The intersection of criminal law and professional licensing creates unique challenges that most attorneys do not understand. Attorneys who practice only licensing defense may miss critical criminal law issues. Attorneys who practice only criminal defense may not understand how to protect your license. Very few attorneys practice in both areas.

I’m Pat Ruzzo, and I have spent over thirty-five years defending criminal cases and representing healthcare professionals before licensing boards. This dual focus is not coincidental. It exists because my observations and experience are that these cases cannot be effectively handled separately.

You get arrested for DWI, drug possession, assault, or another criminal offense. You panic and hire a criminal defense attorney to handle the criminal case. That attorney may be very good at criminal defense, but knows little or nothing about nursing licenses, pharmacy licenses, or physician assistant licensing.

Meanwhile, weeks or months later, you receive a letter from your licensing board. The board has been notified of your arrest and is investigating. You now need to respond to the board.

Your criminal defense attorney tells you they do not handle licensing matters. You need a different attorney for that. So you hire a licensing attorney who handles board cases.

Now you have two attorneys who must communicate effectively with each other, understand how each of the cases affect the other, and may be unknowingly pursuing conflicting strategies.

Your criminal attorney negotiates a plea agreement that seems favorable from a criminal perspective. You accept it. Later, you discover that the plea deal triggers automatic license suspension or revocation under board rules. Your criminal attorney may not know this if they do not have experience in professional licensing law.

Or your licensing attorney advises you to provide detailed written responses to the board explaining your conduct and showing remorse. You do so. Then your criminal attorney discovers that the prosecutor has subpoenaed everything you submitted to the board and is using your statements as evidence against you in your criminal case. Your licensing attorney may not anticipate this if they do not practice criminal law.

In practice, healthcare professionals lose their licenses, go to prison, or both if their attorneys did not understand how criminal and licensing cases intersect.

Healthcare licensing cases and criminal cases intersect in numerous ways that create serious problems when attorneys do not understand both areas:

The Burden of Proof Is Different

In a criminal case, the government must prove you are guilty beyond a reasonable doubt. This is the highest standard of proof in our legal system. It means the jury must be convinced to a near certainty that you committed the crime.

In a licensing case, the board must prove violations by a preponderance of the evidence. This means more likely than not, or just over fifty percent. It is a much lower standard.

What this means:

You can be acquitted in criminal court because there was reasonable doubt, but the licensing board can still find that it is more likely than not that you violated board rules and revoke your license.

The reverse is also true. You can lose your criminal case but still save your license if you can show the board that you have been rehabilitated, do not pose an ongoing risk to patients, and have taken steps to address underlying issues.

An attorney who does not understand both standards cannot develop strategy that accounts for both possibilities.

What You Say in One Case Can Be Used in the Other

This is one of the most critical issues that licensing-only attorneys miss.

When you provide detailed written responses to the licensing board explaining what happened, those responses are not privileged. They are not confidential. Prosecutors can subpoena them and use them as evidence in your criminal case.

I have seen cases where there was initially no criminal case, only a licensing board investigation. The healthcare professional provided detailed statements to the board investigators thinking this would help resolve the matter. Those statements included admissions about conduct that can be an admission. Prosecutors then subpoenaed those statements from the board and filed criminal charges based on the healthcare professional’s own admissions.

An attorney who practices only licensing defense may not anticipate this. They may not understand how criminal cases are built or what evidence prosecutors need.

Certain Plea Agreements Trigger Automatic License Sanctions

Many licensing board rules include provisions for automatic sanctions based on criminal convictions. For certain offenses, the board must suspend or revoke your license. There is no discretion.

For other offenses, there may be mandatory waiting periods before you can even apply for reinstatement. You might be prohibited from holding a license until the fifth anniversary of completing probation or confinement.

These rules are complex and vary by licensing board and by offense. An attorney who does not practice both criminal defense and licensing law may not know which plea agreements will trigger automatic sanctions and which provide flexibility.

I have seen cases where a healthcare professional entered a plea agreement that seemed good from a criminal standpoint but resulted in automatic license revocation. A different plea to a different offense could have preserved the possibility of keeping the license, but the criminal attorney apparently did not know to negotiate for and structure the agreement that way.

Timing and Sequencing Matter

Decisions about which case to address first, when to negotiate, and when to go to trial can significantly affect outcomes in both proceedings.

Sometimes it makes sense to resolve the criminal case first to remove uncertainty and demonstrate to the board how the criminal matter was handled. Other times, it makes sense to address the licensing case first or simultaneously. These strategic decisions require understanding both areas of law.

Investigation Can Be Coordinated or Duplicated

When you have competent representation in both areas from the same attorney, investigation can be coordinated efficiently. Witness interviews, record gathering, and evidence analysis serve both cases.

When you have separate attorneys, investigation may be duplicated, costing you more money, or worse, one attorney may not investigate thoroughly because they assume the other attorney is handling it.

The Stakes Are Different But Equally High

Your criminal case threatens your freedom. Your licensing case threatens your career and livelihood. Both matter enormously.

An attorney who practices only criminal defense may not appreciate how devastating license loss would be and may structure plea agreements that protect your freedom but destroy your career.

An attorney who practices only licensing defense may not appreciate the severity of potential criminal penalties and may advise strategies that help the licensing case but create additional criminal exposure.

You need an attorney who understands that both your freedom and your license matter and can develop strategies that protects both.

My thirty-five years of criminal defense experience directly benefits my clients in licensing cases in numerous ways:

I Understand How Prosecutors Think and Build Cases

Prosecutors build criminal cases by gathering evidence, interviewing witnesses, and looking for admissions. I know what evidence they need and what weaknesses they look for.

This knowledge informs how I advise clients to respond to licensing board investigations. I know which statements could be used criminally and how to structure licensing responses that protect against criminal exposure while still addressing board concerns.

I Know When to Talk and When to Remain Silent

One of the most important decisions in any case is when to provide statements and when to exercise the right to remain silent.

Licensing boards often pressure healthcare professionals to provide detailed written responses and participate in voluntary interviews. Investigators make it sound like cooperation is expected and will help.

Sometimes providing information is appropriate. Other times, it creates more problems than it solves. My criminal defense experience allows me to evaluate when statements help and when they hurt.

I Can Identify Criminal Exposure in Licensing Allegations

When I review licensing board allegations against my clients, I immediately seek to identify potential criminal exposure.

If a nurse is accused of diverting drugs from a hospital, I know that can also result in a criminal charge for theft, possibly burglary, and potentially drug possession. I know which evidence would be needed to prove those crimes and how to evaluate which to present evidence to the board.

If a pharmacist is accused of prescription fraud, I know the potential federal and state criminal charges that could follow. I can structure the licensing response to attempt to avoid creating additional criminal exposure.

An attorney who practices only licensing defense may not see these criminal implications until it is too late.

I Can Structure Plea Agreements That Protect Licenses

When negotiating criminal plea agreements, I know which offenses trigger automatic licensing sanctions and which provide flexibility.

I can negotiate  pretrial diversion or deferred adjudication instead of conviction when possible. I can negotiate for specific offenses that do not trigger mandatory license revocation. I can structure agreements that preserve the possibility of license reinstatement after a waiting period rather than permanent prohibition.

This requires knowing both criminal law and licensing board rules, and very few attorneys have this knowledge.

I Can Evaluate Whether Fighting or Negotiating Is Better

Criminal cases present strategic decisions about whether to fight charges at trial or negotiate plea agreements. The same is true for licensing cases. Sometimes fighting is the right strategy. Sometimes negotiation serves clients better.

My trial experience in criminal cases informs these decisions. I know the types of evidence that are persuasive to juries and judges. I know when cases are strong and when they are weak. I can evaluate realistically whether fighting or negotiating will produce better outcomes.

Very few attorneys practice both criminal defense and professional licensing defense. Most attorneys focus on one or the other.

Criminal defense attorneys develop expertise in criminal procedure, evidence rules, trial advocacy, and negotiation with prosecutors. But they probably do not know about licensing boards, administrative procedure, or how professional license eligibility and discipline processes work.

Licensing attorneys develop expertise in administrative law, licensing board rules and procedures, and representing professionals before regulatory agencies. But they probably do not have experience in criminal law, criminal procedure, or how to defend criminal cases.

Healthcare professionals facing both criminal charges and licensing discipline need an attorney who has developed expertise in both areas. This is rare but essential.

My Dual Focus Practice

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My practice focuses on representing healthcare professionals facing criminal charges and licensing board discipline because I have developed expertise in both areas.

I have defended over two hundred criminal jury trials involving charges ranging from DWI to murder. I understand criminal law, criminal procedure, and trial advocacy.

I have also advised nurses, pharmacists, physician assistants, and other healthcare professionals with licensing issues. I understand administrative law, licensing board procedures, and how to protect professional licenses.

This combination allows me to provide coordinated representation that protects both your freedom and your license. I can develop strategy that accounts for both proceedings, structure criminal resolutions that preserve licensing possibilities, and defend against licensing discipline while protecting against criminal exposure.