How to end a medical career

Terrence Lakin, a physician with the U.S. Army who had earned the rank of LTC, ignored the higher calling of service, caring and healing to play politics earlier this year. Based on the conviction that President Obama wasn't the president because he wasn't born in the U.S., Lakin decided to defy orders to deploy. Lakin gave several high profile interviews, and even made a YouTube video where, though he found it "distateful," he felt he had no choice but "invite my own court martial."

Doing this took ego, narcissism, and arrogance. Physicians in the Armed Forces are a precious commodity. It isn't easy finding people to sign up --either as medical students, reservists or to make the leap from a civilian practice into active duty. His choice to grandstand and play politics was meant with a rightful prosecution. Army prosecutor Neal Puckett told a remorseful Lakin: “You invited this court-martial. You invited this sentence. And for the rest of your life, you get to live with a federal felony conviction.” The full story is here Stars and Stripes. Lakin has started his sentence at Ft. Leavenworth.

But what else does it mean? Some have assumed that he won't be able to get or keep his current state license. Yes and no. His current state license will be revoked. If he reapplies, he will have to admit to the felony, explain in full, and provide documentation. Each state is different, and the licensing board reviews each case separately. Convicted felons face long waits to be heard, and often must hire costly lawyers. In addition, a felony can make it virtually impossible to get privileges at hospitals. Community hospitals are notoriously picky about having anyone with a felony, and usually the answer is an automatic "no," unless the applicant lies and the hospital credentialing board is lax in background checks.

However, Lakin will find it impossible to receive a DEA license, which is issued by the Federal Government. His current one will be revoked. The DEA license is the sole piece of paper that enables a physician to prescribe classes of drugs most commonly found in acute care. In other words, without the DEA license, Lakin won't even be able to work in a Doc-in-the-box or an Emergency room.

There is doubt from many I spoke with that he will be able to keep his National Provider Identification (NPI) number, also assigned by the Federal government. Each physician in the United States is required by law to have one. Whether or not he forfeits this one, or if it becomes flagged, most thought he could have some problems.

Medical malpractice companies also take an interest in whether or not an applicant has any felonies. It is more common than not, when faced with an applicant who has a felony, to deny coverage to this individual. Malpractice insurers are private corporations and they alone decide who they want to risk taking a chance upon.

Each time Lakin applies to contract with a medical group, he will have to come forth with this information. Granted, some people might not see his political views tied in with his ability to provide doctoring. However, the question becomes whether the group will find a convicted felon insurable. If he isn't, then they will not be able to offer him a job.

Forty-five year old Lakin is a physician trained and Board Certified in both Family Practice and Occupational Medicine. He has spent his entire career in the Army. The taxpayers paid for his education, giving him a salary while going to medical school. In addition, the Army system assured him a slot in a residency program, paying him roughly double what his contemporaries were making at university training programs. With his job as a physician in armed forces, he enjoyed paychecks every 2 weeks, vacations, leave, and much shorter hours than his civilian peers. (Believe me, civilian medicine is the trenches). He didn't have to pay for his own health insurance, business insurance, and never saw a medical malpractice premium in his life. Lakin never had to worry about being sued. In addition, he never had to hire employees, negotiate leases, pay state and federal payroll taxes, file quarterly tax returns, or work out coverage with already overworked peers to take a precious weekend away. On the personal side, when they moved, their moves were paid for, and his rank and work garnered respect. In short, Lakin was extremely lucky. He and his family enjoyed a degree of comfort that is extraordinarily rare in the civilian world of medicine.
But maybe this security made it easy for Lakin to get cocky and decide to play this faulty hand. He not only bit the hand that fed him his entire career, he has made it extraordinarily difficult to practice medicine in the civilian world. Lakin admits he is sorry now, and has offered to get on a plane. His attorney wants the charges dismissed. But the military must be clear. To consider back peddling would be an insult to every person who has served regardless of their personal political beliefs.

Service to something higher than oneself, and the willingness to die for it, is what distinguishes the person in the military from a civilian. In addition, service as a physician demands an unwavering commitment to humanity despite cultural, political, or religious differences. It is regrettable that Lakin chose to do neither.