Category: Professional Regulation and Licensure

Will You No Longer Need a License to Do Your Job? States Meeting to Discuss Big Changes to Licensing Rules

Posted on by Louis Fine

hurdlesThe Illinois Department of Financial and Professional Regulation (IDFPR) is responsible for reviewing license applications in 235 separate categories covered by 61 different professional license acts. It licenses and regulates over 1 million professionals and firms throughout Illinois. But those numbers may shrink significantly, professional licensing may no longer be required for many professions, and it may get easier to get licensed in other states depending on the outcome of a multi-state conference of regulators to be held in December.

Should Tour Guides Need Licenses?

Illinois is one of 11 states participating in the Tucson, Arizona meeting, which was called to address what many consider to be the over-regulation of too many professions and occupations. According to the National Conference of State Legislatures (NCSL), which is a co-sponsor of the conference, the number of jobs requiring an occupational license, or government approval to practice a profession, has grown from about 1-in-20 to more than 1-in-4 over the past 60 years.

While no one takes issue with the need to license and regulate medical professionals, accountants, engineers, and the like, do tour guides really need to be licensed, as is actually required in some states (though not in Illinois)?

Economists and others have argued that professional licensing requirements for many occupations present unnecessary barriers that keep many people from entering those jobs while not significantly adding to consumer protection.

A 2015 study by the Brookings Institution found there were “far more cases” in which licensing reduced employment than ones where it improved the quality and safety of services. The restrictions have resulted in 2.8 million fewer jobs nationally and raised consumer costs by $203 billion annually, the study found.

Removing the Barriers to Moving

Additionally, since each state has their own licensing requirements and regulatory regimes, it can be exceedingly difficult and confusing when licensed professionals move to another state and want to continue their career. One state may require more hours of continuing education than another, for example, and simply transferring a license from one state to another can be an administrative nightmare.

The NCSL notes that that having to navigate 50 different licensing systems is particularly hard for military spouses and others who have to move frequently. At the conference, participants will attempt to find solutions that can bring uniformity and minimize the hurdles involved in relocating.

It remains to be seen what will come of this December conference. But there is no question that reforms to the professional licensing scheme here in Illinois and elsewhere would be a welcome development. Hopefully, Illinois regulators will address the unfairness of the professional license disciplinary process next.

Louis Fine: Chicago Professional License Defense Attorney

As a former Chief Prosecuting Attorney and administrative law judge for IDFPR, I have seen the serious consequences that an adverse enforcement decision can have on professionals who suddenly find their future in disarray. I understand how and why the Department decides to pursue investigations, how it handles negotiations, and how to approach formal proceedings in a way that gives my clients the best possible chance of a positive and expeditious outcome.

Please give me a call at (312) 236-2433 or fill out my online form to arrange for your free initial consultation. Together, we will get you back to your clients and your career.

Clearing Your Name: How to Expunge Disciplinary Actions From Your Professional History

Posted on by Louis Fine

 

past 2

As William Faulkner famously wrote, “The past is never dead. It’s not even past.” If you are a licensed professional in Illinois who has been disciplined by the Illinois Department of Financial and Professional Regulation (IDFPR), your past is very much a presence that can haunt your career or practice for years to come.

Sanctions imposed by the department, including consent decrees agreed to by the licensee, are public record, easily seen by potential employers, patients, or clients with just a few mouse clicks. Every month, the IDFPR publishes a list of all of the disciplinary sanctions it has imposed, and a link on the IDFPR’s website allows anyone to search for a professional by name to learn about any sanctions that have been entered against them.

Fortunately, depending on the underlying basis of the sanction and your subsequent conduct, there is a way to expunge a limited number of disciplinary actions from your record. But expungement is not automatic, and it is not available in some cases.

Kinds of Disciplinary Sanctions

There are six primary sanctions the IDFPR imposes, all of which appear on your record once entered:

  • Reprimand– A reprimand is an official record that the license has been disciplined but typically does not affect the status of the license or the licensee’s ability to practice.
  • Probation– Professionals whose licenses are placed on probation can continue practicing subject to certain terms and conditions. The conditions imposed as part of an order of probation will vary depending on the circumstances of the case.
  • Suspension– Professionals whose licenses have been suspended cannot practice during the period of suspension. The term of suspension can range from one day to indefinite. In many instances, the period of suspension is followed by probation.
  • Temporary Suspension– Several Illinois practice acts including medical, dental and pharmacy) give the IDFPR authority to temporarily suspend a professional’s license pending a hearing before the appropriate board or committee where the Director finds that a professional licensee’s continuation in practice would constitute an immediate danger to the public. A hearing must be held within 15 days of the suspension. Professionals may not practice while temporarily suspended.
  • Revocation– Professionals cannot practice with a revoked license.
  • Fine– Monetary fines are another remedy available to the Department and are usually issued in conjunction with one of the above disciplines.

Application to Classify Records as Confidential

A licensee who has been subject to disciplinary action by the IDFPR may file an application to have the record classified as confidential, not for public release and considered expunged. However, only actions relating to one of the following offenses may be eligible for expungement:

  • failure to pay taxes or student loans
  • failure to meet continuing education requirements
  • failure to renew a license on time;
  • failure to obtain or renew a certificate of registration or ancillary license
  • advertising issues
  • any grounds for discipline that were subsequently removed from the applicable licensing act

No application will be considered until at least seven years have passed since the disciplinary offense occurred. A separate application must be filed for each disciplinary action the licensee wants to have removed from their record, and there is a non-refundable fee of $200 for each application submitted.

As noted, even if a sanction is eligible to be removed from your record, there is no guarantee that the IDFPR will grant an application. The application form requests information about any subsequent investigations or disciplinary cases, which will no doubt make it far less likely that the application will be granted. Additionally, as I have discussed before, the IDFPR disciplinary process is not always fair and transparent.

If you have concerns about your existing disciplinary record and want to explore the possibility of clearing your record and your name, contact an experienced Illinois professional license defense lawyer who can answer your questions and advise you of your options.

Louis Fine: Chicago Professional License Defense Attorney

As a former Chief Prosecuting Attorney and administrative law judge for IDFPR, I have seen the serious consequences that an adverse enforcement decision can have on professionals who suddenly find their future in disarray. I understand how and why the Department decides to pursue investigations, how it handles negotiations, and how to approach formal proceedings in a way that gives my clients the best possible chance of a positive and expeditious outcome.

Please give me a call at (312) 236-2433 or fill out my online form to arrange for your free initial consultation. Together, we will get you back to your clients and your career.

Higher Math: Do Illinois Accountants Face Ethics or Licensing Issues for Working With the Medical Marijuana Industry?

Posted on by Louis Fine

pot money$44 billion is a lot of green. That is also the amount of revenue the legal marijuana industry is expected to generate in the U.S. by 2020. As more states permit by ballot initiative or legislation either the medical or recreational sale and use of pot, complex regulatory and taxation regimes have been established to keep tabs on growers, distributors, and dispensaries.

Complicating things even more is the fact that most legal marijuana businesses operate on a cash only basis since pot remains classified as a Schedule I controlled substance at the federal level.  But all that cannabis cash needs to be accounted for, and CPAs across the country find themselves in high demand by the marijuana industry, raising questions about whether providing accounting services for businesses which technically violate federal law raise any ethical or licensing issues.

State Boards Largely Saying OK

Accounting boards in many states with established medical or recreation marijuana programs have weighed in on the matter, largely concluding that providing services to a state-legal marijuana enterprise is not in and of itself problematic or a basis for disciplinary action. All state boards who have issued opinions on the subject emphasize that all other applicable professional standards must be adhered to, caution about possible federal law issues, and advise accountants to seek counsel before a marijuana engagement. That said, the following excerpts from some of those boards make it relatively clear that if pot is legal where the services are being provided, the board won’t be taking any action based simply on the provision of those services:

  • Arizona. “…the Arizona Board of Accountancy has concluded that merely accepting an engagement to provide accounting services to a medical marijuana dispensary does not, on its face, constitute an act discreditable to the profession and it will not pursue independent disciplinary action against an Arizona CPA registrant based solely on such acceptance.”
  • Colorado. “It is the Board’s position that offering to perform or performing professional services for clients in the marijuana industry who are in compliance with Colorado Medical Marijuana Code and the Colorado Retail Marijuana Code is not in itself specifically prohibited by the Accountancy Act…”
  • Connecticut. “…in the absence of such a determination by the courts, the Connecticut Board of Accountancy will not pursue independent disciplinary action against Connecticut CPAs or CPA firms who are operating within the bounds of state law” as to marijuana.
  • Florida. “… the provision of public accounting services… to marijuana-related businesses in states where marijuana-related businesses have been legalized, in the absence of a criminal conviction of the certified public accountant for the provision of those services, in and of itself does not constitute a lack of good moral character.”
  • Maryland. “…in light of the current state of Maryland and Federal law, the Board will take no regulatory action against a CPA or firm solely on the basis that the CPA or firm provides services to a business involved in the sale or distribution of marijuana, provided that the business is operating legally under applicable state law.”
  • Nevada. “After careful consideration, the Board has determined that Nevada licensees and firms that elect to provide services to the marijuana industry legalized in any state in which the licensee practices will not face action by the Board based solely on the fact that the licensee or firm is providing such services.”

According to the AICPA, in a very helpful and comprehensive issue brief on the subject, “As of May 2015, the AICPA is not aware of any state boards of accountancy that have taken action against a CPA for providing services to a marijuana business, nor has the AICPA Professional Ethics Team received any referrals from state boards for such action.”

What About Illinois?

Here in Illinois, 2014’s Compassionate Use of Medical Cannabis Pilot Program Act created a four-year roll out allowing sick and dying patients suffering from debilitating medical conditions access to medical cannabis. The Act permits up to 22 cannabis-growing operations and 60 licensed retail dispensaries to operate across the state.

The Illinois Department of Financial and Professional Regulation (IDFPR) registers, licenses and regulates the dispensaries, and the Illinois Department of Revenue regulates marijuana taxation, which is subject to privilege taxes, occupation taxes and other industry specific surcharges.

Illinois’ Administrative Rules supporting the medical cannabis program effectively mandate that dispensaries retain CPAs as they must engage in, and submit to the IDFPR, annual audits compiled and certified by an auditor or CPA.

So far, however, the Illinois Public Accountant Registration and Licensure Committee has yet to issue guidance on serving the medical marijuana industry in the state beyond advising CPAs to seek legal counsel before deciding to whether to provide services to a medical marijuana business.

While CPAs should definitely follow the Committee’s advice and seek out a professional licensing attorney for advice, I would anticipate that as Illinois’ medical marijuana program grows, and CPAs see an increasingly fertile area for business, the Committee will issue an opinion largely in line with states that have already concluded that serving the legal weed industry won’t harsh an accountant’s mellow from a disciplinary perspective.

Louis Fine: Chicago CPA License Defense Attorney

As a former Chief Prosecuting Attorney and administrative law judge for IDFPR, I have seen the serious consequences that an adverse enforcement decision can have on accountants and other professionals who suddenly find their future in disarray. I understand how and why the Department decides to pursue investigations, how it handles negotiations, and how to approach formal proceedings in a way that gives my clients the best possible chance of a positive and expeditious outcome.

Please give me a call at (312) 236-2433 or fill out my online form to arrange for your free initial consultation. Together, we will get you back to your clients and your career.

Can You Lose Your Illinois Professional License for Personal Conduct?

Posted on by Louis Fine

unprofessionalLet’s say you are an Illinois doctor, nurse, real estate broker or other licensed professional. Let’s say you have an exemplary and spotless record, with commendations and accolades from superiors, praise from patients or clients, and nothing but exceptional and professional performance over many years of practicing your chosen profession.

Let’s also say that you are a vocal white supremacist.

Being a white supremacist, you took a trip down to Charlottesville, VA a few weeks back to participate in the “Unite the Right” rally that has shaken the nation. While you were chanting and marching with torch in hand – without ever breaking the law – someone snapped a picture of you, put it on the internet and it went viral. One of your patients saw the picture and filed a complaint with the Illinois Department of Financial and Professional Regulation (IDFPR).

Is your professional license now in danger because you have been outed as a white supremacist?

Many participants in the Charlottesville march have since been fired from their jobs after they were identified on social media. In the vast majority of states, private employers are well within their rights to fire an employee for being a white supremacist and/or Trump supporter, expressing other political or social views, or for pretty much any reason other than race, sex, religion, and other protected classes.

But the IDFPR is a governmental body, which means that the First Amendment is implicated in any adverse action based on the exercise of a professional’s free speech rights. But the question of whether and how personal, off-the-clock, and non-criminal conduct can lead to professional license disciplinary action is still tricky.

The laws and rules governing all professions in Illinois contain many specific bases for disciplinary action, almost all of which are based on acts and omissions directly related to their professional responsibilities. But some licensing acts and underlying rules contain vague and ambiguous language which could theoretically be used by IDFPR to institute disciplinary proceedings for private conduct.

For example, a nurse is subject to disciplinary action under Section 70-5(b)(7) of the Illinois Nurse Practice Act for “engaging in dishonorable, unethical or unprofessional conduct of a character likely to deceive, defraud or harm the public…”

Note that this section of the Act doesn’t discuss deceiving, defrauding or harming a patient, it talks about “the public.” Is chanting racist slogans “dishonorable” or “unprofessional” conduct likely to “harm” the public? The IDFPR (and most other folks) may see it that way, even if the Board may ultimately be thwarted by the First Amendment if they try to discipline a licensee on that basis. But politics and free speech issues aside, other private conduct can put licensed professionals at risk for disciplinary action.

In Texas, for example, licensing boards have taken a very aggressive approach towards off-the-clock, legal, and harmless conduct which they believe implicates professional “fitness” or “judgment.” As one attorney in Texas described it, using such private conduct as the basis for discipline means that “anything you could do at any point could be considered unprofessional. They really do believe they have the ability to legislate morality.”

In Illinois, all kinds of personal conduct could arguably be scrutinized if a particular investigator or regulator at the IDFPR decides to look at things through that prism. Sexual conduct, controversial parenting techniques, a screaming tirade at a store clerk, internet searches – all legal, all having nothing to do with job performance – they may be fair game.

It would be serious overreach by the IDFPR if they were to take action based on such conduct, but as I have written before, the disciplinary process in Illinois can be manifestly unfair and stacked against you. Experienced and aggressive prosecutors have your license in their sights, and the hearing officer who will determine your fate is bringing their own biases to your case.

Everything we do in life has consequences. While those consequences should not include loss of your professional license for personal and legal conduct, Illinois licensees should be aware that IDFPR may think differently.

Louis Fine: Chicago Professional License Defense Attorney

As a former Chief Prosecuting Attorney and administrative law judge for IDFPR, I have seen the serious consequences that an adverse enforcement decision can have on professionals who suddenly find their future in disarray. I understand how and why the Department decides to pursue investigations, how it handles negotiations, and how to approach formal proceedings in a way that gives my clients the best possible chance of a positive and expeditious outcome.

Please give me a call at (312) 236-2433 or fill out my online form to arrange for your free initial consultation. Together, we will get you back to your clients and your career.

Illinois Chiropractors: Are You Aiding and Abetting the Unlicensed Practice of Medicine?

Posted on by Louis Fine

chiroAiding and abetting the unlicensed practice of medicine can be a potentially disastrous minefield for chiropractors, and often does not involve any knowing or intentional violations of the law. Often, the seemingly innocuous delegation of certain tasks to assistants or others can inadvertently lead to scrutiny and legal action by the Illinois Department of Professional Regulation (IDFPR)

Included among the over 40 enumerated bases for disciplinary action against chiropractors and physicians set forth in the Illinois Medical Practice Act (225 ILCS 60/1 et seq.) is “aiding and abetting an individual not licensed under this Act in the practice of a profession licensed under this Act.”

What Exactly is the “Practice of Medicine”?

The problem arises because the Medical Practice Act, despite its title, nowhere defines exactly what the “practice of medicine” entails. Section 22 of the Medical Practice Act directs the IDFPR to adopt rules that set forth standards to be used in determining several violations and terms under the Act. However, it does not require the Department to set forth explicit standards defining the practice of medicine.

As one court explained, the reason the legislature did not define “the practice of medicine” in the definitions section of the Act is “because a flexible definition of the practice of medicine is required in a statute intended to govern various healers from osteopaths to herb doctors. Siddiqui v. IDFPR, 718 N.E.2d 217 (4th Dist. 1999).

What Can and Cannot Be Delegated

Obviously, not every task that a chiropractor or physician performs on a daily basis constitutes the practice of medicine. Maintaining medical records, taking blood pressure, preparing a patient for treatment – all of these can be delegated to trained staff.

Specifically, Section 54.2 of the Medical Practice Act allows physicians and chiropractors to delegate authority to certain individuals:

  • Physicians can delegate patient care tasks to a licensed practical nurse, a registered professional nurse, or other licensed person practicing within the scope of his or her individual licensing Act.
  • Physicians can also delegate such tasks to physician assistants or advanced practice nurses.
  • In an office or practice setting and within a physician-patient relationship, a physician may delegate patient care tasks or duties to an unlicensed person who possesses appropriate training and experience provided a health care professional, who is practicing within the scope of such licensed professional’s individual licensing Act, is on site to provide assistance.
  • No physician may delegate any patient care task or duty that is statutorily or by rule mandated to be performed by a physician.

What cannot be delegated, and what do not constitute “patient care tasks,” are the diagnosis of illnesses, and the development of treatment plans, including prescribing drugs. Siddiqui v. IDFPR, 718 N.E.2d 217 (4th Dist. 1999).

How You Can Stumble Into Trouble

Chiropractors are not authorized to prescribe controlled substances, but they need to be cautious of their role and the role of any subordinates in any treatment plan that involves prescription medication. A recent complaint brought by IDFPR against a chiropractor offers a prime example of how a chiropractor can innocently stumble into an “aiding and abetting” problem involving prescriptions.

A chiropractor shared office space with a licensed M.D. As a courtesy to the M.D., the chiropractor allowed his secretary to hand out valid prescriptions signed and dated by the M.D. to patients who would come by for appointments and told by the M.D. to pick up the prescription at the front desk when they leave.

The IDFPR asserted that this practice constituted the unlicensed practice of medicine by the chiropractor’s secretary, and sought to suspend or revoke the chiropractor’s license for aiding and abetting this unlicensed practice. The chiropractor no doubt believed that he and his secretary were simply performing ministerial tasks – not the practice of medicine – by facilitating the delivery of a valid prescription issued by a licensed physician. But the fact that the IDFPR saw such action as a basis for disciplinary proceedings should give all Illinois chiropractors pause as they consider the ways in which they could find themselves in trouble with licensing authorities.

Chiropractors should ensure that they have developed specific protocols and procedures that define the permissible roles and actions of nurses, assistants, and others in their practice and be wary of delegating any tasks that may involve the diagnosis and the use of professional medical judgment in deciding on a course of treatment.

Louis R. Fine: Chicago Chiropractor License Defense Attorney

Throughout my career, I have been protecting the livelihoods and professional futures of chiropractors, physicians and other health care providers before the IDFPR, combining insight and experience with zealous and strategic advocacy.

The moment you are contacted by IDFPR or learn that you are under investigation is the moment that you should contact me. I will immediately begin communicating with IDFPR prosecutors and work with you to develop the strategy best suited to achieving the goal of an efficient, cost-effective outcome that avoids any adverse action. Together, we will protect your Illinois chiropractor’s license and get you back to your patients and your career.

Please give me a call at (312) 236-2433 or fill out my online form to arrange for your free initial consultation. I look forward to meeting with you.

Improper Opioid Prescribing Threatens Lives – and Licenses

Posted on by Louis Fine

opioidEpidemic. Crisis. Crime. Career-ender. Killer. Call America’s problem with opioid addiction and abuse what you will, it has become a problem of sprawling and tragic proportions, taking an increasing number of lives every single day and ruining the lives of thousands more. Law enforcement and public health officials from the local level to the federal government are desperately trying to address prescription painkiller overdoses and deaths, including aggressively pursuing the prosecution of health care professionals and others who may be contributing to or profiting off of the epidemic. Just last week, the U.S Department of Justice brought sweeping criminal charges against over 400 doctors, nurses, and pharmacists who were fraudulently or improperly prescribing opioids.

Increased Scrutiny and Enforcement by Licensing Boards

Physicians who play fast and loose with their opioid prescribing practices not only risk criminal charges, they also risk their license to practice medicine. Physicians prescribing opioids and other controlled substances are being scrutinized with greater intensity and numbers by state licensing boards. For example, the Medical Board of California reported a 195% increase in disciplinary action outcomes related to controlled substance prescribing between the reporting years 2009 to 2010 and 2014 to 2015.

The Illinois Department of Financial and Professional Regulation (IDFPR) is also working with law enforcement to crack down on health care providers who they suspect of engaging in improper painkiller prescribing, including sending investigators posing as opioid-seeking patients to see how easily they can walk out the door with a prescription in hand.

Prescribing, selling, administering, distributing, giving or self-administering any drug classified as a controlled substance or narcotic for other than medically accepted therapeutic purposes is a basis for disciplinary action under the Illinois Medical Practice Act. Additionally, physicians are bound by an array of other medical and legal regulations when prescribing opioids. Federal law states that a controlled substance prescription must be issued for a “legitimate medical purpose by an individual practitioner acting in the usual course of his [or her] professional practice” To comply, one must follow the standard of care based on one’s general specialty. For opioid prescribing specifically, substantial compliance with opioid prescribing guidelines is usually the accepted standard of care.

How Physicians Can Protect Themselves – and Their Patients

Illinois physicians should ensure that they are familiar with and comply with all applicable guidelines, rules, and best practices when prescribing opioids. A 2017 article  published in The Permanente Journal – “Physician Guide to Appropriate Opioid Prescribing for Noncancer Pain” – included the following suggestions to help physicians both minimize their exposure and help address the underlying problem of opioid abuse and misuse:

  • Recognize that the opioid crisis is ravaging families and communities
  • Avoid opioid pain medications whenever possible; start with safer alternatives
  • Follow the CDC opioid prescribing guidelines for new patients with pain and for patients with chronic pain when possible
  • Ensure that the opioid prescriptions are truly for medically legitimate purposes, with vigilance for red flags
  • Follow the US Surgeon General’s call to action and consider taking the Surgeon General’s pledge at http://turnthetiderx.org:
  • Screen patients for opioid use disorder and provide or connect them with evidence-based treatment
  • Talk about and treat addiction as a chronic illness, not as a moral failing.

Louis R. Fine: Chicago Physician License Defense Attorney

Throughout my career, I have been protecting the livelihoods and professional futures of physicians and other health care providers before the IDFPR, combining insight and experience with zealous and strategic advocacy.

The moment you are contacted by IDFPR or learn that you are under investigation is the moment that you should contact me. I will immediately begin communicating with IDFPR prosecutors and work with you to develop the strategy best suited to achieving the goal of an efficient, cost-effective outcome that avoids any adverse action. Together, we will protect your Illinois physician’s license and get you back to your patients and your career.

Please give me a call at (312) 236-2433 or fill out my online form to arrange for your free initial consultation. I look forward to meeting with you.

Beware of “Aiding and Abetting” the Unlicensed Practice of Medicine

Posted on by Louis Fine

aiding and abetting“Aiding and abetting” are two words often associated with criminal law, as in, “The getaway car driver was charged with aiding and abetting the bank robbery.” But for physicians as well as many other professionals who are required to be licensed by the Illinois Department of Financial and Professional Regulation (IDFPR), aiding and abetting the unlicensed practice of their profession can also mean severe disciplinary action, including license revocation.

For physicians in particular, aiding and abetting the unlicensed practice of medicine can be a potentially disastrous minefield, as the permissible and seemingly innocuous delegation of certain tasks to assistants or others can inadvertently lead to IDFPR concerns.

Included among the over 40 enumerated bases for disciplinary action set forth in the Illinois Medical Practice Act (225 ILCS 60/1 et seq.) is “aiding and abetting an individual not licensed under this Act in the practice of a profession licensed under this Act.”

What Exactly is the “Practice of Medicine”?

The problem arises because the Medical Practice Act, despite its title, nowhere defines exactly what the “practice of medicine” entails. Section 22 of the Medical Practice Act directs the IDFPR to adopt rules that set forth standards to be used in determining several violations and terms under the Act. However, it does not require the Department to set forth explicit standards defining the practice of medicine.

As one court explained, the reason the legislature did not define “the practice of medicine” in the definitions section of the Act is “because a flexible definition of the practice of medicine is required in a statute intended to govern various healers from osteopaths to herb doctors. Siddiqui v. IDFPR, 718 N.E.2d 217 (4th Dist. 1999).

Not every act performed by a physician constitutes the practice of medicine. Duties such as changing bandages, administering injections, drawing blood, and taking blood pressure are often performed by nonphysicians. However, the fact that licensed professionals other than physicians may be permitted to perform certain medical procedures under the supervision of a licensed physician does not render the performance of those same procedures by unsupervised and unlicensed individuals outside the ambit of the Medical Practice Act. People v. Bickham, 621 N.E.2d 86 (1993).

Delegation of “Patient Care Tasks” to Qualified or Supervised Individuals Can Be Permitted

Similarly, Section 54.2 of the Medical Practice Act specifically allows physicians to delegate authority to certain individuals:

  • Physicians can delegate patient care tasks to a licensed practical nurse, a registered professional nurse, or other licensed person practicing within the scope of his or her individual licensing Act.
  • Physicians can also delegate such tasks to physician assistants or advanced practice nurses.
  • In an office or practice setting and within a physician-patient relationship, a physician may delegate patient care tasks or duties to an unlicensed person who possesses appropriate training and experience provided a health care professional, who is practicing within the scope of such licensed professional’s individual licensing Act, is on site to provide assistance.
  • No physician may delegate any patient care task or duty that is statutorily or by rule mandated to be performed by a physician.

Diagnosis, Treatment Plan, and Prescriptions Cannot Be Delegated

What cannot be delegated, and what do not constitute “patient care tasks,” are the diagnosis of illnesses, and the development of treatment plans, including prescribing drugs. Siddiqui v. IDFPR, 718 N.E.2d 217 (4th Dist. 1999). For example, the Pharmacy Practice Act of 1987 provides that a pharmacist may advise or counsel patients on the use of drugs or devices and provide health information related to them, however, the pharmacist’s role does not extend to deciding whether to prescribe drugs. This requires a medical judgment as to the needs of the patient, the effect of the drug, and the effectiveness of other types of treatment.

Physicians should ensure that they have developed specific protocols and procedures that define the permissible roles and actions of nurses, assistants, and others in their practice and be wary of delegating any tasks that may involve the diagnosis and the use of professional medical judgment in deciding on a course of treatment.

Louis R. Fine: Chicago Physician License Defense Attorney

Throughout my career, I have been protecting the livelihoods and professional futures of physicians and other health care providers before the IDFPR, combining insight and experience with zealous and strategic advocacy.

The moment you are contacted by IDFPR or learn that you are under investigation is the moment that you should contact me. I will immediately begin communicating with IDFPR prosecutors and work with you to develop the strategy best suited to achieving the goal of an efficient, cost-effective outcome that avoids any adverse action. Together, we will protect your Illinois physician’s license and get you back to your patients and your career.

Please give me a call at (312) 236-2433 or fill out my online form to arrange for your free initial consultation. I look forward to meeting with you.

WebMDon’t: Physicians Need to Avoid These Online Professionalism Mistakes

Posted on by Louis Fine

doctor onlineYour medical practice is thriving, and you have earned the trust and respect of thousands of patients. Except for one. This former patient was very unhappy with the care you provided. So dissatisfied was this patient that he decided to put up a scathing one-star review of you and your practice on Yelp! and other websites; a review rife with insults and factually incorrect statements. You cannot abide by this unjustified stain on your reputation, so you respond to the patient’s review on the very same sites. You share some of your own choice words about the patient, and you also correct the record about the care you provided. But in doing so, you also revealed confidential medical information about the patient, who promptly informs the Illinois Department of Financial and Professional Regulation (IDFPR) about your breach of confidentiality. Instead of letting the patient’s rant go unanswered, you now have to answer a complaint from the IDFPR that threatens your license and your practice.

The foregoing, based on an actual case, is just one example of the traps doctors can fall into with their use of the internet and social media. Over the past decade, breaches of online professionalism standards have been the subject of increasing scrutiny and disciplinary action by state medical boards.

A national survey of state medical boards revealed that the most common online activities that led to disciplinary proceedings against physicians were:

  • inappropriate patient communication online, including sexual misconduct
  • use of the internet for inappropriate practice, such as internet prescribing without an established clinical relationship
  • online misrepresentation of credentials
  • online violations of patient confidentiality
  • failure to reveal conflicts of interest online
  • online derogatory patient remarks
  • online depiction of intoxication

Most boards indicated that incidents had been reported to them by patients or their families, although reporting by other physicians was common as well.

While the Illinois Medical Practice does not list any online conduct as one of the 43 specified bases for physician discipline, it doesn’t need to. As the authors of the above-referenced study put it, the problems that doctors get into with the internet and social media are just “online manifestations of serious and common violations offline, including substance abuse, sexual misconduct, and abuse of prescription privileges.”

In 2013, the American College of Physicians and the Federation of State Medical Boards issued guidelines on online medical professionalism. It addresses many aspects of social media and internet use by physicians, but the single best recommendation may be this:

Pause before posting. Trust yourself, but pause before posting to reflect on how best to protect and respect patients, their privacy, and your professional relationships and responsibilities. It is helpful to think of the use of social media as a public speaking arrangement in which everything is recorded and shared.

Louis R. Fine: Chicago Physician License Defense Attorney

Throughout my career, I have been protecting the livelihoods and professional futures of physicians and other health care providers before the IDFPR, combining insight and experience with zealous and strategic advocacy.

The moment you are contacted by IDFPR or learn that you are under investigation is the moment that you should contact me. I will immediately begin communicating with IDFPR prosecutors and work with you to develop the strategy best suited to achieving the goal of an efficient, cost-effective outcome that avoids any adverse action. Together, we will protect your Illinois physician’s license and get you back to your patients and your career.

Please give me a call at (312) 236-2433 or fill out my online form to arrange for your free initial consultation. I look forward to meeting with you.

A Small Number of Big Problems Make Up the Most Complaints Against Illinois Doctors

Posted on by Louis Fine

complaint-1There are 43 specified grounds for disciplinary action against Illinois doctors set forth in the state’s Medical Practice Act. Running afoul of any one of those grounds can result in career-altering action by the Illinois Department of Financial and Professional Regulation (IDFPR). More often than not, the genesis of disciplinary proceedings against Illinois physicians come from citizen complaints. And while a typical year will see at least one complaint involving each of the statutory bases for discipline, some violations, as Orwell might say, are more equal than others. Knowing what the most common complaints are can help Illinois doctors redouble their efforts at avoiding mistakes or misunderstandings that can put their practices at risk.

If You Practice Medicine in Illinois, You Will (Likely) Be the Subject of a Complaint

Over the course of a career, even the most outstanding doctors are likely to face at least one complaint about their conduct by a patient or other individual, whether in the form of a filing with the IDFPR or in a civil medical malpractice complaint. The Board receives approximately 3,000 complaints against Illinois doctors every single year. The majority of those complaints are citizen complaints submitted in writing or through the IDFPR website. Complaints also come from other state agencies, from licensing and regulatory boards in other states, and as mandatory reports from professional liability insurers, professional associates, hospitals, or other health care institutions.

Unprofessional Conduct and Substandard Care Lead the Pack

According to IDFPR statistics, 75 percent of the total number of complaints it receives arise from the same 10 alleged violations of the Act. The most common complaint against Illinois physicians received by the Department are allegations of “unprofessional conduct,” or, as set forth in the Act, “engaging in dishonorable, unethical or unprofessional conduct of a character likely to deceive, defraud or harm the public.”

Within this broad and somewhat ambiguous definition, some of the more common examples of “unprofessional conduct” that can lead to the suspension or revocation of a physician’s license or other disciplinary action include:

  • Physician abuse of a patient
  • Inadequate record keeping
  • Falsifying records
  • Fraudulent insurance, Medicare, or Medicaid claims
  • False or misleading advertising
  • Prescribing drugs in excess or without legitimate reason
  • Failing to meet continuing medical education requirements
  • Dishonesty
  • Conviction of a felony
  • Delegating the practice of medicine to an unlicensed individual

Complaints about the quality of care provided by a doctor grievances – substandard care, improper care, misdiagnosis, delayed treatment, incompetence, etc.-  are right behind allegations of unprofessional conduct. Sexual misconduct and substance abuse issues also are the subject of an alarmingly high number of complaints to the Department.

Whatever the basis of a complaint, and regardless of whether you believe it has any merit, if the IDFPR has become involved, you need an experienced Illinois physician licensure defense attorney to become involved.  With so much at stake, trying to go it alone before the Department is a mistake from which you may never recover.

Louis R. Fine: Chicago Physician License Defense Attorney

Throughout my career, I have been protecting the livelihoods and professional futures of physicians and other health care providers before the IDFPR, combining insight and experience with zealous and strategic advocacy.

The moment you are contacted by IDFPR or learn that you are under investigation is the moment that you should contact me. I will immediately begin communicating with IDFPR prosecutors and work with you to develop the strategy best suited to achieving the goal of an efficient, cost-effective outcome that avoids any adverse action. Together, we will protect your Illinois physician’s license and get you back to your patients and your career.

Please give me a call at (312) 236-2433 or fill out my online form to arrange for your free initial consultation. I look forward to meeting with you.

Dreams Deferred: Avoiding and Fighting Illinois Professional License Application Denials

Posted on by Louis Fine

denialYou have studied and sacrificed. You have put hours upon hours and years upon years into your education and training in order to practice your chosen profession or occupation. You’re ready to begin your career and serve your clients or patients. But you can’t do that unless you receive a license from the Illinois Department of Financial and Professional Regulation (IDFPR). And if the IDFPR denies your license application, all you’ve worked so hard for is at risk.

Applying for a professional license in Illinois can be a complicated process, and any number of missteps can lead the Department to reject your application. While the receipt of an “Intent to Deny” letter from the IDFPR is not necessarily the end of the road for your career dreams, it does mean that the process can become much more difficult and involved. That is why it is so important to make sure that your initial application is complete, truthful, and satisfies all necessary requirements.

Incomplete or Untruthful Applications

The IDFPR is responsible for reviewing license applications in 235 separate categories covered by 61 different professional license acts. While there are many application requirements that are profession or industry specific, some requirements apply universally across all licenses and professions. The most fundamental of these is the duty, under penalty of perjury, to provide answers that are “true, correct, and complete.” If you lie on your application; if you fail to provide relevant information about your criminal history, prior disciplinary or licensing issues in other states, or other relevant information, your application stands a very good chance of being denied.

Criminal History and Past Conduct

The Department can refuse to issue a license or grant a registration if an applicant has been convicted of any crime that is a felony (although recent changes in the law may reduce the chances of a denial on this basis; or that is a misdemeanor, an essential element of which is dishonesty, or that is directly related to the practice of the profession.

The IDFPR will review the circumstances of an applicant’s criminal history and issue a decision on whether or not the information provided disqualifies the individual from licensure, registration, or practice. By the Department’s own admission, this is a highly subjective, and thus unpredictable, standard.

Similarly, an applicant can be denied a license for “engaging in dishonorable, unethical, or unprofessional conduct of a character likely to deceive, defraud, or harm the public.” This too is a highly subjective analysis which can make fighting a denial on this basis a challenging task.

Fighting a Denial

If the Department believes that there is a reason your application should be denied, it will send you an “Intent to Deny” letter. You then have 30 days to respond to the letter to contest the denial and request a hearing. AT such a hearing, you have the opportunity to explain your case and to provide additional information or to answer questions the Department may have.

You should not engage in this process without the assistance of an experienced professional license defense attorney. If your application is again denied at this stage, you could find yourself and your application tied up in administrative limbo for a long time. An experienced IDFPR lawyer will know how make the best case and increase the chances that your application will be approved. Your reputation, career and livelihood are at stake.  Now is not the time to take a flyer and hope for the best.

Louis Fine: Chicago Professional License Defense Attorney

As a former Chief Prosecuting Attorney and administrative law judge for IDFPR, I have seen the serious consequences that an Illinois professional license application denial can have on those who have invested so much. I understand how and why the Department decides to deny applications and can assist you at every stage of the process, beginning with the preparation and submission of your initial application.

Please give me a call at (312) 236-2433 or fill out my online form to arrange for your free initial consultation.