A letter from the Medical Board of California can arrive with little warning: a request for patient records, an invitation to explain your care in writing, or a call from an investigator to schedule an interview. The Law Offices of Nathan Mubasher represents physicians and surgeons in Medical Board matters from the first inquiry through hearing, decision, and probation.
The Medical Board licenses and disciplines physicians and surgeons (M.D.s) under the Medical Practice Act, Business and Professions Code section 2000 and following. Osteopathic physicians are licensed by the Osteopathic Medical Board of California, and physician assistants by the Physician Assistant Board. Their processes are similar but not identical. For the general framework that applies across licensing boards, see Professional License Defense.
Where Medical Board cases come from
Complaints and reports reach the Board from many sources, including:
- Patients and family members
- Other physicians, nurses, pharmacists, and staff
- Hospitals and medical groups filing reports under Business and Professions Code sections 805 and 805.01 after certain peer review actions
- Insurers, self-insured public agencies, and physicians or their counsel reporting malpractice settlements over $30,000 and malpractice judgments or arbitration awards in any amount (Business and Professions Code section 801.01)
- Physicians’ own written reports, due within 30 days, of a felony charge or of any felony or misdemeanor conviction (Business and Professions Code section 802.1)
- Court clerks, coroners, and law enforcement
A report does not mean the Board has decided anything, but early decisions can shape what happens next.
The intake and review stage
The Board’s complaint unit reviews each complaint to decide whether it falls within the Board’s jurisdiction and whether it warrants further review. In quality-of-care cases, the Board typically requests the relevant medical records, often with the patient’s authorization, along with a written summary from the physician. A quality-of-care complaint is reviewed by a medical consultant before any referral for field investigation (Business and Professions Code section 2220.08).
Records requests carry real deadlines. Under Business and Professions Code section 2225.5, a physician who fails to produce requested records within the required time faces civil penalties, separate from the underlying complaint. The deadline is 15 days after receiving a request for certified records accompanied by the patient’s written authorization, and the penalty is $1,000 for each day after the 15th day, up to $10,000, unless the physician has good cause.
The physician’s written summary deserves the same care as any legal document. It should be accurate, consistent with the chart, and focused on the clinical reasoning behind the care. It should not speculate, blame others, or volunteer unrelated issues.
Formal investigation and the subject interview
Matters referred for formal investigation are generally handled by investigators in the Department of Consumer Affairs Division of Investigation, Health Quality Investigation Unit (Business and Professions Code section 159.5), working with the Attorney General’s Health Quality Enforcement Section (Government Code section 12529). Investigators may interview the complainant and witnesses, gather pharmacy and billing records, and subpoena documents.
The physician is often asked to attend a subject interview. The interview is conducted by the investigator, often with a district medical consultant present. A physician may bring an attorney. An unexcused failure to attend within 30 days of notice is itself a violation. Preparation usually includes reviewing the chart closely, understanding the specific allegations, and thinking through how to explain clinical decisions clearly and without overstatement.
The standard-of-care review
In clinical cases, the Board usually sends the investigative file to an outside physician in the same or a similar specialty, which the Board calls an expert reviewer. The reviewer gives an opinion on whether the care met the standard of care and, if not, whether the departure was simple or extreme. These opinions often decide whether a case moves toward charges.
Under Business and Professions Code section 2234, unprofessional conduct includes gross negligence, repeated negligent acts, and incompetence. Section 2266 makes failure to maintain adequate and accurate records, kept for at least seven years after the last date of service, a separate ground for discipline. Documentation therefore matters twice: it is evidence of the care, and its quality can be its own allegation.
When the Board files an Accusation
If the Board decides to pursue discipline, a Deputy Attorney General files an Accusation on its behalf. The physician generally has 15 days after service to file a Notice of Defense and request a hearing (Government Code section 11506). Accusations are public and are posted with the physician’s license record on the Board’s website.
Cases are heard by an Administrative Law Judge of the Office of Administrative Hearings, Medical Quality Hearing Panel (Government Code section 11371). The Board must prove its case by clear and convincing evidence to a reasonable certainty (Ettinger v. Board of Medical Quality Assurance (1982) 135 Cal.App.3d 853). The judge issues a proposed decision, and a panel of the Board decides whether to adopt it.
Some cases are resolved by a stipulated settlement before hearing. Any proposed settlement should be weighed against its full effect on privileges, payers, employment, and licenses in other states.
Possible outcomes and probation
Outcomes range from closure, to a public reprimand (Business and Professions Code section 2227) or, for minor violations, a public letter of reprimand issued by agreement instead of a formal Accusation (section 2233), to probation, suspension, or revocation. The Board’s Manual of Model Disciplinary Orders and Disciplinary Guidelines (Title 16, California Code of Regulations, section 1361) describes typical penalties and probation terms, such as education courses, a practice monitor, prescribing restrictions, or clinical assessment.
Under Business and Professions Code section 2228.1, physicians placed on probation on or after July 1, 2019 for certain categories of violations must give patients a separate written disclosure before the first visit after the order, covering the probation status, its length and end date, any practice restrictions, the Board’s telephone number, and how to find more information on the physician’s profile page on the Board’s website, and must obtain the patient’s signed copy. The categories include sexual misconduct with a patient, substance abuse that harmed patients or impairs safe practice, a conviction directly involving harm to patient health, and harmful prescribing with probation of five years or more. Exceptions include visits in an emergency room or urgent care facility, unscheduled visits, visits where the patient cannot understand the disclosure and no guardian or surrogate is available, and cases where the physician has no direct treatment relationship with the patient. In serious cases, the Board can ask an administrative law judge of the Medical Quality Hearing Panel for an interim suspension order before the hearing (Government Code section 11529), and in a related criminal case the Board may appear and recommend conditions to the court (Penal Code section 23).
How the office helps physicians
Nathan Mubasher works directly with each physician client. Depending on the stage, the work can include:
- Responding to record requests and drafting the physician’s written summary
- Preparing for and attending the subject interview
- Identifying records, literature, or independent opinions that put the care in context
- Filing the Notice of Defense, conducting discovery, and negotiating with the Deputy Attorney General
- Representing the physician at hearing
- Reviewing reconsideration and writ options, probation compliance, and petitions to modify or terminate probation
If the Board matter grew out of a hospital action, see Peer Review and Credentialing. For a practical overview, read Professional License Defense in California: A Survival Guide for Physicians and Nurses.
Frequently asked questions
Do I have to attend a Medical Board interview?
Generally, yes. If you are the subject of a Board investigation, failing without good cause to attend and participate within 30 calendar days of the Board’s notice is itself unprofessional conduct (Business and Professions Code section 2234(g)). Before the interview, understand the allegations, review the chart, and arrange for counsel to attend with you.
Can I keep practicing while I am under investigation?
In most cases, yes. An investigation by itself does not restrict a license. The exception is when the Board seeks an interim suspension order or other emergency relief, or a criminal court imposes restrictions, which generally happens only in cases involving an alleged risk to the public.
Who decides whether my care met the standard of care?
The Board relies on an outside physician reviewer, usually in your specialty, to give an opinion on the care. If the case goes to hearing, both sides may present testimony from qualified physicians, and the Administrative Law Judge weighs the evidence.
Will my patients find out about a Medical Board complaint?
A complaint and investigation are generally confidential. If the Board files an Accusation, it becomes public on the Board’s website. Some probation orders also require disclosure to patients under Business and Professions Code section 2228.1.
How long does a Medical Board investigation take?
It varies widely with the type of complaint, the number of records and witnesses, and the review process. Many matters take months, and some take longer. Under Business and Professions Code section 2230.5, an Accusation generally must be filed within three years after the Board discovers the act or seven years after it occurred, whichever comes first, with exceptions, such as a 10-year outer limit for sexual misconduct, tolling for acts involving minors, and no limit for fraud in obtaining the license or intentionally concealed negligence or incompetence.
Related pages
- Professional License Defense
- Peer Review and Credentialing
- Physician Employment Contracts
- Nursing License Defense
- About Nathan Mubasher
Talk with Nathan Mubasher
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Attorney Advertising. Law Offices of Nathan Mubasher, 8583 Irvine Center Drive, Suite 35, Irvine, CA 92618. Responsible attorney: Nathan Mubasher. This page provides general information about California law, not legal advice for any specific situation. Reading it or contacting the office does not create an attorney-client relationship. Every matter is different, and no particular result can be guaranteed.