When a military doctor receives a notice that his/her privileges at the military hospital have been placed in abeyance and approval for off-duty employment revoked, I generally see two reactions.
The most common reaction by a military doctor who has had his/her privileges placed in abeyance is to think that he or she can resolve the entire thing by making a call on the hospital or military treatment facility commander and resolve the allegation in a 10 minute meeting. Unfortunately, that ship, if it was ever in port, has sailed. Prior to issuing an abeyance, the commander has determined that the allegations are not baseless through a preliminary inquiry. By the time the notice of abeyance is delivered to the military medical provider, the wheels have already started turning to appoint an investigating officer – normally a doctor of similar specialty to the subject of the investigation – to complete a quality assurance investigation. An abeyance will not be lifted until either the commander receives information that supports a finding that the allegation was baseless or the quality assurance investigation is completed and reviewed and it is determined that no adverse privileging action should be taken.
And that conversation with the MTF or hospital commander? Well, to be honest, it is normally more harmful than helpful.
The second type of reaction I see regularly is a desire to throw in the towel – to resign under the belief that a resignation will stop the adverse privileging process or at least frustrate it. A military doctor who is a civilian employee or contractor can terminate his employment during a period where privileges are held in abeyance. However, the quality assurance investigation will continue and, if warranted, will proceed through the adverse privileging action process. By resigning, the provider loses income, makes it more difficult to respond to the privileging action, and may lose sympathy and/or give support to the opinion that he or she actually engaged in misconduct or was impaired or incompetent. There may be a right time to resign, but rarely is it while the potential for an adverse privileging action is real.
An active duty or reserve military doctor normally will not be able to resign in order to avoid an adverse privileging action. First, military resignations normally take 6 – 12 months to process; the adverse privileging action process normally runs its course within 6 months. And, second, I have seen the military wait to process a resignation until after an adverse privileging action is final in a case where the doctor had submitted a resignation before an allegation of misconduct was made. There are other reasons not to submit your resignation because of an allegation that led to an abeyance and quality assurance investigation – for example, a resignation cannot be withdrawn without the permission of the secretary of service. So, if an allegation causes merely a speed bump and is over a month after it started, that officer has still committed to leaving the service.
When notified of an abeyance of privileges, a military doctor needs to retain an experienced attorney to represent him or her – no matter how baseless the allegation may seem. I say this for one reason – the attorney-client privilege. The doctor and attorney can talk without fear of disclosure to anyone. This gives the doctor a chance to speak freely without fear of repercussions. It’s also a great opportunity to prepare for providing a statement to an investigator or submitting a statement to a credentialing committee.
