1. Investigation Procedures for Complaints Margaret B. Hansen, PA-C, MPAS, CMBE President

2.  Patients  Patients’ families  Malpractice settlements or judgments  Other physicians  Other providers from the medical team  Hospitals  Insurance providers

3. ‘Some people from the medical board are here to see you.’

4.  Board’s mission is to protect the public  The Board is not out to “get” anyone  About 80% of complaints are dismissed

5. Dismissal Complaint received/reviewed Dismissal Response requested/received Investigation Complaint Process

6.  Fee disputes  Wrong agency (e.g. nurse, podiatrist, etc.)  No physician-patient relationship established  No clear allegation in the complaint  Rude Provider  Claims of abandonment when clear proper physician properly relationship termination  Etc.

8.  Board staff notifies and requests a response from the provider within 10 to 14 days  Options: ◦ Supplemental response e.g. medical expert  Investigative Review Panel  Board member reviews and makes recommendation to the Board

9.  What do you do if someone files a complaint?

10.  Review the complaint and allegations  Prepare response  Decide whether to get an attorney  Gather records  Extensions are granted as necessary

11. InvestigateClose Continue Investigation Warning Resolve by Consent Board Member Recommendation to the Investigative Review Panel Recommendation to Board Board Final Decision Hearing: Administrative Law Judge or Board Licensee Optional Appeal: Circuit Court

12.  Not Public: o Complaint dismissal o Letter of concern (not a board action, private except to other state licensing boards)  Public o Reprimand o Limit, condition, probation etc. o Suspend or revoke

13.  State Medical Board notice - website  AIM ExecNet  FSMB Disciplinary Alert  NPDB  Other…

14.  confidential information clearinghouse ◦ must report disciplinary actions  help@npdb.hrsa.gov help@npdb.hrsa.gov

15.  Board website Disciplinary Action  License verification board order certified copy  Board meeting minutes

16.  SDCL 36-4-30, (7) Habits of intemperance or drug addiction, calculated in the opinion of the Board of Medical and Osteopathic Examiners to affect the licensee's practice of the profession;  Applicants and Licensees are told: ◦ far better to self report problems

17.  South Dakota Health Professionals Assistance Program (SDHPAP)  Oversight from participating licensing boards  Financial support: Medical and Nursing boards  a multidisciplinary program for health professionals who are experiencing chemical dependency or mental health issues

18.  multiple state licenses = action is reported to the other states.  Disciplinary action is reportable, as required, to national databases: ◦ National Practitioner Databank ◦ Federation of State Medical Boards ◦ Drug Enforcement Agency ◦ American Medical Association.  Disciplinary action may affect: ◦ medical malpractice insurance ◦ HMO coverage ◦ staff privileges