When A Complaint Causes Rising Anxiety
Two years ago, I finished a 10-year period as a member of my state podiatric medical licensing board. During that period, I frequently wondered what a podiatrist must feel when he or she receives a registered letter with a notification of a complaint to the board. Complaints against DPMs came from a variety of sources. Most were from disgruntled patients. Some came from other DPMs, especially when a partnership between two podiatrists breaks up. Some came from the board of pharmacy when a DPM was perceived to be over-prescribing narcotics or possibly Viagra. Some came from left field. This was the case with my first and only complaint after 30 years of practice. I was sharing a joke with a patient who was leaving the office when I received a registered letter. The envelope was from the State Department of Health. “A complaint has been made against you for unprofessional conduct …” I stopped listening to the patient who was laughing at his own joke harder than he laughed at mine. He looked puzzled and offended as I walked like a zombie to my office. I finished reading the letter. Phrases such as “Practice beyond the scope of licensure” and “Investigation will be started” and “You may desire to consult an attorney” jumped out at me. I envisioned 30 years of a practice free of malpractice and professional licensing complaint circling the drain. I eagerly called the state investigator assigned to my case although I felt like a condemned criminal trying to establish a closer relationship with the executioner. The investigator had a down-home country cop sound to his voice. I asked what I had done. He said, “Well, this is a strange one.” Then he did not say anything for a few seconds as my blood pressure climbed. I knew better than to yell, “Get to the point, already!” “First of all, the complaint is anonymous,” he noted. I knew after 10 years on the licensing board that anonymous complaints usually died a natural death, often before the doctor was notified. Why were they pursuing mine? “Since you have been a member of the board, we need to go ahead with the investigation so it won’t look like, well, you know.” “So what did I do?” I practically screamed. “We have a copy of an article you wrote for a magazine called Podiatry Today. It was sent to us in an envelope with no return address. It had a paragraph circled and the question, ‘Is this in the scope of practice for foot doctors?’“ I remembered the article. I had mentioned placing a teenage patient on an antibiotic when I found an infected navel piercing on a pre-op physical. To avoid going beyond my word count for the column, I left out the explanation that it was a few days before bunion surgery and the antibiotic was prophylactic to protect the foot. My sloppy editing made it look like I had expanded the scope of my practice to infected belly buttons. The investigator asked me to write a full explanation and send the patient’s record. Since I tend to write about a composite of 30 years patient care experience in these articles, I could not remember which patient I was writing about. I always consider using a prophylactic antibiotic when a preoperative patient has any type of infection. I refer serious infections with drainage or cellulitis to the family physician for care. I sent the narrative and got a call from the investigator the next week. He told me he had enough information and thanked me for my prompt response. I asked when the case might be resolved, knowing from past experience on the other side that it could take several years. He let me know the process and told me the board would review his findings and recommend closure, sanctions or possible suspension of my license to practice. Eight months passed before I heard from the board again. I wrote a short narrative explaining my open case for hospital and insurance credentialing forms. I submit a copy whenever the question “Have you ever been investigated for anything?” comes up. I received a plain looking envelope from the licensing board recently, letting me know I was off the hook. My case had been closed. I breathed a sigh of relief but now I know how it feels. I am grateful to the complainant for making me a more careful editor. Dr. McCord is a Diplomate with the American Board of Podiatric Surgery. He practices at Centralia Medical Center in Centralia, Wash.