Iowa Supreme Court Holds Board of Medicine’s Correspondence cannot impose discipline without a finding of Probable Cause

Posted on: March 2nd, 2020

Following a Board of Medicine investigation into an emergency room physician after the death of a patient in his care, the physician voluntarily ceased practicing medicine.  The Board closed its investigation without a finding of probable cause that the physician had violated any rule or standard of practice, which is a prerequisite to imposing discipline. The Board issued a letter telling the physician that if he returned to practicing medicine, the Board would order him to “complete a comprehensive clinical competency evaluation.” The physician filed a petition for judicial review alleging that the Board’s letter constituted illegal agency action.

The Board moved to dismiss, arguing that its action is unreviewable because it imposes no present discipline, closes the Board’s investigation, and any future action is not ripe for review. The district court agreed and granted the Board’s motion to dismiss. The court of appeals affirmed the dismissal while acknowledging that the Board’s action prevented the physician from freely resuming his practice. The Iowa Supreme Court granted the physician’s application for further review.

The Supreme Court held that the District Court erred when it determined the Board’s letter was not judicially reviewable.  The Board lacks the statutory authority to impose discipline without finding probable cause of a violation and without giving the physician an opportunity to challenge the alleged violation. The warning letter effectively imposed discipline – the competency evaluation—should the physician return to practice. The Board thereby circumvented the due process safeguards and public reporting requirements codified in the governing statutes. The Supreme Court vacated the decision of the Court of Appeals and reversed the District Court’s dismissal ruling, and remanded the case with directions for the District Court to order the Board to rescind the offending provision in the letter without prejudice to the Board’s ability to reopen its investigation in the physician’s conduct.

Mark B. Irland, v. Iowa Board of Meidicine, No. 18-0353, (Iowa 2020).

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