IF THE IDFPR COMES CALLING…
By: Lisa M. Green
Receiving a Summons and Complaint accusing you of medical malpractice is no doubt a dark day for a doctor but it is nothing compared to the abject fear that a letter from the Illinois Department of Financial and Professional Regulation can strike. The IDFPR is responsible for regulating the approximately 40,000 physicians in the State of Illinois. Under the Medical Practice Act, the IDFPR has the power to restrict the ability to legally practice medicine for more than 40 different reasons ranging from the obvious (drug abuse or mental illness) to the vague (making a misleading statement about your skill set or treatment) or the more common (not including something in a report).
Physicians come to the attention of the IDFPR in a number of ways. An initial claim may arise from a patient’s complaint about care or a referral from an outside agency such as another state’s medical licensing board, State’s Attorney’s Office or the Illinois Department of Revenue. The IDFPR will also conduct a preliminary investigation whenever money is paid out on behalf of a physician to resolve a medical negligence claim either through settlement or verdict. During this investigation, the physician may be required to answer written questions, submit factual information about the claim and sometimes submit medical records. The IDFPR then makes a determination as to whether the matter should be closed or a formal complaint should be initiated. The formal complaint is then typically prosecuted through a series of hearings and ultimately resolved by entry of something called a Consent Order, an agreement by the doctor to accept whatever discipline the IDFPR has decided to impose.
If it sounds bleak, that is because it is. Some of the 40 odd reasons for restricting a physician’s license are elastic enough to encompass some fairly innocuous behavior or have nothing to do with the practice of medicine. Roughly 30 medical professionals (this includes chiropractors) are reprimanded, placed on probation or restricted from practicing altogether every month in Illinois. All are fined sometimes as much as $10,000. Many include doctors who resolved malpractice claims only to discover that the IDFPR had further plans for them.
What can you do to avoid finding yourself on the IDFPR News List after a lawsuit finishes?
Be aware! When a malpractice claim is resolved with the payment of money on your behalf, talk to your defense attorney about what to expect from the IDFPR. Under the Medical Practice Act, you have a duty to report any adverse judgment, settlement or award arising out of a liability claim. The notification is usually done by the insurance carrier but you want to make absolutely sure this requirement is met.
Don’t ignore it! When you do receive a request for information from the IDFPR, do not ignore it. You can be sanctioned for not responding to the request within the prescribed amount of time.
Get legal help! If you are uncertain about how to respond to the preliminary investigation request, ask for help from an attorney. If you receive a formal complaint, you should retain an attorney to represent you in this process. Check your insurance policy as you may have coverage for legal representation.