Common Medical Ethics Violations and Disciplinary Risks in California

As a physician, you’ve taken an oath to “do no harm” and uphold the highest standards of ethical conduct in your practice. But in the realities of modern medicine, ethical dilemmas aren’t always clear-cut. Missteps can happen – and when they do, the consequences can be severe, both for your patients and your professional future.

At TONG LAW, we’ve represented countless physicians facing allegations of ethical violations before the Medical Board of California and other disciplinary bodies. We understand the high stakes involved and the importance of mounting a strong, strategic defense to protect your license and reputation.

In this article, we’ll explore some of the most common types of medical ethics violations, the disciplinary process, and steps you can take to safeguard your practice. If you’re facing a complaint or investigation, don’t hesitate to reach out to our team for guidance.

The Principles of Medical Ethics

Medical ethics is founded on four core principles:

1. Autonomy: Respecting patients’ right to make informed decisions about their care
2. Beneficence: Acting in the best interest of patients and promoting their well-being
3. Non-maleficence: Avoiding harm to patients
4. Justice: Treating patients fairly and equitably

These principles are enshrined in professional codes of conduct, like the American Medical Association’s Code of Medical Ethics. They serve as the ethical north star for physicians, guiding decision-making in clinical situations.

Violations of these principles can give rise to disciplinary action by state medical boards, which are charged with protecting the public and ensuring the integrity of the profession. In California, the Medical Board has broad authority under the Medical Practice Act to investigate and prosecute ethical violations.

Common Ethical Pitfalls for Physicians

While every case is different, certain types of ethical breaches come up again and again in Medical Board investigations. Some of the most frequent include:

Informed Consent and Patient Autonomy

Informed consent is the cornerstone of patient autonomy. Under California law, physicians must disclose the risks, benefits, and alternatives of proposed treatments to enable patients to make voluntary, informed decisions.

Common consent violations include:

• Failing to obtain consent before treatment
• Not fully explaining risks and alternatives
• Disregarding advance directives
• Coercing patients into unwanted procedures

Privacy and Confidentiality

With limited exceptions, physicians have a duty to safeguard patients’ protected health information under state and federal privacy laws like HIPAA.

Breaches of confidentiality are a frequent source of Board discipline, such as:

• Improper disclosure of medical records
• Discussing patient cases in public spaces or online
• Failing to implement proper data security measures
• Allowing unauthorized staff access to records

Professional Boundaries and Sexual Misconduct

The physician-patient relationship is founded on trust and respect. Crossing professional boundaries, especially sexual boundaries, is a grave ethical breach that can result in license revocation.

Examples include:

• Romantic or sexual contact with current patients
• Inappropriate exams or touching
• Exchanging explicit messages or images
• Exploiting the treatment relationship for personal gain

Conflicts of Interest

Physicians are expected to put patients’ interests first and avoid conflicts that could cloud medical judgment.

Some common conflict issues:

• Accepting kickbacks for referrals or prescriptions
• Self-referral to facilities with a financial interest
• Participating in sham research or ghost-writing
• Selling non-FDA approved drugs or devices

Any financial relationship that could influence treatment decisions is ethically fraught and must be carefully scrutinized.

Discrimination and Unequal Care

The ethical principle of justice requires physicians to treat patients equally and avoid discrimination based on race, gender, disability, or other protected characteristics.

Violations in this area include:

• Refusing to accept certain types of patients
• Providing substandard care to marginalized groups
• Expressing bias or perpetuating stereotypes
• Failing to provide interpreters or disability accommodations

California’s Unruh Act (Civ. Code § 51) prohibits discrimination by business establishments, including medical practices. Violating this law can lead to civil liability as well as Board discipline.

The Medical Board’s Disciplinary Process

The Medical Board of California is responsible for licensing and regulating physicians under the Medical Practice Act. The Board investigates complaints from patients, mandatory reports from hospitals and insurers, referrals from other agencies, and malpractice settlements/judgments.

If the Board substantiates a violation, it can take disciplinary action such as:

• License revocation or suspension
• Probation with monitoring and practice restrictions
• Public reprimands
• Citations and fines
• Remedial education or training

The disciplinary process typically involves:

1. Complaint intake and review
2. Formal investigation by sworn investigators
3. Medical expert review
4. Filing of a formal Accusation by the Attorney General
5. Hearing before an Administrative Law Judge
6. Board decision on discipline

Throughout this process, you have rights – but it’s critical to get experienced counsel on board early to help you navigate the system and advocate for your interests.

Blowing the Whistle on Unethical Conduct

If you witness unethical behavior by a colleague, you may have an obligation to report it to protect patient safety. This can be a difficult decision, especially if you fear retaliation or damage to your own career.

California law (Lab. Code § 1102.5) prohibits employers from retaliating against employees who report suspected legal or ethical violations to the proper authorities. If you face demotion, discipline, or termination after making a good faith report, you may have a claim for whistleblower retaliation.

Remedies can include reinstatement, back pay, damages, and attorneys’ fees. But there are strict deadlines and procedural requirements for pursuing these claims. We encourage you to seek legal advice right away if you believe you’ve suffered retaliation.

Defending Your License Against Ethics Allegations

Facing an accusation of ethical misconduct is devastating. Your reputation, livelihood, and professional identity are all on the line. But with the right approach and advocacy, you can fight back and work to clear your name.

Some key strategies for mounting an effective license defense:

• Hire experienced counsel. Medical Board defense is a niche area. Look for attorneys who routinely handle these cases and understand the nuances.
• Gather all relevant records. Your medical records, correspondence, and other documents will be critical to rebutting the Board’s allegations. Start assembling them immediately.
• Don’t talk to investigators alone. Board investigators are building a case against you. Let your attorney handle communications and prepare you for interviews.
• Consider early negotiation. In some cases, you may be able to negotiate a favorable consent order without the expense and stress of a hearing. But this requires finesse and knowing what the Board will accept.
• Prepare for battle. If your case proceeds to a hearing, you’ll need a strong evidentiary showing and persuasive arguments to prevail. This is where having experienced trial attorneys can make all the difference.

The disciplinary process is daunting – but with the right team in your corner, you can fight for a just outcome and get back to caring for patients.

Safeguarding Your Practice and Preventing Complaints

The best defense against ethical complaints is proactive risk management. By putting systems and safeguards in place, you can prevent missteps and demonstrate your commitment to ethical practice:

• Implement robust informed consent protocols
• Train staff on privacy and confidentiality
• Establish clear policies on professional boundaries
• Use EMR systems to document rationale for treatment decisions
• Vet any financial relationships or referral arrangements
• Promote diversity and inclusion in your practice

Most importantly, make ethics a priority. Foster a culture of integrity, openness, and patient-centered care in your organization. When in doubt, consult with colleagues, ethics committees, or our California business law attorneys.

Facing a Medical Board Complaint? We Can Help.

At TONG LAW, we’ve successfully represented physicians across California in Medical Board investigations and disciplinary proceedings. We know what’s at stake for you – and we’re here to provide the skilled advocacy you need to protect your ability to practice.

If you’re facing a complaint or have been contacted by Board investigators, don’t go it alone. Contact us today for a confidential consultation. With offices in Sacramento and Oakland, California, our team is ready to fight for you.