Virginia Board of Health Professions Laws and Regulations:
What you don’t know can hurt you!
By Michael Goodman, JD and Eileen Talamante, RN, JD
In the Summer 2013 issue of Hampton Roads Physician, we discussed the epidemic of prescription drug use in Virginia and nationwide, the increase in related patient complaints to the Virginia Board of Health Professions, and the trend of heightened scrutiny and regulation by the Board in these cases. A year later, that trend continues: well-meaning doctors, acting solely on a sincere wish to relieve their patients’ pain, are increasingly finding themselves before the Board. Unfortunately, they often know little or even nothing about the policies of the Board of Health Professions, and can easily feel overwhelmed.
That’s not unusual. Ideally, physicians aren’t that familiar with the Board for matters other than licensure – if they are, it could mean they’ve already run afoul of one of its regulations.
Both patients and colleagues can file complaints to the Board; and any known substance abuse or public action that reflects poorly on the medical profession is a sure path to a Board investigation. Having hospital privileges restricted is another. While it may seem intuitive that a suspicious drug prescription history would give rise to an inquiry, there are other, less obvious violations that can do the same. A few examples:
• Physicians cannot prescribe weight loss medications without first instructing their patients to attempt traditional methods like diet and exercise. In any case, prescriptions for most weight loss drugs can only be given after the patient has a cardiac workup, including an EKG.
• In this age of ever-present medical advertising, it’s not unusual to see discounted drugs being offered, whether as a one-day special TV ad or even through online deal-of-the-day websites that feature discounted gift certificates for goods or services. Physicians should exercise caution when advertising: offering a discount without including the original cost of the product or service is a violation.
• With regard to advertising, physicians and their marketing personnel should be aware of the language restrictions established by the Board. Claiming superiority in a field of practice is strictly prohibited. While it’s acceptable to refer to awards won – such as “Top Doc” or “Best Doctors in Town” – even those should cite the specific reference. Likewise, any reference to Board certification must include the specialty.
One of the most frequent complaints that call nurses before their Board is suspected medication diversion. Health care professionals, including nurses, may be particularly susceptible to substance abuse problems due to the stresses of working in a health care environment. Because they have an increased opportunity to obtain controlled substances, proper charting procedures are vital to prove that no medications were diverted – particularly in the case of narcotics. As we noted in this column last year, document, document and then document again.
And while it’s not necessarily against Board regulations, we suggest health care providers avoid social media when it comes to their patients. The most well-meaning text or Facebook post can be misconstrued, just as cell phone calls, unless recorded, can result in murky ‘he-said-she-said’ situations that have the potential to damage a physician or nurse just as much as an appearance before the Board.
A final thought.
Safe is always better than sorry. It would be time well spent to visit the website of the Virginia Board of Health Professions – http://www.dhp.virginia.gov/ – and become familiar with its laws and regulations.
Above all, if you get a letter from an investigator working on behalf of the Board, don’t panic. It’s not a criminal proceeding, and it’s not an inquisition — but it’s not a social invitation either. Not every letter from the Board means you have to call a lawyer, but if you do, make certain it’s someone who handles healthcare regulatory matters. You wouldn’t call your orthopaedist to deliver a baby!
Michael Goodman and Eileen Talamante, who also is a nurse, are attorneys with the law firm of Goodman, Allen & Filetti. Their practices focus on health care, risk management, representation of health care providers in credentialing matters, regulatory issues and before the various Boards of the Department of Health Professions. www.goodmanallen.com
