State Member Board Briefs

Medical Board to Address Physician Shortage

The Guam Board of Medical Examiners is actively working to coordinate several competing proposals aimed at addressing the island's physician shortage, including pathways that could bring foreign-trained doctors to work at government facilities. The coordination effort comes as multiple legislative proposals circulate for expanding licensure pathways for international medical graduates. Board Chair Dr. Nathaniel Berg said during a November meeting that the board will meet with representatives from the governor's office as part of ongoing discussions about potential solutions. He, along with Dr. Ricardo Eusebio and Vice Chair Dr. Joleen Aguon, was set to take part in those discussions.

"The idea right now is to get moving," Berg said during the meeting. "Have a meeting; see if everybody's on board and has the same concept."

Further information is available at https://www.postguam.com/news/local/medical-board-weighing-proposals-to-address-shortage-of-physicians/article_0f77fb32-b34f-4cc2-8c67-da2944ebefb2.html

PA Autonomy Reform Shows Decline in Disciplinary Actions

In 2019, North Dakota became the first state in the nation to enact legislation granting physician assistants (PAs) the ability to practice without a state-mandated supervisory agreement. This reform shifted the regulatory model from supervision to collaboration, empowering PAs to practice to the full extent of their education and training within defined practice settings. With five years of post-reform data available, the Board is releasing a report that communicates the impact of these changes on patient safety and professional accountability. The report shows that North Dakota's 2019 PA autonomy reforms have coincided with a notable decline in formal disciplinary actions, even as the PA workforce has grown by nearly 25%. While complaint rates have seen a modest increase, the vast majority were dismissed without formal action, and no malpractice cases were reported in the five years following the reform. These findings suggest that expanded autonomy for PAs can be implemented without compromising patient safety.

Source: https://www.ndbom.org/userfiles/files/2025%20October%20Newsblast.pdf

Interdisciplinary Group Provides Clarity on IV Hydration Therapy

Wisconsin has seen an increase in intravenous (IV) hydration therapy business. Specifically, the Wisconsin Department of Safety and Professional Services (DSPS) has experienced increasing questions from license holders and the public regarding practice in IV hydration businesses, which differ from traditional clinical healthcare settings. In October 2025, the Interdisciplinary Advisory Committee (IAC) met and unanimously adopted comprehensive guidance on the practice of IV hydration therapy. Participating boards independently reviewed and approved the guidance.

"Laws and regulations regarding the operation of these businesses are not specific to any one profession," said IAC Chair Doug Englebert, who also serves as Chair of the Wisconsin Controlled Substances Board. "They cover pharmacy, nursing, and physician practices. That's why the IAC was formed, to help licensees understand how existing laws and regulations that govern individual practices apply in new, unconventional settings."

The IAC guidance for IV businesses/clinics does not include any new laws or rules but clarify how existing laws and rules apply to this emerging practice. The Committee's guidance breaks down the practices occurring at IV therapy businesses into three stages: patient assessment, compounding of IV cocktails, and administration of the treatment. Specific guidance includes details on who can perform which functions and what safeguards should be in place. The guidance on IV hydration therapy will be posted on the IAC page of the DSPS website. DSPS administers Wisconsin's professional regulatory boards and formed the IAC just over a year ago in response to a rising number of concerns and practice questions related to new ways to deliver health care. As part of its work, the Committee researched how other states were regulating practices at these businesses and gathered public input to help shape the final guidance. The IAC's next focus will be on the emergence of the administration of ketamine.

Further information is available at https://dsps.wi.gov/Documents/NewsMedia/20251024IV_TherapyGuidanceNewsRelease.pdf