Practitioners of the Chiropractic Arts Must Maintain Highest Ethical Standards in Missouri

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Chiropractic care continues to suffer from an image problem. Some believe that the chiropractic arts are a bit of witchcraft or voodoo because they are skeptical of its benefits as a healing art. Notwithstanding, given the proliferation of chiropractors in the United States, and in Missouri in particular, chiropractic care continues to grow as a legitimate health care alternative, despite its image problem. Chiropractors must be vigilant to uphold the highest duty of care to their patients as well as their ethical duties so the credibility of the healing art may progress. Any deviation from that high standard can have disastrous consequences for the practitioner. The potentially disastrous consequences is why Professional licensing attorney Danielle Sanger is committed to defending actions against chiropractor’s licenses.

In 2011, the Missouri Bar Association published an article relating to the proper evaluation of chiropractic malpractice relating to strokes purportedly caused by neck manipulation. The risk of stroke, incidentally, the existence of which is conceded by chiropractors, is caused by the twisting of the neck, or cervical spine, which can create a shearing of the major blood vessels leading to the brain. The shearing deprives the brain of necessary blood resulting in a stroke. The article cites a study conducted by medical doctors concluding that manipulation of the neck causes stroke in nearly 1 out of every 40,000 manipulations. By stark contrast, studies advanced by chiropractors conclude the risk of stroke by neck manipulation is 1 in 5.85 million.

The article cautions the legal practitioner on properly evaluating whether the chiropractor committed malpractice causing a stroke. In fact, the article discusses how a plaintiff’s potential expert at trial, i.e., a neurologist, has a natural bias against chiropractic care, which diminishes their credibility as an expert.  That’s on the one hand. On the other, the author instructs the case evaluator to consider the promises and rhetoric a chiropractor uses to convince a potential patient that there is a dire need for chiropractic care vis-a-vis traditional medical care. The author advises that a chiropractor’s website and advertisements are filled with information that can be used against the practitioner.

Ensuring the ethical practice of chiropractic care can only serve to advance the public perception and benefit of chiropractic care. Thus, a chiropractor who truly believes in the healing arts will benefit from closely following the ethical guidelines delineated by the Missouri State Regulations as well as the American Chiropractic Association Code of Ethics. The Missouri State Regulations (“the Regulations”) require a chiropractor to inform the patient of the patient’s “abnormalities” and provide an honest assessment of whether chiropractic care will benefit the patient. Similarly, the American Chiropractic Association Code of Ethics (“Code of Ethics”) mandates a chiropractor to build “trust” in a clinician–patient relationship. Consistent with the Regulations, the Code of Ethics instructs the chiropractor to be completely honest with the patient about the causes of the ailments for which treatment is sought and the possible outcomes as well as the chiropractor’s skill and education.

As the article referenced above indicates, the competition for chiropractic patients is greater than that of a medical doctor’s. Accordingly, chiropractors who choose to advertise must do so without being false or misleading. For instance, promising or guaranteeing certain results will be reached is strictly prohibited by both the Regulations and the Code of Ethics. Preying upon a vulnerable population, such as people suffering from chronic pain, or solicitation of business in the immediate aftermath of an accident, is also prohibited.

Missouri Professional Licensing Attorney Danielle Sanger has devoted her career to defending professional licensees, such as chiropractors, in both Missouri and Kansas. Attorney Sanger, with her experience as an assistant attorney general, will represent you with zeal to protect your license from discipline should you be accused of violating an ethical rule. Call Missouri professional licensing attorney Danielle Sanger at 785-979-4353 to schedule your free consultation and learn what a difference dedication and experience can make for you.

Decisions in 2015 by the Missouri Board of Healing Arts Lead to a Number of Physicians Losing Their License to Practice Medicine

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The Missouri Board of Registration for the Healing Arts has disciplined several medical doctors in 2015 for ethical violations. Most disciplinary actions resulted in a public reprimand or probation, while others have led to suspensions from practice for a given period of time. Some physicians have suffered catastrophic outcomes. To this point in 2015, five physicians have lost their license to practice medicine in Missouri. While the reasons for license revocation vary, the transgressions the Board of Registration for the Healing Arts (“the Board”) found that the physician committed were extremely serious and warranted license revocation. The potential for severe, career and potentially life-altering disciplinary action requires hiring an experienced professional licensing attorney to defend you in disciplinary investigations and hearings.  Missouri professional licensing attorney Danielle Sanger has the experience to vigorously protect you from potentially irreparable disciplinary action.

Physicians, as well as all other licensees who are investigated for unethical conduct by the Board, enjoy certain rights if the investigation leads to a formal disciplinary hearing. The rights granted to physicians facing a disciplinary action ensure that the physician is protected by due process of law before adverse action is taken against the physician’s license. Accordingly, physicians have the right to be present and hear evidence presented at a hearing, to be represented by counsel, to have the allegations proven by “competent and substantial evidence,” the right to confront and cross-examine witnesses present in support of the allegations, the right to present evidence in the physician’s own behalf, as well as the right to a fair and impartial hearing conducted by an administrative hearings commissioner.  The rights are personal to the physician. Accordingly, the physician may waive the enumerated rights and enter an agreement with the Board. The physician may wish to challenge the Board’s evidence and contest the allegations levied at a hearing.  Failure to appear and defend will result in a default judgment against the physician and the Board will conclude that all of the allegations are true.

The Board has the statutory authority to discipline a physician licensed in Missouri for disciplinary action occurring in another state. Thus, the Board revoked the license of a Missouri physician for seven years based upon disciplinary action in Tennessee. Tennessee’s disciplinary tribunal revoked the physician’s license for a period of not less than two but no more than seven years.  Similarly, the Board revoked a Missouri physician’s license for seven years who voluntarily and permanently surrendered his medical license to the Texas Medical Board. This physician was found responsible for unethically dispensing controlled substances to seven patients in Texas.

Three additional investigations by the Board resulted in the revocation of Missouri physicians’ licenses. One physician voluntarily surrendered his license in lieu of other discipline for positive drug screens. The physician admitted to taking morphine pills that were not prescribed for him. This positive test caused the physician to voluntarily surrender his rights to prescribe controlled substances monitored by the State of Missouri and the U.S. Drug Enforcement Administration (“DEA”). Surrender of his privileges to the DEA constitutes “final action” giving the Board grounds to seek disciplinary action. Another physician voluntarily surrendered his “controlled substance privileges” to the DEA during the Board’s investigation. This physician also voluntarily surrendered his license in lieu of other discipline. In another case, the Board, after a full hearing, found that the physician failed to comply with his terms of probation on his license resulting from previous disciplinary action for substance abuse. The Board ruled that to preserve the public safety, the physician’s license must be revoked for seven years.

Professional Licensing Attorney Will Fight To Protect You And Your Livelihood

Kansas Professional Licensing Attorney Danielle Sanger is a zealous advocate for professional licensees, including physicians. Attorney Sanger’s experience as an assistant attorney general, coupled with her extensive accomplishments in private practice, provide her with the knowledge to zealously defend against any disciplinary action or investigation. Call Missouri professional licensing attorney Danielle Sanger at 785-979-4353 to learn how experience and determination can preserve your career and your livelihood.

Recent Examples of Disciplinary Actions Levied by the Missouri Committee of Psychologists

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The Missouri Committee of Psychologists is the governing administrative agency for psychologists in Missouri. The Missouri Committee of Psychologists (“the Committee”) regulates the practice of psychology by ensuring proper licensing by people holding themselves out to the public as psychologists, and making certain that psychologists meet proper educational requirements, as well as continuing educational guidelines. The Committee is also charged with investigating psychologists who have allegedly violated the governing rules of ethics or for other forms of misconduct. Professional licensing attorney Danielle Sanger is a zealous advocate for licensees facing disciplinary actions in Missouri.

The authority to investigate psychologists is conferred by statute in Missouri. Missouri Revised Statutes section 337.035.1 et seq. delineates numerous grounds upon which the Committee may investigate for disciplinary reasons, including but not limited to ethics violations, criminal convictions, failure to pay taxes, and the like. If the Committee finds evidence of one or more grounds for discipline, then the Committee may file a complaint with the Missouri Administrative Hearings Commission. If the Hearings Commission rules that the Committee met its burden, the Hearings Commission may levy discipline.

The Hearings Commission is authorized by statute to hear the allegations brought by the Committee against the licensee. The Hearings Commission then refers the matter back to the Committee if the Committee has met its burden to prove the allegations at the hearing. The authority conferred by statute to the Committee permits discipline in the nature of censure, probation of a license with appropriate conditions not to exceed five years, suspension of a license for no longer than three years, or revocation of a license.

An examination of recent disciplinary rulings is instructive to practitioners to help assess the prevailing rationale of the Committee. In one case, the psychologist was unable to satisfy the continuing educational requirements. The Hearings Commission found that the licensee was subject to discipline as a result of that failure. The Committee placed the licensee on probation for three years with numerous conditions. The licensee indicated to the Commission that his own mental state was not stable, which caused him to fail to meet continuing educational requirements. Those conditions included submitting to an evaluation to assess the licensee’s own mental condition for fitness to practice as a psychologist.

In another decision, involving more egregious facts, the Committee and licensee entered into a stipulation for discipline. The licensee became romantically involved with a former patient. The patient had sought counseling for a period of time and then failed to keep an appointment.  The licensee failed to send a termination letter or conduct a termination session. Shortly thereafter, the licensee and patient became romantically involved. The Committee and licensee reached an agreement wherein the licensee would be suspended for three years from practice and be placed on probation for three years if the license was reinstated. The Committee ordered the psychologist to submit to a psychological assessment and attend counseling if necessary.

In a very recent decision, the Committee accepted a stipulation for a psychologist who self-reported an ethical violation. The psychologist reported that he failed to maintain appropriate notes, referrals, examination tests, and other documentation required to be maintained by Missouri law. The licensee informed the Committee that adverse working conditions prevented the necessary record keeping. The Committee and licensee entered into a stipulation that the licensee would voluntarily surrender his license, “in lieu of other discipline.”

Contact an Experienced Professional Licensing Attorney for Assistance

Even trained professionals make mistakes. Do not compound the problem by representing yourself if you face a disciplinary complaint.  Kansas Professional Licensing Attorney Danielle Sanger has helped many clients keep their licenses despite facing disciplinary action. Attorney Sanger will tirelessly advocate for you to keep your license to practice. Call Attorney Sanger today at 785-979-4353 for your free consultation, and learn what a difference experience makes.

Kansas Professional Licensing Attorney Explains Due Process in Administrative Hearings

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Due process of law is guaranteed by the Fifth Amendment to the United States Constitution.  Each and every person is guaranteed due process protection every time life, liberty, or property is at stake.   Our system of law is premised upon the belief that life and liberty are fundamental to a free society.  Most associate this indispensable tenet of our law as applying to criminal trials but do not recognize the significance of due process in other areas of life.  Professional licensing attorney Danielle Sanger is highly experienced in representing licensees to ensure they enjoy all of the due process protections guaranteed by the Fifth amendment to the United States Constitution.

Depriving a person of life, liberty, or property without due process of law is not just idle legal theory. Due process protects us from arbitrary governmental action taking away something of ours we value. A person charged with a crime enjoys the highest level of protection the due process clause offers because their liberty, and maybe their life, may be taken from them.  In that context, due process means ensuring that a person is represented by competent counsel, is tried publically by an impartial jury of his or her peers, has the opportunity to confront and cross-examine witnesses called to testify, and, significantly, is made aware of the charges the government has  levied against him or her.

A professional licensee also enjoys due process protections when the government seeks to deprive them of their license. This is true because a professional license is “property” within the meaning of the due process clause. Notwithstanding, licensees facing discipline do not enjoy the same protections guaranteed to criminal defendants. A licensee who may be deprived of a professional license is guaranteed due process of law; however, the rights of the licensee are not as extensive in an administrative hearing as are a criminal defendant’s at a criminal trial.

Procedural distinctions between criminal trials and administrative hearings exist. The government in an administrative hearing is not required to specifically plead certain allegations. Rather, the government must inform the licensee about the factual allegations contained in the complaint sufficiently to allow the licensee to form a defense. If the facts are clearly set out, then the licensee has notice of the charges.  Notwithstanding, if the government pleads a violation of specific rules, then the government must prove a violation of the specific rule. Furthermore, allegations amended to the complaint based upon a licensee’s testimony at the hearing violates the due process rights of the licensee.

Kansas passed a statute called the “Administrative Procedure Act (the “Act”), which governs administrative hearings. The Act codifies the procedural rights parties enjoy when facing an administrative hearing. Under the Act, all licensees are afforded the opportunity to be heard and present a defense against the allegations, including the ability to call witnesses to testify on their behalf.  Parties have the right to cross-examine witnesses appearing against them. The Act mandates administrative hearings must be open to the public unless there is a compelling reason to close the hearing.

Take Immediate Action to Preserve Your Due Process Rights

Call Kansas Professional Licensing Attorney Danielle Sanger today at 785-979-4353 if you have been notified of a complaint by a professional licensing board. With 10 years of experience as an assistant attorney general, and many more representing professionals, Attorney Sanger will fight to protect your rights. Attorney Sanger will make certain that any hearing you face will be conducted fairly and impartially. Act now to protect your rights. Call professional licensing attorney Danielle Sanger today to schedule a free consultation.

Social Workers in Missouri Provide Expert Care While Maintaining High Ethical Standards

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Social workers provide an invaluable service to the community. Social work has been described as a “calling” rather than a “career.” Social workers provide care to those who are most in need of service. Many social workers dedicate their professional lives to serving the impoverished, the addicted, the helpless—such as children and the elderly—while fighting for “social justice.” The social worker toils at the intersection of an individual’s private matters and public welfare. Thus, social workers find themselves in a unique position and provide an invaluable service to our communities. Notwithstanding, social workers must adhere to the high standards of ethical behavior. Professional licensing attorney Danielle Sanger understands the invaluable role social workers play in society and is ready to fight for those who fight for justice.

Social workers serve a vulnerable community. They are healthcare providers in terms of mental health counseling and addiction treatment. Social workers fill vital roles in the prison system as well. They assist incarcerated individuals in obtaining treatment, meeting educational requirements, and helping prepare prisoners for reintegration into society upon release. Social workers also fill a critical need at the family level by administering care to children in need and helping to protect them. They also play a similar role for the elderly.

In Missouri, social workers must adhere to high personal moral standards and competence. Social workers must adhere to Missouri’s licensing requirements. These are enumerated by statute. Missouri’s regulations for social workers mandate that social workers have an obligation to protect the public from incompetence, educational deficiency, lack of experience, or low moral standards by people attempting to practice social work. To protect the vulnerable from abuse and mistreatment, social workers must obey promulgated ethical rules, and be truthful. Failure to obey the rules and regulations will subject the social worker to disciplinary action against their license.

Social workers must be vigilant against developing personal relationships with their clients. Social workers are deeply involved in their patients’ lives. It is understandable if the patient develops personal feelings for their social worker. It is incumbent upon the social worker to maintain the highest degree of professionalism and not engage a patient in a personal relationship. Accordingly, a social worker is prohibited from sexually exploiting their clients. Furthermore, social workers may not enter into a personal relationship with a client and remain the client’s social worker in situations where the social worker has provided treatment or services for mental illness or emotional problems. Business relationships are also prohibited between social worker and patient. These prohibitions are in place to protect the patient and also to ensure that the patient receives the highest degree of care from the social worker. A social worker cannot provide competent care when the social worker cannot remain objective about the client.

A social worker must also maintain objectivity about the services they are asked to provide. A social worker must refer a matter to a colleague if they are not competent to handle the client or subject matter. Although it might be financially advantageous to serve clients outside of their main competency, social workers must be objective about their services and make referrals that are in the best interest of the patient. Furthermore, the social worker must terminate treatment when the patient has achieved their treatment goal or is no longer benefitting from services.

Call for Immediate Assistance if You Are Facing Disciplinary Action

Missouri Professional Licensing Attorney Danielle Sanger is a zealous advocate for professional licensees. Call attorney Sanger today at 785-979-4353 to schedule a free consultation. Attorney Sanger will thoroughly analyze your case and provide you with the best defense against allegations of social worker misconduct in Missouri and Kansas. She will fight for those who dedicate their lives to fighting for others.

Athletic Trainers in Kansas are Governed By the Kansas Board of Healing Arts

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Athletic trainers are an indispensable component to scholastic athletes’ health and well-being in Kansas. Recognizing their importance, athletic trainers in the state of Kansas fall under the purview of the Kansas Board of Healing Arts. The Board of Healing Arts (“the Board”) has the authority to license, investigate, and discipline athletic trainers in the same manner as physicians, psychologists, and other health care professionals. The Board’s supervision ensures all athletic trainers are licensed and maintain the minimum level of competence required to treat athletes. Any athletic trainer falling below those standards or failing to satisfy other mandated requirements is subject to discipline. Professional licensing attorney Danielle Sanger has vigorously advocated against discipline on behalf of professional licensees, including athletic trainers, in Kansas and Missouri.

Governance of athletic trainers in Kansas is bestowed upon the Board by statute. That statute, K.S.A. 65-6901 et seq., defines an athletic trainer and a trainer’s duties. Additionally, the statute authorizes the Board to minimum standards for an athletic trainer, licensing requirements, establish regulations governing the practice of athletic training, establish fees, and grounds for discipline. Discipline under the statute includes a criminal sanction for practicing as an athletic trainer without a license which is a class b nonperson misdemeanor. The statute authorizes additional, non-criminal discipline, depending upon the nature of the violation, as denial of licensure, revocation of license, public censure, probation, or any other discipline the Board deems appropriate. The Board also had the authority to apply for an injunction from a court having jurisdiction to immediately stop a violation of the rules and regulations.

The Board is permitted to issue discipline for a number of violations. Violations under the statute are:

  • Use of alcohol and/or drugs to the “extent that it impairs the individual’s ability to engage in athletic training”;
  • Felony conviction or other action that betrays the public trust;
  • Committing fraud or misrepresentation to obtain or maintain a license;
  • Committing fraud or misrepresentation to obtain a fee or other economic benefit;
  • Incompetence, fraud, or other misrepresentation while practicing as an athletic trainer;
  • Violating, or helping someone else violate, any rule or regulation established under the statute;
  • Impersonating an athletic trainer;
  • Intentionally or negligently violating rules or regulations established by statute;
  • Violating the public trust; or
  • Professional misconduct as defined by the rules and regulations established by the statute.

To this point in 2015, the Board has levied discipline against three athletic trainers. One applicant for licensure as an athletic trainer disclosed that he had acted as and held himself out as an athletic trainer in 2014 for the Wichita High School system as well as a semi-professional soccer team without being licensed. The Board issued discipline in the nature of a public censure.   The Board also ordered the applicant to research and draft an essay on the importance of an athletic trainer’s licensing requirements and delineating the scope of practice for an athletic trainer.  

Another athletic trainer faced discipline for failing to timely renew her license.  The trainer practiced athletic training during the months in which she was unlicensed. The Board found she committed misconduct by practicing athletic training without a license. She was publically censured for her transgressions.

A third trainer was disciplined for practicing without a license. This trainer held himself out as an “Interim Head Athletic Trainer” for a community college athletic program despite failing to timely renew his license. This trainer was subject to public censure and ordered to research and draft an essay to be published for public review discussing the importance of licensing and scope of the athletic trainer’s practice.

Professional Licensing Attorney Ready to Help Fight for You

Although public censure and writing an essay does not appear to be serious punishment, any public reprimand against a professional license could have disastrous consequences. Contact Kansas Professional Licensing Defense Lawyer Danielle Sanger if you are facing discipline in Kansas or Missouri. Attorney Sanger is renowned for tirelessly fighting for her clients and obtaining just results. Call Attorney Sanger today at 785-979-4353 today to schedule a consultation.

 

Kansas Board of Healing Arts Has Authority to Investigate Physician’s Conduct Occurring in Missouri

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Physicians who practice medicine in multiple states may be subject to investigation and discipline for conduct occurring outside of Kansas.  The Kansas Supreme Court conferred jurisdiction to the Kansas Board of Healing Arts to investigate physicians and potentially discipline Kansas physicians for conduct outside of Kansas. As an experienced professional licensing attorney in Kansas and Missouri, Danielle Sanger, Esq., is well versed with defending physicians facing discipline.

The Kansas Board of Healing Arts has jurisdiction to sanction a physician’s license despite the actionable conduct occurring in another state.  In Ryser v. State of Kansas et als., 284 P. 3d 337 (Kansas 2012), the Kansas Supreme Court ruled that the Kansas Board of Healing Arts (“Board”) has the jurisdiction, or the legal authority, to regulate the practice of medicine even if the questioned conduct occurred in another state. In so ruling, the Kansas Supreme Court indicated that the Board has “broad authority to regulate the practice of medicine.”   As part of that authority, the Board “shall undertake investigations regarding its authority to regulate medical practice in Kansas under the “Healing Arts Act (‘the Act’).”  

At the time the litigation commenced, Carol Ann Ryser, M.D., was licensed to practice medicine in both Kansas and Missouri. The Board issued a subpoena for medical records for a patient of Dr. Ryser’s pursuant to its subpoena authority conferred under the Act after Dr. Ryser was sued for malpractice in Missouri. Dr. Ryser moved to quash the subpoena. Dr. Ryser argued that the Act did not grant the Board jurisdiction to investigate claims of malpractice that occurred in Missouri. Dr. Ryser sued in the district court to quash the subpoena and the district court denied her motion. Dr. Ryser appealed to the Kansas Supreme Court.

The Kansas Supreme Court upheld the district court’s ruling ordering the subpoena to issue. In ruling against Dr. Ryser, the Court was forced to decide whether the Board possessed jurisdiction over the matter. The Court considered what authority the Act conferred to the Board to investigate. Under the Act, the Board has the duty to investigate matters involving competency, unprofessional conduct, or “any other matter which may result in disciplinary action against a licensee.”  While Dr. Ryser admitted she was licensed to practice medicine in Kansas (because she was in fact licensed in Kansas), she argued that she was not practicing under the Act because the alleged incident occurred while she was treating the patient in Missouri.

The Court thoroughly examined the term “licensee” as it applies to the Act.  The Act itself fails to define what it means to practice under the Act. The Court examined other terms and definitions of other terms within the Act to assist with the interpretation of what it means to “practice.” Consequently, the Court turned to the definition of “healing arts.” The definition of “healing arts” under the Act includes numerous practices and treatments but also without “limitation to the practice of medicine and surgery.”

The Court next turned to the Act’s definition of the “practice of medicine and surgery” to further explicate the meaning of “practice.” The Court was persuaded that “persons deemed to be engaged in the practice of medicine and surgery” are individuals who hold themselves out to the public as physicians or surgeons.  Because the Act, by its own terms, fails to include a geographical limitation upon the practice of medicine, the Court concluded the Board may investigate actions occurring in another state.

Physicians Facing Discipline Must Hire a Zealous Advocate

Danielle Sanger, Esq., has fought to protect the livelihood of Kansas and Missouri physicians facing discipline.  Kansas Professional Licensing Defense Lawyer Danielle Sanger is a zealous advocate who will fight to defend you against allegations of misconduct in the practice of medicine. Call attorney Sanger today at 785-979-4353 for your free consultation.  

An Overview of the Missouri State Committee of Marital and Family Therapists Standards for Ethics

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In Missouri, the State Committee of Martial and Family Therapists governs all licensees practicing marital and family therapy. The State Committee of Marital and Family Therapists (“the Committee”) is established by statute and is charged with passing regulations establishing the ethical standards of marital and family therapy, among other issues involving marital and family therapists. The regulations provide minimum professional standards for therapists and delineates specific concerns regarding client welfare. The regulations seek to maintain the public trust in the profession as well as protection of the individual patient. A violation of the ethical standards allows the Committee to seek discipline against a licensed therapist.  Professional licensing attorney Danielle Sanger is a skilled advocate for licensees facing discipline resulting from an alleged violation of ethical standards of therapists.

Chapter 3 of Division 2233 of the Code of State Regulations for Missouri codifies the ethical standards of marital and family therapists. Not only does Chapter 3 regulate the general practice of marital and family therapy, it also purports to establish the minimum requirements to which a therapist must adhere to protect a patient’s welfare. Although seemingly rudimentary, failure to adhere to these standards is grounds for discipline. All of the regulations are designed to protect the best interest of the patient.

Section .010 of Chapter 3 delineates the competency requirements of a martial and family therapist. A marital and family therapist must limit his or her practice to those areas in which the therapist has studied and trained. The therapist is required to maintain competence by attending continuing educational classes, trainings, and supervision that meets current scientific standards in the profession.  A therapist is not limited to practicing only what they studied. If they do wish to employ a therapeutic technique new to them or practice in a new area, they must educate and train themselves in that new technique or service. The therapist must obtain informed consent from the patient before using the technique or service by warning of the process as well as any potential risks associated with the technique or service.

Section .010 also guides the therapist as to when counseling may not be commenced or must be terminated. Counseling must be terminated if the therapist is unable to perform his or her duties owning to emotional, psychological, or addiction concerns.  Also, a therapist cannot accept a patient or continue to counsel a patient if the therapist’s objectivity or competency is compromised by emotional, sexual, familial, or other relationship with the patient. The therapist is expressly prohibited from making sexual advances, having a sexual relationship, or sexually or suggestively touch a patient. Section .010 contains other patient protections. The therapist must not take financial advantage of a patient and must always maintain strictest confidentiality. 

The patient welfare component of Chapter 3 is set out in Section .020. This section requires that the therapist must advise and obtain informed consent of the patient prior to commencing therapy. Informed consent, in this context, requires advising the patient about the specific form of therapy, the goals of therapy, the benefits and risks involved in therapy, the therapist’s credentials, the financial consideration, and the limits of confidentiality. Additionally, therapists are required to obtain a substitute therapist in the event of lengthy absence from practice. Therapists must also explain the patient’s diagnosis and condition to the patient in terms the patient can understand.

An accusation of unethical conduct is harmful.

If you have been accused of unethical conduct as a marital or family therapist, call Kansas Professional Licensing Attorney Danielle Sanger. She is a tireless advocate for professional licensees. She will fight to protect your livelihood. Her experience in defending ethical violations is unparalleled. Call Attorney Sanger today at (785) 979-4353 today to schedule a no-obligation consultation and learn what a difference experience makes.

Healthcare Providers Risk Suspension for Overprescribing Opiates in Kansas

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Healthcare providers who have prescription writing privileges may suffer discipline for overprescribing narcotics in Kansas. Physicians and other healthcare providers must be vigilant against prescribing narcotics to patients exhibiting drug-seeking behavior.  Given the opiate epidemic currently plaguing the United States, physicians’ drug-prescribing tendencies may be scrutinized.  Any irregularities may subject the physician to discipline, including suspension from practice and substantial monetary fines. Healthcare providers must carefully notate the patient record and medically justify dispensing narcotics. Professional licensing attorney Danielle Sanger tenaciously defends physicians, osteopathic doctors, and other healthcare professionals who are facing disciplinary proceedings resulting from alleged malpractice or unethical practices.

The Kansas Board of Healing Arts (“the Board”) is the administrative agency responsible for ensuring Kansas physicians and other healthcare providers comply with ethical, educational, and licensing standards. Physicians’ ethical standards are delineated by statute. A violation of the law may result in revocation, suspension, or limitation in practice, censure, or denial of renewal of license. The law defines specific ethical violations, including those related to dispensing medication. Under the law, a physician has violated the ethical standards of Kansas physicians if a doctor prescribes, sells, or otherwise dispenses a controlled substance that is not medically required.  In addition, a physician commits an ethical violation if the physician violates a federal law relating to controlled substances.

The Board has found that overprescribing of opiates is grounds for suspension. In 2014, the Board investigated a doctor of osteopathy for overprescribing Oxycontin. The Board found that the doctor overprescribed Oxycontin to 14 patients. Specifically, the investigation conducted by the Board revealed that the doctor saw many patients who complained of pain in different parts of the body. In most cases, the doctor failed to timely order further diagnostic testing to determine the cause of the pain. Instead of ordering appropriate testing, the doctor would prescribe Oxycontin for the pain. The Board’s investigation revealed that many patients returned to the doctor to renew prescriptions before the prescription, if taken according to the doctor’s orders, should have been renewed.  Although the doctor noted the patient returned early and asked his patients for explanations, the doctor failed to investigate the explanations. The Board concluded that the doctor should have investigated the excuses proffered by the patients. Furthermore, the Board concluded that the doctor should have requested his new patients’ medical records from previous healthcare providers who fired the patient for drug-seeking behavior.

The Board reached the conclusion that the doctor violated Kansas’s ethical standards. The Board ruled that the doctor violated Kansas Statute 65-2836(b) by dispensing or prescribing a controlled substance in an improper or inappropriate manner. The Board also ruled that prescribing medication in this manner is also “unprofessional conduct” according to Kansas Statute 65-2837(b)(23).

The Board and the doctor entered into a consent order as to the nature of the discipline. The Board ordered that the doctor should be suspended from practice for a period of 6 months and pay a $5000 fine. Additionally, the doctor was prohibited from prescribing controlled substances for 3 years. The Board obligated the doctor to prove by “clear and convincing evidence” that the doctor was rehabilitated prior to the expiration of the 3-year ban to reinstate prescription privileges.  Lastly, the Board banned the doctor from supervising other practitioners for 3 years.

Contact an Experienced Professional Licensing Attorney for Consultation

If you are a healthcare professional who is being investigated for overprescribing narcotics, immediately contact Kansas Professional Licensing Attorney Danielle Sanger.  As a former assistant attorney general, Attorney Sanger has the experience to defend your professional license against allegations of overprescribing medication. Attorney Sanger will vigorously and zealously fight to defend against these allegations and protect your professional license. Call Attorney Sanger today at 785-979-4353 to schedule your free consultation.

Pleading the “Fifth” in Missouri May Not Protect You from an Adverse Decision by the Administrative Hearing Commission

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Invoking one’s right to not to self-incriminate is colloquially known as “pleading the Fifth.”  The colloquialism refers to the Fifth Amendment to the United States Constitution, which preserves one’s right to be free from government compulsion to give evidence against oneself. Although the Fifth Amendment is most closely associated with criminal matters, it has frequent application in other contexts.  In Missouri, appearing before the Administrative Hearing Commission (AHC) may require the litigant to invoke the privilege against self-incrimination during questioning, depending upon the allegations. Although such an invocation cannot be held against you in criminal court, a different result may be reached outside of criminal court. If you find yourself in this position, Attorney Danielle Sanger, a professional licensing attorney in Missouri and Kansas, has the knowledge and experience to defend you in hearings before the AHC in Missouri and will advise you on the implications of invoking your right to remain silent.

In Missouri, the AHC is the administrative hearings body that adjudicates disputes between licensee and licensing boards. This administrative remedy must be exhausted prior to litigating the case in court. Frequently, licensees find themselves in a position where criminal liability may attach–even if only a remote possibility–in addition to the adverse licensing action.  Accordingly, Missouri law affords the licensee the right to refuse to answer questions because the answer may be incriminating. Permitting an invocation prevents collateral use of a party’s statements in a disciplinary action relating to a professional license in criminal court.

The Missouri courts have stated that the decision to invoke the privilege against self-incrimination is a personal choice. The choice to be made depends on the facts of the case.[1] At a hearing, the litigant must weigh the right to remain silent against the right to tell one’s side of the story.  Either decision has potential adverse consequences.

In Missouri, “pleading the Fifth” does not insulate a party in civil litigation. In civil litigation, the finder of fact is permitted, in many occasions, to make an adverse inference against the person invoking their right to remain silent if the question is relevant to the litigation.  Allowing the fact-finder to draw the inference against the party invoking their privilege promotes fundamental fairness in civil litigation. Otherwise, a party could hide behind the privilege without any recourse to the opposition.

Missouri law places limitations on the adverse inference a fact-finder may make against a party invoking their right to remain silent.  The fact-finder is permitted to make the inference: it is not mandatory. In the context of a particular case, the fact-finder can disregard the inference. A party invoking the privilege is not prevented from offering evidence.  The invoking party can still offer evidence in support of their position even if they refuse to testify. Furthermore, claiming the privilege is not to be taken by the fact-finder as an admission of guilt. The opposition is not relieved of its burden to produce affirmative evidence at the hearing if a party invokes the privilege.  If the opposition offers enough evidence to prove its case at the hearing, then the inference “shifts the burden” to the party invoking the privilege to rebut the evidence.

Missouri Licensing Defense Lawyer Danielle Sanger recognizes the difficult choices a professional licensee must make when facing a complaint. If you are facing that situation in Missouri or Kansas, you need an attorney who will stand by you and guide you to make the best decisions for you personally and professionally. Call professional licensing attorney Danielle Sanger today at 785-979-4353 to schedule your free consultation. Attorney Sanger will fight to protect you.