The practice of medicine is a tightly regulated profession because it involves such a high risk of potential harm to the public. All states require that anyone wishing to practice medicine as a physician must first obtain a state license to do so. Without such a license, anyone practicing medicine in the state commits a crime.
Each state has its own definition of what it means to practice medicine, though these definitions involved the same general type of activity. A person practices medicine whenever they attempt to:
Performing any of the above acts without a valid medical license is a crime. The unauthorized practice of medicine also includes advertising one's services as a physician or holding oneself out to the public as a physician, doctor, surgeon, or someone licensed to practice medicine without having the proper credentials. If the person actually performs medical treatments, it's a crime regardless of whether they received any kind of compensation or caused harm to the patient.
There are some actions that are specifically excluded from the crime of practicing medicine without a license. For example, applying home remedies, offering advice, and writing about nutrition or medical conditions are not considered practicing medicine. Also, performing other types of healthcare-related activities, such as acting as a pharmacist, nurse, or dentist is also not considered practicing medicine, though states also require people practicing those professions to be properly licensed.
Penalties for practicing medicine without a license vary by state and can include criminal and civil penalties.
Many states make it a felony to practice medicine without a license. A felony conviction generally carries prison time of a year or more, plus fines. Texas makes practicing medicine without a license a felony of the third degree, punishable by 2 to 10 years in prison and a fine of up to $10,000. In Illinois, a person will face a class 4 felony for a first violation and a class 3 felony for a subsequent violation. California makes practicing medicine without a license a wobbler that can be punished as a misdemeanor or felony.
Penalties may vary depending on the circumstances. For instance, it might be a misdemeanor to practice with a delinquent or inactive license but a felony to misrepresent one's credentials. And some actions are even more dangerous or harmful than others. Several states impose harsher—often additional—penalties if the illegal practice of medicine results in someone's financial, physical, or psychological harm. If someone dies as a result of the illegal practice of medicine, more serious charges, such as manslaughter, can apply.
(Cal. Bus. & Prof. Code § 2052; 225 Ill. Comp. Stat. §§ 60/52, 60/54, 60/59; Tex. Occ. Code § 165.152 (2022).)
On top of criminal penalties, state law generally authorizes civil penalties for violations, as well as injunctive remedies. Civil penalties can sometimes accrue on a daily or per-violation basis. For example, Florida authorizes the department of health to issue civil fines of up to $5,000 per incident.
A state attorney, health department, or medical board will also likely seek a cease-and-desist order to stop the person from unlawfully practicing medicine. Continuing to practice unlawfully after receiving the cease-and-desist order may also rack up separate civil penalties for violations.
(Fla. Stat. § 456.065; Tex. Occ. Code §§ 165.051 to .101 (2022).)
If a patient suffers injuries or financial losses, they may be able to sue for damages in court based on negligence, battery, or another civil action. New York law presumes negligence on the part of a person who practiced medicine without a license in any action for damages for personal injuries or death.
(N.Y. C.P.L.R. Law § 4505 (d) (2022).)
Criminal charges for unauthorized practice of medicine are very serious, and any time you are facing an investigation or charge you should consult a local criminal defense attorney. You may also want to speak to a lawyer who defends claims in civil court if you face a lawsuit.