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FL May Allow Providers to Avoid Past Mental-Health Conditions, Drug Issues on License Applications

George Indest HeadshotBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

Health care professionals ask patients about their medical histories every day for in treating them. But what happens when they are requested to divulge in their own history to the state as part of the licensing process? Before being licensed in the state of Florida, for example, health care providers are required to disclose if they have been treated for mental-health or substance-abuse disorders within in the past five years. However, this could be changing very soon.

Changes to Past Health Questions.

In December 2018, a committee of the Florida Board of Medicine gave preliminary approval to eliminate questions about past treatment of mental health and substance abuse from applications for medical licenses in Florida. Rather, applicants would be asked only whether they currently have any condition that impairs them from safely practicing.

Medical history questions are asked during the initial application for license, whether the applicant is a new physician or a physician from another state who is seeking a Florida license. This is true for most states. The new questions are designed to be more open-ended and lend themselves to subjective answers.

The proposal to change the initial application questions comes after several studies revealed an alarming suicide rate among physicians and medical students. According to a 2015 study published in the journal JAMA Psychiatry, between 300 and 400 physicians commit suicide each year.

Despite these numbers, the proposal still requires full board approval and faces opposition from some board members.

Click here to read one of my prior blogs about rising baker acts among college students in Florida.

Contact Health Law Attorneys Experienced in Representing Health Professionals and Providers.

The attorneys of The Health Law Firm provide legal representation to physicians, physician assistants, nurses, nurse practitioners, cardiologists, CRNAs, pain management doctors, dentists, pharmacists, psychologists and other health providers in Department of Health (DOH) investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations, Medicare investigations, Medicaid investigations and other types of investigations of health professionals and providers.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Sources:

Sexton, Christine. “Florida doctors may avoid revealing past mental-health and drug-abuse issues.” Orlando Sentinel. (January 16, 2019). Web.

“Change Seeks To Remove ‘Stigma’ For Doctors.” Health News Florida. (January 16, 2019). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

KeyWords: Legal representation Board of Medicine cases, Board of Medicine Representation, legal representation for physicians, legal representation for licensure issues, licensure defense lawyer, legal representation for licensure defense, legal representation for medical students, residents and fellows, legal representation for Board of Medicine hearings, legal representation for complaints against license, Medical Board Cases representation, legal representation for nurses, nurse representation, Board of Nursing Representation, Medical Board defense lawyer, Medical Board representation, Florida health law defense attorney, legal representation for U.S. Department of Health (DOH) investigations, employment law defense attorney, legal representation for employment issues, legal representation for health care professionals, reviews of The Health Law Firm, The Health Law Firm attorney reviews, health law defense attorney, mental health facility defense counsel, mental health professional defense attorney, psychologist defense counsel and legal representation, social worker legal counsel and mental health counselor defense attorney, legal representation for Credentials Committee of Board of Medicine

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2019 The Health Law Firm. All rights reserved.

The Most Common Cases The Health Law Firm Takes

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

One of the most common questions we get asked by doctors and lawyers alike, is about the types of cases our firm takes. They often mistake the practice of health law as medical malpractice defense. However, this is an incorrect assumption. Likewise, if we had a penny for every time we have heard “Yikes, an attorney! I hope I never need you,” we could close our doors and all retire.

As a general health law practice, we concentrate on both proactive and defensive legal issues and clients involved in the health care industry. To a certain extent our law firm does practically everything a physician, medical group, health facility or health care professional could need in the legal arena.

The types of cases we most commonly see are the following:

1. Sales, mergers and acquisitions of medical practices, health care clinics, and health facilities. We represent buyers, sellers and lenders at any stage of the process.

2. Contracts for medical and health care transactions. We prepare contracts, review contracts, negotiate contracts, help to terminate or break contracts, and we litigate contracts. We can be on either side of these transactions. Our litigation can take place in state court or federal court. We review and analyze quite a few employment contracts for medical residents and fellows going to new positions.

3. We research and prepare complex legal opinion letters on proposed health care transactions. The health care industry is the most regulated industry in the United States. There are complex layers of both federal and state laws and regulations as well as numerous federal and state agencies regulating it. Often, legal opinion letters are sought by purchasers and lenders for healthcare transactions for these reasons. We have several board certified health lawyers in our firm who have written dozens of these.

4. We represent health professionals and health facilities in Medicare audits, including fraud audits by the Zone Program Integrity Contractors (ZPICs) and by Recovery Audit Contractors (RACs). This includes representation in the appellate process, including requests for reconsideration, request for redetermination, and federal administrative law judge hearings. Preparation of the response to the audit request, completion of the audit questionnaire, response to the preliminary audit report (PAR), and defense of any repayments demanded, through administrative hearings before federal administrative law judges and appeals if necessary.

5. We represent health professionals and health facilities in Medicaid audits, including fraud audits by the zone program integrity contractors (ZPICs). This includes preparation of the initial response to the audit request, completion of the audit questionnaire, response to the preliminary audit report (PAR), and defense of any repayments demanded, through administrative hearings and appeals if necessary.

6. If there has been an action by the Centers for Medicare & Medicaid Services (CMS) to terminate the Medicare provider’s billing privileges, we aggressively represent them to have the decision reversed and have them reinstated. This includes filing requests for reconsideration and corrective action plans (CAPs). We have been very successful in obtaining relief for our clients.

7. We have represented a number of clinical investigators, primarily physicians, and defensive charges of research fraud, misconduct in science, manipulation of data, manipulating outcomes, in research investigations, and other similar proceedings brought by their institutions or and investigation review board. Whether it is at the initiation of such an investigation or in later hearings and appeals, we have navigated a number of principal investigators through these processes.

8. Our firm has represented a number of medical students, residents and fellow, including foreign medical graduates, in cases brought by the National Board of Medical Examiners (NBME), the United States Medical Licensing Examination (USMLE), and the Educational Commission for Foreign Medical Graduates (ECFMG) in cases where there is an allegation of “irregular behavior” and rules violations through the hearing process and in appeals as necessary.

9. We represent physicians and other health professionals in hospital medical staff peer review proceedings and hearings. Whether it’s the initial application for clinical privileges and medical staff membership or action being taken to revoke or limit clinical privileges, we have been involved representing physicians and other health professionals at all levels. We have also done similar work for physicians in actions initiated by HMOs, professional associations, certification bodies, and other organizations. This is an area where a physician truly needs a health lawyer experienced in this type of proceeding.
10. “Disruptive physician” defense is another area where a doctor really needs an attorney who knows what he or she is doing. When your hospital or medical staff is attempting to place the label on you “disruptive physician,” you are really in trouble. This is an area in which careful navigation is required to prevent actions that result in such a label. Other wise, the physician can be pigeon-holed for life, placed into disruptive physician programs requiring years, if not a lifetime, of close monitoring and can even have discipline commenced against his or her medical license. We can assist you in taking actions to avoid having this happen.

11. When you receive a Medicare, Department of Health and Human Services (HHS), or Office of the Inspector General (OIG) subpoena or civil investigative demand (CID), you know there is serious trouble for someone in the works. We help you to respond promptly and professionally and attempt to keep you from becoming the target of serious federal investigations.

12. We represent physicians, nurses, dentists, psychologists and other licensed health professionals in responding to Department of Health (DOH) letters of investigation. Many physicians, nurses, dentists and other licensed health professionals do not understand that when they receive a letter from the Department of Health complaints advising them that they are under investigation for a complaint that is been made against them, this is a very serious matter. There is nothing that is “routine” about this. This means that there is an investigation that has been opened against your license that could ultimately result in disciplinary action being taken against you. Any disciplinary action taken against you will be on your license forever. This is the time to obtain an attorney. This is not a time to attempt to represent yourself. You should not ever speak with the investigator or provide a statement to the investigator; this is something only your attorney should do and only if it is determined to be advisable considering the facts of the case. We have represented hundreds of licensed health professionals in such investigations and in subsequent disciplinary hearings.

13. We also represent health professionals and others who have been excluded from the Medicare program and placed on the Office of Inspector General (OIG) List of Excluded Individuals and Entities (LEIE). We have represented a number of healthcare professionals in completing and submitting applications to be removed from the LEIE and reinstated to the Medicare program.

14. We routinely counsel and represent physicians, dentists, psychologists, mental health counselors, and other health professionals in referrals to the Professionals Resource Network (PRN) for evaluation. We have found that often the health professional will not actually have any type of substance abuse problem or mental health issue. However, one referred for an evaluation to the PRN can wind up in a five year contract or even a lifetime contract for monitoring containing many mandatory requirements in order to continue practicing his/her profession and a lot of expenses associated with meeting such requirements.

15. We also routinely counsel and represent nurses and nurse practitioners (ARNPs), including certified registered nurse anesthetists (CRNAs) in similar referrals to the Intervention Project for Nurses (IPN). We have found that often the nurse will not actually have any type of substance abuse problem or mental health issue. However, one referred for an evaluation to the IPN can wind up in a five year contract or even a lifetime monitoring contract containing many mandatory requirements in order to continue practicing his/her profession and a lot of expenses associated with meeting such requirements.

16. We have been involved in a number of qui tam or whistle blower cases, either representing the whistle blower or representing an employer or institution that is being accused of wrongdoing. Whether this is pursuant to the Federal False Claims Act (FCA), a state false claims act or a private whistle blower act, we are experienced in investigating, prosecuting, defending, and litigating such cases in state or federal court.

17. Our firm represents physicians, pharmacists, health professionals and health facilities in administrative litigation against the Drug Enforcement Administration (DEA), the Food and Drug Administration (FDA), the Centers for Medicare and Medicaid Services (CMS), the Agency for Health Care Administration (AHCA) and the Department of Health, among other agencies. Whether the government agency is seeking to recover civil monetary penalties (CMP), attempting to recover large Medicare overpayments, seeking to revoke your DEA registration or seeking to discipline your medical license, we have experience in litigating such matters in these administrative tribunals. This can make the difference between a favorable outcome or a devastating outcome.

18. We represent Veterans Administration (VA) physicians, Army physicians, Navy physicians, Air Force physicians, and Indian Health Service physicians, in employment disputes, peer review investigations and hearings, clinical privileging investigations and hearings, and decisions to report to the National Practitioner Data Bank (NPDB).

19. Reporting a conviction for Driving under the influence (DUI) or some other criminal offense is required by most state licensing agencies. We are experienced in making such reports when required and in such a manner that a subsequent investigation and discipline on the professional license is often avoided.

20. Complex litigation involving health professionals is another area in which we routinely practice. Whether the matter involves a dispute between the shareholders of a medical clinic or practice, restraints on trade, allegations of false claims and fraud, the enforcement or avoidance of restrictive covenants (or covenants-not-to-compete), employment, pay and bonus disputes, ownership of practices or facilities, or any other of a number of different situations, we represent either side in state court or federal court.

21. Because of our experience in mental health law, we have come to represent individuals who have been incorrectly confined in mental health facilities in Florida because of allegations of impairment, drug abuse, mental health issues and other issues in which the person is initially though to be a threat to himself or to others. Both law enforcement authorities and medical personnel are being trained to take fewer chances with an individual acting unusual who may tend to hurt herself or someone else. They often tend to err to the side of ordering confinement under the Florida Mental Health Act (also known as the “Baker Act”). When this happens, the individual may be set for a long stay unless he or she has assistance in navigating the way out. We help doing this as quickly and expeditiously as possible.
22. We routinely representing physicians, pharmacists, nurses, dentists and other licensed health professionals in attempting to avoid or in disputing or in appealing adverse National Practitioner Data Bank (NPDB) Reports. There are only limited grounds for doing this so the professional needs to obtain counsel as early in the process as possible.

23. Any type of subpoena or search warrant from a government agency or law enforcement organization seeking your patient records can herald an investigation into false claims, over-prescribing, or other serious possible charges, criminal, civil or administrative. Our representation seeks to determine the reasons for this as early in the process as feasible and to protect your rights and limit your exposure as much as possible.

24. There are many, many other types of cases which we have experience with. To see some of these others, please visit our website.

As the business of health care grows, our law firm also grows. We are always seeking to expand our areas of practice within the health law field. Be sure to check back regularly for updates.

For more information on various health law topics and how The Health Law Firm can help you, visit our YouTube page to watch our video blogs.

Contact Experienced Health Law Attorneys.

The Health Law Firm routinely represents pharmacists, pharmacies, physicians, nurses and other health providers in Centers for Medicare and Medicaid Services (CMS) investigations, Medicare Audit defense, regulatory matters, licensing issues, litigation, inspections and audits involving the DEA, Department of Health (DOH) and other law enforcement agencies. Its attorneys include those who are board certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law is an attorney with The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Altamonte Springs, Florida 32714, Phone: (407) 331-6620.

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“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2019 The Health Law Firm. All rights reserved.

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Florida Department of Health and Law Enforcement Investigate School Providing Nurse Practitioner Courses

8 Indest-2008-5By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

A subpoena purportedly issued by the Clerk of Court for Seminole County, Florida, recently requested academic records on advanced registered nurse practitioner (ARNP) students, including preceptorship agreements for clinical courses they had taken. A follow-up inquiry revealed that the Florida Department of Health was behind the subpoena, seeking evidence concerning possible fraudulent practices involving the supervision of those clinicals.

Apparently South University, which has its main campus and headquarters located in Savannah, Georgia, but offers courses in Florida, had agreements with one or more physicians in the Orlando area to furnish training for nurse practitioner students within their medical practices. Under the terms of the agreement, the physician was required to provide a nurse practitioner to supervise the student taking the clinicals.

However, what is being investigated is the allegation that no nurse practitioners were actually used to supervise those clinicals and the students. Instead, it is apparently being alleged that the names of various licensed advanced registered nurse practitioners (ARNPs) were used without their knowledge and put down as the supervisors for those students’ clinicals. Supposedly at least 20 names of nurse practitioners have been fraudulently used in this manner. Apparently the names of the nurse practitioners were also fraudulently signed to attestations that the students had actually completed the hours of clinical training. Usually there were four quarters or rotations of clinicals required of each student, encompassing hundreds of hours of clinical time.

It is estimated that over 100 advanced registered nurse practitioner (ARNP) students went through this program and graduated. Based on their advanced degrees, they were licensed as advanced registered nurse practitioners (ARNPs) by the Florida Department of Health.

Will those unsupervised student clinical hours be disallowed?

The question is whether action will be taken by the Florida Department of Health, or another organization, to disallow those clinical nurse practitioner hours gained by students in this manner. If so, many who are currently licensed as nurse practitioners who went through this program may lose their licenses and be required to retake required clinical hours. Both the students and the college were apparently unaware of the fraudulent activity.

This case is reminiscent of the massage therapist cases rising in 2012.

This situation seems somewhat similar to the situation that over 180 Florida licensed massage therapists (LMTs) found themselves during 2012. Click here to read one of our prior blogs on this story.

In the case of the massage therapists, each of them had taken courses and graduated from a school in another state. However, when they moved to Florida they had to have the courses re-certified by a Florida approved college and take the additional required courses for Florida licensure. They went to a well known, reputable private college offering massage therapy courses. They paid their tuition and were provided documentation showing that their out of state credits had been transferred in. They were provided other documents by the college showing that they had completed all course requirements and met the standards for licensure. They received their Florida licenses based on this.

Later it was discovered that the registrar at that college had actually been stealing the tuition money paid by these massage therapists and not enrolling them in the college. She was falsifying college documents, including course completion certificates, diplomas, transcripts and other documents using the college’s official seal on them. To see a class action law suit filed discussing this scheme in greater detail, click here.

When the Florida Department of Health found out about this situation, it reacted in a “knee-jerk” fashion and did an emergency suspension of hundreds of massage therapist’s licenses, many of them with no advance notice to the massage therapists. To see a blog I wrote on this, click here.

Hundreds of massage therapist who could not afford to pay a lawyer to mount a legal defense wound up having their licenses revoked or felt compelled to voluntary relinquish their licenses. They lost their national certification in massage therapy because of this.

However, the massage therapists who challenged the revocation and demanded a formal administrative hearing on it, many of whom we represented, were successful in keeping their licenses, mainly because they were not at fault and did not know what the crooked registrar was doing.

Actions to take if you are a nurse practitioner notified of licensure action or that you are under investigation:

Following are the recommendations we would make to any potential client contacting us who has been notified that he or she may be under investigation by the Florida Department of Health or law enforcement authorities:

1. Do not talk to or make any statement, oral or written, to any investigator without first consulting with an experienced health law attorney.

2. Immediately obtain the services of an experienced health law attorney to represent you in the case.

3. Check with your professional liability insurance carrier for any professional liability insurance you had at the time or currently have to see if they will cover the matter. Your current policy may not cover it unless you had it when the events occurred. However, it might.

4. Do not respond to any subpoena for records for testimony until you have consulted with an experienced health law attorney. Even a current professional liability insurance policy should cover you in responding to a subpoena or if a deposition is sought.

5. Do not, under any circumstances, voluntarily relinquish your license, without retaining any experienced health law attorney familiar with this matter to represent you. Such a relinquishment may be the equivalent of a revocation and reported to national reporting bodies as such.

6. If charges arise and you are offered the right to a hearing, always elect a formal administration hearing at which you dispute the issues. Do not elect an informal hearing. In an informal hearing, you have to agree that the charges against you are true, in effect, admitting you are guilty. Do not make that common mistake.

If you desire to see information on emergency suspension orders and emergency restriction orders, click here.

 

Contact Health Law Attorneys Experienced with Department of Health (DOH) Investigations of Nurse Practitioners.

The attorneys of The Health Law Firm provide legal representation to nurses, nursing students and ARNPs in Department of Health (DOH) investigations, licensure defense representation, investigation representation, Department of Health investigations, Board of Nursing investigations , administrative hearings, emergency suspension orders, emergency restriction orders and other types of investigations of health professionals and providers.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

KeyWords: Legal representation for nurses, legal representation for nursing students, legal representation for ARNPs, legal representation for ARNP students, Licensure Defense Representation, Investigation Representation, Department of Health Investigations, Board of Nursing Investigations , Administrative Hearings, Emergency Suspension Orders, Emergency Restriction Orders, nurse attorney, legal representation for health care professionals, health law defense attorney, nursing student defense attorney, ARNP defense attorney, legal representation for licensure issues, legal representation for medical students, legal representation for investigations of health care professionals, DOH investigation defense attorney, The Health Law Firm, reviews of The Health Law Firm, The Health Law Firm attorney reviews

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2017 The Health Law Firm. All rights reserved.

 

 

Medical Students, Residents and Fellows Need to Properly Disclose Medical Disabilities in advance of problems

4 Indest-2009-3By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

We are often retained to provide legal representation to medical school students, residents and fellows who run into difficulties and have disputes with their medical schools or programs. This may be after they are required to repeat a year, terminated from the program, or have other adverse action taken against them. When this occurs and we investigate the details, occasionally we find that the individual we are representing has a medical history of mental health issues that may have caused or contributed to the problems they are facing.

In many situations, the troubles that are faced could have been avoided if the student or resident had disclosed their medical condition to the school, program, or institution, and requested reasonable accommodations. However, after the adverse action has been taken it is often (but not always) too late to do this.

Use the institution’s forms to report a medical condition or disability.

All major medical schools, universities, residency programs, and hospitals in the United States have offices or departments to receive reports of medical conditions and disabilities and to assist the student/resident in obtaining support, resources and reasonable accommodations to help the student/resident be successful. However, if the institution is never notified of the medical condition or disability and is never given the opportunity to provide reasonable accommodations, then the student/resident has failed to take advantage of an opportunity that exists which may have helped prevent the adverse action that was taken.

If you have a medical condition or disability of any kind, especially one such as depression, learning disability, bipolar disorder, anxiety disorder, ADHD, a disease or illness which may affect your performance, or other condition that classifies as an illness or disability, you should be sure that this is diagnosed by the appropriate physician. You must also have that physician formulate reasonable accommodations that your institution, program, school or hospital can take that would help you to accommodate your condition. You should then complete the forms that your institution uses to report this and request reasonable accommodations to help you.

Don’t fear stigma from reporting a medical condition or illness.

We most often find that our clients have failed to report a medical condition or illness and request reasonable accommodations out of a fear that their program, professors, attendings and colleagues will discriminate against them and see them in a lesser light. Actually, the opposite is true. If a medical student our resident is failing academically, is unable to pass exams, or does not appear to be able to handle clinical rotations, it is more likely that the institution will feel that the person does not have the capability or motivation to succeed. However, by disclosing the medical condition or disability, this helps to explain such matters.

 

Illegal to discriminate based on disability or illness.

There are a number of federal laws and often state laws which protect a student or resident who has a medical disability or illness against discrimination. Additionally, almost all major colleges, universities and institutions have policies and procedures in place which prevent this. However, if the resident or student has not disclosed the medical condition or disability to anyone, there can be no argument made that the person was discriminated against because of this. Therefore, disclosure and a request for reasonable accommodation may be a big benefit in challenging adverse actions.

 

Contact Experienced Health Law Attorneys Representing Medical Students, Residents and Fellows.

The Health Law Firm routinely represents medical students, residents and fellows who run into difficulties and have disputes with their medical schools or programs. We also represent other health providers in investigations, regulatory matters, licensing issues, litigation, inspections and audits involving the DEA, Department of Health (DOH) and other law enforcement agencies. Its attorneys include those who are board certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

 

About the Author: George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law is an attorney with The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Altamonte Springs, Florida 32714, Phone: (407) 331-6620.

KeyWords: Legal representation for medical students, legal representation for residents, legal representation for fellows, legal representation for disputes with medical programs and institutions, investigation by National Board of Medical Examiners (NBME), United States Medical Licensing Examination (USMLE), USMLE preparation course, USMLE hearings, USMLE appeals, foreign medical student defense lawyer, medical graduate defense attorney, defense lawyer for doctors, legal representation fro physicians, residents and intern legal representation, medical student attorney, medical resident lawyer, medical intern lawyer, civil proceeding, criminal proceeding, administrative proceeding, medical administrative hearings, administrative law, medical student legal defense counsel, medical resident lawyer, medical resident defense attorney, medical intern lawyer, medical intern attorney, accused of irregular behavior, The Health Law Firm reviews

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2017 The Health Law Firm. All rights reserved.

 

Accused of Irregular Behavior on the USMLE? Here’s What You Need to Know

4 Indest-2009-3By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

At The Health Law Firm, we frequently receive calls for consultations from medical students and medical school graduates who receive a letter from the National Board of Medical Examiners (NBME), concerning the United States Medical Licensing Examination (USMLE). The letter may accuse the student or medical resident of “Irregular Behavior” concerning one or more of the USMLE Step examinations. In many cases, the person receiving the letter is a graduate of a foreign medical schools who have applied through the Educational Commission for Foreign Medical Graduates (ECFMG).

Irregular behavior can consist of many different actions taken by the applicant, before, during or after taking a USMLE step exam. What you must know is that, in effect, you are being accused of cheating or a similar type of infraction.

Types of Irregular Behavior.

Examples of the types of conduct which we have seen before include:

– Attending a commercial USMLE preparation course that provides some of the actual examination questions.

– Soliciting information on the actual contents or actual questions on the examination.

– Using a smart phone during the examination.

– Talking with another person during the examination.

– Sharing information on the types of questions or cases that were on your examination with another person or on a blog over the internet.

– Leaving the test room and looking up answers in a text during the examination.

– Setting the building on fire during the examination so that you won’t have to complete the examination.

– Forging your Step Exam grade or a document containing it and providing it to your medical school or residency program.

These are just a few. For more examples, please see an article I wrote on this by clicking here.

Most Common Errors You Will Make When Accused of Irregular Behavior.

We have represented students accused of irregular behavior by consulting with them before and after USMLE or ECFMG hearings and on appealing the results. We have represented a number of examinees at the hearings held before the NBME at its headquarters in Philadelphia, Pennsylvania, and before the ECFMG, which hearings are also usually held in Philadelphia, Pennsylvania.

From our experience in such cases, the following are the most common errors made by the individual when accused by the USMLE or the ECFMG of irregular behavior:

1. Failure to retain the services of an attorney experienced with such cases immediately upon receipt of a letter from the NBME or ECFMG accusing you of irregular behavior. Take this as a formal charge accusing you of, in effect, cheating. THIS IS SERIOUS.

2. Telephoning, writing or e-mailing the NBME or ECFMG to explain “your side of the story.” Such a writing or conversation will be full of admissions that will help prove the case against you and you will not even understand this. (Please note that under U.S. law any statements you make, oral or written, can be used as evidence against you in any civil, criminal or administrative proceeding. This is not the case with statements that your attorney makes on your behalf.)

3. If you submit documents or statements to the NBME or ECFMG in support of your case, these will not be well-organized, well-labeled and in a form simple and easy to understand. In many instances, you will not even understand the legal issues you are facing or how to refute them.

4. You will fail to request or attend in person the hearing before the NBME or ECFMG Committee on Irregular Behavior or Committee on Individual Review (“The Committee”) in Philadelphia. You will mistakenly believe that a written statement and documents alone will carry the day and persuade them not to take adverse action against you.

5. You will fail to take an attorney experienced in such medical administrative hearings to represent you at The Committee hearing in Philadelphia.

6. You will not know how to properly present your evidence or present your own position to The Committee, if you do attend the hearing.

7. You will not know when or what kind of evidence (expert witness reports, statistical expert affidavits, affidavits of fact witnesses), you need to use to prove issues in your case before The Committee.

8. You will fail to understand and correctly respond to the questions that the many different Committee members (usually 12 or more) will ask you during the hearing.

9. You will fail to correctly follow all procedures in order to preserve your rights in the proceedings.

10. You will falsely believe that if you lose at The Committee hearing, it will be easy to win on appeal or somehow sue in court and prove you are right. This is almost never correct. You will have only one real chance at proving your case and this is at The Committee hearing in Philadelphia.

11. You will incorrectly believe that even if you are only suspended from taking the USMLE Step exams again for a short period of time, this will have no effect on your education or career. (Note: Your USMLE transcript will note this fact and this may prevent you from ever getting into a good residency program. See #1 above.)

Invest in Your Future Career.

You and your family have invested tens of thousands, if not hundreds of thousands of dollars, on your education so that you can become a physician. You have spent years of sacrifice and studying in order to become a physician. This is not the time to be cheap and to think that the cost of hiring an experienced legal counsel is too high. You could lose everything you and your family has invested in this. Do not be “penny wise and pound foolish.” You will need professional help if you are to get through this successfully. If you don’t care about these matters or you don’t believe this is a serious matter worthy of an investment for attorney’s fees, then go ahead and ignore this advice.

If you are not reading this until after you have lost the case and been found to have committed “irregular behavior” by the USMLE Committee on Irregular Behavior or by the ECFMG Committee,, I am sorry for you, but it is probably too late to be able to really do anything about it.

Contact Experienced Health Law Attorneys For Irregular Behavior or USMLE Issues Today.

The attorneys of The Health Law Firm provide legal representation to medical students, residents, interns and fellows in academic disputes, graduate medical education (GME) hearings, contract negotiations, license applications, board certification applications and hearings, credential hearings, and civil and administrative litigations.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

KeyWords: National Board of Medical Examiners (NBME), legal representation for medical students, legal representation for medical resident, Committee on Irregular Behavior (CIB) defense attorney, Committee for Individual Review (CIR) defense lawyer, legal representation for allegations of irregular behavior, United States Medical Licensing Examination (USMLE), Educational Commission for Foreign Medical Graduates (ECFMG) legal defense lawyer, USMLE defense attorney, legal representation for USMLE hearings, USMLE appeals defense attorney, health care defense lawyer, medical student attorney, medical resident lawyer, medical intern attorney, legal representation for civil proceeding, legal representation for criminal proceeding, legal representation for administrative proceeding, legal representation for medical administrative hearings, legal representation for administrative law, The Health Law Firm reviews, reviews of The Health Law Firm attorneys

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2017 The Health Law Firm. All rights reserved.

Rutgers University Faces Lawsuit Over Anesthesia Residency Program Head’s Alleged Sexual Harassment

4 Indest-2009-3By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On May 8, 2017, Rutgers University was hit with a lawsuit in New Jersey state court from former and current school employees. The suit alleges that the university failed to prevent, stop and remedy sexual harassment and retaliation by the director of its anesthesia residency program. Additionally, the suit also alleges that Rutgers “fostered a harassing and discriminatory atmosphere.”

What must be remembered is that residents, interns and fellows fill dual roles. They are employees as well as “students”or graduate medical education (GME) program participants. Therefore, they have the same rights as any other hospital or institution employee.

According to the plaintiffs, they reported their claims to the university in August 2016 and provided ample evidence. Rutgers then followed with an internal probe and issued reports that the allegations were erroneously found. In the report, Rutgers stated that Dr. Jean Daniel Eloy had not violated either the state’s law against discrimination or the university’s policies on sexual harassment.

The Alleged Misconduct.

The lawsuit was filed on behalf of current Rutgers University employee Melinda Ball and former employees Rebecca Scholl and Sam Nia. The alleged misconduct occurred when all three plaintiffs were residents in the program that was overseen by Dr. Eloy.

Melinda Ball and Rebecca Scholl claim Dr. Eloy repeatedly sexually harassed them, and retaliated against them because they snubbed his sexual advances, according to the complaint. Dr. Eloy allegedly retaliated against Scholl in various ways, including falsely stating in her semi-annual review that she was “disrespectful, lazy and unprofessional,” the complaint states. Dr. Eloy also allegedly retaliated against Sam Nia, because she attempted to protect Scholl from the sexual harassment and retaliation.

Ball, Scholl and Nia have accused Rutgers of “failing to conduct an adequate investigation into plaintiffs’ complaints of discrimination, harassment and retaliation; and failing to take appropriate disciplinary action against defendant’s supervisors, managers, agents and employees who discriminated and retaliated against plaintiffs and created a hostile work environment for them,” the complaint states.

To read the complaint filed April 27 in Essex County Superior Court in full, click here.

To read a blog on a similar case of harassment, click here.

Discrimination in Gme Programs More Common than You Think.

Unfortunately, from what our clients have told us, discrimination in different forms is not uncommon in many graduate medical education programs. Although it may be sexually based, as in this case, it may also be based upon an illness or medical condition, sexual persuasion race or national origin. It is illegal to discriminate based on these grounds or even the perception of these grounds when they do not actually exist and most institutions have written policies and standards that prohibit it. Discrimination and harassment can make a residency or other learning experience intolerable and lead to poor performance and failure.

Students, residents, interns and fellows may be reluctant to report incidents of discrimination or harassment because of fears of reprisal. However, you should always report it. You are doing no favors to your self, your peers or the program itself when you fail to report it.

Contact Experienced Health Law Attorneys Representing Medical Students, Residents and Fellows.

The Health Law Firm routinely represents medical students, residents and fellows who run into difficulties and have disputes with their medical schools or programs. We also represent other health providers in investigations, regulatory matters, licensing issues, litigation, inspections and audits involving the DEA, Department of Health (DOH) and other law enforcement agencies. Its attorneys include those who are board certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law is an attorney with The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Altamonte Springs, Florida 32714, Phone: (407) 331-6620.

KeyWords: Legal representation for medical students, legal representation for residents, legal representation for fellows, legal representation for disputes with medical programs and institutions, legal representation for discrimination, bullying and sexual harassment in the workplace attorneys, intentional infliction of emotional distress lawyers, academic review hearing, legal representation for physicians accused of wrongdoing, medical graduate defense attorney, defense lawyer for doctors, legal representation fro physicians, residents and intern legal representation, medical student attorney, medical resident lawyer, medical intern lawyer, civil proceeding, criminal proceeding, administrative proceeding, medical administrative hearings, administrative law, medical student legal defense counsel, medical resident lawyer, medical resident defense attorney, medical intern lawyer, medical intern attorney, The Health Law Firm reviews, reviews of The Health Law Firm attorneys

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2017 The Health Law Firm. All rights reserved.

Medical Students, Interns & Residents Beware: A Finding of “Irregular Behavior” Can Ruin Your Medical Career Before it Starts

4 Indest-2009-3By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

A medical student, intern or resident may receive a letter from the National Board of Medical Examiners (NBME), United States Medical Licensee Examination (USMLE) Secretariat advising them that they are suspected of “irregular behavior” on a Step examination. In the case of graduates of foreign medical schools, this will be a letter from the Educational Commission for Foreign Medical Graduates (ECFMG). Although “irregular behavior” is not the same thing as “cheating,” it is often thought of as the same by medical school officials and residency program directors.

A notice of irregular behavior may delay your entry into a residency program, your graduation from medical school and your potential job opportunities. Your examination scores will be held up while the matter is investigated until a Committee review or hearing can be held.

It is imperative that anyone accused of irregular behavior immediately consult with legal counsel experienced in such matters. At The Health Law Firm, we have represented a number of medical students, interns and residents in hearings on irregular behavior and we have consulted with many before on these matters.

Don’t Listen to Bad Advice.

The following are examples of erroneous advice we have heard was given to those accused of irregular behavior:

1. You shouldn’t have a lawyer represent you in such matters because this will make the Committee angry at you.

2. You don’t need a lawyer because you can just explain it yourself.

3. You just write a statement and explain it; the Committee will understand and find in your favor.

4. You do not need to request a hearing on it because if you submit documents, the Committee will review them, find in your favor and no hearing will be necessary.

5. If you request a hearing on the matter, you do not need to attend it in person.

6. If you request a hearing, an attorney is not allowed to represent you at the hearing.

7. You should not worry about the Committee finding against you because you can always appeal the finding or sue in court.

The above advice is wrong. The only advice you should listen to is the advice of an attorney who is experienced in handling matters of irregular behavior.

The Importance of Retaining Experienced Legal Defense.

The biggest problem faced by an individual accused of irregular behavior who does have a valid defense is to concisely and adequately explain the situation. Additionally, you must produce evidence that supports what you are saying.

Someone who is not trained in the legal profession and who is not familiar with such hearings will be unfamiliar with the process even though such hearings are not as formal as court hearings. Additionally, it is easy for a non-lawyer who is not familiar with the rules of the USMLE to fail to address those concerns and get side tracked on irrelevant matters.

Additionally, documents, statements, affidavits, expert witness reports and other documents presented to the Committee as evidence should be well organized, indexed, with a table of contents, pages numbered and summarized. This will better present an organized, easily understood defense. Sending in a few stray documents with no organization or explanation how the documents relate to the issues can be far less than effective.
Consequences of an Irregular Behavior Finding.

If a finding of irregular behavior is made against you, then this usually means that your best score is voided and you must retake it. The Committee may require you to wait a year or more to retake the examination. This can prevent you from obtaining or entering a residency program or it may delay you from graduating. Furthermore, the notation that you were found to have committed irregular behavior will be placed on your Step exam transcript. This will be reported out when your test scores are reported.

As indicated above, many medical decision makers view this as similar to cheating. It may disqualify you for many jobs or residency programs that you would otherwise be considered for.

If the time and money you have spent on your medical career is valued by you, you will act promptly to retain legal counsel experienced in USMLE hearings and procedures to represent you. You wouldn’t perform surgery on yourself. You shouldn’t attempt to represent yourself in such legal matters.

The takeaway message is that retaining an attorney to represent you against irregular behavior allegations could be the difference between a clear record and a mark that will follow you for the rest of your career. Don’t risk jeopardizing your future as a healthcare practitioner. Consult with an attorney as soon as you receive notice of allegations against you regarding irregular behavior.

To learn more on the repercussions of findings of irregular behavior, click here to read one of my prior blogs.

Contact Health Law Attorneys Experienced in Matters of Irregular Behavior Today.

The attorneys of The Health Law Firm provide legal representation to medical students, residents, interns and fellows in irregular behavior allegations, USMLE issues, academic disputes, graduate medical education (GME) hearings, contract negotiations, license applications, board certification applications and hearings, credential hearings, and civil and administrative litigations.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

KeyWords: Legal representation for allegations of irregular behavior, legal representation for USMLE investigations, National Board of Medical Examiners (NBME), irregular behavior defense attorney, legal representation for medical students, legal representation for medical residents, United States Medical Licensing Examination (USMLE), Educational Commission for Foreign Medical Graduates (ECFMG), legal representation for USMLE hearings , legal counsel for USMLE appeals, health law defense attorney, ECFMG defense counsel, ECFMG legal representation, ECFMG hearing attorney, medical student attorney, medical resident lawyer, medical intern attorney, legal representation for civil proceeding, legal representation for criminal proceeding, legal representation for administrative proceeding, medical administrative hearings defense attorney, The Health Law Firm, reviews of The Health Law Firm attorneys, The Health Law Firm reviews, USMLE Committee for Individualized Review (CIR) hearing attorney, ECFMG Committee for Individualized Review (CIR) hearing lawyer

“The Health Law Firm” is a registered fictitious business name of The Health Law Firm, P.A., and Florida professional service corporation, since 1999, and is also a registered service mark. Copyright © 2017 The Health Law Firm. All rights reserved.

Florida Department of Health and Law Enforcement Investigate School Providing Nurse Practitioner Courses

8 Indest-2008-5By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

A subpoena purportedly issued by the Clerk of Court for Seminole County, Florida, recently requested academic records on advanced registered nurse practitioner (ARNP) students, including preceptorship agreements for clinical courses they had taken. A follow-up inquiry revealed that the Florida Department of Health was behind the subpoena, seeking evidence concerning possible fraudulent practices involving the supervision of those clinicals.

Apparently South University, which has its main campus and headquarters located in Savannah, Georgia, but offers courses in Florida, had agreements with one or more physicians in the Orlando area to furnish training for nurse practitioner students within their medical practices. Under the terms of the agreement, the physician was required to provide a nurse practitioner to supervise the student taking the clinicals.

However, what is being investigated is the allegation that no nurse practitioners were actually used to supervise those clinicals and the students. Instead, it is apparently being alleged that the names of various licensed advanced registered nurse practitioners (ARNPs) were used without their knowledge and put down as the supervisors for those students’ clinicals. Supposedly at least 20 names of nurse practitioners have been fraudulently used in this manner. Apparently the names of the nurse practitioners were also fraudulently signed to attestations that the students had actually completed the hours of clinical training. Usually there were four quarters or rotations of clinicals required of each student, encompassing hundreds of hours of clinical time.

It is estimated that over 100 advanced registered nurse practitioner (ARNP) students went through this program and graduated. Based on their advanced degrees, they were licensed as advanced registered nurse practitioners (ARNPs) by the Florida Department of Health.

Will those unsupervised student clinical hours be disallowed?

The question is whether action will be taken by the Florida Department of Health, or another organization, to disallow those clinical nurse practitioner hours gained by students in this manner. If so, many who are currently licensed as nurse practitioners who went through this program may lose their licenses and be required to retake required clinical hours. Both the students and the college were apparently unaware of the fraudulent activity.

This case is reminiscent of the massage therapist cases rising in 2012.

This situation seems somewhat similar to the situation that over 180 Florida licensed massage therapists (LMTs) found themselves during 2012. Click here to read one of our prior blogs on this story.

In the case of the massage therapists, each of them had taken courses and graduated from a school in another state. However, when they moved to Florida they had to have the courses re-certified by a Florida approved college and take the additional required courses for Florida licensure. They went to a well known, reputable private college offering massage therapy courses. They paid their tuition and were provided documentation showing that their out of state credits had been transferred in. They were provided other documents by the college showing that they had completed all course requirements and met the standards for licensure. They received their Florida licenses based on this.

Later it was discovered that the registrar at that college had actually been stealing the tuition money paid by these massage therapists and not enrolling them in the college. She was falsifying college documents, including course completion certificates, diplomas, transcripts and other documents using the college’s official seal on them. To see a class action law suit filed discussing this scheme in greater detail, click here.

When the Florida Department of Health found out about this situation, it reacted in a “knee-jerk” fashion and did an emergency suspension of hundreds of massage therapist’s licenses, many of them with no advance notice to the massage therapists. To see a blog I wrote on this, click here.

Hundreds of massage therapist who could not afford to pay a lawyer to mount a legal defense wound up having their licenses revoked or felt compelled to voluntary relinquish their licenses. They lost their national certification in massage therapy because of this.

However, the massage therapists who challenged the revocation and demanded a formal administrative hearing on it, many of whom we represented, were successful in keeping their licenses, mainly because they were not at fault and did not know what the crooked registrar was doing.

Actions to take if you are a nurse practitioner notified of licensure action or that you are under investigation:

Following are the recommendations we would make to any potential client contacting us who has been notified that he or she may be under investigation by the Florida Department of Health or law enforcement authorities:

1. Do not talk to or make any statement, oral or written, to any investigator without first consulting with an experienced health law attorney.

2. Immediately obtain the services of an experienced health law attorney to represent you in the case.

3. Check with your professional liability insurance carrier for any professional liability insurance you had at the time or currently have to see if they will cover the matter. Your current policy may not cover it unless you had it when the events occurred. However, it might.

4. Do not respond to any subpoena for records for testimony until you have consulted with an experienced health law attorney. Even a current professional liability insurance policy should cover you in responding to a subpoena or if a deposition is sought.

5. Do not, under any circumstances, voluntarily relinquish your license, without retaining any experienced health law attorney familiar with this matter to represent you. Such a relinquishment may be the equivalent of a revocation and reported to national reporting bodies as such.

6. If charges arise and you are offered the right to a hearing, always elect a formal administration hearing at which you dispute the issues. Do not elect an informal hearing. In an informal hearing, you have to agree that the charges against you are true, in effect, admitting you are guilty. Do not make that common mistake.

If you desire to see information on emergency suspension orders and emergency restriction orders, click here.

 

Contact Health Law Attorneys Experienced with Department of Health (DOH) Investigations of Nurse Practitioners.

The attorneys of The Health Law Firm provide legal representation to nurses, nursing students and ARNPs in Department of Health (DOH) investigations, licensure defense representation, investigation representation, Department of Health investigations, Board of Nursing investigations , administrative hearings, emergency suspension orders, emergency restriction orders and other types of investigations of health professionals and providers.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

KeyWords: Legal representation for nurses, legal representation for nursing students, legal representation for ARNPs, legal representation for ARNP students, Licensure Defense Representation, Investigation Representation, Department of Health Investigations, Board of Nursing Investigations , Administrative Hearings, Emergency Suspension Orders, Emergency Restriction Orders, nurse attorney, legal representation for health care professionals, health law defense attorney, nursing student defense attorney, ARNP defense attorney, legal representation for licensure issues, legal representation for medical students, legal representation for investigations of health care professionals, DOH investigation defense attorney, The Health Law Firm, reviews of The Health Law Firm, The Health Law Firm attorney reviews

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2017 The Health Law Firm. All rights reserved.

 

 

Medical Students, Residents and Fellows Need to Properly Disclose Medical Disabilities in advance of problems

4 Indest-2009-3By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

We are often retained to provide legal representation to medical school students, residents and fellows who run into difficulties and have disputes with their medical schools or programs. This may be after they are required to repeat a year, terminated from the program, or have other adverse action taken against them. When this occurs and we investigate the details, occasionally we find that the individual we are representing has a medical history of mental health issues that may have caused or contributed to the problems they are facing.

In many situations, the troubles that are faced could have been avoided if the student or resident had disclosed their medical condition to the school, program, or institution, and requested reasonable accommodations. However, after the adverse action has been taken it is often (but not always) too late to do this.

Use the institution’s forms to report a medical condition or disability.

All major medical schools, universities, residency programs, and hospitals in the United States have offices or departments to receive reports of medical conditions and disabilities and to assist the student/resident in obtaining support, resources and reasonable accommodations to help the student/resident be successful. However, if the institution is never notified of the medical condition or disability and is never given the opportunity to provide reasonable accommodations, then the student/resident has failed to take advantage of an opportunity that exists which may have helped prevent the adverse action that was taken.

If you have a medical condition or disability of any kind, especially one such as depression, learning disability, bipolar disorder, anxiety disorder, ADHD, a disease or illness which may affect your performance, or other condition that classifies as an illness or disability, you should be sure that this is diagnosed by the appropriate physician. You must also have that physician formulate reasonable accommodations that your institution, program, school or hospital can take that would help you to accommodate your condition. You should then complete the forms that your institution uses to report this and request reasonable accommodations to help you.

Don’t fear stigma from reporting a medical condition or illness.

We most often find that our clients have failed to report a medical condition or illness and request reasonable accommodations out of a fear that their program, professors, attendings and colleagues will discriminate against them and see them in a lesser light. Actually, the opposite is true. If a medical student our resident is failing academically, is unable to pass exams, or does not appear to be able to handle clinical rotations, it is more likely that the institution will feel that the person does not have the capability or motivation to succeed. However, by disclosing the medical condition or disability, this helps to explain such matters.

Illegal to discriminate based on disability or illness.

There are a number of federal laws and often state laws which protect a student or resident who has a medical disability or illness against discrimination. Additionally, almost all major colleges, universities and institutions have policies and procedures in place which prevent this. However, if the resident or student has not disclosed the medical condition or disability to anyone, there can be no argument made that the person was discriminated against because of this. Therefore, disclosure and a request for reasonable accommodation may be a big benefit in challenging adverse actions.

Contact Experienced Health Law Attorneys Representing Medical Students, Residents and Fellows.

The Health Law Firm routinely represents medical students, residents and fellows who run into difficulties and have disputes with their medical schools or programs. We also represent other health providers in investigations, regulatory matters, licensing issues, litigation, inspections and audits involving the DEA, Department of Health (DOH) and other law enforcement agencies. Its attorneys include those who are board certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law is an attorney with The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Altamonte Springs, Florida 32714, Phone: (407) 331-6620.

KeyWords: Legal representation for medical students, legal representation for residents, legal representation for fellows, legal representation for disputes with medical programs and institutions, investigation by National Board of Medical Examiners (NBME), United States Medical Licensing Examination (USMLE), USMLE preparation course, USMLE hearings, USMLE appeals, foreign medical student defense lawyer, medical graduate defense attorney, defense lawyer for doctors, legal representation fro physicians, residents and intern legal representation, medical student attorney, medical resident lawyer, medical intern lawyer, civil proceeding, criminal proceeding, administrative proceeding, medical administrative hearings, administrative law, medical student legal defense counsel, medical resident lawyer, medical resident defense attorney, medical intern lawyer, medical intern attorney, accused of irregular behavior, The Health Law Firm reviews

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2017 The Health Law Firm. All rights reserved.

Medical Students, Interns & Residents Beware: A Finding of “Irregular Behavior” Can Ruin Your Medical Career Before it Starts

4 Indest-2009-3By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

A medical student, intern or resident may receive a letter from the National Board of Medical Examiners (NBME), United States Medical Licensee Examination (USMLE) Secretariat advising them that they are suspected of “irregular behavior” on a Step examination. In the case of graduates of foreign medical schools, this will be a letter from the Educational Commission for Foreign Medical Graduates (ECFMG). Although “irregular behavior” is not the same thing as “cheating,” it is often thought of as the same by medical school officials and residency program directors.

A notice of irregular behavior may delay your entry into a residency program, your graduation from medical school and your potential job opportunities. Your examination scores will be held up while the matter is investigated until a Committee review or hearing can be held.

It is imperative that anyone accused of irregular behavior immediately consult with legal counsel experienced in such matters. At The Health Law Firm, we have represented a number of medical students, interns and residents in hearings on irregular behavior and we have consulted with many before on these matters.

Don’t Listen to Bad Advice.

The following are examples of erroneous advice we have heard was given to those accused of irregular behavior:

1. You shouldn’t have a lawyer represent you in such matters because this will make the Committee angry at you.

2. You don’t need a lawyer because you can just explain it yourself.

3. You just write a statement and explain it; the Committee will understand and find in your favor.

4. You do not need to request a hearing on it because if you submit documents, the Committee will review them, find in your favor and no hearing will be necessary.

5. If you request a hearing on the matter, you do not need to attend it in person.

6. If you request a hearing, an attorney is not allowed to represent you at the hearing.

7. You should not worry about the Committee finding against you because you can always appeal the finding or sue in court.

The above advice is wrong. The only advice you should listen to is the advice of an attorney who is experienced in handling matters of irregular behavior.

The Importance of Retaining Experienced Legal Defense.

The biggest problem faced by an individual accused of irregular behavior who does have a valid defense is to concisely and adequately explain the situation. Additionally, you must produce evidence that supports what you are saying.

Someone who is not trained in the legal profession and who is not familiar with such hearings will be unfamiliar with the process even though such hearings are not as formal as court hearings. Additionally, it is easy for a non-lawyer who is not familiar with the rules of the USMLE to fail to address those concerns and get side tracked on irrelevant matters.

Additionally, documents, statements, affidavits, expert witness reports and other documents presented to the Committee as evidence should be well organized, indexed, with a table of contents, pages numbered and summarized. This will better present an organized, easily understood defense. Sending in a few stray documents with no organization or explanation how the documents relate to the issues can be far less than effective.
Consequences of an Irregular Behavior Finding.

If a finding of irregular behavior is made against you, then this usually means that your best score is voided and you must retake it. The Committee may require you to wait a year or more to retake the examination. This can prevent you from obtaining or entering a residency program or it may delay you from graduating. Furthermore, the notation that you were found to have committed irregular behavior will be placed on your Step exam transcript. This will be reported out when your test scores are reported.

As indicated above, many medical decision makers view this as similar to cheating. It may disqualify you for many jobs or residency programs that you would otherwise be considered for.

If the time and money you have spent on your medical career is valued by you, you will act promptly to retain legal counsel experienced in USMLE hearings and procedures to represent you. You wouldn’t perform surgery on yourself. You shouldn’t attempt to represent yourself in such legal matters.

The takeaway message is that retaining an attorney to represent you against irregular behavior allegations could be the difference between a clear record and a mark that will follow you for the rest of your career. Don’t risk jeopardizing your future as a healthcare practitioner. Consult with an attorney as soon as you receive notice of allegations against you regarding irregular behavior.

To learn more on the repercussions of findings of irregular behavior, click here to read one of my prior blogs.

Contact Health Law Attorneys Experienced in Matters of Irregular Behavior Today.

The attorneys of The Health Law Firm provide legal representation to medical students, residents, interns and fellows in irregular behavior allegations, USMLE issues, academic disputes, graduate medical education (GME) hearings, contract negotiations, license applications, board certification applications and hearings, credential hearings, and civil and administrative litigations.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

KeyWords: Legal representation for allegations of irregular behavior, legal representation for USMLE investigations, National Board of Medical Examiners (NBME), irregular behavior defense attorney, legal representation for medical students, legal representation for medical residents, United States Medical Licensing Examination (USMLE), Educational Commission for Foreign Medical Graduates (ECFMG), legal representation for USMLE hearings , legal counsel for USMLE appeals, health law defense attorney, ECFMG defense counsel, ECFMG legal representation, ECFMG hearing attorney, medical student attorney, medical resident lawyer, medical intern attorney, legal representation for civil proceeding, legal representation for criminal proceeding, legal representation for administrative proceeding, medical administrative hearings defense attorney, The Health Law Firm, reviews of The Health Law Firm attorneys, The Health Law Firm reviews, USMLE Committee for Individualized Review (CIR) hearing attorney, ECFMG Committee for Individualized Review (CIR) hearing lawyer

“The Health Law Firm” is a registered fictitious business name of The Health Law Firm, P.A., and Florida professional service corporation, since 1999, and is also a registered service mark. Copyright © 2017 The Health Law Firm. All rights reserved.

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