Road rage

It was a 95-degree day in July 2015, and emergency physician Martin Maag, MD, was driving down Bee Ridge Road, a busy 7-lane thoroughfare in Sarasota, Florida, on his way home from a family dinner. To distance himself from a truck blowing black smoke, Maag says he had just passed some vehicles, when a motorcycle flew past him in the turning lane and the passenger flipped him off. 

"I started laughing because I knew we were coming up to a red light," said Maag. "When we pulled up to the light, I put my window down and said, 'Hey, you ought to be a little more careful about who you're flipping off! You never know who it might be and what they might do.' " 

The female passenger cursed at Maag, and the two traded profanities. The male driver then told Maag, "Get out of the car, old man," according to Maag. Fuming, Maag got out of his black Tesla, and the two men met in the middle of the street.

"As soon as I got close enough to see him, I could tell he really looked young," Maag recalls. "I said, 'You're like 12 years old. I'm going to end up beating your ass and then I'm going to go to jail. Go get on your bike, and ride home to your mom.' I don't remember what he said to me, but I spun around and said, 'If you want to act like a man, meet me up the street in a parking lot and let's have at it like men.' " 

The motorcyclist got back on his white Suzuki and sped off, and Maag followed. Both vehicles went racing down the road, swerving between cars, and reaching speeds of 100 miles per hour, Maag says. At one point, Maag says he drove in front of the motorcyclist to slow him down, and the motorcycle clipped the back of his car. No one was seriously hurt, but soon Maag was in the back of a police cruiser headed to jail. 

Maag wishes he could take back his actions that summer day 6 years ago. Those few minutes of fury have had lasting effects on the doctor's life. The incident resulted in criminal charges, a jail sentence, thousands of dollars in legal fees, and a 3-year departure from emergency medicine. Although Maag did not lose his medical license as a result of the incident, the physician's Medicare billing privileges were suspended because of a federal provision that ties some felonies to enrollment revocations. 

Maag, 61, shared his story with Medscape to warn other physicians about the wide-ranging career ramifications that can happen as a result of offenses unrelated to medicine… 

Maag ultimately accepted a plea deal from the prosecutor's office and pled no contest to one count of felony criminal mischief and one count of misdemeanor reckless driving. In return, the state dropped the two more serious felonies. A no contest plea is not considered an admission of guilt...

The plea deal was a favorable result for Maag considering his original charges, Fayard said. He added that the criminal case could have ended much differently...

With the plea agreement reached, Maag faced his next consequence — jail time. He was sentenced to 60 days in jail, a $1000 fine, 12 months of probation, and 8 months of house arrest. Unlike his first jail stay, Maag said the second, longer stint behind bars was more relaxing. 

"It was the first time since I had become an emergency physician that I remember my dreams," he recalled. "I had nothing to worry about, nothing to do. All I had to do was get up and eat. Every now and then, I would mop the floors because I'm kind of a clean freak, and I would talk to guys and that was it. It wasn't bad at all."

Maag told no one that he was a doctor because he didn't want to be treated differently. The anonymity led to interesting tidbits from other inmates about the best pill mills in the area for example, how to make crack cocaine, and selling items for drugs. On his last day in jail, the other inmates learned from his discharge paperwork that Maag was a physician...

About the time that Maag was released from jail, the Florida Board of Medicine learned of his charges and began reviewing his case. Fayard presented the same facts to the board and argued for Maag to keep his license, emphasizing the offenses in which he was convicted were significantly less severe than the original felonies charged. The board agreed to dismiss the case… \

Once home, Maag was on house arrest, but he was granted permission to travel for work. He continued to practice emergency medicine. After several months, authorities dropped the house arrest, and a judge canceled his probation early. It appeared the road rage incident was finally behind him…

But a year later, in 2018, the doctor received a letter from the Centers for Medicare & Medicaid Services (CMS) informing him that because of his charges, his Medicare number had been revoked in November 2015.

"It took them three years to find me and tell me, even though I never moved," he said. "Medicare said because I never reported this, they were hitting me up with falsification of documentation because I had signed other Medicare paperwork saying I had never been barred from Medicare, because I didn't know that I was."

 

Maag hired a different attorney to help him fight the 3-year enrollment ban. He requested reconsideration from CMS, but a hearing officer in October 2017 upheld the revocation. Because his privileges had been revoked in 2015, Maag's practice group had to return all money billed by Maag to Medicare over the 3-year period, which totaled about $190,000…

 

Maag went through several phases of fighting the revocation, including an appeal to the US Department of Health and Human Services Departmental Appeals Board. He argued that his plea was a no-contest plea, which is not considered an admission of guilt. Maag and his attorney provided CMS a 15-page paper about his background, education, career accomplishments, and patient care history. They emphasized that Maag had never harmed or threatened a patient, and that his offense had nothing to do with his practice…

Unable to practice emergency medicine and beset with debt, Maag spiraled into a dark depression. His family had to start using retirement money that he was saving for the future care of his son, who has autism.

 

Slowly, Maag climbed out of the despondency and began considering new career options. After working and training briefly in hair restoration, Maag became a hair transplant specialist and opened his own hair restoration practice. It was a way to practice and help patients without having to accept Medicare. Today, he is the founder of Honest Hair Restoration in Bradenton. Hair restoration is not the type of medicine that he "was designed to do," Maag said, but he has embraced its advantages, such as learning about the business aspects of medicine and having a slower-paced work life. The business, which opened in 2019, is doing well and growing steadily.

Earlier this month, Maag learned CMS had reinstated his Medicare billing privileges. If an opportunity arises to go back into emergency medicine or urgent care, he is open to the possibilities, he said, but he plans to continue hair restoration for now. He hopes the lessons learned from his road rage incident may help others in similar circumstances.  

 

"If I could go back to that very moment, I would've just kept my window up and I wouldn't have said anything," Maag said. "I would've kept my mouth shut and gone on about my day. Would I have loved it to have never happened? Yeah, and I'd probably be starting my retirement now. Am I stronger now? Well, I'm probably a hell of a lot wiser. But when all is said and done, I don't want anybody feeling sorry for me. It was all my doing and I have to live with the consequences."

https://www.medscape.com/viewarticle/953594