Kansas and Missouri Professional Licensing Attorney Danielle Sanger Explains How Legalized Marijuana Affects Medical Professional’s Licenses

On November 6, 2018, Missouri legalized medical marijuana. Since then, medical professionals have contacted me to ask what the effect this legal change has on their licenses and whether they are allowed to use medical marijuana.  As of right now, the answers to those questions remain murky, but I can provide some general advice to help guide medical professionals avoid obvious pitfalls. For more specific questions, professionals should contact me directly.

If you are a medical professional in Kansas or Missouri facing an investigation into your conduct, call attorney Sanger today at 785-979-4353 to schedule a free consultation. Medical marijuana is an emerging legal field, and you need the help of an experienced attorney to guide you through any inquiries into its use. Do not agree to speak with an investigator without an experienced attorney by your side. Your career, reputation, and livelihood are at risk, and the challenge facing you is one you cannot navigate alone.

Medical Marijuana Issues

Society holds medical professionals to a higher standard than those in other professions. This is due to several factors, including the trust the public places in the medical professional, the effect of federal drug laws, and the risk to the public involved in medical professionals’ work. Accordingly, just because your friend who is a banker, engineer, or attorney is now using medical marijuana does not mean that you will also be able to use it too.  Having a medical marijuana card is neither a “get out of jail free card” from your employer nor a license to be intoxicated, issues I will describe in depth below. While medical marijuana is a new issue here in Missouri, many of the problems it poses are analogous to those already in place for alcohol and other intoxicants.

Employer Rules May Be Stricter than State Law

While it may be legal in Missouri to use medical marijuana, that does not mean that your employer has to approve of its use. The U.S. Drug Enforcement Agency regulates hospitals and other medical centers, and marijuana remains illegal under federal law. Accordingly, marijuana use in a federally regulated work environment likely jeopardizes the medical center’s license to prescribe and dispense medicine. As a result, your employer may prohibit medical marijuana use. Accordingly, just having a medical marijuana card, even if you do not subsequently use marijuana, may jeopardize your employment as a medical professional.

Use May Still Violate Professional Standards

As I said above, alcohol has been legal for a very long time, but coming to work under the influence of alcohol or even with alcohol in your system may violate the standards of your profession.  The same sort of tension exists now that marijuana is legal for medical purposes in Missouri.  If you make a mistake at work, even one seemingly unrelated to your use of medical marijuana, you may be accused of being under the influence. Similarly, if you come to work smelling of marijuana you may be accused of a lack of professionalism; while it may be legal to use medical marijuana, its use may result in allegations that you are violating other professional standards. Again, this is similar to alcohol. Alcohol is legal, but if you come to work smelling of it, you should expect a professional licensure complaint.

Contact an Experienced Kansas and Missouri Licensing Attorney Now

You have worked too hard to attain your professional license to lose it because you failed to understand issues surrounding your medical marijuana use adequately.  An inquiry from a licensing board or employer regarding your medical marijuana use means that your livelihood as a medical professional is in jeopardy. Contacting an experienced licensing attorney immediately to help you through this process can mean the difference between getting back to helping your patients and losing your career forever.

Kansas and Missouri professional licensing attorney Danielle Sanger is prepared to advocate for your best interests and defend you. Call Attorney Sanger at 785-979-4353 to schedule a free consultation with an attorney experienced dealing with licensing issues.

 

 

Kansas and Missouri Professional Licensing Attorney Danielle Sanger Explains the Difference Between Civil and Criminal Licensure Matters for Nurses

Nurses often come to my office for a consultation, and one of the first questions they ask is “is this a criminal or civil?” Sometimes they have documents with them including a criminal complaint, a notice of a claim from a nursing board, and investigation documents from their employer.  None of the papers makes it clear whether the conduct in question will result in the loss of a job, jail time, loss of a nursing license, or all of the above. I don’t blame those nurses for being confused, as depending on the conduct in question, the conduct alleged could result in civil, criminal, or employer-based hearings. I wrote the following blog post to explain the difference between civil and criminal matters and the legal implications of your disciplinary board matter.

If you are a professional in Kansas or Missouri facing an allegation of misconduct or an investigation, call attorney Sanger today at 785-979-4353 to schedule a free consultation. Your career, reputation, and livelihood are at risk, and the challenge facing you is one you cannot work your way through alone.

The Difference Between Nurses’ Civil and Criminal Matters

Criminal and civil matters may seem similar—they’re both complex legal processes—but they have several significant differences, including the burden of proof involved, the possible penalties, and the type of hearing involved.

Criminal matters involve having your liberty taken by the state—they result in the accused nurse going to jail if he or she is convicted.  A district attorney files a criminal allegation in court using a “complaint,” and a nurse usually learns of the charges by being handed the complaint by a police officer or by being arrested. Because a loss of liberty, incarceration, is a severe deprivation, substantial “due process”—a trial by jury—is required before you can be convicted and put in jail.  Due process means an opportunity to know what the accusations are against you, a chance to review the evidence against you, and a hearing where you and your attorney can confront or attack those accusations and evidence with your own evidence. The standard of proof—beyond a reasonable doubt—is higher in a criminal case, a jury usually judges guilt or innocence, and the hearing or trial is much more formal. For nurses, these claims typically involve an assault on a patient, illegal use or possession of narcotics, and sexual misconduct involving a patient.

If you are served a complaint against you by police or are arrested, you are involved in a criminal matter.

A civil matter is one where the state seeks to take some “property” from you.  Now, you may think of property like physical property such as a car or land, but you also have a property interest in your license as a medical professional. You also have a property interest in your good name and reputation. You’ll remember from the U.S. Constitution’s 5th Amendment that the federal government cannot take your life, liberty, or property without due process of law.  The same holds for state governments.  As a result, the state cannot take your professional license or your interest in your reputation without “due process.” Due process in a civil matter may involve a trial, but not necessarily with a jury. A civil matter may result in having some property—like your license—taken or suspended or having a fine imposed.

If you receive a letter in the mail from a state administrative agency indicating that a licensure action or investigation has initiated against you, that administrative matter is civil in nature and not criminal. The letter signals that the state is starting your due process rights and alerting you to your opportunity to engage in that due process.

When Nurses’ Criminal and Civil Matters Overlap

If you have watched any amount of television, you have probably seen a crime drama where the criminal being arrested is given his Miranda warning of, “you have the right to remain silent, everything you say can and will be used against you in a court of law.”  While the crime drama may be just television, those rights are real.  That warning is relevant to you as well.

Take as an example, a nurse who is giving his relatives opioids for their pain without a prescription. If the state nursing board is alerted to this practice, the nurse will likely receive a notice of accusations in the mail, initiating his due process rights. That letter is a civil matter. If he is found to have violated the nursing regulations by a preponderance of the evidence—by a likelihood of at least 51%—he will have a civil penalty such as a fine, suspension, or license revocation. However, distributing opioids without a license and prescription is also a crime.

If the nurse in the above example admits in his civil hearing before the nursing board that he has been distributing opioids, that information can be used against him criminally. A statement made in a civil hearing, like any statement, can be used against you. The Assistant Attorney General who prosecuted the nurse’s licensing issue can merely hand the transcript of his admission to an Assistant District Attorney who can then charge the nurse with drug distribution.

As I stated above, the burden of proof in a criminal case is “beyond a reasonable doubt,” which is much higher than the civil hearing’s “preponderance of the evidence” standard and is often thought of as 99%. But if the nurse admitted to distributing the opioids, that admission often meets either standard. The same is true if the nurse makes admissions to his or her employer—those statements can be used again or “recycled” by the state’s nursing board or the prosecutor in a criminal case. Simply put, do not make any statement to anyone without an attorney by your side. It is a massive mistake to think you can handle your civil hearing alone or that you can play along with the investigation to make things go away. You are just digging yourself into a deeper hole and playing into the state’s hands when you attempt that sort of foolish strategy.

Contact an Experienced Kansas and Missouri Licensing Attorney Now

You have worked too hard to attain your nursing license.  Contacting an experienced licensing attorney to help you through the misconduct hearing process, explain the criminal implications of any allegations against you, and can mean the difference between getting back to helping your patients and losing your career forever.

Kansas and Missouri professional licensing attorney Danielle Sanger is prepared to advocate for your best interests and defend you. Call Attorney Sanger at 785-979-4353 to schedule a free consultation with an attorney experienced dealing with nursing licensing issues.

 

 

 

 

Kansas and Missouri Professional Licensing Attorney Danielle Sanger Explains What You Should Do if You Receive a Notice of Investigation

Medical professionals often come to my office for a consultation after they have received a notice of investigation from either their employer or their licensing board.  Sometimes they are still in a good position, and there is a lot I can do to either minimize the damage or have it dismissed altogether.  However, there are other times when there is very little I can do because the medical professional involved has tried to “go it alone” or tried “to be helpful,” thinking that these may be successful strategies. They aren’t.

I wrote the following blog post to explain the steps you should take, and more importantly avoid if you receive a complaint from your state licensing board or employer. If you are a professional in Kansas or Missouri facing an allegation of misconduct or an investigation, call attorney Sanger today at 785-979-4353 to schedule a free consultation. Your career, reputation, and livelihood are at risk, and the challenge facing you is one you cannot work your way through alone.

Remain Silent

I have seen so many medical professionals ruin their cases by trying to be “helpful,” thinking that their compliance will make the investigation go away. As you have seen numerous times on crime dramas, “you have the right to remain silent,” and you should exercise that right.  Simply put, do not make any statement to anyone without an attorney by your side. It is a massive mistake to think you can handle an investigative meeting alone or that you can play along with the investigation to make things go away. You are just digging yourself into a deeper hole and playing into the investigating agency’s hands when you attempt that sort of foolish strategy.

Do Not Ignore the Allegations Against You

While you should not speak with investigators or give any statement, you also should not ignore the allegations against you. Failing to respond to any complaints against you will only bolster the argument that you are not performing your work professionally.

Do Not Speak About the Matter with Friends, Family, and Coworkers

Only speak to your attorney about the claims against you. Your statements to your attorney fall within the attorney-client privilege and do not have to be disclosed. Anyone else can be questioned and must disclose your comments.  Your coworkers are likely to be asked about your conduct and statements, so especially avoid making statements to them about anything related to your case.

Stay Off Social Media

Social media such as Facebook, Twitter, and Instagram can all be fun ways to blow off steam, but not about your case.  I recommend that clients delete all of their social media profiles while the allegations against them are pending. It is just too easy to make a statement that will be taken out of context or to post a picture of behavior that investigators can use to support their allegation that you are unprofessional.

Contact an Experienced Kansas and Missouri Licensing Attorney Now

You have worked too hard to attain your professional license. Allegations based on miscommunications, inter-office conflict, and vengeful patients can cost you that license, even if they are not true. But you can hobble your defense by trying to handle parts of it yourself. Contacting an experienced licensing attorney to help you through the misconduct hearing process and can mean the difference between getting back to helping your patients and losing your career forever.

Kansas and Missouri professional licensing attorney Danielle Sanger is prepared to advocate for your best interests and defend you. Call Attorney Sanger at 785-979-4353 to schedule a free consultation with an attorney experienced dealing with professional licensing issues.

 

Kansas and Missouri Professional Licensing Attorney Danielle Sanger Describes Common Real Estate Broker Complaints

Complaints against real estate professionals—agents and brokers—are unfortunately quite common in both Kansas and Missouri. That is easy to understand, as commercial and residential real estate transactions involve tremendous emotion and contain so many complex elements. We also should not lose sight of the fact that, like all professionals, real estate professionals are human beings and that can make mistakes. If something goes wrong during a deal, the realtor frequently gets the blame. I wrote the following blog post to explain the top behaviors for professionals to avoid in the real estate field. I attached both states’ discipline rules for your further review.

If you are a real estate professional in Kansas or Missouri facing an allegation of misconduct or an investigation, call attorney Sanger today at 785-979-4353 to schedule a free consultation. Your career, reputation, and livelihood are at risk, and the challenge facing you is one you cannot work your way through alone.

Misrepresentation

If a real estate profession incorrectly represents any material facts—a fact that if known, might have caused a buyer or seller to make a different decision with regards to remaining in a contract, or to the price paid or received—during a transaction, they are at risk of being accused of misrepresentation. Misrepresentation also occurs when a real estate professional omits or fails to disclose a material fact.

Failure to Supervise

Failure to supervise can occur in two different manners. The first type happens when a real estate professional fails to monitor a subordinate’s work. The second type occurs when a real estate office’s broker fails to supervise the office’s license-required transactions adequately.

Unlicensed Activity

As any licensed real estate professional knows, certain aspects of assisting with the purchase and sale of real estate can only be performed by someone with an appropriate real estate license. If a real estate professional is found to have allowed a non-licensed individual to perform work requiring a license, he or she may be subject to discipline.

Violating Trust Funds

Trust fund violations can occur, first, when a real estate professional either comingles client money with his or her funds or, second, when the professional fails to document financial transactions adequately. In commingling, a real estate professional obviously violates professional ethics when he or she takes client funds; however, it is worth noting that it is an ethical problem to simply comingle the funds, even if none are taken.

Criminal Conviction

A criminal conviction, even one unrelated to the practice of real estate, can cause serious licensure issues for a real estate professional.  Any conviction that calls the real estate professional’s ability to be entrusted with substantial amounts of money can mean trouble for his or her license.  Drug convictions, theft and embezzlement convictions, and even DUI can signal danger for a real estate license.

Contact an Experienced Kansas and Missouri Licensing Attorney Now

You have worked too hard to attain your career as a real estate professional. Allegations based on miscommunications, upset buyers and sellers, and competing agents can cost you your livelihood, even if they are not true. You should know the parameters of the profession’s ethical rules but should contact a licensing attorney if you are accused of violating them. Contacting an experienced licensing attorney to help you through the complaint process can mean the difference between getting back to helping your patients and losing your career.

Kansas and Missouri professional licensing attorney Danielle Sanger is prepared to advocate for your best interests and defend you. Call Attorney Sanger at 785-979-4353 to schedule a free consultation with an attorney experienced dealing with professional licensing issues.

Kansas and Missouri Professional Licensing Attorney Danielle Sanger Explains How a Physician’s Prescription Writing Volume Can Trigger an Investigation

As I have mentioned in earlier posts, the nation’s opioid epidemic is causing an upsurge in investigations into physicians’ prescription practices. State medical boards are on the lookout for any behavior that might signal that a physician is running a “pill mill,” or a place that too easily and too often prescribes powerful drugs. I describe a cautionary tale regarding pill mills below.

If you are a physician and have received a certified letter from your state licensing board indicating that they are opening an investigation into your prescription writing practices, be prepared for a harrowing experience. Most physicians I have represented go through several stages of emotion when they learn that they are being investigated—terror, embarrassment, anger, and fear are all common. But I have helped hundreds of similarly situated physicians through this process and can assure you that many of these investigations, while stressful, have positive outcomes.

If you are a physician in Kansas or Missouri facing an investigation, call attorney Sanger today at 785-979-4353 to schedule a free consultation. Do not agree to speak with an investigator without an experienced attorney by your side. Your career, reputation, and livelihood are at risk, and the challenge facing you is one you cannot navigate alone.

Prescriptions Give Rise to Investigations—A Cautionary Tale

I frequently represent physicians accused of over-prescribing drugs such as OxyContin, Vicodin, Percocet, and Fentanyl.  While it is normal for many Kansas and Missouri physicians to write prescriptions daily, given the opioid epidemic, prescriptions of these drugs and others like them are likely to trigger regulatory scrutiny. That scrutiny can easily transition into licensure issues.  I recently came across information regarding physician whose license was suspended. I won’t use his name because it has not been made public yet but can tell you a bit about his case.

The first trigger for the administrative investigation of this doctor’s behavior was that he wrote thousands of opioid prescriptions in a single year’s time. That may not seem outlandish if he was an orthopedic surgeon or ran a pain clinic and was regularly dealing with people dealing with extreme pain following surgery, but he was a psychiatrist.

The second trigger for administrative investigation was that the prescriptions written by this doctor were primarily filled in a city an hour from the doctor’s practice. This means that those wanting opioids may have been seeking him out, even though there were options for psychiatric care similar to what he offered in their city.

Third, there were irregularities in the psychiatrist’s prescription practices.  For example, many of the prescriptions were written while his clinic was closed and while he was not present in his clinic.  Obviously, that can mean that someone other than this doctor was forging his signature on prescriptions. Regardless, it indicates that there may have been a loss of control over the prescription writing process.

As I indicated above, the psychiatrist’s medical license is suspended, and his practice is closed. There may be reasonable explanations for why the triggers I listed above were present, but this sort of prescription behavior suggests that the psychiatrist may have been operating a pill mill. Situations like this one are not unusual and can often be rectified when counsel presents a vigorous, appropriate defense.

Contact an Experienced Kansas and Missouri Licensing Attorney Now

You have worked too hard to attain your medical license to lose it because you were unprepared to respond to an inquiry from the state medical board.  An inquiry from a licensing board regarding your prescription writing means that your livelihood is in jeopardy. You will need help gathering and organizing evidence, hiring expert witnesses, cross-examining witnesses, among other tasks.  Contacting an experienced licensing attorney to help you through this process and can mean the difference between getting back to helping your patients and losing your career forever.

Kansas and Missouri professional licensing attorney Danielle Sanger is prepared to advocate for your best interests and defend you. Call Attorney Sanger at 785-979-4353 to schedule a free consultation with an attorney experienced dealing with licensing issues.