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LEGAL ISSUES Your duty to report also applies to member organizations such as the ASPS and the AAD. anything negative about the patient. If the patient has anger issues, unrealistic expectations or other psychological issues, the view will be that you should not have treated the patient. Refer to the disgruntled patient with empathy and respect in all of your correspondence. Express sorrow that the patient feels that something unethical occurred. You may not receive any additional correspondence from the state licensing board for a long period of time (a year is not unusual). This does not indicate that the board is no longer pursuing the matter. The entire process can take up to 22 MARCH/APRIL 2013 | MedEsthetics three to four years. It is also prudent to hire an attorney to represent you. Many physicians indicate to me that they are afraid to hire an attorney because it may appear that they are guilty. There is nothing further from the truth. There are procedural guidelines and rights that you have, and it is proper to hire an attorney to represent you. The state boards expect this, and it is the responsible thing to do. Certification Board Requirements Your duty to report alleged ethical violations also applies to member organizations such as the American Society of Plastic Surgery (ASPS, plasticsurgery.org) and the American Academy of Dermatology (AAD, aad.org). In fact, if you read the regulations of certi���cation boards and member organizations, you will see that you have to report a wide variety of events, including criminal investigations and alleged insurance fraud from even a home owner���s insurance claim. In order to comply with the licensing board or member organization requirements, you need only to send a letter indicating that an allegation has been made against you, that you are appropriately responding to the allegation and that you believe there is no merit to the allegation. You will probably never hear from them again, but you will have complied with the requirements for certi���cation or membership. Thus, there is a much greater chance that nothing will happen to your certi���cation or membership. ME Padraic B. Deighan, JD, PhD, is president of Aston McLaren, a medical and spa consulting ���rm, and the former president and CEO of DermAmerica, the nation���s largest network of dermatology and plastic surgery centers. Contact him at 877.557.9669, medicalspaconsulting.com. �� ISTOCKPHOTO.COM of board certi���cation. Af���rmative reporting also decreases the risk of severe sanctions for alleged unethical situations because you cooperated in advance. I strongly recommend that whenever you feel that you are in an ethical conundrum, write to the state medical board and ask for their guidance. This is very powerful. They cannot charge you with an ethical violation if they participated in the course of action. They may choose not to respond to your query, but the fact that you sought their guidance and counsel is compelling. If you receive a letter from your state medical licensing board, pay strict attention to the action items that the board is requesting. The boards typically ask for a response within 10 days. I suggest that you formulate an initial response that acknowledges receipt of the allegation and tactfully denies that any unethical conduct occurred. Also indicate that your initial response is a preliminary one. You will provide a more thorough reply after you review the chart and interview any staff members who were involved in the patient���s care. I should also mention that if your staff member behaves unethically, you are responsible. For example, a medical provider would be liable if a staff member divulged con���dential patient information. I suggest that you send a de���nitive response about 30 days after your initial reply. Do not wait for the state board to ask for the additional response. The de���nitive response will include your version of the incident as well as any supporting documentation. It is important to interview staff members that may have engaged the patient and include a summary of their versions of the incident. The fact that you thoroughly investigated the matter prior to response will go a long way toward a successful outcome. It is prudent that you do not say