What happens when a patient complaint turns into a full-blown medical board investigation? In this episode, hosts Brad and Michael, and partner Jay Reyero, share the story of a plastic surgeon whose response to a patient demanding a refund nearly jeopardized his practice. Learn what to do when you receive a patient complaint, how to respond to a letter from the medical board, and steps you can take to protect your practice.
Listen to the full episode using the player below, or by visiting one of the links below. Contact ByrdAdatto if you have any questions or would like to learn more.
Transcript
*The below transcript has been edited for readability.
00:00:01 Introduction: Welcome to Legal 123s with ByrdAdatto. Legal issues simplified through real client stories and real-world experiences, creating simplicity in 3, 2, 1.
00:00:13 Brad: Well, welcome back to another episode of the Legal 123s with ByrdAdatto. I am your host, Brad Adatto, my co-host, Michael Byrd.
00:00:20 Michael: As business attorneys for healthcare practices, we meet a lot of interesting people and learn their amazing stories. This season’s theme is Asking for a Friend. We’ll tackle questions that practices are sometimes afraid to ask.
00:00:33 Brad: And audience, understand this is a safe place. Everyone knows it’s not you asking the question, only, but only if you say the magic words, “I’m asking for a friend.”
00:00:45 Michael: Okay, Brad, before we get started, we have another special guest this week. For the first and maybe his only time this season, we welcome back our series regular and partner, Jay Reyero.
00:00:56 Jay: Hey, thanks. Wait, wait, hold on. Did I get traded by Nico or Jerry this. Like, what was going on last time? What?
00:01:02 Michael: Still too soon.
00:01:03 Jay: Oh, too soon. Uh, no. And, and Brad, don’t worry, you’re special too.
00:01:07 Brad: Strange. Why- why does everyone keep calling me special?
00:01:11 Michael: Jay and I will try to explain it to you later, um, using very simple words.
00:01:15 Jay: And pictures?
00:01:16 Brad: Ooh, well, I like picture books. Um, oh, okay. Um, so Jay, now that we know that this might be your only time joining us this season, any plans during the, uh, the long layoff in between seasons?
00:01:29 Jay: Yeah, I’m going to start training.
00:01:32 Brad: Okay.
00:01:33 Michael: Well audience, for those that don’t know, Jay’s a big runner. Um, so Jay, what are you training for? Wasn’t expecting that answer, you caught me off guard. Another marathon?
00:01:45 Jay: I’m thinking about competing in the Enhanced Games, I think.
00:01:49 Brad: Yes, I love it.
00:01:51 Michael: I don’t, I’m not familiar with the Enhanced Games, but my competitive spirit is thinking, they’re not just games, but they’re Enhanced Games? I’m very interested.
00:02:00 Jay: Oh, yes.
00:02:00 Michael: Yeah.
00:02:00 Jay: Well, yes, so the Enhanced Games are actually a new athletic, Olympic-style competition, but where athletes are going to be allowed to use performance enhancing drugs. We’re talking steroids, testosterone, growth hormone, you know, things that are, uh, legal to possess, but are banned in sports.
00:02:19 Michael: I’m starting to brace myself for Jay with roid rage.
00:02:22 Brad: Audience members, he’s pretty competitive. Roid rage Jay might be very scary. But the entire concept is really fascinating. How far can the human body be pushed with what long term healthcare concerns are there gone be, going to actually have to forego by using all these enhancements
00:02:40 Jay: Yeah, so their, their stated purpose is to redefine super humanity through science and innovation and sports. And, but all athletes that are going to compete, they have to undergo extensive medical profiling before the competition, so this can allow them to be cleared by medical professionals, uh, that assess their health status. They’ll ensure that safety standards are met, and then they’re going to be monitoring for any potential risks with the enhance performance.
00:03:06 Michael: Jay, I’m actually a little skeptical about all this.
00:03:09 Jay: Well, okay, so proof of concept, recently they just signed, uh, their first one million dollar check as a bonus for someone beating a world record. So, uh, a Greek swimmer, Kristian Gkolomeev, he set a new world record in the 50 meter freestyle swim weeks after he started, uh, training with PEDs. So, he’s 31, he had just competed in the Paris Olympics. Uh, he came in f- uh, fifth in the, uh, Olympics, meeting missing the medal by .03 hundredths of a second.
00:03:42 Brad: Wow.
00:03:43 Jay: He then joined them in December, started training, and by February, he clocked a world record 20.89 seconds, which beat the old world record of 20.91 that had been set way back in 2009.
00:03:58 Brad: All right, so he just started this, uh, so I guess we’re all wondering, did he just quote unquote start using enhancements? Uh, it doesn’t seem like…
00:04:08 Jay: Well, if, if he did, he wasn’t doing it right it.
00:04:11 Jay: So, here, so the inaugural event that I’m going to be training for, I’m thinking about it here, uh, it’s going to take place in Las Vegas in May of 2026. Uh, right now there are planned swimming events, so you have the 50 free and the 50 butterfly, as well as the 100 free and the 100 butterfly. There’s going to be track and field events, and so there’s going to be the 100 meter dash and the 100, uh, and 10 meter hurdles. And then there’s weightlifting, which is going to be the snatch and also the clean and jerk. So, more importantly, there’s going to be prize money at the end.
00:04:40 Michael: Well, I have two thoughts. Number one is, you know, we have our residency in Vegas for a week in April.
00:04:46 Michael: So, we could scope it out, get our training in.
00:04:49 Michael: Um, but I didn’t hear you say tennis. I mean, if we’re going to be enhanced, I think tennis is a natural sport to, to include. What, what about you, Jay? What’s your eye on?
00:05:02 Jay: Yeah, so I love to run, um, so I have my eye on that 100 meter dash, um, because I ran it back in high school, love to sprint. Uh, just announced, Fred Kerley, American sprinter, joined Enhance Games, so it looks like two good old Texas boys will be fighting it out there on the 100 meter dash. Okay.
00:05:21 Jay: All right, you guys.
00:05:22 Michael: Well, I’m, I’m holding out for tennis. I mean, you know, I just, uh, I- I’m looking for the reason to start taking my PEDs to improve my game. I’m guessing, Brad, you’d be the clean and jerk?
00:05:37 Brad: That’s right. Clearly weightlifting. I will pump you up.
00:05:41 Michael: Oh, no.
00:05:42 Brad: Yes. Yes.
00:05:43 Michael: Sorry, Jay.
00:05:43 Brad: Okay, Jay, so I’m asking for a friend now, his name is Arnold, which per- performance enhancing drugs are you thinking about asking to help you win?
00:05:53 Jay: Oh, none. I, I’m actually, I’m going to compete all natural. So, see, I’m going to actually come in with a different purpose. I’m here to redefine super generic humanity. And I’m going to do this through indifferences to science and performance enhancement and strict dietary habits. You know, I want to be a role model for every middle-aged adult out there that was good to great in high school at some athletic event, throwing footballs a quarter of a mile. Exactly. And I want to represent those that have to engage their core and bend with their knees when they pick up that dirty laundry.
00:06:29 Brad: I think I just hurt my back hearing your training regimen, honestly, Jay.
00:06:32 Jay: It’s indifference to training, Brad. Indifference.
00:06:35 Brad: Still hurt my back.
00:06:37 Michael: Nap time. And then maybe we should just jump into our story.
00:06:41 Brad: Yeah, let’s go.
00:06:42 Jay: All right. Let’s, let’s do this. All right, so the question for today is one that us as professionals, uh, with licenses can appreciate and that we’ve been asked so many times directly by clients, um, and others. And so in today’s story the question came to me directly from a plastic surgeon here in Texas and he was asking for a friend, “What is it like to be investigated by the medical board?” And so let’s call our friend for today Dr. Conte of BALCO Plastic Surgery.
00:07:09 Brad: Ooh, Dr. Conte and BALCO. All right, audience members, I believe Jay is using names from about 20 years ago. When there was a huge, huge baseball scandal that lasted three or four years back in the 2000s, a person named Victor Conte, had a lab called Bay Area Laboratory Cooperative, AKA, say it again.
00:07:30 Jay: BALCO.
00:07:31 Brad: BALCO. Uh, according to Conte, he was providing specific sup- supplemental regimens to correct imbalances in baseball players and other athletes. The allegation’s indictment, he was just providing steroids.
00:07:45 Michael: Yeah. I think Barry Bonds, among others, was at the center of the BALCO controversy.
00:07:51 Brad: Yes, he was.
00:07:51 Jay: Yes.
00:07:51 Brad: Now, Jay, you know Michael needs lots and lots and lots of context, so why was Dr. Conte asking these questions for his friend?
00:07:59 Jay: Well, so funny enough, he was actually asking for a friend because the issue didn’t involve him, uh, it involved his physician employee, Dr. Anderson, and one of his patients, Mrs. Bonds.
00:08:11 Brad: Okay, well, we got the Bonds referenced earlier. Audience members, I believe Jay is actually using the name Dr. Anderson from the real childhood friend of Barry Bonds AKA Greg Anderson. Greg, uh, became Bond’s personal trainer back in the 1990s or late ’90s. During this time, uh, Bonds, at least the allegations are, was that Anderson was providing Bonds with a variety of PEDs including designer steroids, which I always find interesting. Anderson was sentenced to prison, uh, for refusing to testify against his friend, Mr. Bonds, during the federal government investigation into the lab and to, uh, Dr. Conte.
00:08:47 Jay: Yeah. So, so Ms. Bonds went to BALCO Plastic Surgery with her husband, uh, and she was unhappy with the results of a breast augmentation that she had had that was performed by a different physician in an- in another pr- uh, practice.
00:09:00 Michael: Yeah, this raises a question of whether or not there was, you know, patient screening. It’s so important and, uh, you know, you hear something like, uh, they, they were unhappy with prior results and it makes me think of the, you know, the importance of screening. We’ve actually talked about this on other episodes but the reality is, is that there is, uh, there’s a lot of, uh, kind of mental health that creates, um, u- unreasonable expectations or unrealistic expectations for people that are coming in for elective procedures and, uh, and it’s so important to have that kind of tool to ferret out people that are actually, uh, good candidates.
00:09:45 Brad: Yeah, I agree. I mean, it, it can be a red flag when someone says they went somewhere else and they were unhappy with those results. And this is going to Michael’s point, you know, as a physician or plastic surgeon, you really want to know what those patients’ expectations are. This allows that surgeon to really identify if there are unrealistic expectations or, um, some type of other obsessive desires, um, which then allows the doctor to determine if they can actually even have a longer, in-depth conversation with this potential patient, talk about the goal, talk about their motivations, talk about those expectations. And if those expectations are consistent with the standard of care, they can continue to move forward. I know some of these patients, um, do have some underlying psychological issues and the surgeons, quote unquote, really actually can never fix what they’re looking for. So what specifically were Mrs. Bond’s concerns?
00:10:37 Jay: Yeah, so essentially her, her chief concerns were that her breasts were sagging, she didn’t have enough cleavage, they were too spaced too far apart. I mean, she basically wanted them fixed, she just did not like the look of them.
00:10:48 Michael: Okay, for those that are watching this, you may see me trying to physically suppress my 13-year-old sense of humor to not engage Jay with just using words that a 13-year-old likes to, uh, take in different directions. So we’ll just say-
00:11:03 Brad: Sounds mature, Michael.
00:11:04 Michael: How did things go?
00:11:04 Jay: Yes. Uh, they actually went great. Uh, after Dr. Anderson did, uh, a couple of preoperative pre-op visits, uh, walked through everything with Ms. Bonds, answering all of the questions, obtaining all the, the necessary consent forms, he performed the, the breast implant. He exchanged from saline to slightly larger silicone, uh, fit them to proportion for her body to, to have a better fit. Also did the breast lift, you know, addressed all the, the underlying concerns that Mrs. Bonds brought.
00:11:32 Brad: Well, that’s awesome. This really does sound like it’s going by the book. Were there any complications with the results or did she suffer from some type of, um, infection or something like that?
00:11:40 Jay: No, not at all. I mean, over the course of the next three months she returned for her post-op visit follow-up appointments and everything was healing perfectly. Uh, at each appointment she, uh, indicated she was happy with the results, um, because they looked much more natural than before.
00:11:54 Michael: Ready to cue the foreboding music in at this point?
00:11:57 Jay: Yeah, so about, um, the four-month mark during a post-op, uh, visit, uh, she returned this time and brought along her husband and while Dr. Anderson observed she was healing beautifully and that she had excellent kind of overall shape and size and everything was exactly as, as he h- as, as he had wanted, um, it’s what Mr. Bonds said that kind of caused a little bit of confusion.
00:12:20 Michael: Uh-oh, what did he say?
00:12:22 Jay: So during the exam and during the, the checkup, Mr. Bonds expressed that they would have liked for her to have bigger breasts but, uh, they were satisfied with the results.
00:12:31 Brad: Okay. So, uh, I guess Mr. Bonds is doing some wish casting there. But I am getting very nervous now, so what happened next?
00:12:40 Jay: Yeah, so we’ll fast-forward to Ms. Bonds’ final appointment, three months later, and at this appointment, she came in hot. She this time, she was adamant that her and her husband wanted her breasts to be bigger, that they, that they were unsatisfied with the, the results, that it wasn’t what they wanted.
00:12:57 Brad: An audience member sitting here listening to it, you might be wondering this can’t be true, but unfortunately, uh, if we had like 10 plastic surgeons in here, they all would probably say that, yes, they have heard this before. So being a plastic surgeon, how did Dr. Anderson respond to this?
00:13:11 Jay: Very professionally cautioned, uh, cautioned Ms. Bonds that in, uh, his medical opinion that if they were going to go bigger, that was- wasn’t going to be in her best interest because the width of her chest and her small frame and would have made her look just, you know, out of proportion. Um, the concern was that with the larger breast size that she was, she was asking about and wanting, uh, and demanding, was actually going to cause them to be wider than the width of her chest.
00:13:36 Michael: Okay. Well, how did Ms. Bonds take that?
00:13:39 Jay: Oh, not, not well at all. She was not happy with the size. She wanted them to be bigger. And so she did what any reasonable person would do, she demanded a refund, um, for everything that she had gotten and, um, you know, given there was no medical complications, the results were exactly as they, uh, as they had expected and, and, uh, everything was good, uh, clinically, uh, you know, Dr. Anderson politely denied the request. And that was it. And Ms. Bonds threatened to ruin Dr. Anderson and just stormed out.
00:14:09 Michael: Well, that took a turn. So what did she do?
00:14:14 Jay: Well, what every angry person does, they cause chaos. Um, she ended up filing a complaint with the medical board and this spurred Dr. Conte to ask us for his friend, what is it like to be investigated by the medical board?
00:14:29 Brad: All right. Well, I guess we can give some context on that in question and answer, and I’ll just use this is Texas. Texas Medical Board investigation typically starts with a quote, quote unquote, “informal letter” from the Texas, uh, Medical Board. Typically, it’s the initial notice sent to the physician informing them that a complaint has been filed. Uh, to be c- clear, this is nothing informal- about that letter. This letter-
00:14:53 Michael: It’s nonbinding.
00:14:53 Brad: No. Yes. This letter really serves as the initial and official notification that, um, that you’re being notified that the board has received the complaint and that you have to respond to it, and often they want to have in writing, they will request certain information, your medical records, et cetera, and then addressing the allegations of the, the complaint, and then they set a deadline. And this deadline is typically, you know, every state’s a little bit different, but it’s less than 30 days. So time is key here.
00:15:24 Michael: Yeah, and it does kind of extend to the other states as well. It may not say informal letter, but it is, uh, it might say preliminary, but it, it will, uh, it, it will take you off guard in terms of how serious you, you take it potentially. And the key is that this, as you said, this is the beginning, and this is probably the biggest opportunity to, you know, respond, respond appropriately, um, and potentially make it go away, because what usually happens is, is that the, the boards, they have to, they have to do this if, uh, reach out if someone makes a complaint. And so they’re taking all the responses and then filtering those into what goes to the next level and that. And so if you ignore it, um, guess which pile you’re going to go into?
00:16:19 Jay: Yeah. And, uh, I mean, uh, at the end of the day, it’s one small thing that can turn into a really big thing.
00:16:23 Michael: Okay, I can’t surprise my 13-year-old. I’m assuming that was a pun intended there.
00:16:27 Jay: Yes, sorry. Not sorry. And, and this is one of the reasons why it’s so important that physicians keep their profile, uh, information up to date, especially address, because the medical board, the licensing board is going to s- be sending that letter to the address on file. And if that’s an old address, you’re not going to get it, and unfortunately, that timeframe to respond, that timeframe to take action, doesn’t wait until delivery. So, um, you, you really have to keep up to date on that address because it can cause a lot of problems without you ever knowing about it.
00:17:01 Brad: Yes. And we know too many stories where those doctors’ licenses were suspended, as they did not reply to the board on time, sometimes because of, uh, issues like it being delivered to the wrong location because they moved multiple times and never told the board. Um, and even for like even minor questions like. An example I have is, “Did you complete your CME this year? We didn’t see the filing.” So for Dr. Conte, did, we get involved with this initial notice of the complaint?
00:17:28 Jay: I wish. Uh, no. Dr. Anderson had gotten the notice and never told Dr. Conte about it, um, and so he just read it, sent in the medical records that it had requested. He, uh, typed out a one-page, uh, stream of conscious kind of rant, uh, about the patient, and so Dr. Conte was actually trying to get us involved when he was notified of the next letter, uh, that had said that the Texas Medical Board had opened an official investigation.
00:17:53 Brad: Was it in a quotes, “official” this time? Just making sure.
00:17:55 Jay: Yes. It was underlined “official.”
00:17:57 Michael: Uh, I alluded to this a, a few minutes ago. This is that, that you get put in that second pile, and it is, you know, a little bit more official, uh, or the next level towards, you know, potentially having a consequence because now, um, you have, uh, you know, an investigative attorney on the other side that is officially investigating this. Uh, the board will hear it, and I’ll let Brad talk about it in a moment. In Texas, it’s also that next step is an informal settlement conference-
00:18:26 Brad: Yeah.
00:18:26 Michael: Is it informal, Brad?
00:18:30 Brad: Yes. You can wear your fake suit with the little tie on it and the shirt.
00:18:34 Michael: Yeah. Uh, but the, the reality is, is that, at this point, it’s an administrative, you know, kind of hearing in nature in the sense that you’re going to have, uh, an opportunity to be heard and so is the kind of prosecution, so to speak, the board attorney. And the board is going to hear these materials about this complaint and, and, uh, and so this can, uh, usually requires more attention. In some states, it can actually lead to depositions and, um, other, uh, levels of, of, uh, you know, kind of fact gathering. Um, in Texas, it is a little less formal. They don’t typically, they typically have the hearing with just the gathering of requested information. Uh, but you, as the physician defending yourself, may have to go and get outside evidence to support your claim. And, uh, and so it is definitely the next level up, um, and, um, and something to, um, that’s not fun to deal with.
00:19:39 Brad: Yeah, and let’s go back to Jay’s story real quick. He, he described that there was a one-page stream of conscious ranting, uh, which typically, by the way, the term ranting never goes well when the, the board is get- receiving something. And again, if the board finds in the initial response it’s satisfactory, it ends. But if it’s unsatisfactory or they feel like they need more information, um, that’s where, as Michael kind of s- alluded to, in many states they call it the informal settlement conference or ISC, and that’s where they start detailing more of these allegations, and they’ll schedule that ISC. They’ll, um, they’ll call that informal hearing where they start going through it and actually start meeting with you, and nowadays most of them will be a Zoom. And that’s where the doctor would have to present their defense to the board or the informal board. It’s not the full board. You know, audience member, this board is represented by an attorney, um, that represents the, in this case, the Texas Medical Board, and there, there are individuals who are both the judge and jury who are sitting there.
00:20:39 Jay: Yeah, and during this time in, in certain states, that’s when investigators can start reaching out to people. Your staff showing up to your facility, asking questions, wanting to interview you, wanting to interview past, uh, physicians, whatever the case may be. And so you really need to understand from a, a process perspective what is your process in your state so that you can have your team prepared to deliver the mail timely or to, uh, get attorneys involved when people are reaching out or showing up to the, the site.
00:21:06 Michael: So when did- what ended up happening?
00:21:08 Jay: Well, so in Texas, because you do have a kind of a second bite at the apple, if you will, we were able to put together, uh, the supportive information in the right way, uh, and we put a comprehensive timeline narrative summary with medical records, cross-referencing, really leading the investigator to the conclusion that we all probably, uh, you know, can, can gather from the story, um, that the allegations were unsupported, and we got it in the hands of the investigator as quick as possible.
00:21:35 Brad: So competitive Jay was involved, it sounds like, which is good. And you weren’t using any enhancement drugs-
00:21:40 Jay: No.
00:21:40 Brad: At the time.
00:21:42 Jay: I was just using a cream.
00:21:43 Michael: Mrs. Bond’s was.
00:21:44 Jay: Yeah.
00:21:44 Michael: Oh, yeah.
00:21:45 Brad: And so with all this work that you just did, did that help?
00:21:49 Jay: Uh, yeah, absolutely. So because the circumstances were pretty clear and there was no standard of care issues, uh, more importantly, the documentation supported everything 100%, um, that we were communicating, so after about 30 days or so, Dr. Anderson received the letter stating that the case was dismissed, investigation closed, so we didn’t have to worry about a SOAH hearing.
00:22:08 Michael: All right, Brad, vocab time. What does SOAH mean?
00:22:12 Brad: Well, first, congrats on the dismissal. And second, Michael, I think SoHo is an area of New York that-
00:22:21 Michael: Not SoHo. So, uh, were you even listening to Jay say that they had a SOAH hearing? Or were you just daydreaming about, uh, Manhattan and shopping?
00:22:30 Jay: He doesn’t have any air pods.
00:22:31 Brad: I don’t, I can’t hear you. I don’t understand you. No comment. All right, for those who don’t know, you know, what, what Jay is referring to in Texas, the, the, that’s known as the State Office of Administrative Hearing. So similar to informal hearings, but this is actually the next kind of level in the sense of if that solution cannot be reached, um, through that agreed order or, or remedial plan that may happen at that time, the case is then assigned to the Texas Medical Board staff attorney. Uh, at that point it’ll be heard by an administrative law judge who subsequently will present in proposals for the decision to the board. So again, this is like the next level. The board then issues an order that may include sanctions or dismissal or other issues. Uh, once the, the board enters the final order, this is the first time the respondent, if they’re unhappy with it, can actually appeal the decision to an outside district court. So in Texas that would be Tarrant County-
00:23:22 Jay: Travis.
00:23:22 Brad: Sorry, Travis Tarrant County.
00:23:24 Brad: But it’s important to understand, this is the thing where audience members do not under- ever understand, in any board investigation, whether it’s, it’s your medical board or nursing board, a lot of times the clients want to jump out of those board hearings and they want to go straight to court to get the protections. No court will ever give you those protections. They want you to go through the entire administrative process. Yes, painful, but you can’t just jump out of that beforehand.
00:23:47 Jay: Yeah. Yeah, didn’t have to, didn’t have to deal with that.
00:23:50 Brad: Yeah.
00:23:50 Michael: All right.
00:23:51 Brad: Which was good.
00:23:51 Michael: Let’s go to break and talk about legal considerations with medical board investigations when we get back.
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00:24:32 Brad: Welcome back to Legal 123s with ByrdAdatto. I’m your host, Brad Adatto, with my co-host Michael Byrd, and series regular, Jay Reyero, or maybe not since it might be your only episode. But Michael, this season, for those who don’t know- the theme is Asking For a Friend.
00:24:46 Michael: And Brad we’re really relieved because the question got asked and answered already, with a good outcome because Jay was involved. Right?
00:24:55 Brad: With non enhancing-
00:24:56 Michael: Yes.
00:24:56 Brad: Right.
00:24:57 Michael: So we have a good, you know, kind of bow on the story. No trouble for our, our doctor in this, um, in this particular, uh, story. But we do want to talk a little bit more about board investigations and that, that asking for a friend question, like, what is it like?
00:25:14 Brad: Yeah.
00:25:15 Michael: And one of the things we haven’t talked about is the emotional component to it and, uh, and we kind of saw it by implication, by the rant response and, uh, and I can’t say enough for those who haven’t had one of these letters come, it is a triggering event because you’re having your license attacked and your, you know, skills as a physician attacked and, and so, uh, there can be, um, obviously those emotions are normal and you should expect them, but they can really get in the way of you, uh, defending yourself in an appropriate manner if you let your emotions rule how you respond. And so it becomes really important to, you know, to A, recognize that that’s going to happen and really slow yourself down. I know, Brad, you, you have the advice of, uh, you know, get out, you know, a Word document and type your rant and cuss all you want and say all the things that you want to be said and then hit Delete.
00:26:25 Brad: Right. And I’ll say the other thing on, on the emotional aspect is w- as Michael was kind of alluding to, it’s going to be a long time so unfortunately, a lot of times our, our clients are like, “How can we accelerate this process?” And, you know, something that’s so simple and should be, in their mind, dismissed within days, could take six months to a year even and we, and we’re, we’re familiar with ones that gone, have gone on for longer periods of time. They have no obligation to do any acceleration in any state so just understand that you just have to have that emotional, um, emotional rollercoaster and then understand that there will be time taken from you.
00:27:02 Jay: And that’s what the emotional part is why it’s so critical to get counsel involved because they add that little buffer to have you have a successful strategy to respond to that informal letter and get it dismissed if the, you know, before it ever goes anywhere. And, you know, when you’re responding, what you’re trying to do is you’re trying to lay out the facts in a very, uh, neutral, professional way. You want to be very clear. You want to, uh, be able to connect it to the real-time documentation in the medical record to prove that you’re. It’s not a, it’s not a story, it’s, it’s just you’re communicating a narrative of the events that actually occurred and so there’s a really important strategy and when you take the, when, you know, you’re going to be emotional so you, you, you defer to or rely upon the legal counsel to really set it out in that professional tone. You’re going to put yourself in, in a better position to have the investigator read it, see it for what it is and be like,
00:27:54 Jay: “Yeah, nothing’s wrong here. Let’s go ahead and move on to something else.”
00:27:58 Brad: Yeah and understanding that’s all good ideas that Jay gave, telling the board to go F themselves, or that this is a witch hunt or here’s a copy of the medical record, you go figure out with no explanation. Those are not good strategies.
00:28:11 Jay: No. No, those, no.
00:28:12 Michael: Yeah. I, I feel like I’ve seen that before .
00:28:14 Brad: I’m just saying.
00:28:15 Michael: Yeah. Another kind of twist to know is that, um, o- oftentimes you will have malpractice coverage, a rider that will cover board investigations so it’s important when you get that first letter to look and see if you have coverage because not only will, um, y- the cost of your defense potentially be covered and they’ll assign counsel for you, but there may even be enough in there to cover a, you know, a fine if you’re, if there’s a, a fine at the end of the, uh, investigation.
00:28:47 Jay: Yeah and you want to make sure all the documentation is complete and that you work with someone to get everything that needs to be in there cause if anything’s missing, as Brad mentioned earlier, if something’s missing, they have questions, they’ll just pass it on to an active investigation rather than try to figure out beforehand.
00:29:00 Brad: Yeah. I mean, the, the clear takeaway here is you want to make it as easy as possible for that person who has an initial file that whatever those allegations are, here’s proof that none of that is real and that you’re a great provider and let’s keep moving on.
00:29:18 Michael: Yeah.
00:29:19 Brad: Jay, you, uh, we’re almost getting, almost to end of the episode. Maybe you and Michael can start giving some final thoughts here.
00:29:25 Jay: Yeah. I mean, um, it’s, it’s, it’s an emotional event, um, there’s no doubt about it, but you get someone in to help you from the beginning and take it serious from the beginning, despite the informal nature of, uh, the process. Um, you, you do all that, you have a higher chance of s- uh, success.
00:29:41 Michael: Yeah. Lean in. I mean, I totally agree that, you can’t, uh, you know, bury your, put your head in the sand and expect that it’s going to turn out okay. No, you got to turn into it.
00:29:55 Brad: Absolutely. Well, audience members, next Wednesday we’ll be back again as we continue this journey of asking for a friend when we actually have our friend, Shawna Chrisman, join us and we’re going to ask her for a friend, what’s it like to sell a medical practice? Thanks again for joining us today and remember, if you like this episode, please subscribe. Make sure to give us a five-star rating and share with your friends.
00:30:17 Michael: You can also sign up for the ByrdAdatto newsletter by going to our website at ByrdAdatto.com.
00:30:24 Access+: ByrdAdatto is providing this podcast as a public service. This podcast is for educational purposes only. This podcast does not constitute legal advice, nor does it establish an attorney-client relationship. Reference to any specific product or entity does not constitute an endorsement or recommendation by ByrdAdatto. The views expressed by guests are their own, and their appearance on the program does not imply an endorsement of them or any entity they represent. Please consult with an attorney on your legal issues.
