When patients visit the doctor in Pennsylvania, the last thing they might suspect is that their doctor should not be practicing. There are a number of reasons this might happen. One of the most notable is losing their license. Doctors may lose or give up their license for several infractions committed over the lifetime of their practice in a specific state.

USA Today shares a few of those reasons:

  • Had sexual relations with vulnerable patients
  • Committed repeated surgical mishaps
  • Wrote improper opioid prescriptions
  • Sold “snake oil” treatments

The problem rests in the fact that doctors may have terrible records in one state but clean records in another. This may cause a doctor with violations in Connecticut, for instance, to move to Pennsylvania and start a whole new practice under the radar. Neither the state nor his patients may be the wiser.

Doctors seem most able to do this when they surrender their license after multiple infractions rather than face formal hearings. Surrendering a license often does not come with restrictions on practicing elsewhere. So, other states become responsible for judging the practice-worthiness of the doctor.

If this sounds terrifying, there is some good news. Business Insider put together tips to help people complete a background check on their doctors. Start with the State Medical Board. If the doctor mentioned practicing in another state, consider checking there too. For a more centralized search, patients may turn to Healthgrades, which draws on everything from federal information on sanctions to patient reviews.

Patients who suspect that their doctors should not be practicing might want to consider running a full check. If they are due for major surgery or are battling a serious illness, the risks of not doing so may increase.