Like all professionals, physicians can become the target of civil, criminal, regulatory or administrative actions by law enforcement, prosecutorial and regulatory authorities. Unlike many other professionals, however, physicians are subject to an adverse action reporting system at both the state and federal level. A physician in New York who enters into a guilty plea, signs a consent order with the New York Office of Professional Medical Conduct (OPMC), settles a civil suit brought by a state or federal government regulatory authority, or resigns from a hospital's medical staff while under investigation, can face significant and often wholly unexpected additional penalties.