Pennsylvania · State Board of Medicine

Who Can File a Complaint With the Pennsylvania State Board of Medicine — and What Follows

9 min readLast updated July 7, 2026

Learning that a complaint has been filed against you is a jolt for any Pennsylvania physician. A single complaint from a patient, a colleague or an insurer is enough to start the process, and the first letter rarely explains where it leads. Knowing who actually regulates you, who is allowed to complain, and what the Department of State does with a complaint takes much of the fear out of that opening moment.

Before you do anything: A complaint is not a finding of wrongdoing. Many are closed after an initial review. Read anything you receive carefully, note any deadline, and resist the urge to fire off an immediate, defensive reply.

Who regulates physicians in Pennsylvania

Physicians in Pennsylvania are licensed and disciplined by the State Board of Medicine, one of the professional boards that sit under the Bureau of Professional and Occupational Affairs (BPOA) within the Department of State. The Board of Medicine regulates medical doctors (MDs) and physician assistants; doctors of osteopathic medicine (DOs) are regulated separately by the State Board of Osteopathic Medicine, though the two boards follow closely parallel processes.

The Board's governing statute is the Medical Practice Act of 1985 (63 P.S. §§422.1–422.53), supplemented by regulations at 49 Pa. Code Chapters 16, 17 and 18. Above all, the Board's stated priority is public safety, and it does not have to prove anything “beyond a reasonable doubt.” It works to the civil standard — a preponderance of the evidence — which is worth keeping in mind from the very first day.

Who can file a complaint

Any member of the public can file a complaint against a licensed physician. In practice, complainants are most often patients or their families, coworkers, other practitioners, and sometimes insurers. Complaints also arrive as mandatory or institutional reports: from hospitals, from law enforcement, from other state agencies, and through the reporting duties created by the MCARE Act and Act 6 of 2018.

Complaints are made in writing, typically through the Department of State's Statement of Complaint Form. A phone call alone will not usually open a formal matter. The Board also receives information about malpractice payments and out-of-state disciplinary actions, any of which can prompt a review even without a patient ever filing a complaint.

What happens after a complaint is filed

Complaints go first to the Professional Compliance Office, within the Prosecution Division of the BPOA's Legal Office. Staff there review each complaint to decide two things: whether the Board has jurisdiction over the conduct, and whether the conduct alleged, if true, could violate the governing laws or regulations. The office reviews thousands of complaints a year, and a large share are closed at this stage without further action.

Where a complaint clears that filter, it is assigned to an investigator from the Bureau of Enforcement and Investigation (BEI) and to a Board prosecutor — an assistant counsel from the Office of General Counsel. For many physicians, the first sign of a matter is a letter or call from a BEI investigator requesting records or an interview.

What counts as grounds for discipline

Not every complaint describes conduct the Board can act on. Section 422.41 of the Medical Practice Act sets out the grounds for disciplinary action, and §16.61 of the regulations defines unprofessional and immoral conduct. Between them they cover a wide field: immoral or unprofessional conduct; conviction of a felony or of a misdemeanor relating to a health profession; gross or repeated malpractice or a failure to meet the accepted standard of care; inability to practice with reasonable skill and safety because of illness, substance use or impairment; fraud or misrepresentation; and violations of prescribing, recordkeeping or continuing-education requirements.

For physicians, the recurring themes are prescribing and controlled-substance issues, boundary violations, inadequate documentation, standard-of-care questions, and conduct arising outside clinical work such as criminal charges. A complaint that does not fit any recognized ground can be closed early, however distressing it felt to receive.

The possible early outcomes

An early-stage matter can move in several directions. It may be closed for lack of jurisdiction or evidence. It may proceed to a full BEI investigation. Where the Board prosecutor concludes that formal action is warranted, the matter moves forward with an Order to Show Cause — the charging document that sets out the specific allegations and opens the formal disciplinary process.

Many matters that reach the charging stage are ultimately resolved by a negotiated consent agreement rather than a contested hearing. What you should not do is treat any stage as a formality. Each has consequences for your license and your record, and each rewards a prepared, well-documented and professionally advised response from the outset.

Key takeaways

Pennsylvania physicians are regulated by the State Board of Medicine (MDs and PAs) under BPOA / the Department of State; DOs fall under the separate State Board of Osteopathic Medicine.
Any person can file a written complaint, and reports also arrive from hospitals, insurers, courts and mandatory MCARE / Act 6 reporting.
Complaints are screened by the Professional Compliance Office for jurisdiction and merit; many are closed without further action.
If a matter proceeds, a BEI investigator and a Board prosecutor take it forward — the investigator's letter is often a physician's first notice.
Grounds for discipline are set by §422.41 of the Medical Practice Act and §16.61; the Board works to a preponderance-of-the-evidence standard.

Related courses

Practical, self-paced courses that map onto the issues in this guide. These are educational courses, not accredited by any Pennsylvania board and not a substitute for legal advice.

Dealing with a Complaint or Investigation Professionally

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Frequently asked questions

Can a single complaint put my Pennsylvania medical license at risk?

A single complaint is enough to open a review, but most complaints are closed after an initial screening by the Professional Compliance Office. A complaint is not a finding against you — it is the start of a process in which how you respond matters a great deal.

Who regulates doctors in Pennsylvania?

The State Board of Medicine, which sits under the Bureau of Professional and Occupational Affairs within the Department of State, licenses and disciplines MDs and physician assistants. Osteopathic physicians (DOs) are regulated by the separate State Board of Osteopathic Medicine, under a closely parallel process.

Who can file a complaint against a physician?

Any member of the public — usually patients or families, colleagues, other practitioners, or insurers. Complaints also come as mandatory reports from hospitals, law enforcement, other agencies, and through MCARE and Act 6 of 2018 reporting duties. The Board also acts on malpractice-payment and out-of-state discipline information.

Will I know who complained about me?

Not necessarily at the outset. Early contact from a BEI investigator usually focuses on the conduct alleged and the records involved rather than naming the complainant. If the matter proceeds to an Order to Show Cause, you receive a written statement of the specific charges.

What kinds of conduct lead to physician complaints in Pennsylvania?

Common themes include prescribing and controlled-substance issues, boundary violations, inadequate documentation, standard-of-care concerns, and conduct outside clinical work such as criminal charges. The full list of grounds appears in §422.41 of the Medical Practice Act and §16.61 of the regulations.

Should I contact the investigator right away to clear things up?

Be careful. You are entitled to prepare and to take advice before responding, and you are not obliged to submit to an interview on the spot. What you say early can shape the whole matter, so a considered, documented response is usually better than a fast one.

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.