Compliance

Don't Go It Alone: How to Respond to Medical Board Requests and Investigations

Medical board investigations or requests of patient records should be handled with the same care as medical professional liability lawsuits.


If served with a medical professional liability lawsuit, you would not attempt to represent yourself in a complex legal system full of technically educated and specially licensed judges and lawyers. Representing yourself in a medical professional liability (MPL) lawsuit would be like a lawyer taking out his or her own appendix.

Requests by state medical boards for copies of patient records and notices of an investigation of a patient complaint are no different than a MPL lawsuit. You should immediately call the MICA Claim Department upon:

    • learning a board complaint has been filed (patients, family members, and other physicians can file complaints) or

    • receipt of a medical board request for records or notice of a board investigation.
      Experienced, courteous, and reliable MICA claim professionals will listen, document, and explain the next steps.

There are at least two reasons to call the MICA Claim Department. First, physicians quick to defend and explain their actions often lack experience and insight into medical board procedures and investigators’ techniques that could result in disciplinary actions such as reprimands, censure, practice probation, and/or license suspension or revocation. An uninformed and emotional response to the allegations could negatively affect the strength and effectiveness of your defense, especially responses submitted without the assistance and guidance of an attorney. Second, the MICA MPL policy e-Med Protection Endorsement may cover eligible expenses, such as reimbursement for legal fees and your attorney’s bills, up to a certain amount.

Medical board investigations are not always straightforward. An investigator may request a meeting, but not fully explain the focus of the investigation, and use meeting notes in the investigation and disciplinary process without sharing them with the physician. A lawyer experienced in licensing board investigations will contact the investigator; ask the right questions to peg the issue(s); and draft a helpful, protective response before the deadline. Physicians representing themselves may dismiss the request for records or notice, fail to respond, and subject themselves to discipline for not responding.

The MICA MPL policy requires MICA members to timely and properly report occurrences, claims, and lawsuits. The e-Med Protection Endorsement to the MICA MPL policy requires reporting occurrences and claims to the MICA Claim department within 30 days of a claim being instituted. Under the e-Med Endorsement, an insured will be reimbursed for legal expenses for the attorney of your choice, when policy conditions have been met and policy exclusions do not apply, up to the limit of coverage. The Endorsement defines a claim to include proceedings by a state licensing authority against an insured for unprofessional conduct.

Medical boards dismiss most complaints against physicians, but an investigation may lead to severe licensure actions. MICA members should contact the MICA Claim department about medical board requests for medical records and notices of investigations to trigger applicable benefits of the MICA MPL insurance policy.


For more information about the MICA policy and e-Med Protection Endorsement contact your insurance agent or MICA Customer Service Representative. MICA Customer Service Hotline 602.808.2111, 877.215.6422, and help@mica-insurance.com.
 

Learn more about Arizona Medical Board investigations

The content of this publication or presentation is intended for educational purposes only; is not an official position statement of Mutual Insurance Company of Arizona (MICA); and should not be considered or relied upon as professional, medical, or legal advice or as a substitute for your professional judgment. Consult your attorney about your individual situation and the applicable laws. The authors, presenters, and editors made a reasonable effort to ensure the accuracy of the information at the time of publication or presentation but do not warrant or guarantee accuracy, completeness, or currency of such information. As medical and legal information is constantly changing and evolving, check for updated information and consult your attorney before making decisions.

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