For California’s three million-plus licensed professionals, the name of the game is to stay off their licensing agency’s radar screen. If you run into a problem, you want to make it go away, or at worst, suffer as little damage as possible. Here are some tips:

1) Get Out of a Problem Workplace: Many license problems arise from reporting by employers to licensing agencies, and can come from spiteful employers and arise from employee conflicts. If you have a bad feeling, get out before you are the subject of a complaint.

2) Solve Your Personal Problems Before They Become License Problems: Alcohol and drug abuse, followed by physical and mental issues, can trigger serious safety concerns for a licensing agency. Seek prompt treatment so that your personal issue doesn’t become a public safety concern that causes the loss of your license.

3) Take Great Care of Your Customers (or Patients, or Clients): When you are wrongly accused of course defend yourself, but if you have made a mistake, fix it, if the customer deserves a refund, make it, if an apology is due, give it. Hurt feelings, refusal to make an account adjustment or rudeness can trigger a license discipline nightmare.

4) Be Honest with Your Licensing Agency: If you are caught in a lie and shatter the trust placed in you by your licensing agency, the lie will almost always overshadow the behavior you wanted to cover up. Most licensing agencies are poorly staffed and rely upon the honesty of licensees when they make an inquiry or do an inspection. Betraying this trust can cost you your license.

5) Keep Your Address Information Up to Date: If your licensing agency has a problem and can’t reach you, they may assume your guilt or never get your side of the story. You could be disciplined or lose your license and not even know it! A license hanging on a wall means nothing if, unbeknownst to you, the license has expired or has been revoked.

The California Medical Board’s Diversion Program ended June 30, 2008, bringing to a close an important option for getting physicians treatment for substance abuse without creating a record of public discipline that leaves most careers in ruins.

For those physicians who remained in the Diversion Program as of June 30th, they were placed into two groups: those who would be discharged early from Diversion thanks to their success, and those who would remain “in diversion” supervised by the enforcement arm of the Medical Board of California. For new cases, the Diversion option no longer exists.

The California Medical Board’s Diversion Program could never adequately satisfy the concerns of its critics. A certain portion of the community felt that the program helped shield addicted physicians from public discipline thereby putting the public at risk. On the other hand, the Diversion Program’s resources were so limited that some participants received inadequate treatment and supervision for their addiction, which would lead to positive drug tests and other violations. Such violations created a predicament for the program, because the program was, by its very nature, designed to treat addicted physicians and not to throw them to the wolves by sending them off for formal Board discipline. Nevertheless, the program had to draw the line and punish some physicians with formal discipline. In summary, the program was too lax for some, inadequate for others, and for some others fundamentally punitive in nature, contradicting its stated mission.

California physicians now must proactively seek confidential help for their addictions. Once the Board is involved, the Board, by its mandate, must “protect” the general public by seeking public discipline if warranted. Such disciplinary actions can be career-ending. A physician’s career, as seen through the eyes of this licensing attorney, is a house of cards, those cards being a myriad of licenses, certifications and privileges from boards, hospitals, associations and insurers. One black mark can place each and every license, certification and privilege in jeopardy.

It is, therefore, absolutely critical that physicians who struggle with drug or alcohol addiction, or other mental illness, swiftly and privately seek help. There are several nationally prominent addiction treatment programs, including Hazelden Springbrook in Newberg, Oregon, and the Farley Center at Williamsburg Place in Virginia, which specialize in the treatment of physicians. Locally in southern California, Cornerstone of Southern California is a well-established and prominent program which treats professionals for drug and alcohol addictions. In this post-diversion era, a physician who wants to salvage their career by privately seeking treatment must seek effective treatment through one of these programs without delay.

In early October 2008, the Los Angeles Times published the findings of an investigation it conducted into the screening and discipline practices of the California Board of Registered Nursing (BRN). The Times found that lapses in the screening and background investigation practices of the BRN had allowed a large number of nurses, including convicted felons and individuals in state prison, to escape license discipline. The Board has reacted to this embarrassing report with new measures to enhance background scrutiny of its licensees and license applicants. Some changes were already underway before the report came out.

Most California licensing agencies require applicants to answer criminal background questions on their license applications, in addition to requiring criminal background checks. However, the BRN had not, until recently, required its applicants to answer a criminal background question, and also it did not ask about new convictions on its renewal forms. Instead, the Board relied solely on “livescan” fingerprint background checks. Before 1990, according to the Times, nurse license applicants were not even asked to submit fingerprints. The BRN did operate a fairly efficient periodic background check system which often caught criminal cases even while they were still pending. Nevertheless, some serious offenders have escaped scrutiny for years, or even decades.

 If you are a nurse with a criminal conviction who has escaped scrutiny, there are things that you should do now, without delay, to reduce or possibly even avoid discipline by the Board. First, keep in mind that some nurses with convictions will never be disciplined. Although there is no statute of limitations for discipline against nurses in California, very old convictions may be difficult to prove or may now seem irrelevant to the nurse’s character and qualifications. On the other hand, if you have a recent conviction that will be reportable on your next renewal, swift action is advised.

 Many felony convictions in California can be reduced to misdemeanors under California Penal Code section 17(b). If your conviction was a “wobbler,” meaning the charge could be alleged as a misdemeanor or felony, and if you were given probation (instead of being sent to state prison), you probably can get your felony conviction reduced to a misdemeanor. Most criminal court judges are inclined to reduce a prior felony conviction if the defendant has successfully completed probation. The newly reduced misdemeanor in turn can be expunged. An expungement (under Penal Code section 1203.4) does not automatically prevent license discipline, but it can be strong evidence of rehabilitation to lessen license discipline. Also, it is little known that some misdemeanor convictions, such as disturbing the peace or driving without a valid license, can be reduced to infractions. An infraction conviction cannot be used to discipline a license in California.

 These criminal court motions and other actions to “clean up” criminal records are best attempted by a criminal defense attorney who is well known and well respected in the criminal court where the case will be heard. I do give seminars to criminal defense attorney groups to teach them how to best handle criminal cases to avoid license discipline and license denials. I will sometimes work in tandem with a criminal defense attorney to guide them in executing the best strategy to minimize license impacts. The most effective strategy is for the criminal defense attorney to recognize early in the criminal case that their client will have potential license issues, and to negotiate for an outcome that reduces the future impact of the criminal case. With this new push for scrutiny by the Board of Registered Nursing, such efforts will be critical for all registered nurses facing criminal charges.