ALABAMA
BOARD ENCOURAGES PREVENTION
Almost every problem physicians encounter that bring them before the Alabama Board of Medical Examiners and the Medical Licensure Commission could have been prevented. It appears, however, that as conscientious as physicians might be at recommending self-care for their patients, they are not always very good at providing it for themselves.
Weardown and burnout are common these days and are thought to be chief among the causes of impairment related conditions. The best prevention for physician burnout is to promote personal and professional well-being on all levels: physical, emotional, psychological and spiritual. This must occur throughout the professional life cycle of physicians, from medical school through retirement. It’s been suggested that the majority of our experience has been with “impaired physicians” and as a result we know much about physicians’ disease and despair, their substance misuse, burnout, and dysfunctional relationships, but very little about what keeps them feeling well.
The Board of Medical Examiners through its Impaired Physicians Committee has developed a new independent nonprofit corporation, the Caduceus Foundation. The purpose of the new foundation is to “promote physician well being.” The foundation’s goal is to accomplish this in several ways:
Fund research to better understand physician stressors and how to improve physician health;
Promote educational programs and workshops on topics such as “Finding Balance” and others and to promulgate information on physician health; and
To develop a fund that will assist individual physicians in crisis.
Reprinted from Volume 21 Number 1, of the Alabama State Board of Medical Examiners Newsletter and Report, published by the Alabama State Board of Medical Examiners.
ALASKA
licensees should Beware of Third Party License Renewal Companies
The Alaska State Medical Board has become aware of third party license renewal services that are contacting physicians by e-mail regarding their medical license renewals. They are particularly focusing on physicians in states that allow for online renewals. The Oklahoma State Board of Medical Licensure and Supervision has reported one of its physicians recently was contacted by an online service offering to file his medical license renewal for him. The physician mistakenly believed the e-mail was from the board, completed the application and was charged $495 by a company called Medlicense.com. The fee charged was over and above the licensing fee charged by the board. The mistake was found only after the board contacted the physician because his renewal application was late. Had the physician renewed his license directly with the board, the renewal fee would have been $150. Because he used this service, he paid a total of $644 for the renewal.
The site states it will complete all licensure forms for renewal in all 50 states and is located at http://www.medlicense.com. This business and others like it are in no way connected to any state licensing board, including Alaska. Please be aware of these third party services and if you elect to use such a service for the renewal of your license instead of the state board’s official website and forms, you do so at your own risk and are responsible for any inaccuracies or missed deadlines that may result. We urge our license holders to only use the Alaska State Medical Board’s website and official forms when conducting business with the board.
Reprinted from the Alaska State Medical Board’s BoardNews Bullets.
ARIZONA
A New Definition for Public Information
During its session earlier this year, the Arizona Legislature approved a bill modifying the information the Arizona Medical Board may provide on its website. The number of “open investigations” for a specific physician is no longer “public information.” Confidentiality laws prohibit the release of information about a complaint until the board finishes the investigation and adjudicates the case. Case information regarding board-ordered discipline and non-disciplinary action will still be available to the public and posted in a physician’s Web profile.
Medical Board Suspends Its Recommendations for P.A. Supervision
While standing by its original analysis, the board decided on Oct. 12 to suspend its recommendations regarding P.A. supervision approved at its Sept. 7 meeting in Tucson. The board’s decision was based on comments from the P.A. community and other stakeholders. Four board members volunteered to serve on a committee to study the matter further. The committee will consider the roles of both the supervising physician and the supervising physician’s agent.
Medical Board Seeks Informal Comment on Draft Rules for Office-Based Surgery
The board has begun the process of making rules to provide standards for office-based surgery conducted in a physician’s office or other outpatient setting that is not part of a licensed hospital or licensed outpatient surgical center. These rules would affect the board, a licensed physician who performs office-based surgery, a health care professional, staff member and a patient. The board believes that most licensed physicians who are currently performing office-based surgery using sedation already follow the provisions in the draft rules. The board believes that providing clear and understandable rules protects physicians, staff members, health care professionals and patients. The informal comment period ended Oct. 13. Once the board accepts the draft, the formal comment period will begin.
Reprinted from the Arizona Medical Board website.
NEW MEXICO
Rule Change Update
The board has been working on revising, updating and adding rules, always with the intention of making the licensing process more efficient and the disciplinary process more transparent, all the while working to protect the health and safety of the public. There are four areas of recent change — all of these draft rule proposals have been approved by the board, and are now in the formal public comment period. The board made final decisions at the May 18, 2006 meeting. The complete proposed rule changes can be found at http://www.nmmb.state.nm.us. Here are some highlights:
Physician Assistants (16.10.15)
Change the language on P.A. renewal and expiration language to match the language for M.D.s. This seems to be an area of constant confusion! P.A. licenses must be renewed by March 1 of the year following NCCPA expiration. The current rule states that licenses not renewed by March 1 are considered expired; but it also says that P.A.s have until May 30 to renew their licenses and pay a late penalty. The proposed change will remove the March 1 expiration, allow late renewals and retain the May 30 summary suspension for non-renewal.
It is not the board’s intent to encourage late renewals. The purpose of this change is to avoid excessively burdening licensees who face unusual or unexpected delays. A second proposed change to the P.A .rules would allow currently licensed P.A.s up to one year to pass the NCCPA re-certification exam. Current rules require NCCPA certification in order to renew a P.A. license, but on occasion a licensee may not be able to take the December re-certification exam, or may fail that exam. This proposed change would give P.A.s one year to remedy the situation and come back into compliance with board rules.
Criminal Background Checks
The Medical Practice Act provides statutory authority for the board to conduct criminal background checks on applicants and licensees, but the board has never developed a rule for implementing that authority. The board now proposes to run nationwide criminal background checks on all new applicants, requiring fingerprints and an additional fee. Statewide checks will be run on all renewing licensees. The board does not want to slow licensing or renewal times, however, so applications can be granted and licenses renewed while the background checks are pending.
Medical Records (16.10.17)
The board has been working for nearly a year now on developing a rule regarding management and retention of medical records, and we think we’re finally “there.” The proposed rule will establish reasonable fees for record copying, a time frame for retention of records and guidelines for closing or selling a practice.
Reprinted from Volume 11, Issue 1, of Information & Report, published by the New Mexico Medical Board.
NORTH CAROLINA
Medical Board Powers Approved by Legislature
Robert C. Moffatt, M.D., president, and R. David Henderson, executive director, of the North Carolina Medical Board, announced the North Carolina General Assembly adopted significant changes to the Medical Practice Act (MPA) that will strengthen the board’s authority to regulate medicine in North Carolina. With the governor’s signature, the changes became effective Oct. 1, 2006.
Under current law, the board has limited disciplinary options. Under the revised law, the board will have greater flexibility with additional disciplinary options, such as probation (with or without conditions), public reprimands, monetary penalties, public letters of concern, free medical services and completion of treatment programs or training designated by the board.
The board is concerned about license applicants who have not practiced medicine for more than two years. The revised law will allow the board to deny a license to applicants who have been out of practice more than two years or impose conditions on reentering the practice of medicine.
The board depends on North Carolina physicians to review patient records related to possible substandard care and reports of malpractice payments. Under the revised law, reviewers’ opinions will be immune from civil liability so long as they are made in good faith, without fraud or malice. The reviewer’s identity will be protected unless there is a hearing at which the reviewer testifies.
The entire board (12 members) now conducts license denial and disciplinary hearings. This limits the number of cases the board can handle. Under the revised law, a hearing committee of three or more board members may conduct a detailed hearing. The committee’s recommendations are reported to the full board. Each party may file exceptions to the recommendations and offer arguments to the full board before the board reaches a final decision.
Current law requires hospitals and other health care institutions to report to the board any change in staff privileges. The revised law requires these reports be made within 30 days. It also specifies reports are required in the following instances: (1) summary actions; (2) any action that has been finally determined; (3) any resignation or voluntary reduction of privileges; or (4) actions reportable under the Health Care Quality Improvement Act of 1986, as amended. Violations may result in a penalty of $250 for the first offense and $500 for subsequent offenses. Current law requires insurance companies or trust funds providing malpractice insurance for physicians to report to the board any payment affecting or involving a physician. Under the revised law, payments relating to physician assistants also must be reported. Violations may result in a penalty of $250 for the first offense and $500 for subsequent offenses.
Under the revised law, the board must report to the appropriate law enforcement agency information that indicates a licensee may have committed a crime. Also, the board must cooperate with law enforcement agencies investigating licensees by providing information relevant to a criminal investigation. Under the revised law, licensees must report to the board any felony arrest or indictment, any arrest for driving while impaired or any arrest or indictment for the possession, use or sale of any controlled substance. This report must be made within 30 days.
Dr. Moffatt and Mr. Henderson noted that, although the North Carolina Medical Board is widely recognized for its commitment to protecting the public, its members and staff continually strive to improve all aspects of their work. The revisions of the MPA, they said, will help the board do that.
Reprinted from the North Carolina Medical Board website.
OKLAHOMA
Reportable Health Information and Notification in Oklahoma (RHINO)
The Oklahoma State Department of Health (OSDH), Communicable Disease Division (CDD) along with Information Technology Services (ITS) has created a Health Alert Network (HAN) system for Oklahoma. The system is the Reportable Health Information and Notification in Oklahoma (RHINO) system. The purpose of a HAN is to have the ability to quickly provide vital health information to health care providers and public health partners. The need to distribute this type of information is increasing rapidly as we attempt to fight terrorism and protect the public from disease outbreaks.
The RHINO system consists of:
A secure website where users can:
View alerts, advisories, updates and events.
Use the included document library as a resource to share sensitive information through controlled access groups.
Update their own professional or personal information to ensure the delivery of alerting messages.
Electronic capabilities to quickly send broadcast fax, email, voice and text messages.
Future goals of RHINO include an electronic bulletin board to provide groups such as emergency department or infectious disease physicians a forum to communicate with others in real time discussions that will be viewable only by others in their group.
The RHINO system is part of a nationwide network of HANs that follow guidelines and policies set from the Centers for Disease Control and Prevention (CDC). Oklahoma’s HAN is unique from other HANs but must meet CDC standards such as contacting key stakeholders in a timely manner, and must be capable of sharing confidential information in a secure format.
The OSDH has embarked on a collaborative effort with the Oklahoma Board of Medical Licensure and Supervision (OSBMLS). The OSBMLS will supply a regular updated database containing physician fax numbers. This will be used to fax emergent HAN information to physicians. It is important that physicians update their contact information through the OSBMLS website.
HAN began in 1999 when 33 states and three city/county health departments were funded to develop capabilities for emergency communication and continuous access to public health information. The HAN has grown now to include all 50 states, eight U.S. territories and four city/county health departments.
The current network of contacts includes physicians, physician assistants, nurse practitioners, veterinarians, all public health nurses, county health department personnel, law enforcement, federal and state officials and emergency contact persons in other states.
Reprinted from Volume 17, Issue 1, of Issues and Answers, published by the Oklahoma State Board of Medical Licensure and Supervision.
LET US HEAR FROM YOU
Would you like for information from your board to be considered for publication in the Journal? If so, e-mail your articles and news releases to Edward Pittman at [email protected] or send via fax to (817) 868-4098.
