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EMPLOYERS & ADJUSTERS MAY REQUEST INVESTIGATION INTO UNPROFESSIONAL CONDUCT BY THE GEORGIA COMPOSITE MEDICAL BOARD

January 18, 2017

Contact Dr. Nudelman if you need help evaluating the merit of such a complaint, or assistance in filing.

 

When John S. Antalis, MD, DABFM (Chairperson) and Bob Jeffery, MBA (Executive Director) spoke at the 2016 Southeastern Medical Legal Symposium this past October, at a session entitled “The Georgia State Board of Medicine – An Ethical Alternative Recourse for Fraud and Other Unprofessional Conduct” – they assured attendees that any complaint of Unprofessional Conduct of a Georgia physician filed with the Medical Board is taken seriously and will be investigated thoroughly. It is something to consider.

 

When employers, insurance adjusters, or their attorneys see the same doctors repeatedly engaging in blatantly unprofessional practices (e.g., performing unnecessary surgeries or medical treatments, providing controlled substances to patients without proper indications, or perhaps fraudulently billing), they often believe there is nothing they can do. However, they may actually have a useful and ethical alternative at their disposal. According to the Medical Practice Act, unprofessional conduct includes "any departure from or failure to conform to the minimal standards of acceptable and prevailing medical practice and shall also include, but not be limited to the prescribing or use of drugs, treatment or diagnostic procedures which are detrimental to the patient as determined by the minimal standards of acceptable medical care."

 

In general, examples of unprofessional conduct include, but are not limited to, physical abuse of a patient, inadequate record keeping, not recognizing or acting upon common symptoms, prescribing drugs in excessive amounts or without legitimate reason, personal impairment (mental or physical) that hinders safely practicing within the scope of one's license or certificate, performing duties beyond the scope of one's license, and dishonesty. The Investigations and Discipline Rules of the Georgia Medical Board, (Rule 360-3.02 and 360-3-.04), also provide additional examples of unprofessional conduct for which a licensee may be disciplined:

 

  • Practicing below minimum standards

  • Disruptive behavior

  • Malpractice settlement or award

  • Fee dispute / billing practices

  • Poor communication with patients

  • Insurance fraud

  • Poor record keeping

  • Impairment (drug/alcohol/cognitive due to medical or psychiatric condition)

  • Boundary violations

  • Inappropriate prescribing

 

Submission of false or misleading information by the physician to the Board of the Physician Profile may also constitute a violation of Rule 360-28-.07. Submission of False or Misleading Information.

 

The Board is authorized to take a variety of actions, including these most common actions:

 

  • Letter of concern (non-disciplinary)

  • Private reprimand (often with requirements such as additional specific CME)

  • Private consent order with conditions such as monitoring, drug/alcohol rehabilitation, etc.

  • Public consent order, often with a reprimand, practice restrictions, fines, etc.

  • Suspension and/or revocation of license

 

The Georgia Composite Medical Board ("Board") is authorized to deny, revoke, suspend, fine, reprimand or otherwise limit the license of a physician or physician assistant for all the grounds set forth in O.C.G.A. § 43-34-8 and to deny, revoke, suspend, fine, reprimand, or otherwise limit the license of a physician. In addition, the Board is authorized to terminate the approval of a physician's assistant and to revoke the license of a physician's assistant.

 

According to Rule 360-3-.02, unprofessional conduct includes prescribing controlled substances for a known or suspected habitual drug abuser or other substance abuser, in the absence of substantial medical justification.

 

Filing a complaint with The Georgia Composite Medical Board is, however, serious business and only legitimate digressions should be considered. For a free consultation to see if your complaint has merit, or for assistance in filing, please contact Mitchell S. Nudelman, MD, JD, FCLM.

 

 

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