Stipulated Orders from the Oregon Medical Board: Lesson Learned

If you are involved in the disciplinary process with a state licensing board, particularly the Oregon Medical Board, be forewarned. It is important for you to understand the risks associated with signing a proposed stipulated order without consulting with a lawyer experienced in this area. Any Order that you sign that essentially “settles” the case between you and the Board may have consequences that are severe and amount to a defacto revocation of your license. If your national licensing board requires its members to carry an “unrestricted license to practice,” any limitation on that license may result in a “withdrawal” of your board certification. Without a board certification, you will likely not be accepted on insurance panels or a hospital medical staff until the restriction is lifted. Without panel membership, you essentially become unemployable. As an example, I once represented a family medicine physician who admittedly had a substance abuse problem. He was reported for suspected abuse and an investigation commenced. He was given the option of signing up with the Health Professional Service Program (HPSP), which is a monitoring program that works with the OMB. He accepted, and a public order was entered that required, as part of his settlement, that he continue participation in the HPSP. Seems fair enough, right? Not so. This physician came to me after he signed the agreement because the American Board of Family Medicine determined that the contract he signed with the HPSP, which was mentioned in the public order, contained a section that states the enrollee would not prescribe controlled substances to friends or family. Unfortunately, the ABFM withdrew his board certification because of this clause. We appealed, arguing (among other things) the OMB states in their literature that this practice is not recommended and, further, they have pursued discipline for this behavior. Therefore, it was no more onerous than what is required of physicians without an HPSP agreement. The ABFM denied the appeal, nonetheless. The physician who did the right thing, admitted wrongdoing and sought help for his disease, was licensed but unemployable. Placing a person who is already battling addiction into this situation is a recipe for disaster and failure. The law failed this physician and his patients, as did the Board and his colleagues on the ABFM. But, the story serves as a reminder for me every day I see a proposed stipulated order. The devil is in the details.