
     
  16. chicagoliz
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    chicagoliz Contributing Member Contributor

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    Ginger's right, insofar as the AMA is nothing more than a professional association. Doctors don't have to join. Many don't. It says nothing about their competency as a physician.

    What you quoted, Maia, only says that the AMA can expel the doctor from the association. A hospital would not care one way or the other about whether the AMA expelled someone from their membership rolls.

    What matters are the state licensing boards. They are the ones who can take away the authorization to practice medicine. They're the ones a hospital would pay attention to.
     
  17. chicagoliz
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    chicagoliz Contributing Member Contributor

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    I'm not so sure you necessarily have to go so far as to put her in a position where she actually loses her medical license for a period of time. You could set up a case where a colleague or someone supervisory to her is also some sort of friend or has some particular interest in her life (perhaps through a relationship with parent or child or something). This person could find out about the drug use and threaten to report her, but tell her to go away for a while or not to come back to work for a couple months/take a leave of absence to protect her. Although this person would be going out on a limb, he or she might have a sufficient motivation to try to make sure the MC's career is not ruined or blemished with indications of drug use, etc.

    It therefore wouldn't be the case that she couldn't get any medical job -- she'd still have the license, it's just that it would not be practical, and she wouldn't be able to use any sort of recommendations from her current hospital, etc. It leaves the door open to her returning after her leave of absence, etc.

    Just a thought I'm throwing out there. Take it for what it's worth (which may be nothing).
     
  18. GingerCoffee
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    GingerCoffee Web Surfer Girl Contributor

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    It helps to quote the whole section:
    It's one thing to state an organization's principles and positions, it's quite another to turn away their membership dues. No one is going to be denied AMA membership first, before the suspendable action was addressed by a state medical board. So any trouble with an AMA membership would be after the fact and therefore moot as far as any employer or hospital would be concerned.

    I'd still be surprised if you could find very many actually expelled physicians, with the exception of the most egregious like Dr Wakefield who falsified medical research. The AMA Journal would have some reputation to uphold as a peer reviewed journal. If you look for a list of physicians expelled from the AMA they instead refer you to the state medical boards for information on physicians for whom complaints have been filed.
     
  19. Alesia
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    Alesia Pen names: AJ Connor, Carey Connolly Contributor

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    The definite is I want her to get busted for DUI and possession. Using your suggestion I could have a colleague come bail her out, hence how they find out about it. However, AJ isn't the type to just up and leave because a friend says so, even if they want to protect her. I'd say she's the type that would say "duly noted," wave off the advice, and move on with her destructive behavior. That said, this would bring about a situation where said colleague might just go ahead and report her out of a sense of duty to the public's safety. That is where the hospital bosses would find out and issue an ultimatum: suspension of privileges with return contingent on Alli completing a treatment program otherwise they will fire her and issue a report to the medical board recommending suspension of license.
     
  20. GingerCoffee
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    GingerCoffee Web Surfer Girl Contributor

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    Don't know about all states but in WA, by law, the hospital administration would have to report any licensed professional that had a drug or alcohol problem. So everything you are describing works except the report would be mandatory. But you can still do everything there as the medical board would allow a monitored program of treatment and regular (usually random) testing to assure compliance.

    In other words, the licensing boards have a formal program to work with impaired licensed professionals.

    Or, you can write it how you want and very few people would notice the minor discrepancy.
     
  21. mammamaia
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    mammamaia nit-picker-in-chief Contributor

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    ginger and liz...
    first of all, my opinions are based on personal experience, study and observation, since my mother was a 50-year-long career RN, my dad was a hospital administrator, i've worked in numerous business-related positions in a hospital and have run a doctor's office... so, my comments were based on wide background knowledge of the subject, not just speculation...

    and i still maintain that, as hospitals are much more sensitive to legal risks these days than they were back then, if a doctor on staff had been suspended or 'expelled' from the AMA that certainly could be of concern to a hospital's legal team and ethics board...

    as for that only taking place after a state licensing board decision, many cases have surfaced where doctors were practicing in one state and their having been censured [or worse] in another state was not disclosed to the hospital that hired them... so it's much more complex than you seem to think...

    that said, if you have specific knowledge to support your claims that i'm wrong in this, i'm of course open to looking into them... what i've said here is based solely on my own firsthand knowledge picked up while working within that world, plus having done a ton of paralegal work for several years, on behalf of two mothers of sexually abused children in two different states, whose legal grievances against doctors were a major part of their cases...
     
  22. Alesia
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    Alesia Pen names: AJ Connor, Carey Connolly Contributor

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    Anyone know where I can find the medical license legalities for the state of CA since this incident takes place in Los Angeles county? I've tried Google and come up dry so far. It keeps wanting to bring up drivers license info only for some reason.
     
  23. chicagoliz
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    This has nothing whatsoever to do with the AMA. I made no assertion that anything having to do with licensure was not riddled with complexities.

    The AMA is a professional association. It is similar to the American Bar Association, which is another organization which many people mistakenly believe has some sort of licensure or regulatory authority over members of the profession. Associations do a lot of good things They can provide a lot of education not only to their own members, but to the public at large. But they are, by nature, concerned first and foremost with themselves. Any sort of expulsion of a member from the organization is actually more likely to be caused by some sort of personality conflict amongst members than from some sort of professional malpractice. If professional malpractice is the basis for an expulsion from an association, it would happen AFTER a state board had given some sort of punishment -- not before, and not as some sort of inciting incident in and of itself.

    I have studied and written papers about various medical/legal issues, and have many family members who are medical professionals. I have worked for associations, and have family members who work for medical associations. I have been a member of various professional organizations. And I am very familiar with litigation and factors that deal with risks related to litigation, having worked in litigation for many years.

    I don't dispute that hospitals are sensitive to litigation risks. But membership or nonmembership in the AMA is simply not one of them. Complaints and punishments by other state medical boards certainly would be, though.
     
  24. GingerCoffee
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    GingerCoffee Web Surfer Girl Contributor

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    http://www.mbc.ca.gov/
     
    Last edited: Oct 26, 2013
  25. GingerCoffee
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    GingerCoffee Web Surfer Girl Contributor

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    I'm not sure what your issue is, @mammamaia? I've never once been asked in a job interview, which professional organizations I belong to. Certifications, yes, that's a different matter. But employers don't care if one is a member of the AMA, the ANA, APIC or any other organization.

    And while the AMA noted their position on members' ethics, they also specifically excluded themselves from any physician reporting, investigating, or disciplinary action.
    So what is it you think I've claimed that you assert is false? The AMA may expel members, I conceded that. It still has nothing to do with one's professional license or employment security.
     

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