NEWSLETTER. The Medical Practices Act By Joseph M. Beck, II, M.D., ASMB Chairman

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1 A r k a n s a s S t a t e M e d i c a l B o a r d W e s t C a p i t o l A v e n u e, S u i t e L i t t l e R o c k, A R Peggy Pryor Cryer Executive Secretary 1401 West Capitol Avenue, Suite Board Members: Joseph M. Beck, II, M.D. Chairman Sylvia D. Simon, M.D. Vice-Chairman Monticello, AR Bob E. Cogburn, M.D. Secretary Mountain Home, AR Harold B. Betton, M.D. Treasurer Omar T. Atiq, M.D. Pine Bluff, AR Steven L. Cathey, M.D. North Jim C. Citty, M.D. Searcy, AR William F. Dudding, M.D. Fort Smith, AR Roger Harmon, P.D. Jonesboro, AR John E. Hearnsberger, II, M.D. Nashville, AR Veryl D. Hodges, D.O. Jonesboro, AR Scott Pace, Pharm.D., J.D. John H. Scribner, M.D. Salem, AR John B. Weiss, M.D. Fayetteville, AR Legal Counsel: William H. Trice, III 211 Spring Street NEWSLETTER The Medical Practices Act By Joseph M. Beck, II, M.D., ASMB Chairman The physicians of Arkansas are empowered to practice medicine by the people of the state, through their elected representatives, who crafted and implemented the Medical Practices Act. The licensure and discipline duties performed by the ASMB are enumerated within the act and its regulations, and the Board can perform no action not sanctioned by this legislation. The Board attorney assists the Board in the interpretation and implementation of this Act as it pertains to our proceedings. A product of the late 40s and early 50s, it came into being to bring standards into the practice of medicine and surgery, and since that time there have been multiple additions in the form of various regulations and rules. It has been noticed by the Board that, although it is the duty of each licensee to familiarize him or herself with the Act, many physicians who present before the Board are unfamiliar with the Act and its tenets. The ASMB may encumber, suspend or revoke a license only for violation of the Medical Practices Act, in the form of gross negligence or ignorant malpractice. These definitions are in the Act and should be read closely. The provisions for order and notice of hearing, emergency orders of suspension, subpoena of witnesses etc. are covered, as well. Several regulations of the Board in the Act appear timely today, including those forbidding prescription of schedule II drugs for members of a physician s own family, participation in a plan, agreement or arrangement which compromises the quality Winter 2013 or extent of professional medical services... at the expense of the public health, safety and welfare. Engaging in a romantic or sexual relationship with a patient, or a former patient, in which the physician exploits trust, knowledge, emotions or influence derived from the previous professional relationship, (the consent of the patient does not change the nature of the conduct or prohibition) is defined as gross negligence and ignorant malpractice. A physician exhibits gross negligence if he provides and/or recommends any form of treatment, including prescribing legend drugs, without first establishing a proper physician/ patient relationship. The minimum definition of a proper physician/patient relationship can be found in the Act. There is even a section delineating the standards for medical care practiced with the help of the Internet. It is to every physician s benefit to read this important document so that potential pitfalls can be avoided. It is available for download at Inside This Issue: The Medical Practices Act 1 ASMB 2012 Annual Report 2-3 Board Actions 4 Important Message 4 Governor Reappoints Three Members 4 Official Board Appointment 4 CCVS Profile Information 5 Board Meeting Dates 5 Allied Healthcare Meetings 5

2 Page 2 The 2012 members and officers of the are as follows: Trent P. Pierce, M.D., Chairman; Joseph M. Beck, II, M.D., Vice-Chairman; Bob E. Cogburn, M.D., Secretary; Sylvia D. Simon, M.D., Treasurer; Omar T. Atiq, M.D.; Harold B. Betton, M.D.; Stephen L. Cathey, M.D. Jim C. Citty, M.D.; Ms. Rose Crane (January April); William F. Dudding, M.D.; Roger Harmon, P.D.; John E. Hearnsberger, II, M.D.; Veryl D. Hodges, D.O. (June December); Scott Pace, Pharm.D., J.D. (November December); Patty K. Pettway, D.O. (January February); and John B. Weiss, M.D. The Board met bimonthly and addressed complaints, hearings, and other pertinent business affecting health care in the State of Arkansas Licensing Statistics 2012 Annual Report 2012 Statistics Medical Doctors and Doctors of Osteopathy Licensed 469 Medical Doctors and Doctors of Osteopathy (total) 9,096 Medical Doctors and Doctors of Osteopathy (in state) 6,018 Occupational Therapists Licensed 101 Occupational Therapists (total) 1,254 Occupational Therapy Assistants Licensed 61 Occupational Therapy Assistants (total) 343 Physician Assistants Licensed 32 Physician Assistants (total) 230 Respiratory Care Therapists Licensed 121 Respiratory Care Therapists (total) 1,873 Radiologist Assistants Licensed 1 Radiologist Assistants (total) 3 Radiology Practitioner Assistants (total) 4 Summary of Board Proceedings for 2012 Individual Discussions and Issues (total) 546 Complaints (including investigations and other issues involving licensed practitioners) 446 Issues Board Actions Suspension 16 Revocation 3 Revocation (stayed) 5 Probation 0 Surrendered 1 Reprimand 11 Consent Orders 10

3 Page 3 Complaint Allegations (including investigations) 13 Attestation/Renewal Affirmative Answers 21 Behavior/Attitude 16 Billing/Insurance Issues 2 Boundaries 7 Criminal Allegations 8 Lack of Communication or Miscommunication 22 CME/CEU Issues 2 Discrimination 71 Dissatisfaction with Treatment/Procedure 2 HIPAA Issues 10 Hospital Reporting 6 Inmate Allegations 17 Inappropriate Prescribing 13 Inquiry from Practitioner 43 Lack of Attention to Medical Needs 23 Malpractice Regulation 23 4 Misdiagnosis 18 Miscellaneous 15 Medical Records Failure to Provide 2 Medical Records Discrepancy 1 Practicing Medicine without a License 26 Over-Prescribing/Over-Testing 21 Actions Taken by Other States 5 Patient Abandonment 4 Doctor Refuses to Prescribe/Refill Pain Meds 8 Didn't/Won't Comply with Patient's Request to Complete Paperwork 7 Staff-Generated Issues 2 Self-Prescribing or Prescribing to Family 4 Self-Reporting 5 Sexual or Romantic Relationship 14 Terminated Patient 1 Unsanitary Treatment Conditions 6 Licensure Issue 27 Update Regulations Amended During this Calendar Year 2012 Annual Report Regulation 17 Governing Continuing Medical Education for Physicians. Amended February 2, Regulation 2(8) Requiring Minimum Standards for Establishing a Physician/Patient Relationship. Amended April 12, Regulation 18 Fee Schedule for Centralized Credentials Verification Service. Amended April 12, Regulation 24 Rules Governing Physician Assistants. Amended April 12, Regulation 10 Regulation Governing the Licensing and Practice of Respiratory Care. Amended October 4, To review these regulations in their entirety, go to our website, go to Forms and Publications and click on Medical Practices Act.

4 Page 4 Board Actions & License Adjustments 10/12/2012 through 2/4/2013 ACKLIN, Jimmy David, M.D. (C-6363) Fort Smith, AR Emergency Order of Suspension, 10/31/2012 BEAVER, Byron Kevin, M.D. (E-6065) North Revoked, 1/4/2013 ELMORE, Candace Ray, LRCP (RCP-1973) Taylor, AR Emergency Order of Suspension, 11/1/2012 GILLIAM, Linda Harris, M.D. (E-4919) Jonesboro, AR Consent Order, 1/29/2013 HOVEY, Charlotte Eileen, M.D. (E-6095) Oak Park, IL Revoked, 1/4/2013 LEONARD, Donald Gerald, M.D. (R-2497) Reprimand, 10/23/2012 McCORMICK, Denise Thormahlen, M.D. (R-3890) Mountain Home, AR Revoked, 10/23/2012 ODOM, Max Kennon, II, M.D. (E-1461) Nashville, AR Emergency Order of Suspension, 1/4/2013 WARREN, William Sidney, Jr., M.D. (C-6145) Emergency Order of Suspension, 11/7/2012 WRIGHT, Charles Kent, M.D. (C-7768) Fort Smith, AR Emergency Order of Suspension, 1/7/2013 WRIGHT, James Claude, D.O. (R-4101) Lake Village, AR Reprimand, 1/4/2013 IMPORTANT MESSAGE Pursuant to Regulation 17(D) the Board conducts a random audit of 10% of license renewals on a monthly basis for continuing education compliance. A letter is mailed to the selected licensees on the first day of the month following the licensee s birth/renewal month. At the August 2012 meeting, the Board voted to allow 90 days for the selected licensees to submit the previous 12 months of continuing education documentation. Licensees who fail to submit the appropriate paperwork within 90 days of the request are automatically required to appear before the Board to discuss their non-compliance prior to their next license renewal. After 90 days, the staff will notify the licensee of their non-compliance and appearance requirement via certified mail. Submission of the documentation after the 90 day period does not alleviate the requirement for you to appear before the Board prior to your license renewal. It is very important for you to receive and comply with the Board s requests in a timely manner. Governor Reappoints Three Members Governor Mike Beebe has reappointed Bob E. Cogburn, M.D., Veryl D. Hodges, D.O. and John B. Weiss, M.D. to the. Dr. Cogburn practices oncology/hematology in Mountain Home and serves on the Board as Secretary and a Congressional District member. Dr. Hodges practices internal medicine in Jonesboro and serves as the Osteopathic Medical Association representative. Dr. Weiss is a cardiovascular surgeon practicing in Fayetteville and he serves as a Congressional District member. Their terms will expire December 31, We congratulate Drs. Cogburn, Hodges and Weiss. Official Board Appointment Governor Mike Beebe has appointed John H. Scribner, M.D. to the as a Congressional District member. Dr. Scribner received his medical doctorate at University of Arkansas for Medical Sciences. He returned to his hometown of Salem, Arkansas to practice family medicine at Salem 1st Care. Dr. Scribner and his wife, Leslie, live in Salem with their children, Glendon, Phoebe, and Marshall. We welcome Dr. Scribner, whose term will expire December 31, Dr. Scribner fills the position held by former Chairman, Trent P. Pierce, M.D.

5 Page 5 CCVS Profile Information The CCVS obtains verification information first from the primary source. The credentials verification organization (CVO) attached to the is required by statute to verify all information provided to credentialing organizations directly from the source. If verification cannot be obtained, there must be a notification to organizations regarding what source (AMA, ECFMG, Federation, Physician copy/information, etc.) was utilized to obtain the information and why the primary source could not verify (records destroyed, no records, files do not go back that far, etc.). Physicians may question why dates are listed on their profiles when the dates might not match their memory or documentation of education or work history. This most often happens when the primary source information may not have provided the correct information, the dates are listed inaccurately in their files or there may be verification organization s internal processes involved. Organizations have a responsibility to provide correct information for credentialing purposes, and the CCVS must accept the data provided unless there is evidence it is incorrect. The CCVS will automatically ask for reverification if there is a wide gap or conflict between what the physician has stated and what is verified. However, unless the CCVS has copies of documentation from the physician to support questioning the dates, the organization will generally maintain their information is correct as it was provided. Some of the organization s internal processes that may impact their data provision to the CCVS might be the practice of not listing temporary or provisional privileges, and only listing the staff privilege start dates once the medical staff meets and votes. That practice may skew the physician s time line by several months. Another internal process that affects accurate data might be in the conversion of paper documentation to electronic. Sometimes the start date entered in the system is the date of the last reappointment and not the date of the initial appointment, including any temporary privileges. The CCVS makes every effort to obtain accurate information but if a physician disagrees with the information on the profile, they can request a reverification be made by the CCVS. This can most easily be accomplished by noting the discrepancy on the annual profile sent with license renewal and faxing it back to the CCVS at with the inaccurate information circled and the correct information written. If the physician has a letter or other documentation from the organization showing the granting of temporary privileges or start date on a specific date, this will help the staff resolve the issue with the organization. If the verification source cannot confirm the information stated by the physician, an entry on the profile stating the physician disagrees with the primary source verification information will be made. This is not an entry that should be interpreted negatively as it simply means that neither the verification source nor the physician can agree on the information that has been provided. If you have any questions regarding information listed on a physician s profile, please send it via to ccvs@armedicalboard.org. Please note that if sending an attachment, it should go to support@armedicalboard.org with the recipient s name in the subject line. Scheduled Board Meeting Dates for the April 4-5, 2013 June 6-7, 2013 August 1-2, 2013 October 3-4, 2013 December 5-6, 2013 The agenda for each meeting will be posted online by 4:00pm the Wednesday of the week prior to each meeting. The Board will hold called meetings when necessary. Meetings will be held in the Board Room at 1401 West Capitol Avenue, Suite 340 Little Rock, Arkansas Allied Healthcare Meetings Respiratory Care Examining Committee March 7, 2013 June 13, 2013 September 12, 2013 December 12, 2013 Occupational Therapy Examining Committee April 15, 2013 July 15, 2013 November 4, 2013 Physician Assistant Committee April 3, 2013 June 5, 2013 July 31, 2013 October 2, 2013 December 4, 2013 Pain Committee February 14, 2013 Dates and times of meetings are subject to change.

6 Page 6 Mission of the Arkansas State Medical Board Protecting the health, safety, and welfare of the people of the State of Arkansas with the goal that all citizens be provided with the highest quality health care West Capitol Avenue, Suite Contact us! Juli Carlson-Regulatory (501) Susan Wyles-Regulatory/Licensing PA/RA (501) Brenda Engelhoven-Regulatory/Malpractice (501) Kim Cormier-Licensing Coordinator (501) Laurel Mills-Licensing Coordinator (501) Kay Zuber-Licensing Coordinator (501) Mandi Roberge-Licensing LRCP/OT (501) Carolyn Blenden-Renewal Coordinator (501) Sarah Apel-Renewal Support Specialist (501) Angie Meehleder-Quality Assurance/ Customer Service Manager (501) Support/Help Center (501) Main Phone (501) Regulatory Fax: (501) CCVS Fax: (501) Accounting/Personnel Fax: (501) Licensing Fax: (501) License Renewals Fax: (501) QI/CS Fax: (501) Online Directory CD-ROM directories are no longer available All actively licensed Arkansas Physicians, Respiratory Therapists, Occupational Therapists, Physician Assistants and Radiology Practitioner Assistants may be queried in the Online Directory. To purchase data files of these practitioners, please visit our website. Payment is via a secured online order form with Visa or MasterCard only. COPIES OF ALL BOARD REGULATIONS ARE INCLUDED IN THE MEDICAL PRACTICES ACT BOOKLET. It is the responsibility of all licensees to read and comply with these rules. MEDICAL PRACTICES ACT BOOKLETS $15 PER COPY or free from the web site at ATTENTION! Change of Address Form is now available on the ASMB Web Site: Please FAX: (501) (support@armedicalboard.org) (.pdf only) or Mail to: 1401 West Capitol Avenue, Suite