A board’s order is rarely the end of a disciplinary case for the licensee. In Episode 2 of Board Insights, Ajay Gohil, a healthcare regulatory attorney with twenty-one years representing licensing boards, points to the consequences that arrive after the board has acted. A disciplined physician or pharmacist can lose hospital privileges and run into credentialing problems. Insurance panels may drop them, or raise their premiums. The board resolves the case, and the licensee carries the result into every other part of their professional life.
Ajay notes that boards are increasingly aware of this, and that it changes how they weigh a decision. Once a board understands that its order sets off consequences well beyond its own jurisdiction, the difference between a punitive process and a constructive one stops being a matter of tone. It becomes a matter of proportion.
Why Adversarial Processes Underperform
Both guests in this episode argue for a less adversarial process, and neither is arguing to go easier on licensees. They are arguing that an adversarial process is often worse at producing the outcome a board actually wants.
Dr. Katrina Mulherin, former deputy registrar of the New Brunswick College of Pharmacists, raises a small change to how decisions are written.
When we write these decisions, is there room, even two sentences, to turn their attention to this next phase, so there’s something they can hook into as hopeful and a road forward?
She points to the Professional Standards Authority in the United Kingdom and its work on kindness in regulation, and asks boards to at least consider whether there is space for some expression of hope in a decision. Ajay reaches the same conclusion from the attorney’s chair. He favors anything that moves a case from a punitive gotcha mindset toward a more transparent remediation approach, which he considers good for regulation.
The reasoning underneath both is the same. A licensee who feels cornered tends to defend rather than reflect, and a licensee who can see a road forward is more likely to engage with what the board is asking. Boards want a licensee to understand what went wrong and not repeat it, and that result depends on the licensee taking the process in. A purely punitive process works against the thing the board is trying to achieve.
Kindness and Accountability Are Not in Tension
None of this softens the standard. The reframe both guests are pointing at is that a board can hold a licensee fully accountable and still run a process that treats them as someone capable of change. Kindness here does not mean leniency. It means treating the licensee as capable of change while holding the standard exactly where it was.
Where Third-Party Assessment Lowers the Temperature
Impartiality is one of the practical ways a board makes a process less adversarial without giving anything up on rigor. When the board itself evaluates whether a licensee understands what they did, the board is both the authority that disciplined the licensee and the party judging their reasoning. That puts the board in two roles at once, and the combination can feel adversarial by its nature.
An independent assessment separates those roles. The board sets the requirement, and a third party scores the result against a structured rubric. One board described the value of that separation directly.
Keeping that separation is really good when you’re dealing with disciplining licensees. I’m not involved. I didn’t score your exam.
The assessment is rigorous, validated, and scored by graders the board never meets. That independence is what makes the result defensible, and it is also what lowers the temperature between the board and the licensee. The board is not the one marking the licensee’s work, so the assessment can carry the accountability without the board having to be the adversary that delivers it.
Holding the Standard and the Door at Once
Kindness is not the opposite of accountability. A board can require a real standard, hold a licensee to it, and still run a process that leaves room for a road forward. An independent assessment helps on both sides of that at once. It carries the rigor, and the separation it creates keeps the board from having to be the adversary in a process that works better when it is not.
About Board Insights: Board Insights is a conversation series from Ethics and Boundaries Assessment Services on how regulatory boards approach ethics, remediation, and disciplinary decision-making. Episode 2 features Ajay Gohil, a healthcare regulatory attorney with twenty-one years representing licensing boards, and Dr. Katrina Mulherin, former deputy registrar of the New Brunswick College of Pharmacists.
