While procedures vary from state to state, in many cases it will be possible to settle allegations pending before a medical board ALJ. If the allegations against you can be substantiated (and it is therefore not possible to avoid sanctions entirely), then it may be in your best interests to work with your defense counsel to negotiate a settlement. This avoids the uncertainty of going to a decision following your ALJ hearing, and it affords you the opportunity to have a say in the sanctions that are imposed. In many cases, proactively approaching settlement prior to or during an ALJ hearing can result in a significant reduction in sanctions compared to what might otherwise be imposed.