Paul has held a state-issued medical license since moving to Bowling Green in 1993. He received his first job from Dr. John Downing of Downing McPeak Vision Centers, which brought him to Bowling Green after completing his residency. Paul worked for Downing for about five years before parting ways. Afterwards, he went to work at the Gilbert Graves Clinic, a private medical group in Bowling Green, for 10 years before creating his own practice in a converted one-story house across the street from Downing's office. After his election to the U.S. Senate, he merged his practice with Downing's medical practice. Paul has had two malpractice lawsuits filed against him since 1993; was cleared in one case and the other was settled for $50,000. Regardless, his medical work has been praised by Downing and he has medical privileges at two Bowling Green hospitals. Paul specializes in cataract and glaucoma surgeries, LASIK procedures, and corneal transplants.
In 1995, Paul passed the American Board of Ophthalmology (ABO) boards on his first attempt and earned board-certification under the ABO for a decade. In 1997, to protest the ABO's decision to grandfather in older ophthalmologists and not require them to recertify, Paul, along with 200 ophthalmologists formed the National Board of Ophthalmology (NBO). Paul's ophthalmology board is not officially recognized by the American Board of Medical Specialties (ABMS). The NBO was incorporated in 1999, but he allowed it to be dissolved in 2000 after not filing the required paperwork with the Kentucky Secretary of State's office. Paul later recreated the board in September 2005, three months before his certification from the ABO was scheduled to expire. His ABO certification lapsed on December 31, 2005. Paul has since been certified by the NBO.
As a member of the Bowling Green Noon Lions Club, Paul founded the Southern Kentucky Lions Eye Clinic to help provide eye surgery and exams for those who cannot afford to pay. He is a regular presenter at the annual Men's Health and Safety Day conference held by The Medical Center of Bowling Green since 1998.
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