Coping with Board sanctions

Even the finest doctors are not immune to disciplinary action from superiors. One of my best friends from medical school recounted such an instance.

"I lost my wife to her cancer battle during my second year of my surgical residency. I dove down into a deep, dark hole and used alcohol and prescription pills to help me cope with the pain. Unfortunately, I made some deplorable decisions that could have harmed my patients.

I would come into work intoxicated or hung over on regular occasions. I would lash out at colleagues. Eventually, I was pulled into my residency program director's office to discuss my future in [the] program and career as a practicing surgeon.

Thankfully, my residency program understood I was fighting a dark battle. Instead of firing me on the spot, I was told to take some time off to undergo mandatory therapy and be under a performance improvement plan upon my return. I took a break from residency for 16 months, and although this set me back from graduating with my residency class, I was able to become whole again.”

Common mistakes

Common disciplinary actions include fines, probation, performance improvement plans, or loss or suspension of a medical license. Disciplinary actions can come from a state medical board, university or residency program, or hospital administration/board.

Although disciplinary action against physicians is rare, it can result in reputational damage, emotional repercussions such as shame and embarrassment, and unhealthy coping skills such as misusing food, drugs, and alcohol.

According to the Federation of State Medical Boards, some examples of poor physician behavior that can result in disciplinary action include:^[]

• Conviction of a felony or fraud

• Sexual misconduct

• Poor record-keeping

• Failure in meeting standards of care 

• Prescribing without legitimate reasons, or in excess

• Dishonesty in license application process

Complex emotions

After being disciplined, healthcare professionals (HCPs) may experience painful emotional and psychological reactions.

Many HCPs experience intense shame and embarrassment. It can revolve around having made a mistake, meaning we’re no longer “perfect,” and leaving us feeling threatened and vulnerable.

Even when the supposed "mistake" is unfounded, shame still surfaces because of the realistic fear that your colleagues, family and friends, and patients may discredit you or see you as a “bad” doctor. We (understandably) perceive discipline as questioning our integrity.

Some physicians respond with anger and may experience grief over loss of confidence, autonomy, respect, and even of their career. If the emotions are not explored and processed in healthy ways, they can lead to prolonged adverse mental and emotional effects, potentially resulting in harmful behaviors such as misusing drugs, alcohol, and food.

Seek legal counsel, therapy

If you could be facing disciplinary action from a state medical board or hospital administration, it may be wise to consult legal counsel, specifically an attorney specializing in administrative care and healthcare.

Lawyers will most likely tell you not to disclose details of the case, which often translates to doctors not discussing the case with anyone. But keeping this experience to yourself is profoundly unhelpful.

Doing so may amplify feelings of loneliness and worsen many of the emotions you’re experiencing. Talking with a therapist or counselor to help you work through the situation may alleviate some of the isolation and help remove the negative feelings.

Therapy can also help you identify other areas that might be helpful to explore. This disciplinary action may be reframed into a learning experience—perhaps there are underlying triggers such as alcohol or drugs that contributed to the situation.

Work on self-forgiveness and acceptance. Find ways to manage your fears of making future mistakes. Therapy’s confidentiality protections help provide a space for this work that often cannot be found with friends, family, or colleagues.

Avoid negative coping skills

It’s also imperative to refrain from staying in bed all day, using substances to numb your feelings, isolating yourself from loved ones, and spiraling into a place that may lead to dangerous thoughts and behaviors.

Taking a vacation, spending time outdoors, going for a long run, and surrounding yourself with others who understand that humans are imperfect are ways to prevent a downward spiral and hopefully let this situation enable you to become a better person and physician.

You may want to refrain from talking to colleagues about your situation if there are any legal implications. But if you have a trusted family member or close friend, find a safe space to express your emotions and thoughts with them.