Frequently Asked Questions about Complaints
Frequently Asked Questions about Complaints
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Who can file a complaint and how?
Any individual or organization can file a complaint against a licensee of the Georgia Medical Board. This includes patients, family members, medical professionals, and healthcare organizations such as hospitals, pharmacies, and insurance companies. Complaints can be submitted online through the Board’s website or via regular mail. While the Board prefers the use of their official forms, they will also accept detailed letters that include all necessary information and authorization.
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What types of complaints fall within and outside the Board’s jurisdiction?
The Georgia Medical Board handles complaints related to the quality of care, improper prescribing practices, and provider impairment due to substance abuse. Other complaints within their jurisdiction include unprofessional or unethical conduct, such as violating patient confidentiality, misrepresenting professional credentials, practicing without an active medical license, inadequate record-keeping, and sexual misconduct.
Complaints that fall outside the Board’s jurisdiction include issues related to rudeness, fee disputes, disability ratings, personality conflicts, and complaints against non-M.D./D.O. providers. Additionally, the Board does not handle insurance billing complaints or workers’ compensation issues. These should be directed to the appropriate state licensing agency, the Office of Insurance Commissioner, or the State Board of Workers Compensation.
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What is unprofessional conduct?
According to the Medical Practice Act, unprofessional conduct includes "any departure from or failure to conform to the minimal standards of acceptable and prevailing medical practice and shall also include, but not be limited to the prescribing or use of drugs, treatment or diagnostic procedures which are detrimental to the patient as determined by the minimal standards of acceptable medical care."
In general, examples of unprofessional conduct include, but are not limited to, physical abuse of a patient, inadequate record keeping, not recognizing or acting upon common symptoms, prescribing drugs in excessive amounts or without legitimate reason, personal impairment (mental or physical) that hinders safely practicing within the scope of one's license or certificate, performing duties beyond the scope of one's license or certificate and dishonesty. The Investigations and Discipline rules of the Georgia Medical Board, (Rule 360-3.02 and 360-3-.04), also provide additional examples of unprofessional conduct for which a licensee may be disciplined.
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Will my provider dismiss me as a patient if I file a complaint?
The Board has found that some licensees choose to dismiss patients who file complaints. Provided they follow all appropriate laws and guidelines, this is within the provider’s rights.
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Will filing a complaint resolve the problem I have with my provider?
The Board does not intervene on behalf of individual patients. Rather, it acts for the people of Georgia at large. When the Board takes action against a provider, that action is aimed at preventing future problems and protecting future patients. Your complaint, therefore, can play a significant part in protecting the people of Georgia from incompetent, unqualified, or unethical practitioners.
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Can I file an anonymous complaint or use a letter instead of the Board’s forms?
The Georgia Medical Board prefers complaints to be submitted using their official forms, either online or by mail, to ensure all necessary information is provided. If submitting a complaint via a letter, it must include all relevant details and a written, signed, and dated statement authorizing the use and release of your name and information for the investigation. Without this, your complaint may be delayed.
For anonymous complaints, the Board prefers signed and dated submissions for transparency. While anonymous complaints are accepted, they must contain sufficient evidence for the Board to act without knowing the complainant’s identity. This ensures the investigation can proceed effectively.
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Is there a statutory limit on when I may file my complaint?
No, there is no statutory limit as to when you may file a complaint with the Medical Board. However, as time progresses, it may be more difficult for our investigative staff to gather information to support the complaint.
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Will my complaint be taken seriously and remain confidential?
Yes, your complaint will be taken seriously and thoroughly evaluated to determine if a violation of Board policy or state law has occurred. The Georgia Composite Medical Board (GCMB) may take public action only if a violation is confirmed.
Regarding confidentiality, investigative information is not public. Complaints are part of the investigative file and are kept confidential, as per the Official Code of Georgia Annotated (O.C.G.A.) 43-1-19(h)(2) and 43-34-37. No part of these records is released except to the Board.
A complaint may or may not result in disciplinary action. If it does not lead to a public board order, it remains confidential. If a hearing is held, the facts will be presented, and the complainant may be called as a witness. If the complaint results in a public board order, the nature of the complaint may be disclosed in the “Findings of Fact” section, making it public
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What happens after I file a complaint?
After you file a complaint with the Georgia Medical Board, the process generally follows these steps:
- Acknowledgment: You will receive a letter or email acknowledging receipt of your complaint within two weeks.
- Initial Review: The Board reviews all complaints to determine if there is a possible violation of the Medical Practice Act. If no violation is found, you will be informed, and the case will be closed. However, the licensee will be notified of the complaint, and the information will be kept on file.
- Further Inquiry: If a possible violation is identified, a copy of your complaint will be sent to the licensee for their review and response. The Board may also obtain medical records as necessary. Your written complaint typically serves as your full statement, and you will only be contacted if additional information or clarification is needed.
- Case Review: Once all information is gathered, the case is reviewed by both medical and non-medical personnel to determine the appropriate level of discipline, if any. This process can take up to six months or more.
- Status Updates: If your complaint is within the Board’s jurisdiction, you can request updates on the status of your complaint, either verbally or in writing. You will also be notified when final action is taken. If your complaint is outside the Board’s jurisdiction, you will be informed immediately via regular mail.
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What actions can the Board take on a complaint?
The Georgia Medical Board can take several actions on a complaint, depending on the evidence and severity of the violation. If there is insufficient evidence of a violation of the Medical Practice Act, the investigation will be closed, and you will be notified by mail. If a violation is found, the Board may take corrective or disciplinary actions, which can range from fines and probation to suspension or revocation of the practitioner’s license.
Complaints are typically resolved in one of three ways:
- No Formal Action: If no violation is found, the provider is notified, and the information is kept on file to monitor for recurrent issues.
- Private Action: If there is concern about the provider’s conduct but no public action is warranted, the Board may issue a confidential letter of concern or conduct a private interview with the provider.
- Public Action: If a violation is confirmed, the Board may take formal public action, such as issuing a public letter of concern, imposing conditions or restrictions on the license, or suspending or revoking the license.
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What does a Public Board Order mean? What does this mean about my doctor?
A Public Board Order is a public document related to a licensee, such as a consent order, notice of hearing, or decision by an administrative law judge. It doesn’t necessarily mean the licensee was sanctioned or is currently under disciplinary action. These orders can result from various circumstances, like additional training requirements, and simply indicate that the doctor agreed to meet specific conditions to be licensed. Review public documents carefully and note the dates to understand the context and current status.
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What does it mean if a physician's license status is listed as Probation, Suspension or Revocation?
Probation: If a doctor or other health care provider has been placed on probation, this means the Medical Board took a disciplinary action and that action extends over a specified period of time. The licensee is monitored periodically by the Board to assure compliance with the terms and conditions established in the Board's order. The terms and conditions of probation vary and it is necessary to read the Board's order to know what they entail. Some examples are requiring supervision by another provider, restricting certain procedures, requiring the licensee to undergo additional training or to undergo medical or psychiatric treatment.
Suspended License or Certificate: If a doctor or other health care provider's license has been suspended, the doctor or other health care provider has been ordered by the Medical Board to temporarily cease the practice of medicine in Georgia until given permission to do so by the Medical Board.
Revoked License or Certificate: If a doctor's license has been revoked, the doctor or other health care professional has had their license to practice medicine withdrawn by the Medical Board. The doctor or provider may not practice medicine in Georgia. This is the most severe type of disciplinary action the Medical Board may render against a licensee.
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When does a disciplinary case become public and who prosecutes it?
A disciplinary case becomes public when the Board issues a notice of charges and allegations, outlining the case and evidence. A public hearing is usually held, or the case may be resolved through a consent order, which is presented in an open session.
Many cases are resolved before formal charges are issued and become public when the consent order is presented for approval.
The Attorney General’s Office prepares and prosecutes charges, while the compliance department ensures licensees comply with consent orders and disciplinary conditions.