- A final order of an administrative agency following a hearing where the licensee was found to have committed medical malpractice;
- A final judgment of a court of law entered against a licensee where the licensee was found to have committed medical malpractice in a civil court action; or
- A decision of binding arbitration where the licensee was found to have committed medical malpractice.
Like all laws with good intentions the Devil is in the Details and the net effect is always different than believed. The goal of getting rid of "Bad Doctors" has not happened so far, but the net effect on all the other providers has probably led to higher costs and more defensive medicine.
The fear of 3 strikes already makes a paranoid medical profession, even more anxious about malpractice and peer review. Most physicians do not realize a referral to the Board of Medical Examiners is more high risk for their careers than a standard malpractice suit.
Hopefully, the 3 strike rule will be rewritten-- defensive medicine and higher costs will always continue to increase with the present adversarial system in place. The New Zealand system of no-fault takes a huge step to reimburse victims of medical incidents without terrorizing providers. After all, even in baseball, there is recognition that the batter is less than perfect. Three strikes there too takes clear and convincing evident; you can foul all day long, but until there is a swing and a miss or one right over the plate, the batter retains his position at bat.