Georgia Osteopathic Medical Association. Barby Simmons, DO John Downey, DO Georgia Composite Medical Board

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1 Georgia Osteopathic Medical Association Barby Simmons, DO John Downey, DO Georgia Composite Medical Board

2 Composition of the Board Sixteen Board Members 15 appointed by the Governor Four-year terms 13 physicians (11 MDs, 2 DOs) Licensed and actively practicing in GA 2 consumers No ties to the practice of medicine 1 physician assistant (non-voting) Appointed by the Board

3 About the Board Licensing authority for 8 professions with over 50,033 licensees as of October 1, 2017: Physicians, including residents 38,067 Physician Assistants 4,755 Respiratory Care Professionals 5,582 Acupuncturists 261 Orthotists and Prosthetists 227 Clinical Perfusionists 258 Cosmetic Laser Practitioners 777 Pain Management Clinics 255 Also the approving authority for APRN prescribing protocols

4 Board Committees Advisory committee for each licensed profession (and APRN prescribing protocols) Recommends Board actions to approve or deny license applications and on other professionspecific matters Wellness Committee Recommends Board actions concerning impaired licensees Investigative Committee Recommends Board actions on enforcement matters Rules Committee

5 Applying for a License Applying online is the quickest and easiest way to get licensed Go to: medicalboard.georgia.gov Click: GCMB Online Services Submit your application online!

6 Applying for a License Most applications are completed within 60 days of the date the physician submits the application. In addition to the completed application and the $500 nonrefundable application fee, the applicant must provide some other documentation.

7 Licensure Process Common reasons for the Physician Licensure Committee to review an application include: Multiple unsuccessful attempts to pass the USMLE Step 3 Out of clinical practice Record of a conviction Record of impairment issue Discipline by school, residency program, licensing board, or other entity Malpractice settlement/payout within past 10 years Other more unique issues

8 Telemedicine: What it is A useful tool that increases access to health care with the same standards of practice and ethics as officebased care

appropriate instructions on follow-up emergent care related to treatment You must be able to

9 Telemedicine Requirements You must have a Georgia license to practice telemedicine in Georgia! Telemedicine occurs where the patient is Maintain complete patient records Provide clear, appropriate instructions on follow-up emergent care related to treatment You must be able to examine the patient using technology / peripherals that are equal or superior to an exam done personally

10 The Complaint Process Jane Doe makes a complaint to the Board My doctor propositioned me and we had a sexual relationship. A Board Agent is assigned to interview Ms. Doe and Dr. X to determine validity and garner what evidence is available.

11 The Complaints Process Complaint received and reviewed Response from physician requested/received Dismissal Board action (sanction, reprimand, letter of concern, etc.) Investigation conducted Board review (through committee)

12 The Complaint Process The Board Agent prepares a report of the investigation that is given to the Investigative Committee to make a recommendation. The Investigative Committee determines Dr. X s actions are grievous and they vote to revoke his license.

13 Enforcement of Board Rules Actions the Board may take: Revocation of License Suspension of License Voluntary Surrender of License License Under Probation License with Practice Restrictions License with Fines Imposed

14 How Licensees Get Into Trouble Some people from the medical board are here to see you.

15 How Licensees Get Into Trouble Disruptive behavior

16 How Licensees Get Into Trouble Practicing below minimum standards

17 Boundary Violations REMEMBER: According to Rule (8), committing any act of sexual intimacy, abuse, misconduct, or exploitation of any individual related to the physician s practice is unprofessional conduct regardless of consent! This rule applies also to former patients where the physician did not terminate the patient relationship in writing at least two years before the romantic or sexual relationship began.

18 How Licensees Get Into Trouble Boundary violations

19 Boundary Violations It is ALWAYS the physician s responsibility to maintain appropriate boundaries no matter how difficult or boundary-testing the patient is Crossing boundaries by a physician is ALWAYS a power differential If you are unable to maintain appropriate boundaries, refer the patient for competent help or counsel

20 How Licensees Get Into Trouble Poor recordkeeping

21 How Licensees Get Into Trouble Poor communication with patients

22 Enforcement of Board Rules The Board is authorized to take a variety of actions, including these most common actions: Letter of concern (non-disciplinary) Private reprimand (often with requirements such as additional specific CME) Private consent order with conditions such as monitoring, drug/alcohol rehabilitation, etc. Public consent order, often with a reprimand, practice restrictions, fines, etc. Suspension and/or revocation of license

23 Professional Health Program Program to help licensees deal with wellness issues without first dealing with the Board s disciplinary process Most common referral is for help with an addiction illness Referral sources: Family members, colleagues, friends, and the licensee

24 How Licensees Get Into Trouble Impairment due to drug or alcohol use

25 Professional Health Program For more information: MyGAPHP

26 Prescribing According to Rule , unprofessional conduct includes: Prescribing controlled substances for a known or suspected habitual drug abuser or other substance abuser in the absence of substantial medical justification Prescribing controlled substances for personal use or for your spouse, children, siblings, or parents except for documented emergencies

27 How Licensees Get Into Trouble Inappropriate prescribing

28 Writing Prescriptions Safely Secure all blank prescription pads to avoid theft Minimize the number of prescription pads in use at any given time Avoid prescribing large quantities if not necessary NEVER sign blank prescriptions!!

29 Pain Clinic Requirements A pain management clinic is any medical practice that advertises services in the treatment of pain, uses the word pain in the name of the clinic or practice, or has more than 50 percent of its annual patient population for chronic, non-terminal pain by the use of Schedule II or Schedule III controlled substances. Each pain management clinic location must be licensed individually. The application process includes payment of a $500 application fee, a criminal background check, and other documents & forms. Clinics must be wholly owned by licensed physicians. Clinics and practices owned or operated by hospitals do not need to be licensed, but must file an annual notification with the Board.

30 Proposed Rules Under Development SB10 allows CRNAs to practice in pain clinics without a physician present. SB47 Provides licensure exemption for physicians of visiting sports teams. SB242 Allows physicians to enter into up to 8 APRNs, but may not supervise more than 4 at any one time.

31 Opioid Prescribing Rules Rule Opioid Prescribing Rule requires physicians that have an active DEA and whom prescribes controlled substances to obtain 3 hours of AMA/APA PRA Category I CME. See handout for FAQs.

32 PDMP Proposed Rule Prescribers must enroll as a PDMP user by January 1, Prescribers who obtain a DEA registration after January 1, 2018 must enroll with the PDMP within 30 days of obtaining a DEA registration for purposes of prescribing controlled substances in Georgia.

33 Friendly Reminders Do not work on an expired license. This constitutes practicing medicine without a license Use a chaperone when examining the breast and/or genitalia of a patient of the opposite gender Effective communication with patients prevents complaints and could reduce risk of malpractice actions Document, document, document!

34 Your Medical License is Valuable! Your license grants you the privilege not the right to practice medicine. Other than your integrity and your ethics, your license is perhaps your most valuable asset. Protect it! Be cautious Be thorough Remember that your patients lives depend on you

36 Stay in Touch Go to our home page and subscribe to our monthly newsletter Contact us at to subscribe to our Rules notices Tell us how we re doing we want to serve you and the citizens of Georgia better every day Thank you!

37 Contact Information Georgia Composite Medical Board 2 Peachtree Street, NW 36 th Floor Atlanta, GA LaSharn Hughes, MBA Interim Executive Director lhughes@dch.ga.gov (404)

RULES AND REGULATIONS OF THE MAINE STATE BOARD OF NURSING CHAPTER 4

RULES AND REGULATIONS OF THE MAINE STATE BOARD OF NURSING CHAPTER 4 AS AMENDED 2015 The RULES AND REGULATIONS OF THE MAINE STATE BOARD OF NURSING are adopted and amended as authorized by Title 32, Maine