Pennsylvania · State Board of Medicine

The Pennsylvania State Board of Medicine Investigation Process, Step by Step

A Pennsylvania board investigation can feel opaque, especially when the first contact is a phone call or a records request with no clear explanation of what comes next. The process, though, follows a defined path through the Department of State. Understanding each step — and where your rights sit within it — lets you engage from a place of understanding rather than dread.

Step 1: Complaint intake and review

Every matter begins with a written complaint to the Professional Compliance Office in the Prosecution Division of the BPOA's Legal Office. Staff review it to determine whether the Board has jurisdiction and whether the alleged conduct, if proven, could violate the Medical Practice Act or the Board's regulations. Many complaints are closed here, without the physician ever being contacted.

Documents and information gathered during an investigation are treated as confidential and privileged unless and until they are admitted as evidence in a formal disciplinary proceeding. That confidentiality protects the integrity of the process on both sides.

Step 2: Assignment to a BEI investigator

If the review concludes that further inquiry is warranted, the matter is assigned to an investigator from the Bureau of Enforcement and Investigation and to a Board prosecutor. For most physicians, this is where the case becomes visible: a BEI investigator makes contact, identifies themselves, and asks for records relevant to the allegation — or requests an interview.

It is worth pausing at this point. Anything you say to an investigator can be used to support disciplinary action, even when you believe you are helping your case. You have the right to take advice before responding, and speaking to an investigator without preparation is one of the most common ways physicians create avoidable problems.

Step 3: The investigation itself

A BEI investigator gathers the facts. That can involve interviewing the complainant and witnesses, obtaining and subpoenaing documentary evidence, and asking you to respond to the allegation in writing. Importantly, as the respondent you have no obligation to submit to an interview — a right that exists precisely so you can prepare and take advice first.

Where the matter involves clinical judgment, a medical consultant — a licensed physician retained by the Board — may review the file, advise the prosecutor, and in some cases conduct a physical or mental examination where impairment is a concern. The investigator then provides their findings to the Prosecution Division for review.

Step 4: The Board prosecutor's decision

Once the investigation is complete, the Board prosecutor decides whether to initiate formal charges. If the evidence does not support the complaint, the matter is dismissed. If it does, the prosecutor prepares an Order to Show Cause setting out the specific allegations and the grounds relied upon under the Medical Practice Act.

This is a genuine decision point, not a rubber stamp. A well-documented, professionally presented response during the investigation can be the difference between a matter that is closed and one that proceeds to charges.

Step 5: The Order to Show Cause and the hearing

Contested cases are heard by a hearing examiner — an attorney employed by the Board and approved by the Governor's Office of General Counsel — unless the Board orders otherwise. At the hearing you may appear, be represented by counsel, present evidence and witnesses, and cross-examine the Commonwealth's witnesses. The standard is a preponderance of the evidence: the Board need only be satisfied that a charge is more likely than not to be true.

The hearing examiner issues a proposed adjudication, which the State Board of Medicine reviews before making its decision and imposing any sanction. A physician who disagrees with the Board's final adjudication may appeal to the Commonwealth Court of Pennsylvania. A person harmed by the conduct may also submit a written impact statement, considered only in relation to the sanction.

How long it takes

There is no single timeline. A straightforward matter closed at intake may be over in weeks. A contested case that runs through investigation, charges, a hearing and Board adjudication can take a year or more, and an appeal longer still. Under the MCARE Act, the Board is required to commence certain investigations within four years of notice of a related malpractice action.

Long periods of apparent silence are normal and do not signal the outcome. The most useful thing you can do throughout is keep your own file — records, correspondence and a clear chronology — organized, so you can respond quickly and accurately whenever the process asks something of you.

This article is general information for physicians licensed in Pennsylvania and does not constitute legal advice. Regulatory processes and the law can change, and every case turns on its own facts. If you are the subject of a complaint or investigation, seek advice from a qualified professional-license attorney or your defense organization. Last updated July 7, 2026.