State Member Board Briefs

The Arkansas State Medical Board recently released its 2012 Annual Report, providing a variety of statistics on licensure and disciplinary activity in the state.

Arkansas licensed 469 medical doctors (MDs) and doctors of osteopathy (DOs) in 2012, bringing the total number of MDs and DOs with Arkansas licenses to 9,096. Of this total, 6,018 are registered as in-state physicians.

Arkansas also licensed 101 occupational therapists last year, bringing the state total to 1,254. It licensed 121 respiratory therapists, bringing the state total to 1,873.

In 2012, Arkansas logged 546 individual discussions and issues, of which 446 were complaints (including investigations and other issues involving licensed practitioners).

Board actions for the year included 16 license suspensions, 11 reprimands, 10 consent orders, 5 stayed revocations, 3 revocations and one surrendered license.

The leading category of complaint allegations was dissatisfaction with treatment or procedure, followed by lack of attention to medical needs, over-prescribing or over-testing, continuing medical education issues, malpractice and behavior/attitude problems.

Source: Arkansas State Medical Board website, March 2013

In coordination with the California Office of Administrative Hearings, the Medical Board of California has begun training Administrative Law Judges (ALJs) who hear Board disciplinary cases. Government Code section 11371 requires that ALJs receive medical training as recommended by the Board and a training program has been developed that includes topics such as pain management and appropriate medication standards, chronic pain issues, new developments in medicine, electronic health records, and other relevant subjects.

The new training kicked off recently in California with a day-long course conducted via video conferencing technology, with presenters located throughout the state and the judges participating from their respective offices. This model is being used to increase efficiency and cost-effectiveness, allowing the Board to hold training sessions with presenters and ALJs without accruing travel expenses or interrupting hearings.

According to the Board, the conferences will continue on an ongoing basis and additional training opportunities are being developed.

Source: Medical Board of California Newsletter, Winter 2012/2013

In an effort to reduce the incidence of wrong patient/wrong site/wrong procedure disciplinary cases in Florida, the Florida Board of Medicine's Surgical Care/Quality Assurance Committee recently updated the state's guidelines for safety procedures prior to surgery.

Despite requiring a “pause” before surgery to confirm patient identity, surgery site and procedure, the Board noted that it was continuing to see cases in which the required “pause” had been performed but surgery is still performed on the wrong patient, wrong site or using the wrong procedure. In hearing public testimony and reviewing Rule 64B8-9.007 of the Florida Administrative Code — Standards of Practice, the committee determined that the definition of surgery needed to be clarified.

The board has updated its rule, adding new requirements:

• Physicians must now confirm the patient's identity, confirm the procedure being performed and confirm the correct surgical site with another healthcare practitioner.

• “Pause” must be performed again if the physician leaves the room at any time during the procedure or surgery.

As a part of its review, the board also clarified the definition of surgery.

More details about the board's new requirements are available at www.flboardofmedicine.gov.

Source: Florida Board of Medicine website, March 2013

The State of Illinois recently announced that it will deploy the National Association of Boards of Pharmacy Program, PMP InterConnect^®, which allows states to share information from their Prescription Monitoring Programs (PMPs) more efficiently in an effort to control prescription abuse and other prescribing-related issues. NABP InterConnect gives authorized PMP users the ability to request and share program data across state lines.

The announcement brings the total of participating state PMPs in the program to 14. Illinois joins PMPs in Arizona, Connecticut, Indiana, Kansas, Kentucky, Louisiana, Michigan, New Mexico, North Dakota, Ohio, South Carolina, South Dakota, and Virginia.

Eight additional states have signed memorandums of understanding (MOUs) to participate in the program. NABP continues to work with other states to facilitate their participation in the NABP InterConnect, and NABP says it anticipates that more than 25 states will be sharing data or will have executed an MOU to participate in NABP InterConnect in 2013.

NABP InterConnect provides a highly secure communications exchange platform that facilitates the transmission of PMP data across state lines to authorized requestors, while ensuring that each state's data-access rules are enforced. According to NABP, the program's connected web of information “allows appropriate intervention and aid in the prevention of substance abuse and diversion of controlled substances” — particularly in detecting so-called “doctor shoppers,” who often travel across state lines to fill multiple prescriptions.

Additional information about NABP InterConnect is available at http://www.nabp.net

Source: National Association of Boards of Pharmacy website, March 2013

The Kentucky Board of Medical Licensure has approved the book “Responsible Opioid Prescribing: A Clinician's Guide,” published by the FSMB Foundation, to satisfy new state Continuing Medical Education (CME) requirements.

The book, which presents clinicians with effective strategies for reducing the risk of addiction, abuse and diversion of opioids that they prescribe for their patients in pain, provides the core of the new CME activity on opioid prescribing. The content of the CME activity is divided into three modules that together comprise 7.25 AMA PRA Category 1 credits.

Since its publication in 2007, the book has been widely used and supported in the medical and regulatory communities as the leading CME activity for prescribers. To learn more about the book, visit www.fsmb.org/book.

Source: Kentucky Board of Medical Licensure Newsletter, Winter 2013

The Massachusetts Board of Registration in Medicine Quality and Patient Safety Division (QPSD) has issued a new advisory on robot-assisted surgery that draws attention to potential issues with the robot-assisted procedures and offers steps health care facilities are taking to increase patient safety and reduce potential complications.

Issued in March, the advisory was created in response to an increasing number of reports of patient complications received by the QPSD over the last two years. It includes three case studies in which patient complications occurred during a robotic procedure, followed by a “Lessons Learned” section for each case that discusses what went wrong.

The advisory suggests that health care facilities offering robot-assisted surgeries should “reevaluate their credentialing and other quality and safety systems to ensure they are adequate and current.” Among the system components that should be reviewed as a priority are patient selection and risk-assessment procedures, as well as standards for the training, proctoring and assessment of proficiency for personnel involved in robot-assisted surgery. Health care facilities offering the procedures should also place a special emphasis on creating a strong informed-decision-making process between patients and the medical team, and be aware of a variety of perioperative issues unique to robot-assisted surgery.

“Health care facilities should utilize a ‘systems approach’ as they move into the emerging and expanding field of robot-assisted surgery,” the advisory concludes. “Developing innovative and adaptive credentialing, pre-operative assessment and other processes that reflect the evolving nature of the field will help to ensure adequate patient protection.”

The advisory is available at www.mass.gov/eohhs/docs/borim/physicians/pca-notifications/robot-assisted-surgery.pdf.

Source: Commonwealth of Massachusetts Board of Registration in Medicine Quality and Patient Safety Division website, March 2013

The Oklahoma State Board of Medical Licensure and Supervision has become one of the first licensing agencies in the nation to use QR (quick response) codes in the registration process for its physician licensees.

QR codes are two-dimensional bar codes — similar to commercial bar codes used by retailers — that can be read by smart phones and other electronic devices, such as computer tablets. The small black and white codes can now be found in the lower right-hand corner of all newly issued or renewed physician licenses in Oklahoma.

Scanning the Oklahoma QR code will provide direct, instant access to a physician's information page as it appears on the Board's website, www.okmedicalboard.org. Data available at the website includes the physician's educational background, medical specialty and board certification, office address, telephone and office hours, hospital privileges, insurance participation and board status.

“In the same way that traditional UPC bar codes changed the way we pay for groceries, this use of QR Codes can allow for a rapid check-in of medical professionals at training events, clinics and hospitals,” the Board said in a news release.

Board Deputy Executive Director Reji Varghese said among the many advantages of having the new QR code on medical licenses will be its use during emergencies.

“Law enforcement or emergency medical personnel establishing an incident command system at the scene of an accident or emergency will be able to immediately identify and confirm that the Good Samaritan offering assistance is, indeed, a licensed medical doctor,” he said.

To learn more, visit www.okmedicalboard.org.

Source: Oklahoma State Board of Medical Licensure and Supervision news release, February 1, 2013

The Oregon Board of Medicine recently released annual statistics that give a snapshot of medical licensing and disciplinary activity in the state during 2012.

Inquiries from the public related to investigations of licensees totaled 3,033 in 2012 (including phone calls, emails and written complaints), compared with 3,413 in 2011. The state opened 757 investigations during the year and closed 761 investigations.

During the year, the majority of complaints in Oregon were related to unprofessional conduct (49%), followed by inappropriate care (26%) and inappropriate prescribing (8%). Other, less frequently reported categories included sexual misconduct, physical or mental illness or impairment, personal substance abuse and board-order non-compliance.

The total number of licensees registered by OBM in Oregon grew from 17,123 in 2011 to 18,464 in 2012. The total includes 14,593 doctors of medicine (MD), 1,129 doctors of osteopathy (DO), 195 podiatric physicians, 1,289 physician assistants and 1,258 acupuncturists.

Source: Oregon Medical Board Report, Winter 2013