Kansas Professional Licensing Attorney Discusses Recent Disciplinary Decisions

Kansas professional licensing attorney Danielle Sanger closely monitors disciplinary decisions issued by the Kansas State Board of Healing Arts (the “Board”). Understanding the decisions issued by the Board assists Attorney Sanger in advising her clients who are facing discipline. Attorney Sanger appreciates the commitment and sacrifice required to earn and maintain a professional license and employs that same commitment in fighting for clients.

The Board has issued several decisions to this point in March of 2016. Two decisions illustrate the vital importance of appearing before the Board when ordered to appear. Failure to appear permits the Board to enter a default against the licensee and enter appropriate orders without a contest from the licensee. In one case, a chiropractor’s license was canceled for failure to timely renew. The chiropractor subsequently applied for reinstatement. Disciplinary counsel for the Board alleged that the chiropractor failed to disclose pending criminal actions pending against him to the Board on his application. The chiropractor was given notice to appear before the Board. The chiropractor requested a continuance of the appearance based upon personal reasons. The Board sought further information about his proffered reasons. The chiropractor failed to supplement his request for continuance. Consequently, he attempted to withdraw his application for reinstatement. The chiropractor failed to appear at the scheduling conference and was defaulted. The Board found that the chiropractor committed fraud by misrepresenting his criminal history to the Board and finding that the fraud proves the chiropractor is unfit to practice in Kansas. Moreover, the Board found that the chiropractor should not be allowed to withdraw his application to avoid discipline.

The second default order of March 2016 resulted in revocation of a physical therapy assistant’s license. The therapist failed to appear at a scheduling conference despite being warned that a failure to appear would result in a default finding. The therapist failed to appear as ordered. Consequently, the therapist’s certificate was ordered revoked. The therapist forfeited any argument to keep her certificate to practice, which was active at the time of her default.

The Board took other disciplinary action in March 2016 as well. The final consent order entered against a physician’s assistant accused of incompetence, improper prescribing, inadequate record keeping, and assisting in the care of a patient without consent of that patient. The physician’s assistant substantially complied with the educational requirements imposed by the Board and complied with the prohibition from performing urological surgery. However, the Board imposed, and the physician’s assistant did not oppose, the condition that he have a prescription monitor for an additional year.
The Board approved a second consent order in March 2016. This order was issued against the certificate of a physical therapy assistant. The assistant was convicted of a second offense for driving while intoxicated after a motor vehicle accident. The assistant waived her rights to a hearing and voluntarily entered into a consent order. The terms of the consent order are for two years. Many of the terms of the order are redacted from public record as “confidential.”

The Board exercised its statutory authority to issue an ex parte emergency order against a doctor of osteopathy. The Board issued the emergency order after finding that the physician may harm the public if allowed to practice. The facts giving rise to the emergency order are redacted as “confidential.” The Board ordered the physician to immediately cease the practice of urgent or emergency care of patients.
The Board issued two further decisions. The Board summarily canceled the license of a radiological technician who failed to timely pay her reinstatement fee. Finally, a physician’s license to practice medicine and surgery was revoked by the Board for malpractice and failure to participate in the complaint process. The physician, after being duly subpoenaed, failed to appear for a deposition. The physician also failed to answer interrogatories and disclose witnesses. Thus the physician’s failure to participate precluded the physician an opportunity to be heard and fight to retain the privilege to practice medicine in Kansas.

Seek Immediate Assistance
If you have been given notice of a complaint pending against you, call Kansas Professional Licensing Attorney Danielle Sanger immediately. Attorney Sanger has dedicated her practice to representing licensees in Kansas and Missouri who are facing discipline. Call 785-979-4353 today to schedule your free consultation.

University of Missouri Hospital and Clinics School Offers Guidance On Withholding Futile Treatments

Health care providers can grapple with the decision to withhold treatments that may be futile for their patients. The ethical decision influencing that decision can be daunting. Assisting patients, or their health care proxies, make these decisions must be made with consideration of several factors. If the patient reaches the point of “biomedical futility” the physician need not administer the treatment. Understanding “biomedical futility” and its implications is vital in making an ethical decision. Physicians and other health care providers can face ethical complaints if the patient or family disagrees with the decision to withhold futile medical treatments. Missouri professional licensing attorney Danielle Sanger has devoted her career to representing licensees such as physicians and other health providers who face potential licensing discipline.

The University of Missouri Hospital and Clinics (“the University”) issued guidelines relating to withholding futile treatments. The University’s directive was based upon the desire to assist physicians and their team in decisions regarding when to “withhold or withdraw” biomedically futile treatments. Biomedical futility is a judgment the physician must make. The University defines biomedical futility as a treatment that cannot meet its goals and is therefore “medically ineffective.” The physician must determine to a “reasonable degree of medical certainty” that the treatment cannot prevent or slow the patient’s decline or cannot prevent impending death of the patient. Those conditions seem obvious. However, a medically ineffective treatment is also one that cannot change the course of a disease in a meaningful way. It is critical to note that a treatment that is medically effective but may diminish the quality of life of the patient is not defined as a biomedically futile treatment.

The University established a procedure for physicians and their health care teams to follow in the event they are faced with making a decision of whether a treatment is medically futile. At the outset, the physician must determine that a treatment is medically ineffective to a reasonable degree of medical certainty. If so, then the physician must discuss treatment goals with the patient and/or the health care proxy. This consultation must include a discussion regarding the medical ineffectiveness of a proposed treatment, the potential or lack thereof for patient improvement, and the burden a given treatment may have upon the patient. Physicians must closely document this procedure in the patient’s medical record.

Once this discussion occurs, then a team meeting must be held. The meeting includes interdisciplinary treatment providers, the patient, the patient’s health care proxy, and the patient’s family. Any decision made during this team meeting must be documented in the patient’s medical record. The patient, their proxy, and staff should be afforded an opportunity to meet with Pastoral Care and/or the Ethics committee in reaching this decision.

At times, the patient and physician may disagree on whether the treatment should be administered. The physician is not required to administer a treatment that is medically ineffective. The physician should advise the patient to seek an alternative opinion. The physician must not abandon the patient if such a disagreement occurs. The physician should arrange for alternate care and take steps to ensure the patient is safe. The physician should consult other health care providers and the ethics committee if the physician determines the treatment must be discontinued. It is also important to note that this decision must be made between the health care providers and the patient. Any opinion offered by a third party of whether the treatment is medically effective must not be considered.

Where To Turn For Help

Missouri Professional Licensing Attorney Danielle Sanger vigorously fights for her clients to protect their livelihood. Attorney Sanger understands that a physician’s decisions can be second guessed, which can lead to facing an ethics complaint. Call Attorney Sanger today at 785-979-4353 to schedule a free consultation and mount your defense today.

Kansas Board of Healing Arts Complaint Process

The Kansas Board of Healing Arts (“the Board”) has an established procedure for investigating and adjudicating complaints of wrongdoing lodged against one of its members. The procedure is a natural progression from intake of complaint to investigation and either closure of the investigation or adjudication. Each step in the process is critical to both the complainant and the health care provider under investigation. Any caregiver who learns of an investigation must retain counsel as soon as possible. Failure to hire counsel timely could have dire consequences and lead to disciplinary action that may have been avoided. Kansas professional licensing attorney Danielle Sanger will zealously fight to protect your professional license from discipline.

The Board has developed a standardized procedure to handle complaints against its members. Most commonly, complaints are filed by patients. The Board may receive a complaint from any number of sources. However, information from complaints may be forwarded by other healthcare agencies, other healthcare providers, data bank reports, malpractice information, and adverse findings from other licensing boards. Once that happens, the complaint is added to the Board’s complaint database and is forwarded to disciplinary counsel. Disciplinary counsel reviews the complaint to determine whether the disclosed allegations may violate the Healing Arts Act. If disciplinary counsel determines that there is no violation of the Healing Arts Act based upon the factual allegations in the complaint, then the complaint is closed and no further action on the complaint is taken. At that point, the complaint is forwarded to an investigator for closer examination and investigation.

The assigned investigator is responsible for gathering information from various sources. The investigator will accumulate records from the licensee and all other relevant agencies. The investigator will also interview several individuals, if warranted, by the investigation. The investigator may interview the licensee or at least try to obtain a response to the allegations. The investigator should speak with patients, complainants, and other witnesses who may possess relevant information. The matter is referred back to disciplinary counsel when the investigation is complete.

Disciplinary counsel reviews the investigation to determine whether the complaint should proceed. If the complaint lacks support from “credible evidence” and the allegations are unsupported, then the complaint may be closed. At this juncture, the process proceeds toward adjudication if the complaint is supported by competent evidence.
The path the matter takes to adjudication depends upon the nature of the proceedings. If the complaint is based upon a violation of the standard of care, then the disciplinary counsel forwards it to the complaint review committee or professional council. Standard-of-care issues are reviewed by practitioners from the same profession or initial peer-review board. Conduct issues are those that do not involve an alleged breach of the standard of care. Conduct issues include the business of medical practice, practicing without a license, billing issues/complaints, practice by an impaired healthcare professional, and criminal convictions. Conduct issues are referred to litigation counsel by the Board. If the review board or committee determines the matter should proceed, then disciplinary counsel refers the matter to the disciplinary panel.

The disciplinary panel makes a recommendation to initiate discipline or close the case. The recommendation to close or initiate discipline is reviewed by the Board. Each level of review is independent of the previous and is not bound by those decisions. Initiating disciplinary action may take the form of a professional development plan or letter of public concern. The licensee may also agree to a resolution such as a consent order. The licensee may also contest the panel’s recommendation. The Board ultimately reviews and may approve all actions by the disciplinary panel. The Board may also seek further review of closed matters.

Protect Your Livelihood
Kansas Professional Licensing Attorney Danielle Sanger will vigorously fight to protect your ability to make a living. She understands the sacrifices made to achieve professional licenses and the devastation discipline can cause. Do not go it alone. Call Attorney Sanger today at 785-979-4353 to schedule your free consultation.

Kansas State Board of Healing Arts and Board of Nursing Collaborate On Pain Management Initiative

In February of 2016, two critical policy-making agencies collaborated to revise their approach to combating opioid addiction in Kansas. Delegates from Kansas’s State Board of Healing Arts and the Board of Nursing met to discuss a proposed redrafting of a “Joint Pain Management Policy.” The draft serves as an attempt to devise pain management plans that address each patient’s individual needs while countenancing and interdicting addictive behavior. The draft purports to expand the health care provider’s role in administering pain medication to impose greater oversight over the patient’s treatment with opioids.  Any health care provider licensed by either Board is now on notice that each respective licensing authority is carefully monitoring narcotics dispensing practices. A breach of this policy may result in disciplinary action. Kansas professional licensing attorney Danielle Sanger advises all of her clients to carefully monitor their opioid dispensing practice consistent with a health care provider’s duty of care.

The current Joint Pain Management Policy promulgated by the State Board of Healing Arts and the Board of Nursing was issued in 2002. Since that time, opioid abuse and addiction has spiked to levels heretofore unseen, not only in Kansas but nationwide. Accordingly, the Boards have undertaken the responsibility to craft a new policy that addresses the new reality of opioid addiction. The most recent draft of the policy circulated by the Boards emphasizes appropriate pain management for the individual patient by a team of health care providers. One of the problems facing health care providers today is the treatment of chronic and/or acute pain. The Boards recognize that many patients’ pain is improperly managed due to under- or over-prescription, or ineffective treatment. Because the reporting of symptoms of pain is subjective, the Board strives to balance the appropriate treatment of pain with the specter of drug-seeking and addictive behavior.

The Board proposes that health care providers should be wary of potential drug-seeking behavior. Recognizing the risks and the benefits of opioid prescription is critical to appropriately addressing a patient’s pain management. Health care professionals must be aware of the dangers that inure to long-term opioid use. These complications include addiction and abuse of the medication. Health care providers must understand that a patient may need opioid medication to combat pain and that a request for an increased dose is not necessary a symptom of drug dependency. It is therefore incumbent upon the health care provider to understand the signs of addictive behaviors and address those accordingly.

The draft emphasizes the growing need to investigate health care professionals who “treat pain inappropriately.” While proper investigation is necessary, the draft is very clear that a request for information concerning prescription practices does not equate with a formal complaint. To be sure, the draft stipulates that prior to filing of any allegations the information gathered during the investigation will be subject to peer review and health care providers should not “fear disciplinary actions” if they appropriately manage their patients’ pain.

Interestingly, the draft policy purports to not create a new standard of practice or claim to be a so-called “best practice.” However, the Boards’ stated intention is to delineate practices that are “within the boundaries” of professional practice and is not designed to usurp a health care provider’s judgment exercised consistent with a competent health care provider. Disclaimer notwithstanding, the Boards counsel that patients must be individually assessed for pain level, tolerance, and likelihood of recovery, and that instruments should be used to obtain an objective pain threshold. Additionally, the patient must be evaluated to determine whether the patient is a candidate to abuse prescribed narcotics. The use of baseline testing is recommended. The Board recommends using a written treatment plan and that every patient should have one health care provider who controls prescribing pain medication. The Boards counsel utilizing a written agreement with the patient who will agree to be strictly monitored while on prescribed narcotics.

Whom To Call For Help

Call Kansas professional licensing attorney Danielle Sanger if you are under investigation for dispensing pain medication. Despite claims to the contrary, an investigation into your medical practice is never meaningless.  Kansas Professional Licensing Defense Attorney Sanger has the experience to vigorously defend your rights and defend you against allegations of wrong-doing. Call Attorney Sanger today at 789-979-4353 to schedule your free consultation.