10 Ways to Avoid Losing Your Nurse Practitioner License: Part 1

By Healthcare Law Attorney Alex Scarbrough Fisher

This is the first article in a three part series designed to inform nurse practitioners and physician assistants about proactive steps that can be taken to avoid licensure discipline by the Department of Health.

1. Renew your license and timely respond to all correspondence from the Board of Medical Examiners or Board of Nursing.

If the Board of Nursing (BON) or Board of Medical Examiners (BME) sends a letter to a nurse practitioner or physician assistant stating that he/she needs to renew his/her license or pay licensure fees and the NP or PA does not respond, the Board can formally reprimand the provider for failure to respond. A reprimand by the BON or BME becomes part of the public record, is searchable on the National Practitioner Data Bank, and is difficult to expunge. Once a reprimand or other action becomes part of a nurse practitioner or physician assistant’s record, this can make the licensure process in another state more difficult, and lead to harsher punishment of future infractions due to a history or noncompliance.

2. Avoid engaging in unprofessional, dishonorable, or unethical conduct. 

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Unprofessional conduct can affect the status of your license. For example, the Tennessee Court of Appeals found in January of 2013 that the statue prohibiting unprofessional, dishonorable, or unethical conduct is not unconstitutionally vague, and the court upheld the Board of Medical Examiner’s discipline of a physician based on a DUI (Ernest B. Kleier v. Tennessee Board of Medical Examiners). A disciplinary action taken by the Board of Medical Examiners under this statute does not have to be related to the direct treatment of a provider’s patients; rather it can be related to any action that is an indication of a provider’s “unfitness to practice medicine”.

3. Avoid violating criminal law. 

Violating, or conspiring to violate your state’s criminal statutes or any lawful order of the Board of Medical Examiners or Board of Nursing can result in licensure discipline. In a ten-year study of physician discipline, for example, researchers looked at the age and specialty of physicians who were disciplined for criminal activity across the country. Seventy percent of physicians disciplined for criminal activity were forty-five years of age or older, with general practice being the most represented specialty. Although many hypotheses exist to explain these results, healthcare providers often work long hours for the majority of their careers.

It should come as no surprise that as providers advance in their careers, fatigue may set in, leading to a desire to cut corners and associated poor decision making. Recognizing this temptation in oneself and others may lead to greater self-awareness, and a decision to seek healthy ways to manage stress and fatigue before one’s personal life has negative spillover into professional life.

To be continued…


Alex Scarbrough Fisher is an associate attorney at Frost Brown Todd, LLC. Her practice area focuses on litigation and administrative law. Alex’s administrative law practice’s emphasis is in health care related boards, including the Tennessee Board of Medical Examiners and the Tennessee Board of Nursing. 



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