What happens when someone complains to the Tennessee Board of Veterinary Medical Examiners?
While we all hope that we are never the subject of a complaint, the reality is that many of us will face this situation at some point in our careers. Hopefully, by understanding what occurs during a Board complaint, we might be better able to respond and resolve a complaint in our favor.
First, complaints can be lodged in various ways and by various sources. A client may file a complaint by sending a letter to the Board, filling out a state provided complaint form, or complaints may be made through the state's anonymous tip line (although this is uncommon). A veterinarian, veterinary technician, employee, or even a family member can file a complaint. For example, a spouse may feel that the veterinarian they are married to is a danger to his or her patients due to a substance abuse problem and may file a complaint in an effort to get help for that veterinarian. The complaintant may choose to remain anonymous. The Board itself can lodge a complaint when a violation is brought to light during a hospital inspection or while another case is being investigated. For example, if the Board is investigating a case against Dr. A for failure to maintain a valid license and finds that Dr. B has been employing the unlicensed Dr. A, the Board could lodge a complaint against Dr. B for permitting unlicensed practice within his practice.
Once a complaint is received by the Board, it is assigned to the Office of Investigations. Some complaints, especially those of a nuisance variety, may be closed by the staff at that point. If someone complained that they weren't offered coffee while in the waiting room (don't laugh... it's happened!), that complaint would be closed by staff. Substantive complaints are scheduled for a first review (called a P1 reveiw) by the Board's attorney and a consultant to the Board, who is a licensed, practicing veterinarian, but is not a member of the Board. Since ultimately the Board may have to hear a case and make a ruling, it is important that the Board members have no prior knowledge of a pending case. Consultants are utilized to help the attorney determine if a violation of the Practice Act has occured and/or whether there has been a deviation from the standard of care.
If the P1 review raises concerns that a violation may have occured, the complaint is forwarded to an investigator in the Office of Investigations. The investigator will then contact and interview all parties involved, gather certified copies of medical records, radiographs, lab reports, and other information, and may visit the clinic to interview employees and photograph aspects of the practice. The investigator will file this report and a P2 review with the Board's attorney and a consultant will then be scheduled. In addition, the attorney for the Board and the consultant may elect to close a case at the P1 review with no action, issue a Letter of Concern, or issue a Letter of Warning.
A Letter of Concern indicates that a minor infraction may have occured or the complaint may be entering a "gray area" and the respondent should take care in the future to insure that an infraction does not occur. A Letter of Warning is a harsher letter and indicates that a violation has occured and action should be taken to insure future compliance.
At the P2 review, the attorney and consultant (it may or may not be the same consultant that performed the P1 review) will review the original complaint and the information gathered by the investigator. The reviewers may then take a number of actions. The file may be closed if no violation is found to have occured. The investigator may be asked to gather some additional specific information. The reviewers may conclude that a minor violation did occur, but no formal action by the Board is required. A Letter of Concern or a Letter of Warning may be drafted and sent to the veterinarian voicing some misgivings regarding the complaint and asking for corrective action to be taken.
Some cases may be referred to a Screening Panel, an informal process used to facilitate a settlement of the case. These panels consist of three veterinarians, one of whom is a Board member, and this panel would try to work out an agreement with the licensee. Either the P2 reviewers or the Screening Panel members can recommend action against the respondent to the Board. Upon a finding by the Board that a respondent has violated the Practice Act or Rules, the Board may impose any of the following: civil penalties, a reprimand, probation, a suspension or a revocation. In addition, the Board can impose additional conditions on the licensee such as completion of additional continuing education in a particular subject or participation in a substance abuse program. Lastly, more serious violations may be referred to the Office of General Counsel (the attorneys for the Department of Health) for prosecution in a contested case hearing before the entire Board.
Next month, we'll outline what happens at a contested case hearing. It is essential a trial by a jury of our peers... in this case, the members of the Board of Veterinary Medical Examiners.