How the Healthcare Industry Fails Patients and Pins the Blame on Physicians: Medical Board Complaints

This is part two in a three-part series detailing the ways in which patients are harmed by the Healthcare Industry and how I was complicit as an employed physician. I was threatened with a lawsuit due to a patient who suffered medical and financial harm from the Health Insurance System. A Medical Board complaint was made against me due to corporate policies designed to increase profitability. Finally, I was the victim of both libel and verbal assault with the threat of bodily harm by the family member of a patient who was struggling with prescription drug dependency and addiction perpetuated by the Healthcare Industry and its campaign of “Pain as the Fifth Vital Sign”. This series also illustrates the moral injuries perpetuated by corporate healthcare upon physicians.

In order to practice medicine, physicians must maintain a medical license in every state where they practice, which includes completing continuing medical education and paying fees. Each state has a Board of Medicine with the power to suspend or revoke a physician’s medical license for various reasons. In some states, a physician who sees a mental health counselor puts their medical license at risk. Anyone can file a complaint against a physician with the Board of Medicine, even if they are not a patient. Physicians are often afraid to speak out publicly because someone with an opposing viewpoint could file a board complaint against them in retaliation, which is a form of doxing, or cyberbullying. Most of these board complaints are baseless and are eventually dismissed; however, even false claims can damage a physician’s reputation since complaints are part of the public record, and they can lead to loss of income as the investigation process is often time-consuming. Since doctors leave medical school with at least $200,000 of educational debt, threats against one’s medical license can be financially devastating.  

I have had one board complaint filed against me, and it was dismissed, but the process caused significant distress. The true reason for the complaint was that the patient was angry that she was unable to reach me by phone and did not want to come in for an appointment. When I was employed, I typically saw 25-30 patients per day and tended to run at least an hour behind because it simply was not possible to provide adequate care in the time allotted. Certainly, it was not possible to speak with patients over the phone during normal business hours. I barely had time for bathroom breaks and never for lunch. The office policy was to put patients on the schedule when they called asking to speak to a physician. This was necessary because physicians were too busy seeing patients to talk on the phone, and it was more profitable because patients and insurance companies could be billed for office visits but not for phone calls.

The patient included two unrelated complaints. The first was the complaint that I did not take her phone call, which was in regards to a request for a refill of a controlled substance started by another physician. My nurse spoke with her and offered her an appointment, but she declined. The second was an accusation that I was inappropriately managing her hypothyroidism by increasing the dose of her thyroid medication in response to an elevated TSH level. Any physician would know immediately that this is the appropriate way to adjust the dose of thyroid medication, but it is commonly misunderstood by patients. In fact, in the past week, one of my patients with hypothyroidism emailed me to ask why I had lowered her dose of thyroid medication when her TSH had been low. I emailed her back a simple explanation to reassure her that there had been no error.

Neither of these complaints would ever occur in a Direct Primary Care practice. Since patient volume is low, there is always plenty of time to respond to patient inquiries. Since there is no charge for in person appointments, there is no reason to force patients to come into the office for a question which could be quickly answered by phone, email or text. There is also plenty of time for education, so that patients understand their medical conditions, lab results and treatment plan. The main reason why medical board complaints are not an issue for Direct Primary Care physicians is because patients choose their own physicians and pay them directly. If patients feel like it’s not a good fit based on the personality of the physician or their practicing style, they have the freedom to choose a new physician, and since patients are both the payors and the recipients of medical care, market forces ensure both quality and affordability.