The call says you are on leave, or that your privileges are suspended pending review, or that a committee has questions about your cases. From that moment two clocks are running that the hospital will not explain: 14 days under the federal peer review statute, and 30 days before a restriction becomes a permanent entry in the National Practitioner Data Bank. What you sign, say, and skip in the first week decides most of what follows.
A physician facing discipline is usually inside two processes at once: an employment relationship governed by a contract, and medical staff membership governed by bylaws, a credentials policy, a fair hearing plan, and federal reporting law. The firm works both, in writing, on a flat fee quoted before any work begins.
Administrative leave is usually an employment action. Your agreement decides whether you are paid during the leave, what counts as cause, whether you get notice and a chance to cure, and what happens to tail coverage and your non-compete if the relationship ends. Many physician agreements let the employer terminate immediately if privileges are suspended, restricted, or revoked, and some are triggered by the mere opening of an investigation. Those clauses are read first, because they decide how much time you actually have.
A suspension of privileges, a focused review of your cases, or a referral to the medical executive committee is a medical staff action governed by the bylaws and by the Health Care Quality Improvement Act, 42 U.S.C. 11101 through 11152. The hospital keeps its immunity from damages only if the action meets the standards in 42 U.S.C. 11112(a), and the notice and hearing procedures in 42 U.S.C. 11112(b) are what the hospital must offer to stay inside that safe harbor: written notice of the proposed action and the reasons, at least 30 days to request a hearing, a hearing officer or panel not in direct economic competition with you, representation by an attorney or other person of your choice, a record, cross-examination, and written findings. You may be in both processes at once. They are handled separately, and the first letter asks which body acted and what document governs the next step.
42 U.S.C. 11112(c) lets a hospital suspend or restrict privileges for not longer than 14 days while it investigates whether a professional review action is needed, and lets it suspend immediately where failing to act may result in imminent danger to any individual's health, with notice and hearing to follow. Past 14 days, the investigation exception is gone and the hospital must be offering the notice and hearing process to keep its immunity.
The second clock is the one physicians learn about too late. Under 42 U.S.C. 11133 and 45 C.F.R. 60.12, a professional review action based on competence or professional conduct that adversely affects clinical privileges for more than 30 days must be reported to the National Practitioner Data Bank, and so must any surrender or restriction of privileges while you are under investigation or in return for the hospital not conducting one. The NPDB Guidebook is explicit that the label does not matter: a suspension called precautionary, summary, emergency, or administrative is reportable once it has been in place for more than 30 days, and a leave of absence that keeps you from exercising privileges during an investigation is treated as a surrender. Ohio adds its own duty: under R.C. 4731.224, the hospital must report a formal disciplinary action against your privileges, including a summary action and a surrender while under investigation, to the State Medical Board within thirty days after it is imposed.
Those two clocks shape the strategy. The goal in the first weeks is to resolve or narrow the action before day 30, to keep any interim arrangement from amounting to a restriction, and never to resign, request a leave, or agree to stop exercising privileges without knowing exactly what will be reported and to whom.
The written request for the bylaws, credentials policy, and fair hearing plan; the demand for the specific concerns, case identifiers, and governing provision; your factual response; and the negotiation of any interim arrangement so that it does not become a reportable restriction.
Responding to a focused review of your cases, including an independent expert review of the charts where the clinical question is real, and keeping the process inside the bylaws' own timelines. Ohio's peer review privilege, R.C. 2305.252, keeps the committee's records out of civil discovery, so the fair hearing is often the only point where the case against you can be seen and tested.
The hearing request within the deadline, objections to panel members in direct economic competition with you, witness and exhibit preparation, cross-examination, the written closing statement, and the appellate review the bylaws provide. The record built here is what any later court challenge or Medical Board proceeding will turn on.
Whether an action is reportable at all, the wording of any resolution, and, if a report is filed, your subject statement, the dispute process, and the request for Secretarial review under 45 C.F.R. 60.21, which asks only whether the report is accurate and whether the action was reportable.
A hospital report under R.C. 4731.224 can open a separate Board matter under R.C. 4731.22. The firm coordinates what you say to the hospital with what will later be said to the Board, since the two files tend to meet.
Remediation, probation, non-renewal, and dismissal run under the sponsoring institution's GME policies and the ACGME Institutional Requirements rather than the medical staff bylaws, and the reporting rules are different: the NPDB Guidebook treats an action taken within the scope of a training program as not reportable, while a later Ohio license application asks about it directly. The resident and fellow guide walks through the process.
Cause definitions tied to privileges or investigations, pay during leave, notice and cure, tail coverage, and the non-compete that follows a termination. Where the hospital's real objective is a quiet exit, the firm negotiates the separation terms with the reporting consequences in view, so that the resolution does not create the very report the physician was trying to avoid. See Physician Employment Contract Review for the contract side.
The full guide to administrative leave and peer review in Ohio covers each of these in detail.
Advisory work during a leave, investigation, or fair hearing is a flat fee quoted in writing before any work begins, for a scope defined at the same time: the initial assessment and written map, the responses and requests to the hospital, and preparation for and representation at the hearing. Litigation, whether a challenge to the hospital's action or a discrimination, retaliation, or contract claim that the discipline reveals, is a separate scope quoted separately before it starts.
The firm represents physicians only, never the hospital or the medical staff, and checks for conflicts before opening any matter. That is why the first thing the firm needs is the name of the hospital or health system, not the documents. Sean Sobel is licensed in Ohio and advises physicians and trainees nationwide on the HCQIA, NPDB, and ACGME questions, with local counsel engaged where a question turns on another state's law.
Name the hospital or program, what you have been told, and the date of the leave or suspension. You will get a written reply after a conflict check that says what the engagement would cover and the flat fee for that scope before anything is billed.
Do not attach or send any notice, chart, or committee correspondence yet. After a conflict check, usually the same day, you will get a written reply that says how to send it and what the engagement would cover. Submitting this form does not create an attorney-client relationship.
Every matter is different. Descriptions of typical timing, fees, and outcomes are general and do not guarantee any particular result in your case.
It depends on what the leave does to your privileges, not what it is called. A professional review action based on competence or conduct that adversely affects clinical privileges for more than 30 days must be reported under 42 U.S.C. 11133, and the NPDB Guidebook treats a leave that keeps you from exercising privileges during an investigation as a reportable surrender. A leave that leaves privileges fully intact is not reportable. Ask the hospital in writing whether your privileges remain in effect.
For a limited time. 42 U.S.C. 11112(c) allows a suspension of not longer than 14 days while the hospital investigates whether a professional review action is needed, and an immediate suspension where failing to act may result in imminent danger to any individual's health. In both cases the notice and hearing process must follow if the hospital wants to keep its immunity, and your bylaws and fair hearing plan set the specific steps and deadlines.
Not before you know what will be reported. A surrender of privileges while under investigation, or in return for the hospital not investigating, must be reported to the National Practitioner Data Bank under 42 U.S.C. 11133 and to the State Medical Board under R.C. 4731.224, and the Guidebook says your awareness of the investigation does not matter. That report follows you to every future credentialing and licensing application. Any exit has to be structured with the reporting rules in view.
Usually not through a lawsuit. R.C. 2305.252 makes a peer review committee's proceedings and records confidential and not subject to discovery in a civil action against the hospital or a provider. Information available from original sources, such as the chart, is not protected, but you must get it from the original source. The fair hearing, with its witness list, cross-examination, and record, is often the only point where the case against you can be seen and tested, which is why the hearing request matters.
The process is different. A resident's remediation, probation, non-renewal, or dismissal runs under the sponsoring institution's GME policies and the ACGME Institutional Requirements, which require written notice of intent and a due process policy but no longer set a minimum notice period. The NPDB Guidebook treats an action taken within the scope of a training program as not reportable, while the Ohio license application asks about program discipline directly. The firm advises residents and fellows on the same flat-fee basis.
Name the hospital and the date of the leave or suspension. The first reply is in writing, after a conflict check.
Schedule a Consultation ›