29 minute read
The Florida Dentist’s Guide to Peer Review
By Renee Thompson, Director of Communications and Marketing
The Peer Review program is designed to help Florida Dental Association (FDA) member dentists avoid costly legal fees, malpractice suits and Board of Dentistry complaints.
Designed to assist members with resolution of patient disputes before they become lawsuits or complaints to the Florida Board of Dentistry (BOD), the FDA’s Peer Review program is an incredible member benefit that’s both free and confidential. The process can be initiated by a patient or an FDA member dentist.
FDA’s peer review coordinator, Lywanda Tucker, works with both the patient and the dentist to negotiate a compromise when there are differences in opinion about the care provided. If she is unable to successfully find a compromise, the case will be referred to the appropriate component peer review chair (a volunteer dentist) for additional mediation or a formal review.
The peer review process is not designed to handle every type of situation or problem that ”may arise between dentists and patients. Only cases involving problems with actual dental treatment and procedures are eligible. Cases not qualified for peer review include: those already in malpractice litigation; those already being investigated by the BOD; disputes that are only about dental fees; treatment that occurred more than 12 months before the patient’s last appointment; and cases involving nonmember dentists. The current peer review system is also not intended to handle a complaint initiated by one dentist against another. Thank you so much for your professionalism and handling of my recent peer review case. I greatly appreciate your responsiveness and patience while achieving an amicable result for all parties. — Florida Dentist
Why Start with Mediation?
Mediation is the initial step in peer review and is one of the most important steps in the process. During mediation, the disputing parties, with the assistance of Ms. Tucker as a mediator, identify disputed issues, discuss alternative ways to resolve the issues, and
potentially reach a settlement that is satisfactory to both parties. If mediation is successful, cases are concluded at that stage and do not need to proceed on to formal peer review.
The crux of the mediator’s work is to help the parties think through the issues and generate ideas for resolving the dispute. Ms. Tucker begins by gathering information about the dispute and asking each party to explain what the dispute is about in his or her own terms and hears each party’s initial position on the matter. Sometimes, it seems patients just want to be heard. Even if there are differences in the versions of the events, it is not always necessary to resolve them. Ms. Tucker focuses more on finding out what needs each party wants to satisfy and how to best resolve the dispute. Ms. Tucker’s experience, dental knowledge and personality aid in problem-solving and finding compromise.
In fact, Ms. Tucker has more than 16 years of dentistry experience in varying positions including work at periodontal, general and orthodontic offices. She has been a chairside assistant, a treatment coordinator and a member of the front office staff. This training and experience are of great benefit and allow her to properly conduct mediation as an impartial — but knowledgeable — third party. She works to establish communication, build trust and resolve problems expeditiously. Mediation can result in resolution of many cases initiated in the peer review system and can be a very valuable tool in resolving dental disputes.
A Brief History
Peer review provides an impartial, easily accessible and generally expedient means for resolving misunderstandings regarding dental treatment. It benefits the patient and the dentist; however, it hasn’t always been in existence.
The American Dental Association (ADA) first established policy on peer review in 1970, with the adoption of the statement on Dental Society Review Committees. That statement outlined the purpose and functions of review committees and clearly specified that such committees were to be established for prepayment programs. Other committees, such as patient grievance, patient relations or patient counseling, dealt with disputes between patients and dentists. Since its establishment in 1970, the peer review program has grown and changed through adoption of policies:
1971 — peer review committees got the right to review radiographs and other treatment records.
1972 — third parties were encouraged to use the peer review process.
1973 — constituent societies were urged to seek statutory exemption from civil damage liability for peer review committee members.
1975 — the prerogative and duty of the dental profession to conduct all necessary review of dental services through its established mechanisms, including peer review was acknowledged.
1977 — the responsibilities for grievance and peer review committees were combined under the auspices of a single
“peer review committee.”
1979 — constituent societies were urged to cooperate in the resolution of inter-jurisdictional cases.
1980 — the Bylaws definition of member in good standing was amended to include, among other things, cooperation with dental society peer review bodies.
1987 — policies were revised to reflect the current practices in peer review and the changing nature of the various relationships that exist in the delivery of dental care.
Most of the remaining peer review policies were modified where necessary and incorporated into a statement, “Guidelines on the Structure, Functions and Limitations of the Peer Review Process.”
FDA’s Peer Review Program:
Maintains high dental standards.
Aids in mediation efforts.
Meets the needs of the public regarding the quality and appropriateness of dental care.
Assists parties in avoiding litigation.
t
For questions or additional information, please visit FloridaDental.org/PeerReview or contact Peer Review Coordinator Lywanda Tucker at 850.350.7143 or ltucker@floridadental.org.
That statement was revised and adopted in 1992, by the ADA House of Delegates.
Peer review continues to grow, change and improve. For example, in Florida, there was a shift to moving administrative duties to the FDA’s headquarters rather than at each of the components. This was done, in part, to ensure consistency in intake of cases throughout the state. Having a qualified and trained staff person dedicated to peer review will benefit all members. And, parts of the process remain consistent with prior systems so cases will still be referred to the appropriate component peer review chairs as appropriate and necessary.
In all, peer review is a valuable tool to help FDA member dentists succeed.
Section 466.022(1), Florida Statutes, states (among other things) that “a professional organization or association of dentists which sponsors, sanctions, or otherwise operates or participates in peer review activities is hereby afforded the same privileges and immunities afforded to any member of a duly constituted medical review committee by s. 766.101(3).” Section 766.101(3)(a), Florida Statutes, provides that “[t]here shall be no monetary liability on the part of, and no cause of action for damages shall arise against, any member of a duly appointed medical review committee, or any health care provider furnishing any information, including information concerning the prescribing of substances listed in s. 893.03(2), to such committee, or any person, including any person acting as a witness, incident reporter to, or investigator for, a medical review committee, for any act or proceeding undertaken or performed within the scope of the functions of any such committee if the committee member or health care provider acts without intentional fraud.” These statutory protections are intended to encourage good faith participation in the peer review process without fear of liability.
However, it is important to remember that records generated in the peer review process may be subject to disclosure in response to a subpoena or other legal process, and the original records (patient’s chart and dental records) and underlying facts of a matter submitted to peer review are almost always discoverable.
Dentists are encouraged to have this card handy for front desk staff to give to patients who may be good candidates for Peer Review. Cut out these 10; print more at bit.ly/3UWTMRe.
Peer Review Coordinator Lywanda Tucker 850.350.7143 or ltucker@floridadental.org
One of the goals of Florida Dental Association (FDA) member One of the goals of Florida Dental Association (FDA) member dentists is to provide you – the patient – with personalized dentists is to provide you – the patient – with personalized attention and the high-quality dental care. But, sometimes attention and the high-quality dental care. But, sometimes problems occur. If you cannot satisfactorily resolve an issue problems occur. If you cannot satisfactorily resolve an issue or believe your dentist has not provided the best quality or believe your dentist has not provided the best quality care possible, there are options. You may have the dispute Peer Review Coordinator Lywanda Tucker care possible, there are options. You may have the dispute mediated through the FDA’s Peer Review Program. 850.350.7143 or ltucker@floridadental.org mediated through the FDA’s Peer Review Program.
One of the goals of Florida Dental Association (FDA) member dentists is to provide you – the patient – with personalized attention and the high-quality dental care. But, sometimes problems occur. If you cannot satisfactorily resolve an issue or believe your dentist has not provided the best quality Peer Review Coordinator Lywanda Tucker care possible, there are options. You may have the dispute Peer Review Coordinator Lywanda Tucker 850.350.7143 or ltucker@floridadental.org mediated through the FDA’s Peer Review Program. 850.350.7143 or ltucker@floridadental.org
One of the goals of Florida Dental Association (FDA) member dentists is to provide you – the patient – with personalized attention and the high-quality dental care. But, sometimes problems occur. If you cannot satisfactorily resolve an issue or believe your dentist has not provided the best quality care possible, there are options. You may have the dispute Peer Review Coordinator Lywanda Tucker Peer Review Coordinator Lywanda Tucker mediated through the FDA’s Peer Review Program. 850.350.7143 or ltucker@floridadental.org 850.350.7143 or ltucker@floridadental.org
One of the goals of Florida Dental Association (FDA) member dentists is to provide you – the patient – with personalized attention and the high-quality dental care. But, sometimes problems occur. If you cannot satisfactorily resolve an issue or believe your dentist has not provided the best quality Peer Review Coordinator Lywanda Tucker care possible, there are options. You may have the dispute Peer Review Coordinator Lywanda Tucker 850.350.7143 or ltucker@floridadental.org mediated through the FDA’s Peer Review Program. 850.350.7143 or ltucker@floridadental.org
One of the goals of Florida Dental Association (FDA) member One of the goals of Florida Dental Association (FDA) member One of the goals of Florida Dental Association (FDA) member dentists is to provide you – the patient – with personalized dentists is to provide you – the patient – with personalized dentists is to provide you – the patient – with personalized attention and the high-quality dental care. But, sometimes attention and the high-quality dental care. But, sometimes attention and the high-quality dental care. But, sometimes problems occur. If you cannot satisfactorily resolve an issue problems occur. If you cannot satisfactorily resolve an issue problems occur. If you cannot satisfactorily resolve an issue or believe your dentist has not provided the best quality or believe your dentist has not provided the best quality or believe your dentist has not provided the best quality care possible, there are options. You may have the dispute Peer Review Coordinator Lywanda Tucker care possible, there are options. You may have the dispute Peer Review Coordinator Lywanda Tucker care possible, there are options. You may have the dispute mediated through the FDA’s Peer Review Program. 850.350.7143 or ltucker@floridadental.org mediated through the FDA’s Peer Review Program. 850.350.7143 or ltucker@floridadental.org mediated through the FDA’s Peer Review Program.
One of the goals of Florida Dental Association (FDA) member One of the goals of Florida Dental Association (FDA) member One of the goals of Florida Dental Association (FDA) member dentists is to provide you – the patient – with personalized dentists is to provide you – the patient – with personalized dentists is to provide you – the patient – with personalized attention and the high-quality dental care. But, sometimes attention and the high-quality dental care. But, sometimes attention and the high-quality dental care. But, sometimes problems occur. If you cannot satisfactorily resolve an issue problems occur. If you cannot satisfactorily resolve an issue problems occur. If you cannot satisfactorily resolve an issue or believe your dentist has not provided the best quality or believe your dentist has not provided the best quality or believe your dentist has not provided the best quality care possible, there are options. You may have the dispute Peer Review Coordinator Lywanda Tucker care possible, there are options. You may have the dispute Peer Review Coordinator Lywanda Tucker care possible, there are options. You may have the dispute mediated through the FDA’s Peer Review Program. 850.350.7143 or ltucker@floridadental.org mediated through the FDA’s Peer Review Program. 850.350.7143 or ltucker@floridadental.org mediated through the FDA’s Peer Review Program.
One of the goals of Florida Dental Association (FDA) member One of the goals of Florida Dental Association (FDA) member One of the goals of Florida Dental Association (FDA) member dentists is to provide you – the patient – with personalized dentists is to provide you – the patient – with personalized dentists is to provide you – the patient – with personalized attention and the high-quality dental care. But, sometimes attention and the high-quality dental care. But, sometimes attention and the high-quality dental care. But, sometimes problems occur. If you cannot satisfactorily resolve an issue problems occur. If you cannot satisfactorily resolve an issue problems occur. If you cannot satisfactorily resolve an issue or believe your dentist has not provided the best quality or believe your dentist has not provided the best quality or believe your dentist has not provided the best quality care possible, there are options. You may have the dispute Peer Review Coordinator Lywanda Tucker care possible, there are options. You may have the dispute Peer Review Coordinator Lywanda Tucker care possible, there are options. You may have the dispute mediated through the FDA’s Peer Review Program. 850.350.7143 or ltucker@floridadental.org mediated through the FDA’s Peer Review Program. 850.350.7143 or ltucker@floridadental.org mediated through the FDA’s Peer Review Program.
One of the goals of Florida Dental Association (FDA) member dentists is to provide you – the patient – with personalized attention and the high-quality dental care. But, sometimes problems occur. If you cannot satisfactorily resolve an issue or believe your dentist has not provided the best quality care possible, there are options. You may have the dispute Peer Review Coordinator Lywanda Tucker mediated through the FDA’s Peer Review Program. 850.350.7143 or ltucker@floridadental.org One of the goals of Florida Dental Association (FDA) member dentists is to provide you – the patient – with personalized attention and the high-quality dental care. But, sometimes problems occur. If you cannot satisfactorily resolve an issue or believe your dentist has not provided the best quality care possible, there are options. You may have the dispute Peer Review Coordinator Lywanda Tucker mediated through the FDA’s Peer Review Program. 850.350.7143 or ltucker@floridadental.org
One of the goals of Florida Dental Association (FDA) member dentists is to provide you – the patient – with personalized attention and the high-quality dental care. But, sometimes problems occur. If you cannot satisfactorily resolve an issue or believe your dentist has not provided the best quality care possible, there are options. You may have the dispute mediated through the FDA’s Peer Review Program.
One of the goals of Florida Dental Association (FDA) member One of the goals of Florida Dental Association (FDA) member dentists is to provide you – the patient – with personalized dentists is to provide you – the patient – with personalized attention and the high-quality dental care. But, sometimes attention and the high-quality dental care. But, sometimes problems occur. If you cannot satisfactorily resolve an issue problems occur. If you cannot satisfactorily resolve an issue or believe your dentist has not provided the best quality or believe your dentist has not provided the best quality care possible, there are options. You may have the dispute care possible, there are options. You may have the dispute mediated through the FDA’s Peer Review Program. mediated through the FDA’s Peer Review Program.
One of the goals of Florida Dental Association (FDA) member One of the goals of Florida Dental Association (FDA) member dentists is to provide you – the patient – with personalized dentists is to provide you – the patient – with personalized attention and the high-quality dental care. But, sometimes attention and the high-quality dental care. But, sometimes problems occur. If you cannot satisfactorily resolve an issue problems occur. If you cannot satisfactorily resolve an issue or believe your dentist has not provided the best quality or believe your dentist has not provided the best quality care possible, there are options. You may have the dispute care possible, there are options. You may have the dispute mediated through the FDA’s Peer Review Program. mediated through the FDA’s Peer Review Program.
One of the goals of Florida Dental Association (FDA) member One of the goals of Florida Dental Association (FDA) member dentists is to provide you – the patient – with personalized dentists is to provide you – the patient – with personalized attention and the high-quality dental care. But, sometimes attention and the high-quality dental care. But, sometimes problems occur. If you cannot satisfactorily resolve an issue problems occur. If you cannot satisfactorily resolve an issue or believe your dentist has not provided the best quality or believe your dentist has not provided the best quality care possible, there are options. You may have the dispute care possible, there are options. You may have the dispute mediated through the FDA’s Peer Review Program. mediated through the FDA’s Peer Review Program. One of the goals of Florida Dental Association (FDA) member dentists is to provide you – the patient – with personalized attention and the high-quality dental care. But, sometimes problems occur. If you cannot satisfactorily resolve an issue or believe your dentist has not provided the best quality Peer Review Coordinator Lywanda Tucker care possible, there are options. You may have the dispute 850.350.7143 or ltucker@floridadental.org mediated through the FDA’s Peer Review Program.
One of the goals of Florida Dental Association (FDA) member One of the goals of Florida Dental Association (FDA) member One of the goals of Florida Dental Association (FDA) member dentists is to provide you – the patient – with personalized dentists is to provide you – the patient – with personalized dentists is to provide you – the patient – with personalized attention and the high-quality dental care. But, sometimes attention and the high-quality dental care. But, sometimes attention and the high-quality dental care. But, sometimes problems occur. If you cannot satisfactorily resolve an issue problems occur. If you cannot satisfactorily resolve an issue problems occur. If you cannot satisfactorily resolve an issue or believe your dentist has not provided the best quality or believe your dentist has not provided the best quality or believe your dentist has not provided the best quality care possible, there are options. You may have the dispute care possible, there are options. You may have the dispute Peer Review Coordinator Lywanda Tucker care possible, there are options. You may have the dispute mediated through the FDA’s Peer Review Program. mediated through the FDA’s Peer Review Program. 850.350.7143 or ltucker@floridadental.org mediated through the FDA’s Peer Review Program.
One of the goals of Florida Dental Association (FDA) member One of the goals of Florida Dental Association (FDA) member dentists is to provide you – the patient – with personalized dentists is to provide you – the patient – with personalized attention and the high-quality dental care. But, sometimes attention and the high-quality dental care. But, sometimes problems occur. If you cannot satisfactorily resolve an issue problems occur. If you cannot satisfactorily resolve an issue or believe your dentist has not provided the best quality or believe your dentist has not provided the best quality care possible, there are options. You may have the dispute Peer Review Coordinator Lywanda Tucker care possible, there are options. You may have the dispute mediated through the FDA’s Peer Review Program. 850.350.7143 or ltucker@floridadental.org mediated through the FDA’s Peer Review Program.
One of the goals of Florida Dental Association (FDA) member One of the goals of Florida Dental Association (FDA) member One of the goals of Florida Dental Association (FDA) member dentists is to provide you – the patient – with personalized dentists is to provide you – the patient – with personalized dentists is to provide you – the patient – with personalized attention and the high-quality dental care. But, sometimes attention and the high-quality dental care. But, sometimes attention and the high-quality dental care. But, sometimes problems occur. If you cannot satisfactorily resolve an issue problems occur. If you cannot satisfactorily resolve an issue problems occur. If you cannot satisfactorily resolve an issue or believe your dentist has not provided the best quality or believe your dentist has not provided the best quality or believe your dentist has not provided the best quality care possible, there are options. You may have the dispute care possible, there are options. You may have the dispute Peer Review Coordinator Lywanda Tucker care possible, there are options. You may have the dispute mediated through the FDA’s Peer Review Program. mediated through the FDA’s Peer Review Program. 850.350.7143 or ltucker@floridadental.org mediated through the FDA’s Peer Review Program.
One of the goals of Florida Dental Association (FDA) member dentists is to provide you – the patient – with personalized attention and the high-quality dental care. But, sometimes problems occur. If you cannot satisfactorily resolve an issue or believe your dentist has not provided the best quality care possible, there are options. You may have the dispute mediated through the FDA’s Peer Review Program. One of the goals of Florida Dental Association (FDA) member dentists is to provide you – the patient – with personalized attention and the high-quality dental care. But, sometimes problems occur. If you cannot satisfactorily resolve an issue or believe your dentist has not provided the best quality care possible, there are options. You may have the dispute mediated through the FDA’s Peer Review Program. One of the goals of Florida Dental Association (FDA) member dentists is to provide you – the patient – with personalized attention and the high-quality dental care. But, sometimes problems occur. If you cannot satisfactorily resolve an issue or believe your dentist has not provided the best quality care possible, there are options. You may have the dispute Peer Review Coordinator Lywanda Tucker mediated through the FDA’s Peer Review Program. 850.350.7143 or ltucker@floridadental.org
One of the goals of Florida Dental Association (FDA) member dentists is to provide you – the patient – with personalized attention and the high-quality dental care. But, sometimes problems occur. If you cannot satisfactorily resolve an issue or believe your dentist has not provided the best quality care possible, there are options. You may have the dispute Peer Review Coordinator Lywanda Tucker mediated through the FDA’s Peer Review Program. 850.350.7143 or ltucker@floridadental.org
One of the goals of Florida Dental Association (FDA) member dentists is to provide you – the patient – with personalized attention and the high-quality dental care. But, sometimes problems occur. If you cannot satisfactorily resolve an issue or believe your dentist has not provided the best quality care possible, there are options. You may have the dispute Peer Review Coordinator Lywanda Tucker mediated through the FDA’s Peer Review Program. 850.350.7143 or ltucker@floridadental.org
One of the goals of Florida Dental Association (FDA) member dentists is to provide you – the patient – with personalized attention and the high-quality dental care. But, sometimes problems occur. If you cannot satisfactorily resolve an issue or believe your dentist has not provided the best quality care possible, there are options. You may have the dispute Peer Review Coordinator Lywanda Tucker mediated through the FDA’s Peer Review Program. 850.350.7143 or ltucker@floridadental.org
Peer Review Case Studies
Case Study #1:
A patient called and wanted to file a complaint against a dentist he saw in 2021 to have a crown replaced that fell off a front tooth. Patient was told the crown could not be saved and it would have to be replaced with a new crown. According to the patient, the tooth was filed down too much when being prepped for the first crown and a new crown. The permanent crown later fell off again and this time there was not enough tooth left for another crown. The tooth had to be extracted. The patient went to another dentist and had treatment and wanted to receive a refund from the previous dentist.
Peer Review Results:
The case was forwarded to the peer review chair dentist for the patient’s area since the case was not able to be resolved with simple mediation. Upon full review of all records and talking to both the patient and the treating dentist, the case was closed. The treating dentist had done everything within the standard of care and the patient was looking for a refund since he needed to have additional treatment for the tooth. Case Closed!
Case Study #2:
A patient called to file a complaint about an FDA member dentist whom she said had done a filing for her that later came out. The patient stated she’d already spoken to the dentist about a refund, and he agreed to refund her, but she wanted to file a complaint about the amount to be refunded. The patient sent in her statement from the dental office.
Peer Review Results:
Peer Review Coordinator Lywanda Tucker called and spoke with the treating dentist about the patient’s complaint. He agreed to refund the patient and wanted to know the amount to refund her. After looking over the patient’s statement the dentist agreed to refund her the amount she paid out of pocket as well as her insurance. Case Closed!
Case Study #3:
A patient called and stated she went to a dentist to have two lower implants placed for permanent dentures. According to the patient, the implants were causing her a lot of discomfort and the permanent dentures would not fit. The patient went for a second opinion and was told that one of the implants had not been placed directly in the bone; it was in the gum and had to be extracted.
Peer Review Results:
Peer Review Coordinator Lywanda Tucker called and spoke with the treating dentist to discuss the complaint and he agreed to refund the patient. No need for a more formal complaint with the Florida Board of Dentistry or a lawsuit. Case Closed!
Case Study #4:
A patient called and stated that she went in for treatment, but had a lot of discomfort and temporary crowns keep breaking. The patient went to another dentist to have a second opinion and decided to have treatment with him. The previous dentist refunded the patient the amount she paid for the permanent crowns but, the patient wanted more to cover the expenses she’d accrued with the current dentist.
Peer Review Results:
After speaking with the dentist about the complaint, Peer Review Coordinator Lywanda Tucker determined that the dentist had already refunded the patient. The patient understood, but was insisting that she should have received more from the treating dentist. Ms. Tucker forwarded the case to the peer review chair doctor for the patient’s area. After looking over the records and speaking to both the patient and the dentist, the peer review chair doctor decided that the refund the patient received was sufficient for what she had paid out. Case Closed!
Peer Review is Simple
By Hugh Wunderlich, DDS, CDE, FDA Editor
The Florida Dental Association (FDA) basically provides you with a liaison to navigate the process. It’s fair. It’s free and it’s the finest FDA benefit. Oh, not a member of the FDA? The next three pages give you some insight to the legal morass you might be facing. I mean it’s only your license! Join the FDA. We are here to help YOU succeed!
Complaint
Department
Probable Cause Citation Issued Disputed
Receipt and Analysis
Prosecution Attorney Review Non Disputed Final Order
Closure/Referral to other agencies as Non-Jurisdictional OR Closure as legally Non-sufficient
Mediation Complaint Closed
Investigation
Prosecution
Mediation Draft Emergency Action
Findings:
Case Disposition State Surgeon General Review and Signature
No Probable Cause Found
Dismissal/ Closure
Probable Cause Found
Administrative Complaint Filed With Department of Health
Election of Rights by License
Revised 11/2019 Formal Hearing Before DOAH (Contest Charges)
Informal Hearing Before Board (No Dispute)
Hearing Waived Before Board (No Dispute)
Settlement by Licensee to Board for Approval
Consumer Services (CSU) Investigative Services (ISU) Prosecution Services (PSU) State Surgeon General
Boards
Compliance Management (CMU) Courts of Appeal
Confidential Public
Appeal Procedures To District Courts of Appeal
Compliance Monitoring
Final Order Imposing Discipline Filed with Department of Health
Full Board Action and Disposition
Settlement Rejected
The division of Medical Quality Assurance’s (MQA) Bureau of Enforcement fields and investigates complaints against health care practitioners and facilities/establishments regulated by the Florida Department of Health.
The path of a complaint:
• Consumer Services Unit (CSU): Where the complaint process begins. • Investigative Services Unit (ISU). Legally sufficient complaints are forwarded here. • Prosecution Services Unit (PSU). Conducts legal review of ISU-generated investigative reports. • Probable Cause Panel. Determines what becomes of the case.
Cases are ultimately decided by a Probable Cause Panel (PCP). It is not bound to go along with the recommendation PSU attorneys give upon legal review. *456.073(2) & 456.073(4), Florida Statutes
A Probable Cause Panel…
• reviews all evidence and information gathered during the investigation. • is made up of 2 or 3 board members – usually 1 or 2 licensed health care professionals and a consumer member. (*A consumer member represents the public interest. He or she does not necessarily have specialized medical knowledge/training and does not practice medicine.) • can feature different members from meeting to meeting.
The PCP will issue one of the following recommendations: (1) Escalation to the Formal Administrative Complaint phase. (2) Closure, with a letter of guidance (3) Dismissal.
FAST FACTS
Florida Statutes outline the parameters by which probable cause panels operate, especially its strict disclosure policy. (Example: The only time a case will be made public is if an administrative complaint is approved by the PCP – 10 days after such a finding.) *456.073(10)
1
True or False?: The person(s) whose complaint initiated an investigation of a health care professional is given unlimited access to the PCP and its conducting of official business.
Answer: False. Even the complainant in the case is not privy to what happens at PCP meetings. Furthermore, he or she cannot sit in on PCP discussions, receive transcripts of the proceedingsor obtain copies of the case evidence presented. *456.073(9)(a),(b), and (c)
2
True or False?: The licensee whom the complaint was filed against has the overriding expectation of confidentiality.
Answer: True. If a case is closed without an administrative complaint being issued – either with a letter of guidance or a regular dismissal ‒ no one gets to know anything about it, including who was on the PCP or what the alleged violation was. That is, unless, the licensee waives his/her right, in writing, to keep everything confidential. *456.073(10)
1
A Quick Guide to the MQA Disciplinary Process Discretionary Emergency Orders – 3 Things to Know
The Emergency Action process is applicable to any licensed Florida health care professional who poses an immediate, serious danger to the public health, safety or welfare. *456.073(8); 120.60(6), Florida Statutes
What that means:
• Immediacy is necessary. If an incident occurred too long ago to be considered immediate anymore, it will not qualify for Emergency Action. (Determination of “too long ago” is made on a case-by-case basis.) • The allegation(s) need to rise to a sufficient level of seriousness to warrant the emergency order.
Emergency Restriction Orders (EROs) and Emergency Suspension Orders (ESOs) are exclusively issued by the State Surgeon General. As with Probable Cause Panels, the Surgeon General can either accept or disregard the preceding investigation-based recommendation made by Prosecution Services Unit attorneys.
In addition to immediacy, the DOH is only permitted to use the “least restrictive means” to stop the danger. *120.60(6)(b)
What that means:
The Emergency Action must be in line with what danger is posed to the public – whether it be just a portion, or, the public as a whole. (Example: If a male licensee accused of sexual misconduct against females will only be restricted to not treating females.)
The distinction between orders: • ESOs – For licensees deemed to be a threat to the public at large • EROs – For licensees considered a threat to a segment of the population
The Emergency Order process is carried out without a hearing. Restricting someone’s right to work without the benefit of a hearing, the balancing act dictated by appellate law calls for it be done by the least restrictive means.
An ESO or ERO is not considered final agency action.
What that means:
• Orders can be appealed within 30 days of issuance. The appeal can play out while the normal disciplinary process – toward administrative complaint and regular prosecution – runs its course. *120.60(6)(c)
• The accused health care practitioner is entitled to a hearing before final action is taken by a regulatory board or by the Department of Health. He or she can request an expedited full evidentiary hearing, which requires the presentation of evidence that is admissible in court and witnesses to testify to prove the alleged violation.
2
3
• Complaints have to be filed within 20 days of an ERO/ESO – *Rule 28-106.501(3), Florida
Administrative Code.
The violation posing the public danger must be a viable charge listed under the Practice Acts or the rules Page 1 regulating the Department of Health, including: commission of crimes; violations of standards of care; drug use / impairment; drug diversion; sexual misconduct; and student loan defaults.
