0:00

It's a phrase from popular movies . It's

0:02

also a question that comes up in our daily

0:05

life . The question is is

0:07

that even legal ? We talk

0:09

about the things that drive you crazy , the

0:11

things you won't believe and the things

0:14

you need to know and understand . I'm

0:16

attorney Bob Sewell , and this is the podcast

0:19

. Is that Even Legal ? Let's

0:21

get started . Today's

0:29

guest on the show is David Williams . David

0:32

Williams is an attorney that practices

0:34

in the area of administrative licensing

0:37

and professional defense . David

0:39

is an expert in the field of

0:42

administrative licensing . Dave

0:44

, welcome to the show . Thanks , bob . I

0:47

want to tell you a story , two stories

0:49

actually , and

0:52

they just opposed against

0:54

each other . They seem odd

0:56

. I'll be honest with you . The first

0:59

story is a story of a dentist in

1:01

Arizona . This

1:03

dentist has

1:05

a history of being he's

1:09

having his hands slapped if you will by

1:11

the Arizona Board of Dentistry . He

1:14

was working on a patient , for example , and

1:16

an instrument dropped

1:20

on the throat of his client . He

1:23

was working on the patient . He gave

1:25

the patient five different types

1:28

of sedatives and medicines and

1:30

during the process of

1:32

his procedure , the

1:35

patient dies . And

1:38

then , after he begins

1:41

, after when he's supposed to be being

1:45

disciplined and he's not supposed to

1:47

be practicing , he

1:49

goes and practices anyways and

1:52

he ends up

1:54

getting some complaints based

1:57

on putting these

2:00

people at risk for his poor professionalism

2:04

. On the other hand , we have

2:06

a nurse and this

2:08

nurse is out in I think she

2:10

was in Tennessee

2:13

and

2:15

, through a series of

2:17

unfortunate events , she

2:19

is administering the wrong

2:21

medication . This

2:29

is not a person who is an evil person

2:31

, is not a person who's going out and trying to do

2:33

bad things . We're talking about

2:35

a nurse and

2:37

we all know these nurses are overstressed

2:40

, they're

2:42

pushed to the max

2:44

. There's not enough

2:47

of them and in the heat

2:49

of the moment she grabs the wrong medication

2:51

, she administers the wrong medication if I

2:53

got the facts right and

2:55

the guy dies , she

2:58

ends up losing her license . All right

3:00

, fair enough . But then

3:02

she takes it one step

3:04

further , or the state

3:07

takes it one step further and they criminally

3:09

prosecute her and

3:13

she's found guilty of criminal

3:16

negligent homicide . Frankly

3:20

, I'm flabbergasted because on the one hand

3:22

, we got some guy who's out there

3:27

violating the terms

3:29

of his sanction

3:32

from the dental board and

3:37

he kills someone

3:39

when he's practicing

3:41

, and on the other hand

3:43

, we have someone who doesn't have a history of

3:45

misconduct and now she's being

3:48

charged with criminal negligent

3:50

homicide and found guilty

3:53

of it , even losing her livelihood

3:55

.

3:55

It just seems outrageous . Yeah

3:58

, these are two extremes of it . These are two opposite

4:00

ends of extreme situations . So

4:04

the case with the nurse out of Tennessee . She

4:07

was working as a nurse and she's

4:09

working under the authority of a prescribing physician

4:11

. There was an order put in for a

4:13

sedative medication because the patient was

4:15

going to have a closed MRI

4:18

scan and instead of giving her the sedative

4:20

, the nurse actually gave her a

4:22

medication

4:24

that actually caused paralysis and it caused

4:26

that patient to stop breathing as she died . That

4:29

nurse , setting aside

4:31

her error like she made an error , but she

4:33

did the right thing as far as she reported

4:35

her error to her supervisors there

4:38

was an internal investigation at the hospital

4:40

where she worked . Then there was an

4:42

investigation by her licensing board in

4:44

the state of Tennessee that issued her a nursing

4:47

board license and then she lost her

4:49

license , she lost her job . There

4:51

was actually a lawsuit that was filed that resulted

4:53

in an out of court statement to

4:56

the person who passed away . But then the

4:58

state of Tennessee , a local district attorney , criminally

5:01

prosecuted her and that

5:03

case raises a whole number of questions

5:05

because you don't

5:07

want to criminalize a medical error

5:10

and by doing that , if

5:12

you criminalize a medical error , what

5:14

you're doing is you're scaring nurses , or

5:16

scaring health professionals in general , not

5:18

to acknowledge when a mistake is made , because

5:20

we only learn from our mistakes in these situations

5:23

. Now you've got the opposite end of

5:25

the spectrum with this Arizona dentist who

5:27

had a history of some sort of

5:29

prior discipline from the Arizona dental board

5:31

of examiners and still

5:34

was practicing unsafely

5:36

, which resulted in the death of a patient

5:39

, and then , rather than immediately taking

5:41

this dentist license , they

5:43

put him on a restricted practice

5:46

, but then he violated those terms

5:48

again . So you have almost two extremes

5:50

where you have lax regulation

5:53

, not enough regulation from one entity

5:55

and over-regulation on the other . So

5:58

how do you reconcile that ? And

6:01

I think before you can reconcile that

6:03

, bob , I think you have to understand

6:05

how

6:08

people get licenses

6:10

generally for

6:12

health professionals and then how

6:14

do those licenses get regulated .

6:16

So let me just start there , ok , well , OK

6:18

, yeah , before you go there

6:21

, I want to go there , I do , but

6:23

I just want to say it

6:26

is offensive

6:28

in many respects because I have to be licensed

6:30

right and any professional

6:32

who practices knows no

6:34

professional practices perfect

6:36

at whatever they do . They know it's

6:39

not possible . We're not perfect . We

6:41

will do things that we

6:43

know later that there's better

6:45

ways to do them , it's just the

6:47

way it is . It's called a practice

6:50

right and I

6:53

spent three years

6:55

of my law school , four years

6:57

of undergrad . Nurses spend

7:00

four years of undergrad

7:02

and sometimes we have people with

7:04

masters in nursing and you

7:06

have doctors who spend four

7:08

years of undergrad , four years of residency

7:11

, four years of med

7:13

school , then four years of residency or less

7:16

or more , and you

7:18

spend all this time , all this money

7:20

, and

7:23

we have to be perfect

7:27

. That's what I feel like and

7:32

we're getting set in gas . And it's outrageous

7:34

that nurse who

7:40

was criminally charged

7:42

outrageous .

7:44

Yeah , it is absolutely outrageous . So

7:47

that's the tension that's built into a

7:49

system where you give people

7:51

the privilege of having

7:53

a professional license that lets them serve

7:57

the public . Now keep in mind this every

7:59

person that

8:02

seeks medical care is seeking

8:04

and is putting their trust in the hands

8:06

of a trained professional . They are

8:08

putting their life in the hands of someone to

8:10

treat whatever medical ailment they have , whether

8:12

it's a root canal , a

8:14

heart procedure , whatever the thing is , and

8:18

so you put your life in the hands of someone . You

8:21

want to ensure that

8:23

that person knows what they are doing

8:25

, that they're properly trained , that they're

8:27

credentialed , that they've gone through a review

8:29

process to make sure that they are competent

8:32

to be able to provide the medical services

8:34

that you are putting your

8:36

life in their hands . So in

8:39

most states , every state has a

8:41

licensing process for a health professional

8:43

, and so I practice in Arizona

8:45

, and Arizona has different

8:48

licensing boards for different health professionals

8:50

. In fact , in Arizona we have over 30

8:52

different regulatory boards that

8:54

cover anything from licenses for

8:56

a barber to an acupuncturist , to

8:58

health professionals , and before

9:01

you can get a license , you

9:03

have to be trained . You have to go get a formal education

9:06

through medical school or chiropractic school or dental

9:08

school , nursing school , and then you have to take a licensing

9:11

exam , and then you have to go and

9:13

pass a background check , and then

9:15

you get a license that's issued

9:17

by your state licensing board . And

9:20

then the purpose

9:22

, though , of these boards is not to protect

9:24

the professional . They are there to

9:26

protect the public from

9:28

the professional , and so their

9:30

mission , in every state that

9:33

licenses a health professional

9:35

specifically , their goal is

9:37

to regulate their profession

9:40

, and the state actually

9:42

allows the professionals to generally regulate

9:44

themselves . They basically appoint to these

9:46

licensing boards doctors and

9:49

people who work in that area to regulate

9:51

themselves , and so those

9:53

boards regulate their profession to

9:55

ensure that the people that work in their profession

9:57

are qualified , competent and

10:00

safe to practice For

10:02

the health seeking public . Now

10:04

, that's the way it's supposed to be

10:06

. What is scary is you

10:08

have these two extreme situations

10:10

where the system broke down

10:12

, and , with respect to the nurse , the system

10:15

did what it was supposed to do , like she

10:17

lost her license , there was compensation

10:20

to the family , and then the hospital

10:23

where she worked implemented changes . You

10:25

had the extreme situation

10:27

of a prosecutor that

10:29

decided they were gonna criminalize that process

10:32

, which I think is completely in error

10:34

and blows the system up , because

10:36

the licensing system is

10:38

built upon recognition of

10:40

errors . We are not trying to create

10:42

a perfect situation where people

10:45

don't have a problem and problems

10:48

never occur . What you want to do , through

10:50

a regulatory system that allows

10:52

you to practice , is to create a system

10:55

where you can recognize an

10:57

error and you can correct

10:59

it , either by and we could talk

11:01

about this in a few minutes correcting

11:03

that error by maybe retraining the physician

11:05

, giving that health provider some education

11:08

, having them come under a

11:10

tutor like a professional practice

11:12

manager , or maybe you pull them

11:14

out of the practice for a while , you suspend their license

11:16

and don't let them practice . So the system

11:18

is designed to be self-correcting

11:20

. In the Arizona dentist

11:23

example , the system did not self-correct

11:25

, and that's the problem . So

11:30

let me , before we kind of get into that , though , in

11:32

order to understand why the system kind of had

11:34

these extreme results , you kind of need to understand

11:36

how the system works . So let

11:39

me sort of start there . So , like I said , every

11:41

person that generally

11:43

works in a health profession has to have a professional

11:45

license issued by a professional licensing

11:47

board , and

11:50

the way these , like these

11:52

physician , these health practitioners , are governed

11:54

is they

11:56

are governed when a complaint comes in . So something

11:58

happens that triggers

12:01

an investigation by that licensing

12:03

board , usually from a complaint by like

12:05

a patient that's been harmed , or from another

12:07

professional , like another doctor that practices

12:10

with a health professional that made an

12:12

error , or a hospital reports them or

12:14

a lawsuit was filed . And then there's a report

12:16

from something called the National Practitioner Data

12:18

Bank . So a complaint gets filed and

12:21

then a licensing board opens an investigation

12:23

. They gather facts , they

12:25

bring the health professional in

12:27

to provide testimony

12:29

or evidence and from

12:31

there they then undergo

12:34

a process to correct that

12:36

health professional . And that process

12:39

can involve a lot of different things . It

12:41

could involve just re-educating

12:44

the doctor or the physician or the health

12:46

professional , making them do some continuing education

12:49

. You could

12:51

limit their practice for a period of time

12:53

, you could put them under

12:55

a practice monitor for

12:58

a probationary period , you

13:00

could suspend their license for

13:02

a period of time or , in really bad

13:04

examples where there's really no

13:07

way that they can be rehabilitated , you

13:10

take away their license . And that is

13:12

very scary . That licensing

13:14

complaint process is very

13:16

scary for a health professional because

13:19

you just identified . They go to school

13:21

, they spend hundreds of thousands of dollars in

13:24

their undergraduate education , their graduate

13:26

education to get a degree

13:28

that they stick on the wall , and

13:30

now suddenly , because of some issue

13:33

that comes up sometimes rightfully or wrongfully

13:35

, they run the risk now of losing

13:37

their income and their ability to

13:39

provide for themselves and their family , and

13:42

so that is a very scary thing for a health

13:44

professional , but at the same time

13:46

, that's needed because you have the

13:49

medical seeking public

13:51

that wants to ensure that the people that they're

13:53

getting services from are safe to practice

13:55

. So the system , like I said , is

13:58

supposed to balance itself out .

13:59

But let me challenge you on that Now , and

14:02

I'm not saying that we should get rid of these . There's

14:04

a portion of me that agrees with everything you're just

14:06

saying . That is so we can have

14:09

a safe practice . There's another portion

14:11

of me that says come on , dave

14:14

, it's

14:16

practically a rubber stamp to

14:18

get the license , and then they

14:20

only discipline you after there's

14:22

a problem arises . Right , it's

14:25

only after there's a problem

14:27

that you get any sort of discipline . It

14:29

doesn't train them to be a good doctor

14:31

. There

14:35

, it is right , I mean . So is

14:38

it really helpful

14:40

to the public ?

14:43

It is , and so it's helpful to the public on a

14:45

couple of different levels . One is

14:47

let me take like a medical board

14:49

Generally . A medical board you

14:52

have to be , you know . You have to go

14:54

through all of your professional training . You have to go

14:56

through medical school and then you have to go do your residency

14:58

and then you have to get your specialization and

15:01

you have to pass your certification boards and

15:03

then you have to pass the licensing exam for

15:05

that particular , you know , to obtain your

15:07

medical license . So there's a lot of education

15:10

and on the job training that goes into that

15:12

. Then every

15:14

medical , every health professional that has a license

15:17

anywhere across the country , even lawyers , have to do

15:19

this . They have to have continuing

15:21

ongoing education every

15:24

year , every two years , to keep

15:26

their license , and so if they don't continue

15:28

their educational process then

15:30

they can run the risk of having their license

15:33

taken from them . And then the third way

15:35

that it's self-correcting is when

15:37

a complaint comes in and

15:39

a complaint is investigated and validated

15:42

. Then there could be some

15:44

sort of ramification , some sort

15:46

of what we call discipline against

15:49

that practitioner's professional license

15:51

. So there are those things

15:54

that are built into it . But

15:56

, frankly , for the licensed professional

15:58

going through a

16:01

complaint investigation is

16:03

a very , very stressful process

16:05

because on the extreme

16:07

they could lose their professional license and their way

16:09

of earning income . So it's very

16:12

eye-opening for a lot of my

16:14

clients , especially some of my

16:16

clients that you know . You sometimes

16:18

get a God complex when you're a health professional

16:20

and you sometimes think that you are error-proof

16:23

or bulletproof and it's a very , very humbling

16:25

process to

16:27

have yourself sort of put under

16:30

a microscope by your peers

16:32

through a complaint process and it's

16:34

very stressful for a lot of them and that in

16:36

and of itself that process is

16:38

sometimes all the education

16:41

a professional needs because they

16:43

are now very self-aware that their

16:45

future income opportunities could

16:47

be put at risk .

16:51

You know you help a lot of healthcare professionals

16:53

over the years . Do they ? Are

16:56

they repeat customers or

16:59

are they one and done ? Tell

17:02

me that they're one and done . Yeah , most of them

17:04

are one , and done .

17:05

Most of them are one and done and in fact , like in the health

17:08

area , let me just stay with like

17:10

a doctor , for instance . You sort of see

17:13

certain fat

17:16

patterns that develop as you

17:18

do this long enough . But

17:21

most of these are one and done . You

17:23

typically see a complaint arise when

17:26

there's a what we call an adverse

17:28

event . You know there's a . Somebody

17:31

makes a medical error , you know they . Something

17:33

happens during a surgical procedure . There's

17:35

a failure to diagnose , there's a medication

17:38

error , like the Tennessee example . Maybe

17:40

there's a failure to prescribe

17:43

medication . There's

17:45

a they don't get informed consent from the

17:47

patient . The patient doesn't understand the ramifications

17:50

of a procedure . Or you know , you get

17:52

the extreme situation where somebody drops

17:54

a screw down your mouth during a dental

17:56

procedure , like the Arizona example . So

17:58

you see certain fact patterns that happen

18:01

from from what I call practice

18:03

related issues . That's where the

18:05

majority of complaints come from . But you

18:07

also see complaints come about because

18:09

physicians deal with substance . There's

18:12

they might have something that affects their fitness

18:14

to practice , like they've had a medical . They've had

18:16

an injury , like a back injury , and they

18:18

start taking meds and pain meds and

18:20

so suddenly they become addicted to a pain medication

18:23

and so now they start dealing with substance abuse

18:25

issues you have . Sometimes

18:27

you'll see situations where there's

18:29

opiate

18:32

issues or sometimes you even get

18:34

inappropriate contact

18:37

with a patient , you would be surprised . There's

18:40

actually been a heightened awareness

18:42

, especially coming out of the Me Too movement , of

18:44

physicians that are inappropriately

18:46

touching or inappropriately

18:48

being involved with a patient

18:51

, which then obviously compromises

18:53

their medical judgment . If you're dating your patient

18:55

, but

18:59

some people just lose their sense of sense

19:01

of balance sometimes . So you

19:04

see a lot of these kind of similar

19:06

fact patterns when you deal with

19:08

health professionals . But on the most part

19:10

, medical complaints

19:13

that come in while there are , you know there are

19:15

high numbers sometimes most of them

19:17

do not result in a

19:20

taking of the physician's license , because the majority

19:23

of the types of complaints that come

19:25

in are things that can be dealt with

19:27

through rehabbing or

19:29

educating the health

19:31

professional so that they know not to

19:34

do that , or putting in place certain

19:36

guardrails like a mentor

19:38

or a practice monitor or making them

19:41

go through some sort of retraining

19:43

process . Nine times out of 10

19:45

solves those problems , so you don't get

19:47

the reoffender .

19:50

So let me ask you I'm

19:52

a healthcare professional , bob , so I became

19:54

a doctor and , of course , because

19:57

it's me , I am a fantastic

19:59

doctor . Okay , and

20:02

, anyways , I become a doctor

20:05

. I never want

20:07

to have to talk to you , I

20:10

never want to have to hire you . Okay

20:12

, what am

20:14

I going to do ? What am I going to ? What type

20:16

of ? How am I going to go about my practice

20:18

? That's going to make so

20:20

I don't need you , bro .

20:23

Well , I think the first thing is education

20:25

, making sure that you've put in best practices

20:28

and being on top of cutting edge

20:30

things . So , if you're in a field because

20:32

most people that work in a

20:34

particular health field are generally specialists

20:37

, at least in the medical area , in nursing

20:39

that's more of a generalized , obviously medical

20:42

field chiropractic , naturopathic

20:44

medicine , some

20:46

of these integrative kind of like non-medical

20:50

, what I would say , non-traditional medical practices

20:52

, what I would say is two things

20:55

education , making sure

20:57

you're staying on top of the new

20:59

trends , things like that , being involved in

21:01

the medical community , what you serve , and

21:04

then following up and trying to make

21:06

sure you've implemented best practices . Are

21:08

you taking care of yourself ? First of all

21:10

, are you doing the things to take care of yourself on

21:12

a personal level ? Are you ? Do you

21:14

have guardrails in place when you're in

21:17

your practice , whether it's a hospital , a doctor's

21:20

office , a private office ? Are

21:22

you taking care of your staff ? Do you have good systems

21:24

in place ? On the business side , are you

21:26

doing your medical billing correctly ? Are you

21:29

? Do you have a good office manager

21:31

, things like that ? So it's more like what am I doing

21:33

on the personal level to take care of myself ? What

21:35

am I doing in the professional world in my own professional

21:38

development . And then what do I have systems

21:40

in place around me ? If I run like my own practice

21:43

, or I have a team around me that makes sure

21:45

that my practice is firing

21:47

on all , on all pistons .

21:50

Oh right , I mean that makes some perfect sense to

21:52

me , because if I'm distracted

21:54

with all the business aspects of my practice

21:56

you know I have a bunch of HR concerns

21:59

and you know a doctor is typically a great

22:01

, great at medicine but they're not necessarily

22:04

trained in how to be a business manager

22:06

, how to run a business . So if I'm

22:08

dealing with all these business issues that

22:11

are not in my wheelhouse , I'm not

22:13

going to be able to focus

22:15

. And

22:17

on the healthcare I'm

22:19

providing , you know , and so

22:22

that makes perfect sense to me to eliminate the

22:24

distractions , focus

22:26

on what I do best .

22:27

Yeah , and I think also you have to look at there's

22:30

two different , probably two different people

22:32

that are two different people that are listening to us today

22:34

, that are gonna be listening to us . There are the

22:37

non-professionals and then there are the professionals

22:39

. So let me talk to the , let me speak

22:41

to like the general person

22:44

right now . If you're going to a doctor and

22:46

you have concerns about that doctor and

22:48

you feel like there's been a problem , sometimes

22:51

you can go talk to a lawyer , but the medical

22:53

licensing process for that

22:55

professional is there to protect you

22:57

. So if you're concerned and you think that

22:59

doctor did something wrong , first talk

23:02

to your medical provider

23:04

and raise concerns , ask questions

23:06

and be an active

23:09

consumer of your medical care , be

23:11

involved in making informed decisions and

23:13

then , if you feel like something happened , talk

23:15

to the physician , make sure you get your questions

23:18

answered . If you think that there was something wrong and

23:20

then if you don't feel like you're getting your questions answered , then

23:22

go seek redress , either

23:24

by hiring a lawyer and

23:26

honestly , most medical problems

23:29

never turn into a lawsuit and make you millions of dollars

23:31

. That's not the point . But if you want to

23:33

seek redress , you can also file

23:35

a complaint with that doctor or health professionals

23:37

licensing board . So there are ways that

23:39

you , as the medical seeking public , can take care of

23:41

yourself . Now , if you're the health professional

23:44

and you get one of these complaints

23:46

, the first thing I would always advise

23:48

you to do is talk to a . There's two

23:50

people you should call . Talk to a lawyer

23:52

, find a lawyer that practices in this area

23:54

and seek their advice . The second

23:56

thing you need to do is call your insurance broker

23:58

, cause most likely , you have some

24:01

sort of medical liability or

24:03

professional liability insurance that

24:05

you need to make your insurance

24:07

carrier aware of , and they may actually have a lawyer

24:09

available to you to talk to for free , or they may hire

24:12

a lawyer to help you through that process and

24:14

then talk to that lawyer about

24:17

the process and make sure you understand

24:19

what you're getting involved with

24:21

, and let your lawyer be your advocate

24:24

through that complaint licensing

24:26

process .

24:29

Yeah , I'm gonna challenge you a little

24:31

bit about that . I think you're 100% right

24:33

. But

24:38

there's been a lot of studies on

24:42

who gets sued by their patients . Okay

24:44

, who gets the complaints ? It's

24:48

the unlikeable doctor who

24:50

gets the complaints generally . It's

24:52

the guy who is arrogant

24:55

, who is boring , who

24:57

is mean , who's

24:59

not compassionate . They get the complaints

25:02

. It tends to end to be . The people

25:04

who complain tend to end up having a personal

25:06

difficulty with the professional

25:08

rather than necessarily practice

25:10

the difficulty generally speaking

25:13

. But if the doctor is humorous

25:15

, they find , or is

25:17

encouraging patients to talk

25:20

to them and ask questions , and they're

25:22

helpful and they're prompt

25:24

and they apologize

25:28

if something went wrong . Hey , I'm

25:30

sorry about that , that's not how this

25:33

was supposed to go . They

25:37

tend to have less complaints , less

25:41

likely to be sued . Do

25:43

you think this is wise counsel ?

25:45

Yeah , I think so . And here's what I think you're going

25:47

to find is the reason you have a complaint

25:50

filed against a health professional through their licensing

25:52

board . Nine times out of 10 is

25:54

because there was a failure to communicate

25:57

. The doctor or

25:59

the health professional did not see

26:03

this from the perspective of the patient and

26:05

they did not proactively

26:08

address the concerns of the patient

26:10

during that process . And that can happen for a lot of

26:12

reasons , like doctors get busy , they

26:14

have too big of a high patient load , like there's a bunch of reasons

26:17

why sometimes communication breaks down

26:19

. But nine times

26:21

out of 10 , most complaints come about because

26:24

there's a breakdown in the doctor-patient

26:27

relationship on the communication

26:29

level . And so if you are

26:31

a physician listening to this , making

26:33

sure that you are adequately talking

26:36

to your patient , don't talk medical to them , talk

26:38

regular , talk to them , you know . Talk

26:40

to them , not at them , and listen

26:43

to their concerns . And if you could do

26:45

that most of the time

26:47

, you will calm that patient down

26:49

, because that patient's just scared . They're

26:51

just scared that something's happening and they don't

26:53

understand what's going on in their own body and

26:56

they're looking to you , mr

26:58

Doctor , mrs Doctor , as the

27:00

person that's going to help them through this process

27:02

and so not only are you

27:05

a medical professional , but sometimes you have to be part

27:07

therapist also and you have to be

27:09

able to listen and empathize and be empathetic

27:11

to that patient . And if you are

27:13

, a lot of times

27:16

you can work through these situations

27:18

. And that happens with every licensed professional

27:20

. That's not just a doctor

27:22

, I mean . That even happens with lawyers , like clients

27:25

that get mad at us and our legal profession nine

27:28

times out of 10 , they get mad because we haven't communicated

27:30

to them adequately , help

27:32

them understand where they're coming from

27:35

, and so it all breaks down really to a relationship

27:37

Are you there to

27:39

take care of the people that are being

27:41

entrusted to your care ? And if you are

27:44

, then nine times out of 10 , you're going to float

27:46

through this very smoothly . And then , for

27:48

the one-off situations where something extreme

27:50

happens , recognize where

27:52

there's a problem , seek help

27:54

from a legal professional if you're

27:56

a doctor and the health professional and get

27:59

ahead of that process instead of

28:01

being the surgeon that does their own surgery

28:03

on themselves . That's where I see a lot of people

28:05

screw up is that they

28:07

try to do this themselves . They don't recognize , they're

28:09

not humbled through the process , they get defensive

28:12

, and that's

28:14

where the doctor or the health professional makes mistakes

28:17

through the investigative complaint

28:19

process . Because they don't recognize

28:21

their error , they don't seek legal help and they

28:23

try to do it themselves and they try to minimize

28:25

what actually happened , versus taking

28:27

it very seriously , recognizing their licenses

28:30

on the line even if it's a minor complaint that

28:32

their license could potentially be on the line

28:34

and being proactive

28:36

and working through an attorney to get ahead of

28:38

that process . And if they do that nine times

28:40

out of 10 , it's going to work out in their favor . I mean , work

28:43

out in their favor is a better

28:45

result versus them doing it themselves .

28:47

David , you

28:49

know I'm going to close the loop on a couple different

28:51

things here . The first thing is when

28:54

a medical

28:57

professional gets that

28:59

letter or that phone call from

29:01

the board and they say we're

29:03

concerned about your conduct with regard

29:06

to whatever patient .

29:09

When do they call so ?

29:12

um , they call a view .

29:13

I should say yeah , I would say the

29:15

sooner they can . There's two people they should

29:17

call at the beginning of this process the minute you

29:19

get contacted by your licensing

29:21

board and typically it's going to become a letter that

29:24

says , hey , a complaint's been filed against you

29:26

and we want you to provide a written response

29:28

. That's what starts the investigative

29:30

process , the investigative complaint process . The

29:33

minute you get contacted , there are two calls you should

29:35

make . You should call a lawyer first , somebody

29:38

that knows what they're doing and that's not your , not

29:40

your . You know your next door neighbor who

29:43

you got a referral from , but find

29:45

somebody who's qualified in this area . The second

29:47

person you should call is your insurance broker . Okay

29:49

, and then , if you work in a hospital setting , the third

29:51

person you should probably call is you need to report

29:53

it up your chain of command . If you work in a medical

29:56

office , medical practice , um

29:58

, but those are really the three calls you need to make . You

30:00

need to call your lawyer , you need to call your insurance broker and

30:02

you probably need to report it up your training command , depending on

30:04

the environment , the medical

30:06

setting and what you work . Um . Once

30:09

you get involved with a lawyer early

30:11

, then we are more able to

30:13

help you navigate that process sooner

30:15

and the investigative process looks

30:17

different based upon what particular licensing

30:20

board and in what particular state . But generally

30:22

here's what it looks like A written complaint comes

30:24

in um . That medical board

30:26

will sign as an investigator who will go and gather

30:29

facts , gather the medical records

30:31

, talk to the patient , talk to the

30:33

family members . If there's other witnesses

30:36

, they may talk to them . And then they will reach

30:38

out to the medical professional , the licensee

30:40

, and then seek their input and

30:42

typically they'll ask you to provide your records , your charts

30:45

, um provide a written response

30:47

and then that medical investigator

30:49

, that investigator , will gather all

30:52

of that information . They may want

30:54

to interview the medical professional , um , and

30:56

so obviously you would want to have a lawyer with you during that

30:58

and then eventually that that

31:00

once the investigation phase is completed

31:03

, then it will be considered by the

31:05

entire medical board or the medical licensing

31:07

agency , um , on how to

31:09

resolve that complaint . And at

31:11

least in Arizona , um , a

31:14

medical compli a a a a professional's

31:17

license , can only be disciplined if they engage

31:19

in a very specific term called unprofessional

31:22

conduct and they have to buy . An unprofessional

31:25

conduct has a bunch of different scenarios

31:27

by which something can rise to unprofessional conduct

31:29

. But what the medical board

31:32

or the licensing agency is looking at is is

31:34

what happened here ? Does that rise

31:37

to the level of unprofessional conduct ? It

31:39

doesn't fit within one of these enumerated

31:41

categories of unprofessional conduct . And if

31:43

it does , how are we going to resolve

31:45

that ? And so once

31:48

the medical board or the licensing agency considers

31:50

that , then they can dismiss it . They can

31:52

require the , the professional , to have

31:54

some education . They can , they can take

31:56

some what we call non-disciplinary steps which

31:58

don't doesn't affect the license of the professional

32:00

or um . They

32:02

can take some action against the license , put

32:04

them on probation , make them do some

32:07

ordered um continuing education

32:09

under under , you know , under a

32:11

uh , somebody who's

32:13

going to watch over their practice um

32:15

, have a practice monitor , suspend their

32:17

license and there's a whole bunch of things . Now you

32:19

also would have due process rights around all that

32:21

. Maybe you have an administrative hearing

32:24

, but ultimately the

32:26

medical agency has to figure out how to resolve

32:28

that complaint . And getting a lawyer

32:30

involved early to help you

32:32

navigate that process is how you do it . And that's

32:34

really what I do in my practice is helping

32:37

medical professionals or health professionals

32:39

work through that process

32:41

and hopefully educating

32:43

them about it and helping them hopefully get a positive

32:45

outcome on the back end .

32:47

That makes sense to me . The reason why

32:50

is if you're a medical professional

32:52

, you're trained in medicine . You're

32:54

not trained in advocacy and

32:57

lawyers . Jobs are to package

33:00

the story and why the story is supposed

33:02

to work out favorably of favor of client

33:04

or make the story in . You

33:06

know , show the story in the best light . That's

33:09

in the best light in favor

33:11

of our client . So that

33:13

makes perfect sense to me . We want you're

33:15

going to help people package

33:17

, package themselves more palatably

33:20

for the board . One

33:22

question I'm a consumer

33:25

and I

33:27

don't want to pick the doctor that

33:29

has 1000 complaints against them

33:31

. Is there a way

33:33

for me to know that doctor or medical

33:35

professional has complaints against ?

33:37

them ? Yes , and

33:40

it depends . It depends a lot on

33:42

the state in which you're looking for them . But

33:44

if you go to that local state

33:46

agency , licensing agency or state

33:49

regulatory board , go to their website . You

33:51

can typically type up and do a search

33:53

for the doctor you're looking for and

33:55

if that doctor has been disciplined

33:57

, had action actually taken against their

33:59

license . That's typically available

34:02

online for a period of time . Some states limit it to

34:04

like five years , some states go back 20 years . It

34:06

just depends upon which the state . It

34:08

will not tell you if a complaint's

34:11

been filed . It will only

34:13

typically show you information on whether

34:15

that physician's been disciplined . The other

34:17

place you can look at it and it's kind of a you

34:19

know what the default for a lot of people do is

34:21

. There's websites like health grades or

34:23

Yelp or Google reviews that

34:25

give at least information

34:28

, that give you a little bit more information about

34:30

that professional and then

34:32

also realize sometimes you're limited by your insurance

34:34

plan and sort of where you can go and

34:36

sometimes your insurance plan will also

34:39

provide a grade or a review

34:42

or a assessment

34:44

of the doctors in that health plan

34:46

. So there's a couple of different resources you can go to . You

34:48

can go to the state license , the state licensing board

34:50

. You can kind of look online and do your own research

34:53

or you can even look at kind of how that

34:55

person is graded by your insurance

34:57

carrier . So that's usually a good way to

34:59

get your questions answered . Or , you

35:01

know , maybe sometimes even seek a

35:04

second opinion from a physician If

35:06

you don't feel comfortable at the

35:08

end of meeting with that physician . For

35:10

, like , this is for non-emergency issues , but you

35:14

don't feel comfortable , you always can go talk to another

35:16

doctor . You are not locked into that particular doctor

35:18

. And so what I would tell the medical

35:20

public is be active

35:23

in your medical care , be educated

35:25

about your medical care , don't just be a passive

35:28

consumer . Be an active consumer of

35:30

your medical care . And if you do that nine times

35:32

out of 10 , you're going to be fine . Yeah

35:34

this is good advice , Dave .

35:36

Dave , thanks for coming on the show .

35:38

Thank you very much . I really appreciate you having me , and this is

35:40

a fun topic to talk about .

35:42

If I am a medical

35:44

professional , I need to get your services

35:47

. How do I contact you ?

35:48

You can contact me on my

35:50

website at wwwDavisMilescom

35:54

, or you can contact me through

35:56

my email address at dwilliamsdwilalimascom

36:01

. Talk to you in

36:04

a day .

36:04

Thanks . Thank you very much . Have a great day

36:06

. Thanks for listening to . Is

36:08

that Even Legal ? Remember

36:10

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36:12

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36:15

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