Physicians/Psychiatrists Dealing With The Connecticut Department Of Public Health
By Richard R. Brown, Esq.*
Nothing is more unsettling than being a physician or psychiatrist and being contacted by the Connecticut Department of Public Health, (DPH), informing you that a patient, fellow doctor, or health care facility has been contacted about alleged inappropriate behavior involving you. The conduct may not concern your actual practice; it may have even occurred during your off-duty time. Maybe it’s a letter from DPH’s Hartford office seeking the records of a specific patient(s), not revealing what the patient’s complaint might be. What do you do? Can they do this to you? How do you protect yourself in dealing with DPH? Do you need to give them the patient’s file?
The first rule is not to panic, but to gather your thoughts and figure out how to respond in a way to best protect you, your career and your reputation; all that you have worked so hard to achieve and maintain. How to best approach the Department depends in part upon the nature of the issue of concern. Normally, there are two distinct categories most cases fall into, substance abuse or substandard treatment of a patient.
The Connecticut General Statutes, including, Section 52-146o(b)(3), allows the Department to obtain a patient’s records without the need for a subpoena; in fact, this statute even allows them to obtain your patient’s records without the patient’s consent. Furthermore, HIPAA protection does not protect you or the patient’s privacy in these situations. Section 164.512(d) of HIPAA may allow you to release the patient’s information to DPH without an authorization, consent, release, or opportunity by the patient to object to the release. Of course, patients also can sign a release permitting DPH to obtain these otherwise private records.
After the records are received, if a case involved alleged substandard care, DPH would provide you or your lawyer with a copy of the complaint or questions directed to you concerning patient(s). You would then be given another deadline to respond. This is a very important stage of the proceeding. How you or your lawyer, after consulting with you, respond may be key in getting a favorable outcome in this matter. Your response, along with the patient(s) record, most likely will be forwarded to a so-called “expert” in your field of practice for an evaluation and report. This usually takes three to four weeks. After their response, you have one more opportunity to clarify your answer or attack their expert. Next, meetings with officials from DPH will most likely occur. It can be a long process and may result in a full hearing before the Medical Board.
If the reason for the complaint or other verbal contact is because of suspected substance abuse (including alcohol), the process may be even quicker, due to immediate concern of possible danger to the public. In these situations, DPH routinely seek a quick intervention, including possible summary suspension of your license.
Additionally, you might hear from DEA or the Drug Division of the Connecticut Department of Consumer Protection over possible misuse or abuse of your DEA or state drug license. You might be told that you need to check-in with an organization called “HAVEN” for the purpose of seeking immediate treatment. You could be instructed to stop practicing immediately. Failure to act accordingly could result in summary suspension of your license and hearing before the state Medical Board. Again, how you chose to handle this situation will certainly affect you, your practice, and what happens to your license now and in the future. This is a critical time to make the right choices; to make the right decision.
The good news is that in many, if not most situations, you can act in consultation with your attorney to prevent the loss or suspension of your license from happening. There are things that must be done quickly. There are things that you must never do. If there are possible criminal charges involved, quick and appropriate action must also occur. How you handle the DPH matter can affect any possible criminal action and how you handle the criminal matter, if any, will definitely affect any DPH matter. In those cases, one should immediately contact an attorney who has significant legal experience in both criminal and administrative areas of the law. In those cases, it is very important to speak to a qualified attorney before responding to DPH’s questions and before answering questions or signing documents or surrendering your DEA registration to a law official or federal DEA agent. No matter what they tell you, getting the right advice early is far more important than giving quick answers that you will have to live with throughout the investigation and perhaps longer. Acting quickly, decisively and appropriately is your best opportunity to a positive outcome when dealing with DPH.
*Former prosecutor, State of Connecticut
Former Assistant Attorney General, Connecticut