How Doctors Lose Their Licenses

Shawn Steel, JD

Last year, the California Acupuncture Board processed approximately 200 complaints against licensed acupuncturists. The general breakdown for those complaints is as follows:

Unprofessional conduct 65%
Unlicensed activity 13%
Fraud 9%
Criminal charges/convictions 5%
Negligence/incompetence 4%
Sexual misconduct 3%
Other 1%

Each of these complaint components is clearly covered in the acupuncture regulations published by the Board.

Fraud

Fraud covers false billing, over billing and charging for services not performed. Patients may also complain that they were mischarged. "Gouging" the patient is particularly interesting to the Board. Doctors who use prepaid plans and do not have valid reimbursement plans will be investigated. The Board looks for frequent patterns, not just a one-time procedure. The doctor's duty is to render reasonable and necessary charges. Insurance companies have a mandatory duty, under Section 1841 of the California Insurance Code, to file a complaint if they suspect fraudulent activity.

Negligence/Incompetence

Complaints of negligence, though self-explanatory, are almost always generated by patients or their families. Oftentimes, a personal injury attorney will file the complaint before initiating suit to pressure the doctor's carrier into an early settlement. Additionally, any time a malpractice insurance company has to pay a significant settlement, it must report the settlement to the Board for license investigation.

Unprofessional Conduct

This is the largest area of concern for the Board. Examples of such conduct in an acupuncture setting are the use of controlled substances or medical techniques not authorized by law: techniques outside the scope of practice. For example, if an herb is prescribed medically, it becomes a drug substance. That constitutes unprofessional conduct. Physical therapy alone is also forbidden.

Other examples include diathermy; hot and cold packs; infrared and ultrasound, which cannot be used for the purpose of stimulating acupuncture points. Those modalities must be used in conjunction with acupuncture treatment.

Massage therapists cannot be employed unless they have academic certification and a business permit. Police and sheriff agencies report illicit massage parlors/prostitution houses that display acupuncture licenses to the Board on a weekly basis. Some doctors actually "rent" their license for $500 to $1000 a week. There are no patient files or any real patients in these settings. These violations are vigorously pursued by the Board.

Unlicensed Activities Acupuncture students or people who do not have licenses are frequently reported to the Board. Some students mistakenly offer acupuncture services to fellow students, family or friends. If such activity is reported to the Board, the student will have huge problems in getting his/her license even if he or she passes the examination.

Sexual Misconduct

For a few years, the Board was concerned that this would be major growth area of complaints. However, doctors presently seem to be more careful. Obviously such charges are serious. They ruin practices and lives. Patients understand the power of this particular complaint. Statistically, 98% of these problems come from male practitioners who treat female patients alone.

Criminal Charges

Doctors who are convicted of offenses outside the practice of acupuncture may also lose their license. If the crime is one of a "moral turpitude," it may affect their professional licensure. For example, conviction of driving under the influence, failure to pay income taxes, or drug possession will mean loss of a license.

Using common sense will protect most acupuncturists from investigation by the Board, yet surprisingly, many doctors carelessly risk their family's future, their good name and reputation. Any time the Board calls, the doctor should always employ an attorney who specializes in license protection.

When serving on the Board, it is most dismaying for me to see former acupuncturists begging to be readmitted to the profession. Often, we cannot allow him or her to return to practice.

June 2000
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