As indicated above, in certain circumstances, an ALJ or state medical board can make a decision without conducting a hearing. Whether this is a possibility depends on the specific rules and procedures in your state. Additionally, if you have a hearing scheduled and you fail to appear, then the ALJ can enter the equivalent of a default judgment and take adverse licensing action based upon the allegations against you.
When facing disciplinary action as a doctor, you need to do everything possible to protect your license. You need to request a hearing if it is necessary to do so, and you need to make sure you appear fully prepared to defend against the allegations at hand. You have the right to legal representation during your ALJ hearing, and it is strongly in your best interests to engage an experienced medical license defense attorney to develop and execute a strategic defense on your behalf.