By R Carter
I’ve made a few posts on patients rights, Chronic Pain, the Loss of Civil Freedoms, Medical Fraud, a Patient Bill of Rights Parts 1, 2 and 3, but filing a complaint is the last resort on this subject. I continue to come back to it because it represents one of the few tools patients have for protecting their individual rights.
Most people are happy with their medical providers and that’s good news, but the opiate crisis has brought to the surface a number of problems which medical boards were unprepared for and a few doctors, fearful for their ability to continue practicing medicine, have taken advantage of, such as the public’s lack of knowledge and understanding of their rights. This has a greater impact on the poor, elderly and now chronic pain patients in an environment of opiate hysteria.
In the current anti-opiate environment, with so many doctors afraid of state medical boards and the DEA, some are willing to gamble with your life to protect their own interest. Those who won’t cross that line, simply quit treating chronic pain altogether.
Those willing to gamble quality of life for patients don’t represent the majority, but they are out there. And as more reports surface about patient abandonment, denial of care, forced tapers or termination of medication and other abuses, the State Medical Board of Ohio continues its proactive stance on early adoption of guidelines and regulations which attempt to strike a balance between physician and patient rights.
It’s important to stress that the role and job of a state medical board is not one of punishing doctors, but of protecting the public while providing clear practice guidelines for them. Both groups, physicians and patients have rights, so one definition of a boards role is to be an arbitrator of those rights. The ability of the public to file a complaint is the center piece of that arbitration process, but many patients fail to take such steps, believing that any effort to do so will result in the complaint going straight to a trash can.
Many physicians have refused to treat chronic pain because of a lack of clear practice guidelines in the face of stiff penalties for misinterpreted standards of care. For those who have continued treating chronic pain, some patient contracts have crossed lines, requiring patients to sign away their legal rights for counsel or representation as a condition to be seen and treated.
All patients should understand this, they can’t be compelled to sign away their rights for legal counsel as a condition for being treated for a medical problem, this is a protected right under federal and state law in all fifty states.
In my post “When to be Afraid of your Doctor – Part 1” I include elements from patient contracts I have seen which are at best confusing, and in some cases, clearly unethical, or in violation of existing state or federal regulation based on precedence if not violating an actual statute. Knowing how to spot such concerns is the first step to filing a complaint with a state medical board.
Medical boards don’t regulate physician behavior, only physician practice, so angry rants over unfair treatment won’t get you anywhere. Your best chance of getting action on a complaint is to review the physician practice guidelines, the responsibilities of the medical board and limit your complaint to those issues and actions specific to practice guidelines in your state. If there’s sufficient cause on a specific action taken by your physician, the medical board is obligated to investigate.
I admit that the difficulty in doing this is knowing how to interpret those practice guidelines and regulations. Even with a medical background I have trouble doing so. Still, there are many blogs and website where you can ask for guidance to get terms and conditions explained that will help you understand and of course the internet is a wealth of information on this and other concerns.
This except is from the website of the State Medical Board of Ohio and will help answer some questions.
Complaints and Investigations Key Steps
The State Medical Board of Ohio’s purpose is to protect the public. The Board has a responsibility to evaluate every complaint they receive.
The Medical Board is required by state law to maintain the confidentiality of all information related to Board investigations. For example, you may be the subject of the complaint. However, if you are not the subject of the complaint, you still may be contacted for information related to the investigation. Either way, the investigator cannot disclose your role to anyone, including you, during an open investigation. An exception is that if you are the subject of the complaint, the investigator may be required to acknowledge that fact to you in order to investigate.
Each complaint is appropriately triaged prior to being assigned to an investigator. Although certain standards are adhered to, each complaint and situation present a unique set of circumstances and is handled as such. Not all complaints result in an investigation or discipline.
Once a complaint is assigned to an investigator, it becomes an investigative case. We investigate using the complaint number assigned at intake.
Upon receipt of the complaint, the investigator may decide to gather preliminary information before contacting the Subject of Investigation (SOI). Such activities may include interviewing the complainant, reviewing an OARRS report or the subpoena of medical records. With the complainant’s permission, the complaint may be sent to the SOI for a response. If allegations pose a serious risk to the public, the complaint may be sent directly to the Enforcement section attorneys for review.
The investigator may contact the SOI by telephone to schedule an interview. Sometimes, the nature of the complaint requires an unscheduled office visit. Examples include allegations of a dirty office or allegations of drug/alcohol impairment.
Because the Board conducts thorough and just investigations, an average time for follow-up contacts is not easily determined. Factors which contribute to delays include working in coordination with other regulatory or law enforcement agencies or the unavailability of witnesses. For more information about timeframes, visit Case Management Timeline
Investigative Report and Review
When the investigator has gathered necessary information for the case, they will prepare a Report of Investigation (ROI). The ROI is reviewed and approved by the Investigator Supervisor. The report is then routed to the Board’s Secretary and Supervising Member for review. The Secretary and Supervising Member are responsible for supervising all Medical Board investigations, according to law.
Determination of Outcomes
The Secretary and Supervising Member determine the next steps of the process, which may include:
- closing the complaint
- subpoena medical records for review
- direct additional investigation
- request an Investigative Office Conference with the SOI
- direct the development of formal disciplinary action
If the investigation does not justify formal action, but does leave the Board with concerns, the Board may recommend remedial education or caution the SOI regarding problematic activities.
To check on the status of a complaint, please email: firstname.lastname@example.org.
This chart outlines the complaint process once a resident has filed.