Get a medical license? It's easier to get a gun

That's what the author discovered when he tried to do volunteer work after retiring to Florida. Could he fight through the bureaucratic bungling?

By Stanley J. Tyler, MD
Retired Internist/Pembroke Pines, FL

Six years after I retired from my New York practice and left for nonstop sun and fun in Fort Lauderdale, an unsettling wave of discontent began to wash over me. I realized that the absence of medicine in my life was getting to me.

Fortuitously, one day while getting a haircut, I happened upon an article in a local paper. The story explained how a group called The Elderly Interest Fund provided free medical care and prescriptions through its MediVan Project—two vans equipped as mobile clinics. Staffed by retired physicians, nurses, and social workers, the service was available to those with incomes at or below the poverty level. Eligible patients at more than 22 sites in Broward County could take advantage of it simply by making an appointment.

This project was recognized as a "Daily Point of Light" by the Bush administration, and received numerous citations from the state of Florida and other national, state, and local organizations, according to the paper. As fate would have it, the project was looking for more volunteers. Perfect, I thought. Take me!

An endless application process

I began the process of volunteering with booming enthusiasm. After inquiring about the organization's professional requirements, I looked into getting a Florida medical license. Florida requires state board examinations, except for physicians who volunteer to work unpaid for certain nonprofit organizations such as the MediVan Project. For that, you need only a limited medical license. I sent for an application.

Much to my surprise, the requirements for a limited license seemed to be exactly the same as those for a regular one. The Florida Board of Medicine requested original documentation of my medical school graduation and all my postgraduate training. The latter, in my case, consisted of an internship and three-year internal medicine residency. In addition, I needed to produce letters from all the states in which I'd been previously licensed. Oh, and my fingerprints had to be sent to the FBI for investigation.

Even this barrage of bureaucracy might have seemed reasonable if I were requesting a full license. But I was just trying to pitch in and help the indigent for free. Why set up so many obstacles?

Remember, I'd been retired for six years. Original diplomas, medical licenses, and such were buried in boxes at my son's house—in the basement crawl space. It took hours to ferret them out of the cold, damp cellar with a flashlight and clean them up. Fifty-some boxes later, I found the original diplomas issued after my internship and residency. Triumphant, I immediately shipped copies to the board along with other paperwork.

I expected the board to process my application perfunctorily. It didn't. We don't take unauthenticated material, the board sniffed in a letter responding to my application. All correspondence and documents had to be notarized.

I could see a lot of people throwing up their hands at this point, but by now I was on a mission. This time, I got all my paperwork officially stamped, embossed, and signed. Then I shipped it all off again.

A full month later, the board graced me with yet another letter. I'd omitted one state from the list of those in which I'd been licensed. The board's letter had an ominous tone: What have you been hiding from us?

By now, this endeavor had gone from the sincere to the ridiculous. If the medical board had a full AMA profile of me that included my entire medical background—which is what allowed it to discover my omitted state—why did I have to go through the tedious process of trying to pull together all these long-lost records?

Fed up and frustrated, I nonetheless wrote to the overlooked state. Total time to date: six months.

I get an audience with the board

I finally managed to pull everything together and get it into the medical board's hands. To my amazement, I then had to fly from Fort Lauderdale to Tampa to be questioned in person.

I waited hours for my turn, watching other physicians, most of whom were seeking limited or regular licenses, endure grueling questioning. When my turn came, the board asked simply, "What have you been doing since you retired, Doctor?"

"Playing golf," I replied.

Brevity appeared to be key. With that quick exchange, my application would be approved, I was told. I notified the people at the MediVan Project that all systems were go.

Silly me.

Roughly three weeks later, a letter arrived from the Florida board. My limited license?

Alas, no. This time, it was a claim that the board had never received my fingerprints. I'd sent the prints six months before—by certified mail—along with my original application. And I had the signed receipt to prove it.

"Sorry," said a clueless clerk at the medical board lamely. "They're just not in our records."

So I schlepped to the local police station in Pembroke Pines again, and again got my pinkies inked. Then, staffers at the Elderly Interest Fund once again sent the complete set with the requisite $43 fee, via certified mail, return receipt. And again, when we received the receipt, I called the board.

And again, true to form, board staffers said they had no record of receiving the prints.

I asked how they could explain away two signed receipts. Their deft reply: "Maybe the envelope was empty."

Back to the police, who must have wondered why I needed three sets of fingerprints. A few days passed. Then, just when I'd nearly despaired of ever getting licensed by the Florida Board of Medicine, the folks at The Elderly Interest Fund reviewed their bank records and found the canceled check for my first fingerprint submission. They called the board.

Confronted with the ink of their own signature, board workers suddenly, miraculously, located the first fingerprint set, and shipped it off to the FBI—finally.

Eventually, the board would forward all three sets—and the FBI would reject all three without explanation. As a last resort, I had a fourth and fifth set of prints taken by the New York City Police Department when I was visiting family and friends. (Much later, the FBI would reject these, too. The board then allowed me to sign a notarized affadavit that I wasn't a criminal—something I could have done at the beginning of the process.)

At last, a license

After the fourth set of prints had been rejected, The Elderly Interest Fund staff (who had been extremely helpful at all times) asked the Broward County Medical Association and the Department of Health to intervene for me. They eventually brought enough pressure to bear on the board to facilitate my getting a provisional limited license. Six months later, my permanent license finally came through—14 months after my initial application. I suspect I could have joined the CIA with fewer forms and fingerprintings.

The reasoning behind the red tape?

I suppose that Florida medical board leaders can produce many reasons why they need to be so careful in handing out medical licenses. But certainly, they ought to get better at accessing their own computer records. They should also hire a few more qualified personnel. And, it probably wouldn't hurt them to spend a few bucks on an administrative consultant to streamline procedures. After all, how many volunteer organizations really want to beat away free help with a medical degree?

Many years ago, an older physician told me that medicine would be fun if you didn't have to worry about making a living and raising a family. He was right. I've been seeing patients in the MediVan for the past few months now and, I'm happy to report, I love it. Not since I first opened my office have I enjoyed the practice of medicine as much.

I recently received a license renewal notice. In addition to a bill for the $355 fee was an affidavit stating that I had not received compensation for medical services. I had to sign and return it—with a notary's seal, of course.

Some things never change, I guess.