When Physicians Begin to Fear the Practice of Medicine
Perspective from a Licensing Defense Attorney who has observed the regulatory process from both sides and remains committed to protecting both professional judgment and patient well-being. By Samuel E. Spital — Licensing Defense Attorney
Over the course of more than four decades representing physicians in licensing and regulatory matters, I have heard an increasingly troubling statement from thoughtful and dedicated medical professionals: “Perhaps it is time to leave the practice of medicine.”
These words are rarely spoken lightly. They are often expressed by physicians who entered medicine with a deep commitment to patient care but who now feel overwhelmed by regulatory scrutiny, an over stressed fear of disciplinary action, and the natural perception that every clinical decision may later be second-guessed.
Having observed the regulatory process over five decades from both sides — first while serving as a Deputy Attorney General for approximately eight years, and since that time representing physicians and other healthcare professionals in private practice for over forty years — I have gained a deep appreciation for two equally important principles: protecting the public and fairly evaluating the professional judgment of conscientious practitioners. When approached thoughtfully, these principles should reinforce one another.
Physicians today practice in an environment that often feels and/or is perceived very different from the one many entered years ago. Stories about regulatory investigations, complaints, and disciplinary actions circulate quickly among colleagues and can create understandable anxiety about whether far too many clinical decisions might later be questioned.
Yet perspective is essential. The overwhelming majority of physicians continue to practice responsibly every day without disciplinary action, and when questions arise, they are often resolved once the full clinical context is reviewed and carefully analyzed.
Medicine has never been purely mechanical. It requires a thorough history and physical and/or mental health examination, thoughtful and complete professional judgment, evolving knowledge, and a careful balancing of risks and benefits in the best interests of the patient.
Physicians frequently encounter patients suffering from chronic pain, inflammatory conditions, or other medical conditions that do not always respond to conventional therapies. In such situations, responsible medical practice may reasonably include consideration of supportive or adjunctive treatment(s) that are non-invasive and carry a low risk profile.
Whether the modality involves lifestyle interventions, physical therapies, holistic medicine, nutritional support, integrative medicine, multi-disciplinary medicine, or emerging treatments such as clinical photobiomodulation — often referred to as red light therapy — the guiding principle should remain constant: the ultimate objective is to enhance the patient’s well-being while exercising careful and balanced clinical judgment and transparency regarding the limits of current scientific evidence.
Exploring such approaches responsibly — with informed patient communication, appropriate monitoring, collaborating with (other) medical specialists, and thoughtful documentation — is not a departure from good medicine. It is often an expression of a physician’s commitment to improving the patient’s quality of life when conventional treatments alone may not be sufficient.
Beyond the regulatory framework and the day-to-day realities of medical practice, there is a broader societal dimension that should not be overlooked.
Many individuals today struggle to find reliable guidance when confronting illness, chronic pain, or uncertainty about their health, personal status or position in life. When legitimate medical care appears constrained by fear or misunderstanding, some patients may feel alienated, lack insight, and/or become unstable without acknowledging or understanding such am outcome, and/or turn instead to substance abuse, unreliable or misguided activities and/or sources of attention, advice or treatment.
Responsible physicians play an essential role in preventing or marginalizing this negativity or outcome. When physicians are able to practice thoughtfully, communicate honestly with their patients, and consider reasonable approaches aimed at improving well-being, they provide something that cannot be replaced by misinformation or false promises: trusted medical guidance utilizing proper tests and procedures, along with effective treatments, grounded in both science and good professional judgment.
Helping even one patient regain clarity, hope, or relief can make an extraordinary difference. Medicine has always advanced one patient, one thoughtful decision, and one act of compassionate care at a time.
The practice of medicine has always required integrity, reasoning, compassion, and dedication to patient welfare. Physicians who approach patient care with honesty, transparency, and thoughtful professional judgment should remain confident in the value of their work, now and in the future.
Medicine ultimately exists for one purpose: enhancing the well-being of the patient.
Protecting healthcare professionals who act responsibly in pursuit of that goal ultimately protects the patients and communities who depend on them, thereby improving human well-being and society. Even helping a single patient regain clarity, hope, or relief can make an extraordinary difference that reaches families and communities in ways that are often immeasurable.
In future articles, I will discuss how medical board investigations actually unfold and how physicians can navigate the regulatory process while continuing to practice thoughtful patient-centered medicine.