By their very nature, most physicians—including Medical Doctors (M.D.s) and Doctors of Osteopathic Medicine (D.O.s)—tend to have an independent decision-making spirit. While they are also generally very intelligent and dedicated to their patients, the responsibilities that come with gaining admitting and practicing privileges at a particular hospital can sometimes seem to conflict with a doctor’s sense of independence.

In addition to standards of care, hospital privileges also involve collegial, social, and legal elements that are more complicated than just taking care of patients. A physician who does not live up to all of a hospital’s expectations could quickly find that he or she is in danger of losing membership on the hospital’s medical staff.

Avoid These Types of Behaviors

It is understandable that concerns over the level of care that a physician provides could lead to the possible suspension or termination of the doctor’s hospital privileges. Such concerns could pertain to the doctor’s bedside manner, the failure to seek approval before trying unorthodox treatments, or not reaching out to specialists or consultants for questions outside of the physician’s area of specialty. Repeated incidents could become problematic and lead to the hospital suspending your privileges.

According to the Centers for Medicare & Medicaid Services (CMS), there are currently more than 60 million Americans who are enrolled as Medicare beneficiaries. This number includes individuals enrolled in “original” Medicare as well as in Medicare Advantage plans with private insurers. In order to be able to serve this large portion of the population, a medical provider must enroll as a Medicare provider and keep that enrollment in good standing. This means the provider must meet all of the requirements set forth by CMS and avoid behaviors that could lead to a revocation of the provider’s Medicare status.

Revocation of Medicare Enrollment

Under §424.535 of the Code of Federal Regulations, there are many different reasons for which a provider could have his or her Medicare enrollment status revoked. They include noncompliance with enrollment requirements, causing harm to patients, being convicted of certain felonies, improper medication prescribing practices, and failing to comply with CMS reporting requirements, among many others.

As a provider, you could also lose your Medicare enrollment status for abusing your billing privileges. Under the law, abuse of billing privileges includes but is not limited to:

Have you recently learned that your medical practice or pharmacy is being audited or investigated by the U.S. Drug Enforcement Agency (DEA)? You might have discovered this information by chance or have been informed directly by a DEA agent. Either way, a DEA investigation can be frightening, especially if your livelihood depends on keeping your DEA registration and your professional license. The good news is that our firm is equipped to help healthcare professionals of all types in all types of DEA-related matters.

DEA Tasked With Helping to Manage the Opioid Crisis

Over the last few years, the misuse and abuse of opioid drugs have become major problems throughout the country. In fact, the situation is serious enough that the acting U.S. Secretary of Health and Human Services declared a public health emergency in 2017, and health officials began using the word “epidemic” to describe the widespread nature of the crisis. At the time, the Centers for Disease Control and Prevention estimated that 91 per day were dying from opioid overdoses.

As part of the effort to address the crisis, President Trump has utilized federal law enforcement agencies, including the DEA, to play an important role. When it comes to medical practices and pharmacies, the DEA is primarily responsible for ensuring that doctors and pharmacists are prescribing and dispensing controlled substances in accordance with the law and proper clinical guidelines. In most cases, this means investigators are looking for possibly excessive combinations of drugs listed on Schedules II and III by the Controlled Substances Act. If the DEA launches a full-scale investigation, it generally means that there is suspicion of systematic and severe violations.

The global pandemic COVID-19 has hit the U.S. especially hard, with over 199,000 confirmed cases in Illinois alone. From the beginning, this virus has led to overfilled hospital beds and overworked medical professionals. With no vaccination in sight and a high demand for doctors, nurses, and other medical professionals, the U.S. has been forced to reevaluate their licensing procedures and state-by-state restrictions. It is common for states to adopt emergency licensing processes in response to natural disasters and their aftermath. Many states have followed this trend by enacting emergency-response licensure laws to allow volunteers from other states to practice their profession without being required to seek out licensure in that specific state.

Uniform Emergency Volunteer Health Practitioner Act

The Uniform Emergency Volunteer Health Practitioner Act (UEVHPA) is legislation that was initially developed in 2006 and is being modeled by many states during the COVID-19 pandemic. This legislation allows any participating state, Illinois included, to recognize out-of-state medical licenses during a declared state emergency. All practitioners who wish to participate in this reciprocal-licensing program must register to do so.

Illinois-Specific Legislation

Aside from the UEVHPA, which has been adopted by most states during this time, Illinois has enacted a few regulations of its own. Under Gov. Pritzker’s direction, the Illinois Department of Financial and Professional Regulation is allowing healthcare workers whose licenses have recently expired to temporarily restore their licenses to assist with COVID-19 patients. Physician assistants and doctors who have expired or inactive licenses from less than three years ago are able to return to work without paying any required licensing fees or making further progress on their education requirements. Additional leeway has been given to nurses and respiratory therapists, giving them a five-year pass rather than the three-year allotment given to doctors and physician assistants.

At some point, we have all felt exhausted, cynical, or unhappy with our jobs. This is called burnout and it can have negative effects on job performance and personal happiness. Physician burnout has been one of the topics of concern among the medical community for a few years now. According to the American Medical Association (AMA), more than 40 percent of all physicians in the United States report experiencing signs of burnout. Physician burnout has been linked to higher rates of medical errors, lower quality of patient care, and a higher rate of physician drug and alcohol abuse and/or addiction. Physician burnout and its associated outcomes could have serious implications for your Illinois medical license.

Signs of Burnout

Burnout is a long-term response to work-related stress that is characterized by emotional exhaustion, depersonalization, and diminished feelings of personal accomplishment. Burnout is not unique to medical professions, but physicians tend to be more prone than others. Other symptoms of burnout can include:

• Fatigue
• Loss of empathy
• Cynical or negative attitudes toward patients
• Decreased productivity
• Detachment
• Depression
• Suicidal thoughts

Effects of Burnout

Physician burnout has been considered by many to be an epidemic that is consistent with providers across the country. Not only does burnout severely impact the provider’s own physical and mental health, but it can also impact their job performance, future job prospects, and patient care and health. According to a study published by researchers at the Stanford University School of Medicine, physicians who reported symptoms of burnout were more than twice as likely to make a medical error than physicians who did not report symptoms of burnout.