Spital & Associates

04/05/2026

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03/16/2026

When Physicians Begin to Fear the Practice of Medicine

Perspective from a Licensing Defense Attorney who has observed the regulatory process from both sides and remains committed to protecting both professional judgment and patient well-being. By Samuel E. Spital — Licensing Defense Attorney

Over the course of more than four decades representing physicians in licensing and regulatory matters, I have heard an increasingly troubling statement from thoughtful and dedicated medical professionals: “Perhaps it is time to leave the practice of medicine.”

These words are rarely spoken lightly. They are often expressed by physicians who entered medicine with a deep commitment to patient care but who now feel overwhelmed by regulatory scrutiny, an over stressed fear of disciplinary action, and the natural perception that every clinical decision may later be second-guessed.

Having observed the regulatory process over five decades from both sides — first while serving as a Deputy Attorney General for approximately eight years, and since that time representing physicians and other healthcare professionals in private practice for over forty years — I have gained a deep appreciation for two equally important principles: protecting the public and fairly evaluating the professional judgment of conscientious practitioners. When approached thoughtfully, these principles should reinforce one another.

Physicians today practice in an environment that often feels and/or is perceived very different from the one many entered years ago. Stories about regulatory investigations, complaints, and disciplinary actions circulate quickly among colleagues and can create understandable anxiety about whether far too many clinical decisions might later be questioned.

Yet perspective is essential. The overwhelming majority of physicians continue to practice responsibly every day without disciplinary action, and when questions arise, they are often resolved once the full clinical context is reviewed and carefully analyzed.

Medicine has never been purely mechanical. It requires a thorough history and physical and/or mental health examination, thoughtful and complete professional judgment, evolving knowledge, and a careful balancing of risks and benefits in the best interests of the patient.

Physicians frequently encounter patients suffering from chronic pain, inflammatory conditions, or other medical conditions that do not always respond to conventional therapies. In such situations, responsible medical practice may reasonably include consideration of supportive or adjunctive treatment(s) that are non-invasive and carry a low risk profile.

Whether the modality involves lifestyle interventions, physical therapies, holistic medicine, nutritional support, integrative medicine, multi-disciplinary medicine, or emerging treatments such as clinical photobiomodulation — often referred to as red light therapy — the guiding principle should remain constant: the ultimate objective is to enhance the patient’s well-being while exercising careful and balanced clinical judgment and transparency regarding the limits of current scientific evidence.

Exploring such approaches responsibly — with informed patient communication, appropriate monitoring, collaborating with (other) medical specialists, and thoughtful documentation — is not a departure from good medicine. It is often an expression of a physician’s commitment to improving the patient’s quality of life when conventional treatments alone may not be sufficient.

Beyond the regulatory framework and the day-to-day realities of medical practice, there is a broader societal dimension that should not be overlooked.

Many individuals today struggle to find reliable guidance when confronting illness, chronic pain, or uncertainty about their health, personal status or position in life. When legitimate medical care appears constrained by fear or misunderstanding, some patients may feel alienated, lack insight, and/or become unstable without acknowledging or understanding such am outcome, and/or turn instead to substance abuse, unreliable or misguided activities and/or sources of attention, advice or treatment.

Responsible physicians play an essential role in preventing or marginalizing this negativity or outcome. When physicians are able to practice thoughtfully, communicate honestly with their patients, and consider reasonable approaches aimed at improving well-being, they provide something that cannot be replaced by misinformation or false promises: trusted medical guidance utilizing proper tests and procedures, along with effective treatments, grounded in both science and good professional judgment.

Helping even one patient regain clarity, hope, or relief can make an extraordinary difference. Medicine has always advanced one patient, one thoughtful decision, and one act of compassionate care at a time.

The practice of medicine has always required integrity, reasoning, compassion, and dedication to patient welfare. Physicians who approach patient care with honesty, transparency, and thoughtful professional judgment should remain confident in the value of their work, now and in the future.

Medicine ultimately exists for one purpose: enhancing the well-being of the patient.

Protecting healthcare professionals who act responsibly in pursuit of that goal ultimately protects the patients and communities who depend on them, thereby improving human well-being and society. Even helping a single patient regain clarity, hope, or relief can make an extraordinary difference that reaches families and communities in ways that are often immeasurable.

In future articles, I will discuss how medical board investigations actually unfold and how physicians can navigate the regulatory process while continuing to practice thoughtful patient-centered medicine.

A licensing defense attorney with experience on both sides of the regulatory process discusses how physicians can maintain confidence, professional judgment, and patient-centered care in a complex medical board environment.

09/02/2024

Help for an Investigation: Government or Employer meeting, interview, or conversation.

First, we acknowledge and understand this type of a situation is challenging for you. Frankly, it would be difficult for anyone under the circumstances, particularly because of the uncertainty associated with a government or employer Investigation. It makes little difference whether it is called a meeting, interview, conference or conversation, Interrogation is the actual and proper title. Since we understand how problematic, agonizing and potentially unmanageable this has been and/or will be for an individual, we recommend, as we do in many clients’ cases, to also consider the various forms of counseling and support to regain one’s strength and positivity to remain focused on making good career and personal decisions.

Second, we have decades of experience. A perusal of my profile includes in 1970 when I was chosen a Deputy Attorney General. Being a prosecutor for Regulatory Agencies provided me with a heightened level of knowledge that existed due to the intimate relationship working with Investigators who served on behalf of over three dozen State Agencies. Their protocols and mindset became indelibly etched in my brain. Since 1978, working on the defense of these matters, I brought and expanded on these unequaled skills, knowledge and expertise.

As a team with my Senior Associate Attorney for well over twenty (20) years, we have applied these uniquely learned principles and methodology, combined with our personal characteristics, energy, drive, creativity and desire to be the best of the best in what we do. Every case is different because each client experiences different thoughts, feelings, attitudes, along with (perhaps) physical and emotional pain. But everyone shares the same desire and dream to have their lawyer truly care about them individually. With us, we also go beyond these issues by focusing on our role as a champion of our clients’ CAUSE, and knowing their situation is “enormously important.”

Third, having us communicate on our clients’ behalf, you have this “double” layer of protection As we address and communicate with the investigator on an ongoing basis, we are insulating our client from “saying or doing anything that can and will be used against you.” Building an effective and compelling written and lengthy Legal Brief is our ultimate reward. As to certain cases or situations, the intervening period of time allows us the opportunity to influence each client to be laser focused during this stage of the case: To grow and improve their career, take relevant courses, develop an interest in additional professional/occupational goals and opportunities, read articles and treatises to regain strength, peace of mind, and self confidence, send an email and obtain an extended teleconference at a mutually satisfactory range of time, seven (7) days a week, with my devoted team of lawyers, with legal advice from an accomplished and seasoned lawyer you can feel her/his heart and sole are behind you and genuinely have your back, thereby acquiring safeguards, procedures and policies to demonstrate your law abiding nature and intent, etc.

These proactive measures should give you a sense of confidence that you are going in the right direction and, therefore, be more prepared in the event of any future follow up. In addition you will have the opportunity to improve and develop your personal knowledge and skills. at the same time. We are cognizant there could be unintended consequences such as a civil or criminal case, a subpoena for you to testify &/or produce documents, the filing of an Accusation or Interim Suspension Order (immediate Cease and Desist from working in your chosen area of practice. While it may not be the most comfortable position for you, it does provide a level of vigilance and motivation to make changes now and to serve you well as you flourish in your career and become more healthy and mature intellectually. Essentially, you can be laser focused with us to build and develop a pattern of legally significant facts along with persuasive mitigating factors to demonstrate WHO YOU REALLY ARE.

All of this in combination and individually can serve as an umbrella of protection as well as minimize and marginalize any negative claims, allegations, inferences and conclusions. Although this may not seem a “quick fix” you might dream of, there really is no way to force the Investigator to disclose or share what (s)he knows, what (s)he is doing, etc. And finally, we cannot guess or predict any outcome in such a case. What we do is to focus on each step, help each client make objective choices as we provide alternatives with the pros and cons, so you can participate in the decision making process; responding when required; and, monitoring the current status and direction the case takes. We level the playing field. As such and after reading this, we fervently hope you will send us an email or call, to find out how you can use this valuable time to have trust and confidence in the interim, following the written outline and steps we recommend to improve your personal situation and practices.Wishing you the very best, Sam Spital, Managing Attorney.


NOTE: This is designed for general information only. Any information you obtain from this BLOG should not be construed as legal advice, nor as grounds for forming an attorney-client relationship. You should consult an attorney for information on obtaining formal legal advice.

03/29/2024

CHOOSING THE RIGHT LAWYER

The choice of a lawyer is an important decision, and it should never be based solely upon the attorney’s fee. Before making your choice of a lawyer, you should give your situation careful thought.

It goes without saying, the selection of an attorney is an important decision. Our clients favor our “natural” ability, “art of communication; “art” of negotiation; proactive, relevant, resourceful, passionate, and formidable characteristics to obtain continuing winning results; along with utilizing a methodology to craft a compelling presentation. Every case is different and must be judged on its own merit. While past performance cannot be used to predict a result for a particular case, we also have an unprecedented 325+ “five-star” client reviews and attorney endorsements, along with being the unmatched recipient of the “CLIENT’S #1 CHOICE AWARD” for 18 years in a row, 2007 thru and including 2024.

We know how important it is to have trust and confidence in your attorney as (1) she/he provides advice and representation; (2) her/his willingness and desire to maintain communications with YOU on an ongoing and priority basis; (3) coordinate obtaining percipient witness statements; as well as (4) all of the legally significant facts, principles, and issues; along with (5) relevant legal documents (6) to develop a persuasive defense and critical “offense;” (7) provide a written and detailed action plan to you within 5-7 days of being retained; (8) perform the pivotal research and analysis; (9) implement a laser focused strategy; (10) build and present a comprehensive and lengthy (50-75 pages) written and compelling legal argument; (11) handle all written and verbal communications with the government; (12) assist in obtaining a “highly credible and persuasive expert” for you to retain; and, (13) communicate with that expert on your behalf regarding his/her action plan concerning your case.

Continued: click

Read the latest blog posts from Samuel Spital & Associates

02/05/2024

Imagine someone who truly understands and cares about the challenges one faces with personal, health, family and perhaps financial issues, along with their life, vocation or professional career.

We do not compromise by superficial verbal or written communications with the opposition. We get respect for our methodology, winning defense and offense. We bring to the table five (5) decades of utilizing a pivotal strategy, focusing on the legally significant facts and relevant principles.

Moreover, we have the enlightenment, natural ability and character traits to identify and underscore our clients’ unique and exceptional qualities, personality, knowledge and skills. We go beyond money to produce ethical, reasonable and proper results, FOR OUR PROFESSIONAL AND OCCUPATIONAL LICENSE CLIENTS.

Free Preliminary Lawyer Teleconferences

Statewide California Professional License Defense, San Diego Criminal Law Attorney, Personal Injuries, and Civil Litigation Defense.

11/13/2023

https://www.avvo.com/attorneys/92108-ca-samuel-spital-248191/reviews.html

Saved my career
5.0 stars
Posted by Derrick November 9, 2023
Making this phone call to Sam was the hardest and most humbling experience I had ever had in my life. I had made a dumb mistake and put my RN license in danger. I never expected Sam himself to pick up the phone when I called and he right away began to calm me down he cared about who I was and wanted to know about my life and family not just what had happened. We shared stories and by the end of the conversation he had already outlined a plan on how we would approach the board. He even gave me a set of questions and directions for the attorney I had out of state handling my criminal matter. He knew what this career meant to me and the outcome of case shows it. I had NO accusation, NO discipline, NO citation and, NO fine with the BRN
Sam thank you from myself and my family !

SAN DIEGO, CA attorney Samuel Spital - read reviews from former clients.

10/28/2023

Should a Nurse File a Disability Claim?

Some attorneys may caution against a nurse filing a disability claim since a “disability alone” (by itself) can be the basis for the BRN to seek disciplinary action against an RN, including issuing an Interim Suspension Order (ISO), which is to cease and desist working during a pending suspension. On the other hand, an individual may be physically and/or emotionally disabled and, therefore, (s)he may decide to file a disability claim, which may constitute a reasonable and proper decision.

Th role of an effective lawyer is to establish the good judgment of a nurse and/or marginalize or refute a claim of wrongdoing, incapacity or unprofessional conduct. In other words, produce evidence of the nurse’s personal qualities and characteristics along with her/his relevant knowledge and experience enabling the nurse to form appropriate opinions and make reasonable decisions. In a somewhat isolated situation, a nurse may be unavoidably disabled, choosing to make that decision, which might be the right course of action for him/her.

First, it is best for YOU to consider all of the legally significant facts.Your lawyer should provide advice after a complete analysis and pivotal strategy (methodology) in which a decision is made or an opinion rendered on a case-by-case basis. Your attorney should refrain from making generalizations, setting a blanket rule or engaging in what may constitute a common practice; instead, you want a lawyer who appies logic and reasoning to each fact situation.

Second, the report and diagnosis by a competent (qualified) physician is relevant.

(A) Before requesting a report, it would be helpful to have a nurse provide to his/her lawyer a written summary of what the physician said.

(B) In addition, with the client’s written consent, having a teleconference between the lawyer and the physician at the outset may provide more clarity.

Third, the range of acts or omissions [such as specific activities, tasks, etc.], being restricted are relevant to one’s ability to work. In other words, how broad the work limitations or restrictions, the length of time being considered or proposed, and whether and what duties and functions that are permitted, if any, would also be relevant.

Almost any contact by the government can be stressful, intimidating and/or uncomfortable. A similar feeling may exist in the environment in which a nurse is employed. That is why a nurse should obtain a complimentary extended teleconference with an experienced and highly accomplished attorney. The goal is to provide the pros and cons, alternatives, and unintended consequences for the nurse to make an informed decision on how to proceed.

It may be extremely helpful to also obtain a consult or few sessions with a therapist to help deal with the situation, promote good choices and make better decisions, be able to concentrate on the duties and functions of a nurse at work, and to be able to obtain restful patterns of sleep.

You are invited and welcome to obtain a complimentary and preliminary teleconference with Attorney Sam Spital, who is available seven days a week, approximately 8:30 am to 8:30 pm.

11/07/2022

As part of more than 100 new pieces of legislation, on September 29, 2022, California Governor Gavin Newsom signed AB 1949. Effective January 1, 2023, AB 1949 adds section 12945.7 to the Government Co...

03/28/2021

Five Common Misconceptions About Professional License Defense Attorneys
No one should gamble on their career.
When clients call us, we hear of countless errors, omissions, and challenges in their case, whether they had the courage to handle it on their own or hire a lawyer. Hence, it is critical that YOU learn about the material facts and operative legal issues that are deemed essential to the California Regulatory Agencies. Additionally, you want to obtain the maximum benefit from retaining a Professional or Occupational License Attorney.
Therefore, it is best to perform due diligence and research of the prospective lawyer by looking in advance at a national directory, such as www.avvo.com, to obtain each lawyer’s rating; number, nature and recency of “5-STAR” client reviews; endorsements by other lawyers; number, type, and recency of national awards; full resume, including number of years in practice; law school graduated; lawyer’s articles and/or books written; lectures presented by the attorney; and whether the attorney served as legal counsel for the particular Board, Department or Agency involved.
As such, YOU will then be able to make an objective numerical list of the qualifications, capabilities and written proven success of the attorney from whom you desire legal advice and representation. It is noteworthy, the State Bar of California cautions the public to NOT use past performance as a prediction of future results. Instead, to focus on objective factors. Ultimately, there must be a substantial basis for complete trust and confidence or you may select an attorney that is not effective in what may be a defining moment in your life, now and in the future.
Misconception #1: The attorney’s fee is the most important criteria in hiring a lawyer. That is a false narrative since there are lawyers who seek to handle more cases in order to charge the same or less than a superb attorney. The volume offsets the fees they collect. More importantly, by limiting the professional services, you will at best obtain a superficial end product , if at all; and, a result you do not now or later have confidence was the best possible outcome under all of the facts and circumstances. Clearly, you know there is a difference in a verbal presentation or letter vs. a comprehensive written legal argument, perhaps 60-75 pages in length, supported by exculpatory evidence and other proof submitted on your behalf. In other words, there should be a meticulous process utilized to demonstrate in a forceful and comprehensive manner why and how you should NOT be defined by claims, mistakes and allegations of the past, if any.
Misconception #2: Any lawyer can handle a Licensing case. This is a huge fallacy. Even the advantages set forth above will not be enough if the lawyer of your choice does not have the natural ability, true passion, and relentless commitment to obtain a favorable outcome for YOU. As such, the lawyer needs to obtain all of the facts and scrutinize each of the legal issues; identify and strategize on the points the Regulatory Agency will deem legally significant; obtain one or more credible forensic experts to write a compelling Forensic Report to substantiate the elements, conclusions and inferences that support the attorney’s defense, along with his/her pivotal “offense.”
Misconception #3: What you wish for is what you will get. In Administrative Law, this is a misunderstanding because hope is NOT a strategy. Here again, it is essential you focus upon objective criteria to accomplish your goal(s). Of course, one’s resources are a valid consideration. However, some individuals think primarily about the cost of the legal services, and most frequently do so by NOT focusing on what they have to lose. Nothing is more important than fulfilling your dreams or goals, even when there are or may be challenges. YOU deserve to be content in your personal and professional life. The rewards of achieving what you strive for are priceless. Every day you wake up is sweeter knowing you are doing what you want, no matter what it takes to reach the destination. Srarch for a lawyer who works harder, longer and smarter, rather than choosing a lawyer on the basis of his/her fees alone.
Misconception #4: Hiring a lawyer is a standalone solution. This is a misconception because a lawyer does not work alone. YOU should be an integral part of a well-planned process. You can bring useful facts, generous details and real advantages as a team member. Of course, you want a tough, smart, experienced, and skilled advocate. However, you are also a crucial player in order for your lawyer to level the playing field. The result can be evolving, complete, and effective; just as in the case of an enhanced, compelling, and memorable production, script, story, movie or performance.
Misconception #5:Retaining an experienced lawyer will suffice. Maybe. Possibly. Potentially. However, why settle for less when YOU can have a trusted, respected, and truely superb lawyer who understands the challenges you face with a unique commitment to achieve an outstanding result, even against big government. It starts with a fighter who is a compassionate and dedicated advocate, laser focused on developing meaningful strategies for YOU.
Next Step: Weigh the alternatives, pros and cons, and choose value and benefits over expediency.

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02/22/2021

A physician licensed in California is required by law to notify the Medical Board of certain specific occurrences. Reporting forms are provided for your use, links shown below. Pursuant to California Business & Professions Code:

§ 801.01(b)(2), a licensee must report malpractice settlements over $30,000 and judgments or arbitration awards of any amount, if the licensee does not possess professional liability insurance. (See Report of Settlement, Judgment or Arbitration Award)
§ 802.1, a licensee must report:
The bringing of an indictment or information charging a felony against the licensee.
The conviction of the licensee, including any verdict of guilty, or plea of guilty or no contest, of any felony or misdemeanor. (See Physician Reporting - Criminal Actions)
§2240, a licensee who performs a medical procedure outside of a general acute care hospital, that results in the death of any patient on whom that medical treatment was performed by the licensee, or by a person acting under the licensee's orders or supervision, shall report, in writing, on a form prescribed by the board, that occurrence to the board within 15 days after the occurrence. (See Outpatient Surgery - Patient Death Reporting Form)
§ 2021, each licensee shall report to the board each and every change of address within 30 days after each change. (See Notification of Name Change and Address of Record )

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