California
Medical Board Web Page Helps Physicians and Patients Understand California's New ‘Death with Dignity’ Law
The Medical Board of California has launched a new web page that provides comprehensive information for physicians and patients about California's End of Life Option Act, a new “death with dignity” law that allows terminally ill patients to request aid in dying under certain conditions. The law was passed by California's legislature and went into effect in June 2016.
More and more health organizations are turning away from the term “suicide” to describe a terminally ill patient's choice to reduce his or her suffering prior to an anticipated death. California's new legislation allows patients to ask for a prescribed life-ending medication, which in California is called “aid-in-dying medication.”
Among the resources at the Board's new web page is information that helps physicians and patients understand what they need to do in order to comply with this new law. Among its provisions, the law requires that the patient make a request for an aid-in-dying medication to his or her “attending physician.” The law specifically defines an “attending physician” as the physician who has primary responsibility for the health care of an individual and treatment of the individual's terminal disease. Any physician performing these services must meet this definition and must follow the requirements set forth in the Act. If a physician chooses to refer his or her patient to another physician, the new physician must meet the definition of an “attending physician” in order to fulfill the patient's request for an aid-in-dying drug.
CALIFORNIA'S NEW LEGISLATION ALLOWS PATIENTS TO ASK FOR A PRESCRIBED LIFE- ENDING MEDICATION, WHICH IN CALIFORNIA IS CALLED ‘AID-IN-DYING MEDICATION.’
All forms required by the law are available through the Board's web page, including links to forms that must be filed with the California Department of Public Health and must also be included in the patient's medical record. These include the Attending Physician Checklist and Compliance Form, the Consulting Physician Form, the Patient's Request for Aid-in-Dying Drug, and several other forms.
The web page also provides the Board's analysis of the California legislation, and an overview of it by an expert in psychiatry and behavioral health. Links to a variety of other resources are also provided.
To view the web page, please visit www.mbc.ca.gov/Licensees/Physicians_and_Surgeons/End_of_Life.aspx.
Source: Medical Board of California Newsletter, Summer 2016
Georgia
Board Responds to Hurricane Matthew, Authorizes Temporary Licenses for Physicians
The Georgia Composite Medical Board announced during its October 2016 meeting that temporary licenses would be approved and issued to physicians licensed in good standing in Florida or South Carolina whose patients were evacuated to Georgia.
Physicians licensed in good standing in Florida or South Carolina whose patients are evacuated to Georgia as a result of Hurricane Matthew will be issued the temporary license upon making application for Georgia licensure. The temporary license will become void November 4, 2016, the date of the next regular meeting of Georgia's Board. A physician who has been issued a temporary license under Board's specific circumstances will be permitted to withdraw his or her application without penalty after the disaster.
Source: Georgia Composite Medical Board website, Oct. 7, 2016
Annual Report Summarizes Board Licensure and Discipline Activities for 2015
The Georgia Composite Medical Board issued 4,652 new licenses in Fiscal Year (FY) 2015, an increase of more than 20% from the previous year, and it processed 23,078 renewal applications, according to the Board's 2015 Annual Report.
The majority of new licenses issued in FY 2015 were for physicians (2,321), followed by assistant laser practitioners (469) and physician assistants (448).
DURING FY 2015, THE BOARD RECEIVED AND OPENED 1,550 NEW COMPLAINTS. THIS COMPARES WITH 1,771 COMPLAINTS IN FY 2014 AND 1,729 COMPLAINTS IN FY 2013.
The Board also issued 724 temporary residency training permits. Georgia also issues licenses for respiratory care professionals, acupuncturists, perfusionists, and several other categories.
The number of new physician-licensees have increased significantly in Georgia in recent years, according to the Board, growing from 1,648 in FY 2012 to 2,321 in FY 2015.
During FY 2015, the Board received and opened 1,550 new complaints. This compares with 1,771 complaints in FY 2014 and 1,729 complaints in FY 2013. During FY 2015, the Board issued 50 public sanctions against 48 licensees through various dispositions, including public reprimands, probation, revocation and others.
The Board's total budget in FY 2015 was $2,402,124. The Board notes in its report that during the year, it collected “nearly three times that amount in fees, which were turned over to the state's treasury — a return on investment of 190.8%.”
Source: Georgia Composite Medical Board 2015 Annual Report
Iowa
New Rule Establishes Minimum Standards for Supervision of Physician Assistants
The Iowa Board of Medicine has adopted a new administrative rule to provide more guidance to physicians who supervise physician assistants.
The rule, which establishes minimum standards for appropriate supervision, reinforces that while a supervising physician will be held accountable for the care of a patient diagnosed and treated by a physician assistant, the supervising physician does not have to be continually present when a physician assistant performs the delegated medical services.
A physician who agrees to supervise a physician assistant must review the requirements of physician assistant licensure and regulation and must assess the education, training, skills and experience of the physician assistant before delegating medical services. The rule requires the supervising physician to be available for timely consults with the physician assistant and to conduct and document an ongoing review of a representative sample of the physician assistant's patient charts. The rule also mandates regular meetings between supervising physicians and physician assistants in remote clinics — where physicians may not always be present — to assess and discuss the medical services provided by the physician assistant.
A physician assistant in Iowa cannot practice without a supervisory relationship with a physician. In a news release, the Board said that “questions about what constitutes appropriate supervision have persisted since the 1980s when the licensure and regulation of physician assistants was moved from the Board of Medicine to a new Board of Physician Assistants.”
According to the Board, the uncertainty about supervisory standards has “caused confusion among health care systems and patients about the responsibilities and the accountabilities of both the physician and the physician assistant.”
“In addition, physicians have expressed reluctance to supervise physician assistants due to this ambiguity,” the Board said.
According to the Board, approximately 17 percent of physicians practicing in Iowa report supervising at least one physician assistant. Since 2012, a physician has been allowed to supervise up to five physician assistants at the same time.
In 2015, Iowa's legislature directed the state's Boards of Medicine and Physician Assistants to address the supervisory ambiguity by jointly establishing specific minimum standards or a definition of supervision.
Earlier this year, subcommittees of both boards reached consensus on a rule establishing specific minimum standards for appropriate supervision and this rule was subsequently adopted by the Board of Medicine and became effective on June 15.
Source: Iowa Medical Board news release, August 16, 2016
Ohio
Ohio Legalizes Medical Marijuana; New Website Keeps Ohio Physicians Up to Date
Ohio House Bill 523, effective on September 8, 2016, legalized medical marijuana in Ohio. The Ohio Medical Marijuana Control Program has now been established to allow people with certain medical conditions, upon the recommendation of an Ohio-licensed physician certified by the State Medical Board, to purchase and use medical marijuana.
THE OHIO MEDICAL MARIJUANA CONTROL PROGRAM HAS NOW BEEN ESTABLISHED TO ALLOW PEOPLE WITH CERTAIN MEDICAL CONDITIONS TO PURCHASE AND USE MEDICAL MARIJUANA.
While the legislation set a basic framework for the program, it left the task of establishing specific rules and guidelines for the cultivation, processing, testing, dispensing and medical use of marijuana to different state agencies. A new website has been established, designed to keep Ohioans informed about the development of Ohio's Medical Marijuana Control Program, including important timelines and the announcement of opportunities for public input. Visit http://medicalmarijuana.ohio.gov/ to learn more.
Source: Ohio Medical Marijuana Control Program website, Oct. 17, 2016
Oregon
Oregon Board Amends Rules Regarding Physician Assistants and Supervising Physicians
After a two-year rulemaking process, the Oregon Medical Board is amending rules regarding physician assistants (PAs) and supervising physicians. One important change in Oregon now allows supervising physicians and PAs to communicate by means other than telephone. According to the Board, this expansion in communication methods “enables health care teams to use new technology for real-time conversations.”
The changes in Oregon's rules also impact supervising physician organizations (SPOs). For the first time, the primary supervising physician's role is defined as providing administrative direction; the primary supervising physician may provide clinical supervision. This new definition provides greater flexibility for the team by allowing the other supervising physicians within the SPO to share the clinical supervision responsibilities. This shift will now require that all new supervising physicians in an SPO apply to be Board-approved supervisors before supervising PAs.
The rule changes in Oregon became effective September 1, 2016. To learn more, please visit http://omb.oregon.gov/rules.
Source: Oregon Medical Board Report, Summer 2016
Pennsylvania
Pennsylvania Drug Monitoring Program Implemented
The Pennsylvania Department of Health recently announced the implementation of the Pennsylvania Prescription Drug Monitoring Program (PA PDMP), an initiative to address opioid abuse in the state. All prescribers (including those licensed as “active retired”) in Pennsylvania who prescribe a controlled substance must now be registered with the PA PDMP system. In addition, all prescribers must access and search the PA PDMP system for each patient when the patient is prescribed a controlled substance for the first time, and/or when there is a clinical concern that the patient may be suffering from the disease of addiction or diverting a controlled substance.
The Pennsylvania PDMP Portal, PA PMP AWARxE, is a gateway for prescribers, pharmacists, and their delegates to look up their patients' controlled substance prescription history before prescribing or dispensing. A prescriber may grant access to any delegate under their employment or supervision to query the system on their behalf.
To access PA PMP AWARxE, visit pennsylvania. pmpaware.net. For more information about Pennsylvania's PDMP regulations, please visit www.doh.pa.gov/PDMP.
Source: Pennsylvania Department of Health website, Sept. 27, 2016
Texas
Director of Texas Medical Board Resigns to Accept New Position with University of Texas
Longtime Texas Medical Board Executive Director Mari Robinson, JD, has resigned to accept a position directing the telehealth activities of the University of Texas Medical Branch. Scott Freshour, the Board's General Counsel, will serve as interim Executive Director as the Board seeks to fill the vacated position. In her new role, Robinson will guide University of Texas telehealth development across the university's various health outlets in Texas.
The Texas Medical Board, which is headquartered in Austin, Texas, is now accepting applications for the executive director position. For more information, call (512) 305-7030.
Sources: Politico, October 17, 2016; and LinkedIn, October 17, 2016
Washington
Guidelines Published in Washington to Help Improve Communication Between Practitioners and Patients
The Washington Medical Quality Assurance Commission has published a formal guideline intended to help health care practitioners communicate more effectively with their patients — a goal it says will help prevent complaints it receives, while improving patient care.
Titled “Communication with Patients, Family, and the Health Care Team,” the guideline was developed as an outgrowth of studies that show communication is often a key factor in patient health outcomes and overall satisfaction.
The guideline provides a set of principles physicians should fall back on when communicating with patients, including ideas for greeting and interviewing patients, handling difficult patients, communicating with seriously ill patients and how to develop proactive communication training for staff who interact with patients.
The guideline also provides links to resources that can help physicians become better communicators. To learn more, visit http://go.usa.gov/xWqyC.
Source: State of Washington Medical Quality Assurance Commission website
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