The Power of the Prosecutor

     The Florida medical license renewal process is not a simple matter.  Besides filling out a standard demographic form there is a series of questions containing legal language requiring translation into layman's English, thirty Florida Statutes and Administrative Codes* that must be navigated, and a multitude of continuing education requirements the applicant has to prove he or she has met, including specific classes on domestic violence, HIV and prevention of medical errors.  Links to two different agencies, CE Broker and the American Academy of Family Practice, are supposed to make it easier to collate one's study and class credits accumulated over the past six years, but they don't itemize the precise categories of credit required by the Board of Medicine.  After four phone calls and hours of gathering education data, I was allowed to pay $379 to renew my license.
     The fourth phone call was to my lawyer.  Given that it's a crime to fill out the license application wrong, an act which could be interpreted as misrepresenting one's position, I had to make sure that certain questions meant what I thought they meant.  Have I entered "a plea of guilty or nolo contendere to, regardless of adjudication, a felony under chapter 409, chapter 817, or chapter 893, or a similar felony offense committed in another jurisdiction"?  If so, "any such conviction or plea shall exclude the applicant or candidate from licensure, examination, certification, or registration," unless it's been more than 15 years since the probation period for the plea has ended, for a first or second degree felony, and ten years for a third degree--except under section 893.13(6)(a).  What did all this mean?  And was it applicable to me?
     My lawyer returned my call promptly and told me none of this applied to me, at least not yet, since I haven't been charged or convicted with anything, nor have I plead "no contest" (nolo contendere="I do not wish to contest," meaning I don't accede guilt or innocence, which is viewed, in the eyes of the Medical Board, as about as damning as a guilty plea).  I finished my application and paid the fee, but not without calculating how much power the federal prosecutor has to ruin everything I have worked for in my chosen profession.   
      Having made it through medical school and residency training, having practiced without triggering malpractice lawsuits for twenty-one years,** having studied for and passed the Family Practice Board Certification exam (required every seven years) in November for the fourth time, having earned 138.25 hours of continuing education credits in 2013 (similarly for all preceding years), having jumped through all the hoops to maintain a clean medical license, DEA privileges and Board certification, having attended workshops and conferences to keep abreast of medical advances, having devoted at least 30 minutes a day to reading current medical journals, I could lose it all with one swoop of his sharpened statutory scythe, if the prosecutor should decide, out of boredom, or irritation with me and my blog, or a necessity, begotten by pressure from his superiors, to make something happen in a case that has been in limbo for forty-three months.
     There you have it, the power of the government--the power of one prosecutor--to destroy a person's world, a profession built up over decades--and to wave a victory baton afterwards, followed by hurrah's from a propagandized public--glad that greedy doctors and other villains have been brought down--and maybe even to get promoted to newer and more purposeful positions of power.

*Here's an example of one of the codes:  
     456.0635 Health care fraud; disqualification for license, certificate, or registration.—

(1) Health care fraud in the practice of a health care profession is prohibited.

(2) Each board within the jurisdiction of the department, or the department if there is no board, shall refuse to admit a candidate to any examination and refuse to issue a license, certificate, or registration to any applicant if the candidate or applicant or any principal, officer, agent, managing employee, or affiliated person of the applicant:

(a) Has been convicted of, or entered a plea of guilty or nolo contendere to, regardless of adjudication, a felony under chapter 409, chapter 817, or chapter 893, or a similar felony offense committed in another state or jurisdiction, unless the candidate or applicant has successfully completed a drug court program for that felony and provides proof that the plea has been withdrawn or the charges have been dismissed. Any such conviction or plea shall exclude the applicant or candidate from licensure, examination, certification, or registration unless the sentence and any subsequent period of probation for such conviction or plea ended:

1. For felonies of the first or second degree, more than 15 years before the date of application.

2. For felonies of the third degree, more than 10 years before the date of application, except for felonies of the third degree under s. 893.13(6)(a).

3. For felonies of the third degree under s. 893.13(6)(a), more than 5 years before the date of application;

(b) Has been convicted of, or entered a plea of guilty or nolo contendere to, regardless of adjudication, a felony under 21 U.S.C. ss. 801-970, or 42 U.S.C. ss. 1395-1396, unless the sentence and any subsequent period of probation for such conviction or plea ended more than 15 years before the date of the application;

(c) Has been terminated for cause from the Florida Medicaid program pursuant to s. 409.913, unless the candidate or applicant has been in good standing with the Florida Medicaid program for the most recent 5 years;

(d) Has been terminated for cause, pursuant to the appeals procedures established by the state, from any other state Medicaid program, unless the candidate or applicant has been in good standing with a state Medicaid program for the most recent 5 years and the termination occurred at least 20 years before the date of the application; or

(e) Is currently listed on the United States Department of Health and Human Services Office of Inspector General’s List of Excluded Individuals and Entities.

This subsection does not apply to candidates or applicants for initial licensure or certification who were enrolled in an educational or training program on or before July 1, 2009, which was recognized by a board or, if there is no board, recognized by the department, and who applied for licensure after July 1, 2012.

(3) The department shall refuse to renew a license, certificate, or registration of any applicant if the applicant or any principal, officer, agent, managing employee, or affiliated person of the applicant:

(a) Has been convicted of, or entered a plea of guilty or nolo contendere to, regardless of adjudication, a felony under chapter 409, chapter 817, or chapter 893, or a similar felony offense committed in another state or jurisdiction, unless the applicant is currently enrolled in a drug court program that allows the withdrawal of the plea for that felony upon successful completion of that program. Any such conviction or plea excludes the applicant from licensure renewal unless the sentence and any subsequent period of probation for such conviction or plea ended:

1. For felonies of the first or second degree, more than 15 years before the date of application.

2. For felonies of the third degree, more than 10 years before the date of application, except for felonies of the third degree under s. 893.13(6)(a).

**The average family doctor is sued every seven years.