The Office of Professional Medical Conduct is the entity in charge of investigating complaints filed against physicians in New York. Many complaints are issued annually, and most are pointlessly filed by patients looking for a handout or doing little more than telling on a physician for not following the patient’s rules. These are unsubstantiated claims as they don’t indicate a physician broke any laws or behaved in an unethical manner. When a physician is thought to have done either/or, an investigation is opened. The physician’s license is looked into, and the claims must be proven.
There are dozens of things a physician might end up in trouble for, but most of them fall into specific categories:
– Billing fraud
– Sexual misconduct
Billing fraud occurs when a physician or physician’s office is accused of sending falsified bills to patients and/or insurance companies. This does happen by accident in many instances. A bill is inadvertently duplicated and mailed to an insurance company twice. An administrative assistant makes a mistake when transcribing the information the doctor provided for records, and a bill is sent for the wrong services. It’s also willful and voluntary in some occasions, and physicians and their offices are just looking to increase their own bottom line with the use of fraud.
Negligence is any instance in which a physician doesn’t behave appropriately in the office and a patient suffers as a result. This could be as simple as showing up for work exhausted after a long night and not reading a patient’s charge correctly, providing medication a patient is allergic to. The results of negligence are damaging in most instances.
Sexual misconduct is a serious charge, and it’s one no physician ever wants to be accused of. It could mean touching a patient inappropriately, coming onto a patient in an inappropriate setting, or even making inappropriate comments to a patient when the patient is in the office. This is why no procedure should ever be done without a secondary medical professional in the room with the doctor.
Addiction can be a problem both in and out of the office. If a patient or employee of a physician feels the physician has an issue with drugs or alcohol, they can file a complaint whether the doctor showed up drunk or high to work or not. This is a serious problem that can result in negligence if a physician is not careful.
It’s important to note not all physicians accused of any of the above issues are found guilty and even if they are, many patients prefer a monetary settlement in lieu of a court date and legal action. They’ll happily drop charges for the right compensation. Those who are found guilty of addiction issues can seek treatment as advised by the board or a court of law and eventually work on reinstating a suspended license once recovery can be proven.
Discipline and License Revocation
Physicians who are under the microscope for violating any state or local laws are facing serious punishment. Even a doctor arrested and charged with a criminal charge outside of the office can lose their license despite it having nothing to do with their work. The most common disciplinary action for violating laws and ethics include:
– Jail – Physicians who break the law can go to jail. Most counts include a maximum of 5 years in prison for each count.
– Fines – Monetary fines are often imposed when physicians are unable to prove their innocence. Fines start at $10,000 and go up based on the type and number of charges.
– Restitution – If a doctor swindles money from insurance companies or patients, they’re required by law to repay all the money they obtained illegally, and sometimes more depending on the outcome of the investigation.
– Probation – This happens most often when a physician is accused of substance abuse. They are required to go through mandatory rehabilitation programs, and they must go through a period of probation before they can reinstate their professional license.
Going through the investigation process alone is never recommended. Physicians facing the potential loss of their license should make it a point to call an experienced attorney right away when they’re notified of an active investigation.