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

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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

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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 Describes Common Real Estate Broker Complaints

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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

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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.

 

Kansas and Missouri Professional Licensing Attorney Danielle Sanger Discusses Prescription Drugs’ Effects on Medical Licensing

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There is an opioid crisis in the United States, and in its aftermath, there has been increased scrutiny of physicians’ patterns of prescribing these powerful drugs. That scrutiny precipitated an increase in licensing investigations regarding prescription patterns and opioid use by physicians themselves.

If you are a physician contacted by an investigator, do not make the mistake of trying to handle your response to the investigation alone. I have seen physicians’ lives and careers devastated because they tried to be helpful with investigators, in the wrongheaded belief that that generosity would buy them the investigator’s good favor. It won’t. Physicians under investigation often erroneously believed that “playing ball” or helping the investigators helps their case, but this positive impulse consistently results in negative consequences. Don’t fool around, get the help you need from an attorney that specializes in licensing issues. 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.

How Prescription Drugs Can Affect Your Medical License

There is no question that being a physician can be incredibly stressful. In addition to staying up to date on current medical procedures and regulations regarding patient care, being a physician can pose personal challenges as well. Time away from home, massive workloads, relationship issues, and medical school debt can make work-life-balance challenging to achieve. Every day, physician prescribe medication to help alleviate their patients’ anxiety and pain. As physicians’ own stresses mount, the temptation to self-prescribe can be powerful.  Unfortunately, some physicians succumb to this pressure and self-prescribe powerful opioids and other. While physicians understand these drugs’ powerful effects better than anyone, self-awareness diminishes as drug use increases.  Drug dependence ensues.

In my practice, I most commonly see physicians who have developed an addiction to Vicodin, OxyContin, and Valium. I also see the frequent misuse of amphetamines, depressants or painkillers, such as Darvocet, Percocet or Demerol. While these brand names vary, all opioids are highly addictive and are associated with controlled substance addictions in physicians.

Allegations that give rise to licensing issues can take several forms. First, I frequently see physicians that are legally attaining the drugs but have become addicted to them. This addiction leads to sloppiness and mistakes in the medical setting. Even if the doctor is not making mistakes, if colleagues and coworkers note that he or she is coming to work under the influence of prescription drugs, they often file a complaint. Second, I also see physicians that have stopped attaining these drugs legally and have transitioned to either self-prescribing them or to attaining them illegally. Obviously, this is a serious issue that may lead to criminal charges in addition to licensing issues.

If any of the above descriptions describe your scenario, you need legal help now to thwart efforts to suspend or revoke your medical license. I have helped physicians in Kansas and Missouri in your situation and can help you too.

Contact an Experienced Kansas and Missouri Licensing Attorney Now

You have worked too hard to attain your medical license.  If you are a physician under investigation or have developed an addiction to opioids, pain pills, or any other drug, do not agree to any suspension of any kind or speak to an investigator without an attorney by your side to defend you and to negotiate the best possible outcome. Your career, reputation, and livelihood are at risk, and the challenge facing you is one you cannot navigate alone. 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 prepared to guide you through your licensing issues.

 

 

Kansas and Missouri Professional Licensing Attorney Danielle Sanger Explains How Charting Errors Can Lead to Discipline

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One of the most time consuming and tedious aspects of the nursing profession is charting. That said, it is also one of the most vital tasks, as it is the primary line of communication between you and the rest of the medical professionals on your team. If you are a veteran nurse or work in a rural or small clinic, you may be acquainted with hand-charting your patients’ health information. On the other hand, if you work in a modern medical facility, you may use an entirely electronic charting program. Regardless of the charting system you use, charting errors and omissions can cost you your job and your nursing license

Before my work representing medical professionals in licensing cases I advised the boards that discipline them. As a result, I have a unique insight into how to avoid discipline altogether or to minimize it when avoidance is impossible. I frequently represent nurses accused of charting errors and often achieve positive results on their behalf. If you are a nurse in Kansas or Missouri facing an investigation that jeopardizes your professional license, call attorney Sanger today at 785-979-4353 to schedule a free consultation.

Charting Mistakes and Fraud

I frequently see nurses accused of charting mistakes that fall into two categories. The first category is somewhat minor mistakes that taken together demonstrate a pattern of sloppiness. The second is serious, singular errors that result in harm to patients and other sentinel events. I am categorizing both of these types of allegations as “mistakes” because they are the unintentional results of overwork, poor charting systems, or other medical professionals’ errors.

The following is a list of common chart mistakes that I see: food allergies, medication reactions, changes in patient conditions, treatment actions taken, physicians’ requests to discontinue the use of a medication, adverse effect of a medication, known preexisting conditions. I also frequently see mistakes such as inadvertently writing one patient’s chart notes on another patient’s chart. Finally, I often see mathematical errors, such as writing “2 milligrams” when in fact the patient received “.2 milligrams” of a drug.

Less frequently, my clients are accused of fraudulent charting, which is the intentional misrepresentation of patients’ medical information. The reasons alleged for fraudulent charting vary, but often involve an overworked nurse trying to “catch up” on charting that he or she did not do but should have. Rather than come clean about the omission, the nurse fabricates information for a patient’s chart to cover his or her tracks.

Often, nurses’ inadvertent mistakes are misconstrued as a pattern of sloppiness or intentional fraud when, in fact, they are simple human error.  An attorney can help you gather evidence and explain the situation in a manner that makes that critical distinction clear. A single mistake or mischaracterization should not define your nursing career.

Contact an Experienced Kansas Licensing Attorney Now

You have worked too hard to attain your nursing license.  If you receive a notice of investigation, my experience is that “playing along” and being helpful will only hurt you in the end.  Do not speak to any investigators or agree to any type of suspension without an attorney to protect your interests. Your livelihood is at risk, and the challenge facing you is one you cannot navigate alone. Contacting an experienced licensing attorney to help you through this process and can mean the difference between getting back to helping your clients 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 prepared to guide you through your licensing issues.

 

Kansas and Missouri Professional Licensing Attorney Danielle Sanger Explains Common Ways that Social Workers Endanger Their Licenses

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Social workers frequently work with their community’s most troubled and marginalized populations, often working closely with people suffering from addiction, poverty, and abuse to accomplish their goals. But these necessary aspects of the social worker’s job frequently expose social workers to accusations of misconduct. Because social workers often work one-on-one with clients, these allegations can be tough to defend.

If you are a social worker in Kansas or Missouri facing an investigation into your conduct, 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.

Most Frequent Allegations Against Social Workers 

Boundary Violations—allegations of boundary violations arise when a social worker’s relationship with a client extends beyond a therapeutic relationship. Sexual and romantic relationships are clear boundary violations, but even a perceived friendship or connection on social media can give rise to allegations. With the rise of social media, I advise clients to have a strict rule that they will have no virtual or social media relationship with their clients.

Failure to Maintain Client Records and Case Notes—social workers often struggle under oppressive caseloads. Clients’ immediate emotional and safety needs can seem more important than paperwork. But maintaining client records is a vital and mandatory aspect of the social work profession, and a failure to keep up with case notes results in an inability to communicate across the therapeutic team. Have a system for documenting client interactions at the time those interactions occur or soon after. I frequently see social workers find themselves in the midst of an administrative investigation when they have tried to catch up long after a client meeting or when they created false records long after a client interaction has occurred. 

Working Outside the Scope of Practice—while social workers are all compelled to help those in need, that compulsion can result in licensure issues when the social worker wanders outside his or her area of competency. If you are trying to develop a new competency, seek and document mentoring, supervision, training, and education. The problem with working outside the scope of practice is that, without mentoring and training, you can easily make mistakes and not be aware you are making them, even when you are otherwise conscientious. 

Failing to Keep Up with Continuing Education Requirements—many disciplinary actions start with an allegation that a social worker was unable to keep up with required continuing education requirements and grow from there. Keep up with your continuing education requirements and document your compliance so that this issue never arises. 

Contact an Experienced Kansas and Missouri Licensing Attorney Now

You have worked too hard to attain your social work license to lose it because you failed to adequately document your compliance with continuing education requirements or some other housekeeping issue.  An inquiry from a licensing board regarding your professional actions and decisions means that your livelihood as a social worker is in jeopardy. As the investigation progresses, you will need help in 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 clients 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.

 

 

 

 

Missouri Professional Licensing Attorney Danielle Sanger Explains Missouri Dental Board Complaint Process

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Dentists enjoy tremendous respect from their patients and community because they are professionals providing a valuable service. The vast majority of dentists go through their career without any disciplinary issues, so they are often entirely unfamiliar with the complaint and discipline process here in Missouri. There are many reasons why these otherwise rule following dentists receive notices of complaints, which I will detail below. I will also describe the two different complaint resolution processes and what you should do if the Missouri Dental Board contacts you about a complaint.

If you are a dentist in Missouri facing an investigation, call attorney Sanger today at 785-979-4353 to schedule a free consultation. Do not agree to any resolution process, speak to an investigator, or agree to any temporary suspension without the assistance of a licensing attorney. Your career, reputation, and livelihood are at risk, and the challenge facing you is one you cannot navigate alone.

Why Good Dentists Get Accused of Misconduct

As I said earlier, most dentists here in Missouri are law-abiding, rule-following pillars of their communities.  While some commit severe lapses in judgment that result in discipline, such as sexually abusing a patient or self-prescribing, others are accused of misconduct when they have done nothing wrong. I see an increase in cases linked to the nation’s opioid crisis. People are addicted to these drugs that may have been legitimately prescribed to them at some point. Others go to the dentist with phantom symptoms to convince the dentist that opioids should be prescribed. Either way, when the dentist stops filling out prescriptions for opioids, the patient often uses the Missouri Dental Board Complaint process as a tool to leverage more drugs. If the dentist refuses to prescribe more opioids, a complaint ensues.

The Missouri Complaint Process

In Missouri, a complaint to the Missouri Dental Board can be handled two different ways, either through the Peer Review Program or the Missouri Dental Board complaint process.

Peer Review provides an alternative dispute resolution mechanism, at no cost to either party. Peer Review is a where other dentists review and attempt to resolve dental treatment problems and misunderstandings through mediation. The process may involve merely talking through a complaint or may require a clinical review of the accused dentist’s practice. One important point to note is that you may not be represented by counsel in the Peer Review process.

The Missouri Dental Board process is more formal and operates more like a court. The dental board will notify the dentist of the complaint, investigate the complaint, and offer a hearing. The Dental Board will have legal counsel, and the accused dentist is well-advised to have counsel as well.  A licensing attorney is an asset before the Board, as few dentists know how to cross-examine witnesses, challenge evidence’s credibility and relevance, and understand how to proceed strategically through the administrative process.

What You Should Do if You are Contacted About Misconduct

Because most attorneys are law-abiding and rule-following members of their communities, they all-to-often believe that “coming clean” and admitting misconduct is the right thing to do when they are accused of misconduct. While that is an admirable worldview, it rarely results in the favorable outcome that the dentist intends. Let me be clear, I want my clients to tell the truth and to be forthcoming, but I want them to do those things strategically.  If you just admit to misconduct without accompanying legal advice, you are more likely than not hurting your case, not helping it. I advise clients to exercise their rights to remain silent and simply say that they will be happy to speak with an investigator once they have an opportunity to consult with an attorney. Having worked for boards myself, I know that this statement is never taken as nefarious by investigators; they also know that this is the best course to take.

Contact an Experienced Kansas and Missouri Licensing Attorney Now

You have worked too hard to attain your dental license to lose it because you failed to attain competent legal advice when you needed it.  If you are a Missouri dentist and you have received a notice of complaint from the Missouri Dental Board, you need to know that this is a dire situation and that the process could result in a loss of licensure.

An inquiry from a licensing board means that your livelihood is in jeopardy. Contacting an experienced licensing attorney to help you through this process and can mean the difference between getting back to helping your patients or clients 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 Provides an Overview of the Nursing Complaint Process

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I have seen nurses’ lives and careers devastated because they agreed to a “voluntary suspension” of their nursing license or to speak to an investigator without the assistance of an attorney while the nursing board investigated allegations of misconduct. While the nurse under investigation believed that “playing ball” or helping the investigators would help their case, this seemingly positive action had tremendous negative consequences.

If you are a nurse in Kansas or Missouri facing an investigation that jeopardizes your professional license, call attorney Sanger today at 785-979-4353 to schedule a free consultation.

What Should You Do If an Investigator Contacts You?

If you are a licensed nurse in Missouri or Kansas and have been contacted by a state nursing board investigator, it means that a complaint was made against you. More troubling, it indicates that the state nursing board believed that the complaint had some merit and was worth investigating.  Former patients, former coworkers, or an employer can file a complaint against you. The complaint can be based on procedural grounds—you made a mistake or were negligent in treating a patient—or on ethical grounds.  Ethical grounds cover behavior within and without the treatment context, such as having an inappropriate relationship with a patient or getting charged with a crime.

What Can I Expect Now That an Investigator has Contacted Me?

If a nursing board investigator contacts you, the board has found enough evidence of wrongdoing to warrant further inquiry into your conduct. The investigator’s job is to find out the facts by interviewing witnesses, requesting documents, and reviewing treatment records. They will request a meeting an interview with  you. They commonly require that you submit a written statement describing the incident that led to the complaint. For each of these stages, you will benefit from having the assistance of an experienced licensing attorney’s help. I previously advised these boards and have seen how poorly drafted statements and incomplete records resulted in devastating results for nurses who tried to “go it alone.” Even small improvements based on years of experience can mean the difference between a dismissal and a finding.

What Happens After the Investigator Finishes His or Her Inquiry?

An investigation takes several months to conclude, depending on the complexity and availability of evidence. When the investigation ends, the investigator submits a summary report. Further action, including discipline, is decided based on the summary report. Discipline may include:

Dismissal– This is the best outcome. This results when the nursing board determines that the behavior alleged does not rise to the level of a violation.

Private Caution Letter– This outcome is not as good as a dismissal, but is favored over discipline. A caution letter involves the board privately admonishing and warning the nurse under investigation that his or her conduct—while not warranting discipline—was imprudent or unwise. The board will remind the nurse under investigation of applicable rules and laws governing the profession.

Formal Complaint –This outcome should be avoided at all costs. It involves the board finding a regulatory or statutory violation. The nurse under investigation often has the option to sign a consent agreement or may refuse to sign the consent agreement and instead request a full hearing before the board. If the nurse signs a consent agreement, he or she agrees that a violation occurred and to a set penalty. If the nurse goes before the board, they have another opportunity to challenge the investigation’s validity and to contest the investigator’s findings.  The board will then punish the nurse as they see fit.

As the above process indicates, the investigator’s findings and recommendations will determine the course of action in your case. The matter could be resolved quickly and favorably or may be drawn out. Having an attorney with experience before the board is invaluable at this step. Do not let an investigation ruin what you have worked so hard to build. If a state nursing board investigator has contacted you, seek the help of an experienced licensing attorney immediately.

Contact an Experienced Kansas and Missouri Licensing Attorney Now

You have worked too hard to attain your nursing license.  If you are a nurse under investigation, do not agree to any suspension of any kind or speak to an investigator without an attorney to defend you. Your career, reputation, and livelihood are at risk, and the challenge facing you is one you cannot navigate alone. 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 prepared to guide you through your with licensing issues.

 

Kansas and Missouri Professional Licensing Attorney Danielle Sanger Explains the Kansas Pharmacist Complaint and Investigation Process

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Given the opioid crisis occurring in the United States and the uptick in complaints against pharmacists, I have recently defended pharmacists accused of violations here in Kansas. As someone who actually provided legal advice to medical boards in the past, I can also tell you that I have seen well-meaning professionals have their lives destroyed because they decided to try to represent themselves. No matter how seemingly inconsequential your case seems, attempting to represent yourself is a massive mistake. Because I have seen a rise in the number of chiropractor complaints over the years, I wrote the following blog post and attached a Kansas Board of Pharmacy overview for your review.

If you are a chiropractor here in Kansas facing an investigation that jeopardizes your professional license, call attorney Sanger today at 785-979-4353 to schedule a free consultation.

You Have a Constitutional Right to Due Process

The Kansas Board of Pharmacy is an administrative arm of the State of Kansas. So when the Kansas Board of Pharmacy begins actions that could result in the loss of your license, that is the state acting to take your property from you. Any time the government acts to restrict your life, liberty, or property it must first provide you with “due process,” a legal term that means you must have an opportunity to know the allegations against you, to review the evidence underlying those allegations, and to have an opportunity to “confront” that evidence in a meeting with an investigator.

While you could probably struggle through an investigation on your own and could likely even sit through a hearing, you want someone by your side that has been through hundreds of proceedings like yours. A licensing attorney can challenge the state’s evidence and can even have it excluded. Similarly, a licensing attorney can effectively cross-examine witnesses and access expert witnesses that can help your case.

The Initial Stage of an Investigation

Most reports received by the Kansas Board of Pharmacy come from consumers as formal complaints, but there are a host of other sources.  Some complaints originate with employers, the court system, law enforcement, neighbors, relatives, or other agencies. Once a complaint comes in, an investigator is assigned to begin gathering facts and evidence. It is vital that you remember that you have the right to legal help throughout the investigative process.

What Does an Investigation Look Like?

State investigators from the Kansas Board of Pharmacy will review medical records, personnel records, agency records, and records of discipline on licensing from other states. They will conduct interviews of witnesses and take their statements. It best if you have documents ready and organized for the investigator’s review and do not make them search for them; obviously, this promotes an air of transparency that can only help your case.

You will also have an opportunity for an interview. It is crucial that you have an experienced licensing attorney help you prepare for your interview and be by your side as it is conducted. This is also an opportunity to provide exculpatory and mitigating evidence to the investigator, and your attorney will help you collect the evidence that is most persuasive.

The investigative process takes six to nine months to complete. Factors such as the availability of evidence, cooperativeness of witnesses, and case complexity influence how long an investigation will take.

What Happens After the Investigation?

The investigator’s work is not complete once the investigation is complete.  The investigative summary and file are forwarded to the Kansas Board of Pharmacists and is reviewed by the Investigative Member of the Board, who decides what disciplinary action should be taken.  Options include, but are not limited to 1) revocation, 2) probation, 3) monetary fines, 4) non-discipline probation agreements, 5) agreements to obtain specific CE courses, and 6) referrals to the impaired provider program.

The Kansas Board of Pharmacy will notify you once they decide your discipline. The Board must approve whatever disciplinary action is recommended against you. While this may seem like the end of the road, it isn’t. You still have an opportunity to appeal this decision to the Kansas courts. However, agency decisions such as disciplinary decisions are given great deference by the courts, so it is more effective and much cheaper to work with an experienced licensing attorney to reduce your discipline at the investigation or Board level.

Contact an Experienced Kansas Licensing Attorney Now

You have worked too hard to attain your pharmacy license.  If you are under investigation, do not agree to any suspension of any kind or speak to an investigator without an attorney to defend you. Your livelihood is at risk, and the challenge facing you is one you cannot navigate alone. Contacting an experienced licensing attorney to help you through this process and can mean the difference between getting back to helping your clients 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 prepared to guide you through your licensing issues.