The threats we face throughout our medical practice years are rarely published in the world medical practice literature for a good reason. The medical practice system has so many disruptive, threatening, and hidden educational factors to confess to that it is a miracle we have any American physicians still practicing today. That needs to be changed.

Most physicians in private medical practice, who suffer the most economically, are now reaching their tolerance limits, burnout levels, and wonder daily how they were able to stick with their professional goals this long. Your job is not easy when you are in control of your own practice. You never seem to get far enough ahead economically to enjoy your job of helping sick patients to get well and injured patients to heal fast.

In my 88 years in, and connected with, medical practice in the U.S., there is one kind of persistent threat to your survival that you rarely hear about, let alone know about. One that has caused millions of physicians far more harm while in practice and long after they left medical practice. Let’s talk about how quickly state medical boards can end your many years of successful and enjoyable private medical practice in one day.

Your survival in medical practice won’t happen unless you violate the rules and standards of medical practice. Are you aware of the hundreds of rules that you might violate? It’s a very long list that you are not aware of, and no one told you about. Open your AI program and see if you can find them.

I don’t want you to unknowingly succumb to the “deep state” of the medical-industrial-economic context, with their manipulations within the medical and health care systems in our nation. The right arm of the deep state has become the punitive focus of state medical boards. What they legally are allowed to do to “bad doctors” does not end when you leave the meeting room to comply with the rules you did not know existed in the first place.

The consequences of the medical boards’ actions are permanent, fully encoded in their files with your name on the label, and go far beyond the sinister nature and depth of the state medical boards’ legal ability to destroy any physician, any medical practice, and any physician’s hope for a future in medical practice.

Statistics tell us that about 3 to 4 percent of physicians will be taking their turn in front of their state medical boards, even if they never violated any of the rules of practice. Medical state licensure is another job they are responsible for. One of the worst problems I had with the state medical board was when I innocently asked their medical board for a medical practice license, which is normally the easiest process to go through.

The surge for forcing physicians to be totally responsible for what they do in medical practice was upgraded in the 1950s. The punitive side of the job of the medical boards has become the primary focus of what they are authorized to do. While the other job component, called physician rehabilitation, has become thoroughly ignored by the state medical boards because it takes up too much time and cost, and besides, the non-professional health care providers are ready to run the health care system just as well as physicians are doing.

Huge numbers of older practicing physicians still today have not recognized the danger they have been practicing in over all those years in practice because they luckily never faced a medical board, or if they did, it was because of such simple issues that do not require an investigation of their medical practice history, reputation, and accomplishments.

You were trained to be an indentured servant to the system, not the steward of your career. The medical system is a machine that has transformed the freedom to practice medicine as you choose to a commercial system where physicians have become “bought and sold” commodities. It makes you angry even to think that.

The medical system was never created to reward physicians for doing the right thing. You must forget the idea of quitting medicine. You need the knowledge and support they never gave you to win this battle. It’s probably why Harvard has well over 200 courses for physicians to learn all the areas of medical practice that we are never given a hint about while in medical school (some examples are legal self-defense, strategic career design, leadership, along with marketing clarity and adaptation, and business literacy and superstructure).

It’s overwhelming to suddenly become aware of the amount of learning that should be taught to medical students. It’s good that they don’t teach all that knowledge; medical students and most practicing physicians would never be able to pay the educational debt it would add up to.

I teach that you should stick tightly to the specific segments of practice that help you make the most income, incite you to be far more diligent concerning where you practice (close to industries where jobs provide the patient income to pay for your medical care, etc.), and avoid the poverty areas where people can’t afford to pay you.

You cannot be a good physician anywhere unless you have the income from your practice that meets all your needs. You must also learn the shortcuts to higher places. Be ready to transform your life and practice as the health care system transforms.

Some critical essentials to dealing with state medical boards

State medical boards must be viewed no differently than you being in a legal court with a federally appointed judge staring at you, just waiting to make lifetime changes in every aspect of your living circumstances. Just because you think that you can defend yourself when you are surrounded by appointed medical doctors and citizen appointees who are ignorant about physicians who break practice rules, they will vote on your degree of punishment anyway.

Always have an experienced defense attorney with you any time you appear at the medical board.

Your attorney being there gives you legal power to later obtain all the evidence, paper trail, and conversation notes and interactions of the physicians in their discussions about what you violated and their thoughts that will not be revealed in the board meeting with you. You do have ways to get those hidden records on your own, but it takes a lot more money and time, and you may not ever get all the hidden records. No attorney, and you will likely never find out what the board really felt about your situation.

When you have the records, you will be able to see the lies being told about your actions, the biases of all the board members for or against you, and can legally have the punishment decreased or dismissed from the information found in those records.

I doubt that even one percent of physicians know that they could access the board records and alter their punishment considerably based on the board’s sloppiness with their case.

Curtis G. Graham is a physician.