A US court has rejected Conrad Murray's bid to have his conviction for the involuntary manslaughter of Michael Jackson overturned.
The Los Angeles appeal court ruled there was substantial evidence of guilt laid out at his trial in 2011.
Murray was sentenced to four years in jail, but was released last October after serving two years of his term.
The ex-medic was convicted of administering a lethal dose of an anaesthetic drug to Jackson in 2009.
In a ruling amounting to 68 pages, the court said the pop star "was a vulnerable victim and that [Murray] was in a position of trust, and violated the trust relationship by breaching standards of professional conduct in numerous respects".
The court also said that imposing the maximum sentence of four years at the original trial was right, as the evidence revealed a "callous disregard" for the singer's health and safety.
They added that it was clear that Murray "administered a number of dangerous drugs to Mr. Jackson without the appropriate medical equipment, precautions or personnel in place".
Their ruling also concluded that Murray had been wrong to leave Jackson unattended at the time.
Murray's appeal argued that the trial judge had excluded jurors from hearing evidence.
It was also argued that the judge quashed attempts by Murray's lawyers to introduce arguments about other doctors who had treated Jackson.
His legal representative Valerie Wass said that Murray's intention is to take the matter to a higher court.
In a separate development, the insurers of Jackson's This Is It tour have settled with the late singer's estate over a policy amounting to $17.5m (£10.1m).
The wrangle over the matter was due to go to trial next month.
The policy was taken out to insure against postponement or cancellation of the series of London concerts. Jackson died of a drugs overdose while preparing for the shows.
Lloyd's of London had asked for the policy to be declared null and void, saying they were not told that the star was taking powerful medication.
Details of the settlement have not been disclosed.
A series of legal cases have taken place since Jackson's death more than four years ago.
Earlier this week, his family's bid to launch a second wrongful death trial against concert promoters AEG Live was turned down.
The company were responsible for hiring Murray as Jackson's personal physician.
In the first trial in October, the jury concluded that the former doctor had been fit for the job when he was originally employed.