Kansas Professional Licensing Attorney Explains The Kansas Board Of Healing Arts Sanction Guidelines-Part Three Of Four

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The Kansas Board of Healing Arts (“the Board”) in 2008 released guidelines for disciplinary sanctions. The Board broke the guidelines down into ten general categories of ethical violations.  The guidelines explain the various categories of ethical violations and the rationale for the proposed sanctions.  The Board follows the guidelines when devising a sanction for an ethical violation. However, these are not set in stone. The Board specifically retained their discretion to sanction to the extent allowed by law. Therefore, the guidelines are suggestions for sanctions. Notwithstanding, a licensee must be aware of the potential penalties they may suffer if the Board finds them in responsible for an ethical violation. If you find yourself in that situation, Kansas professional licensing attorney Danielle Sanger will use the guidelines to obtain the best result for your situation.

This article discusses the sixth through tenth categories of ethical violations. A previous article discusses categories one through five. The sixth category of ethical violations is concerned with advertising.  The First Amendment to the United States Constitution protects the licensee’s right to free speech.  Advertising is a protected form of speech.   Freedom of speech does not extend to false, misleading, or deceptive claims. While the advertising technique of
puffing is permitted, factual misrepresentations must be sanctioned. The Board recommends that sanctions for making factual misrepresentations include remediation, deterring future errors, and a punitive sanction such as a fine.  The Board considers false advertising that is confusing to patients rather than leading to potential physical or monetary harm is “less serious.”

The seventh category of ethical violations relates to the lack of fitness to practice a healing art. Impairments affect the licensee’s ability to practice with “reasonable skill and safety.” Impairments include drug and alcohol abuse in addition to mental and physical limitations. The Board will look to the practitioner to provide insight into the condition when fashioning an appropriate sanction.  The guidelines indicate that the Board will look more favorably upon a practitioner who seeks help for their condition. Addressing the impairment is the goal of the sanction, however, accomplishing that goal may result in suspension during the licensee’s rehabilitation period.  In treating practitioners who are cooperative and seek treatment differently, the Board’s policy that referral to a treatment facility or monitoring is not disciplinary action if the sole reason is a treatment for impairment.  The Board encourages its members to seek treatment and therefore the action is not considered a sanction. Notwithstanding, the Board will consider any available sanction for a licensee who is uncooperative or when “uninterrupted practice endangers the public.”

Administrative requirements are the eighth category of ethical violations. Administrative requirements involve reporting breast examine abnormality, maintaining liability insurance, and posting requirements. The Board levies sanctions for administrative violations by examining the state of mind of the practitioner.

Inappropriate prescribing refers to prescribing medication without a legitimate medical purpose as well as failing to follow prescribing requirements.  The Board determines this category of offense as serious because of the potential health risk involved. The Board cautions practitioners that following the Board’s policies on pain management is distinct from inappropriate prescribing. Furthermore, prescribing medication in a manner that deviates from the standard of care is considered incompetence unless the behavior is criminal in nature. The Board will distinguish behavior that is merely negligent from more deviant behavior when devising sanctions.

The final ethical category is proper maintenance of patient records. Healthcare professionals have a duty to maintain patient records and release them upon patient request.  This category includes unethically releasing private information.   The Board is particularly interested in the pervasiveness of the licensee’s failure to properly maintain patient records when fashioning an appropriate sanction.

Kansas Professional Licensing Attorney Ready to Help

Kansas Professional Licensing Attorney Danielle Sanger is a zealous advocate for professional license holders. Attorney Sanger possesses the skill and expertise to protect your livelihood. Call Attorney Sanger today at 785-979-4353 to schedule your no obligation consultation.

Kansas Professional Licensing Attorney Explains The Kansas Board Of Healing Arts Sanction Guidelines-Part Two Of Four

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The Kansas Board of Healing Arts (“the Board”) promulgated its sanctioning guidelines in 2008. The Board issued a sanction grid to accompany the guidelines.  The Board grouped laws and regulations under headings describing a particular type of misconduct. The grid compares the severity of the allegations to the licensee’s prior record of discipline. Then a sliding scale determines the appropriate sanction for the alleged misconduct.  The Board made it very clear: it reserves the right to order any lawful sanction it sees fit within the bounds of its discretion and is not limited by the guidelines.  Nonetheless, the guidelines assist licensees facing discipline understand the potential discipline they face and can advocate for alternatives. Kansas professional licensing attorney Danielle Sanger is a tireless advocate for licensees facing discipline and will use the guidelines to your advantage.

The Board divided the guidelines into ten general categories of professional misconduct. The first through the fifth categories are discussed here; whereas categories six through ten are discussed in a subsequent article. The first category of misconduct falls under the general heading of “competence.” The Guidelines list multiple potential violations under the general category of competence. The Board’s rationale for sanctioning lack of competency is very clear. The Board follows the ruling of the Kansas Supreme Court regarding incompetence in the healing arts. The Court stated, as quoted in the guidelines, “[n]o conduct or practice could be more devastating to the health and welfare of a patient or the public than incompetency . . .” Consequently, the Board seeks to sanction incompetence for failing to adhere to the appropriate standard of care resulting in gross negligence or repeated instances of ordinary negligence. Incompetence applies to the practitioner’s actions and his or her actions about the supervision of another healing art professional.

The Board describes the second category of sanctionable offenses as general misconduct. The Board defines misconduct as conduct that is “unsafe or improper.” According to the Board, general misconduct is dishonorable conduct or unprofessional conduct as well.  The Board further defines misconduct as conduct that does not conform to the standards necessary to protect the public from harm.  The Board defines professionalism as qualities of integrity, respect, and compassion. Misconduct is the exact opposite: unethical, corrupt, and dishonest. The Guidelines state clearly that the sanction for misconduct is punitive in nature, rather than remedial.

Criminal conduct is sanctionable by the Board. The Board concerns itself with the criminal conduct of its members because criminal conduct is evidence of lack of fitness for treating patients. The Board is also concerned about the public trust deteriorating if criminal acts committed by its members went unpunished. The Board announced in the Guidelines that discipline for criminal acts must be punitive in nature. The Board considers criminal conduct as serious in nature under the sanction grid when fashioning discipline.

The fourth category of misconduct is sexual misconduct. Sexual activity between consenting adults is misconduct if one of the consenting adults is a patient. Exploiting vulnerable patients for sexual gratification is not only a crime but a very serious violation of the ethical rules. The Guidelines call for the revocation of the license if allegations such as these are proved. The Board has a zero-tolerance policy for sexual misconduct involving a minor and counsels such intolerance extend to sexual contact with an adult as well. Sexual misconduct extends to the work environment. Sexual advances made by a supervising licensee to a subordinate create an untenable situation and must be sanctioned. The Board considers sexual misconduct such as sexual harassment to be a serious offense and has enumerated many factors to consider when deciphering an appropriate sanction.

The fifth category of misconduct involves business transactions. Misconduct involving business transactions ranges from over charging, fee-splitting, and welfare fraud to business transactions involving patients. This category of misconduct falls in the middle of the sentencing grid.

Kansas Professional Licensing Attorney Danielle Sanger will fight to protect your livelihood. Attorney Sanger is a zealous advocate for her clients. Call attorney Sanger today at 785-979-4353 to schedule your free consultation.

Kansas Professional Licensing Attorney Explains The Kansas Board Of Healing Arts Sanction Guidelines-Part One Of Four

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The Kansas Board of Healing Arts (“the Board”) released a comprehensive set of rules announcing the possible range of penalties for conduct offensive to the ethical rules governing practitioners of the healing arts.  In 2008, the Board issued the “Guidelines for the Imposition of Disciplinary Sanctions” (“Guidelines”). The Guidelines provide practitioners with the rationale the Board employed when devising the potential sanctions and is more than a set of rules and penalties for violating those rules. Thoroughly understanding the potential penalties for rules violations permits the licensee a sense of predictability and uniformity in applying the penalties but also affords the opportunity to propose lesser sanctions in an attempt to promote growth in the Healing Arts. Kansas professional licensing attorney Danielle Sanger has successfully utilized the Guidelines to advocate successfully for her clients.

The Board does not seek to impose the maximum sanction for every alleged ethical violation. The Board espouses a sanctioning philosophy designed to protect the public and the medical professions. Accordingly, the Board will sanction practitioners who run afoul of the ethical rules “with the least restrictive discipline necessary to meet the proper sanctioning goals.” Notwithstanding, the Board comprehends its primary goal is to protect the public and therefore will order sanctions to protect against immediate or irreparable harm. However, the Board may fashion a sanction that will rehabilitate the offender in the appropriate circumstance.

The Board enjoys wide discretion in fashioning sanctions for alleged misconduct. In fact, the Board reserves the right to impose any sanction within its discretion. The possible sanctions vary from no punishment at all to revocation of license. Included in the sanction continuum are alternatives such as censure, fines, suspension, limitations placed on the license, and denial of application or revocation. The Board imposes upon itself a mandate that when fashioning a sanction, the Board must consider the goals for sanctions. The goals included remediating the situation, protect the public from immediate harm from, or to punish.

In addition to the possible sanctions cited above, the Board has the authority to enter into a letter of agreement with the practitioner. The agreement may state a plan for the practitioner to correct any mistakes and to avoid future violations. The Board may also send the practitioner a letter informing the practitioner of the Board’s concern about present conduct in special circumstances to avoid non-conforming behavior becoming a future ethical violation.

The Board frequently imposes a term of probation on a license. A period of probation is a remedial sanction. In contrast, the Board describes fine and censure as purely punitive. With probation, the Board can impose restrictions upon the practitioner’s license such as attending and completing continuing educational courses, strict supervision by another practitioner, periodic medical record review, treatment for physical, emotional, or psychological conditions. The Board may also limit the types of services the offending practitioner may provide or the setting in which the practitioner provides their services.

The Board imposes the most severe sanctions in the appropriate circumstance. Revocation, denial of an application, or suspension achieve the goals for punishment but are imposed in situations when the practitioner is adjudged by the Board to no longer be fit to enjoy the privilege of practicing the healing arts or is purely incompetent. The primary aim of these sanctions is to remove the practitioner from the public to prevent future harm.

Kansas Professional Licensing Attorney Danielle Sanger devoted her career to helping medical practitioners and other professional licensees avoid the disastrous consequences of disciplinary action. Attorney Sanger is a devoted advocate who is keenly aware of the sacrifice one makes to obtain and keep a professional license. Call Attorney Sanger today at 785-979-4353 to arrange for your no-obligation consultation.

Kansas Professional Licensing Attorney Discusses Recent Disciplinary Decisions

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Kansas professional licensing attorney Danielle Sanger closely monitors disciplinary decisions issued by the Kansas State Board of Healing Arts (the “Board”). Understanding the decisions issued by the Board assists Attorney Sanger in advising her clients who are facing discipline. Attorney Sanger appreciates the commitment and sacrifice required to earn and maintain a professional license and employs that same commitment in fighting for clients.

The Board has issued several decisions to this point in March of 2016. Two decisions illustrate the vital importance of appearing before the Board when ordered to appear. Failure to appear permits the Board to enter a default against the licensee and enter appropriate orders without a contest from the licensee. In one case, a chiropractor’s license was canceled for failure to timely renew. The chiropractor subsequently applied for reinstatement. Disciplinary counsel for the Board alleged that the chiropractor failed to disclose pending criminal actions pending against him to the Board on his application. The chiropractor was given notice to appear before the Board. The chiropractor requested a continuance of the appearance based upon personal reasons. The Board sought further information about his proffered reasons. The chiropractor failed to supplement his request for continuance. Consequently, he attempted to withdraw his application for reinstatement. The chiropractor failed to appear at the scheduling conference and was defaulted. The Board found that the chiropractor committed fraud by misrepresenting his criminal history to the Board and finding that the fraud proves the chiropractor is unfit to practice in Kansas. Moreover, the Board found that the chiropractor should not be allowed to withdraw his application to avoid discipline.

The second default order of March 2016 resulted in revocation of a physical therapy assistant’s license. The therapist failed to appear at a scheduling conference despite being warned that a failure to appear would result in a default finding. The therapist failed to appear as ordered. Consequently, the therapist’s certificate was ordered revoked. The therapist forfeited any argument to keep her certificate to practice, which was active at the time of her default.

The Board took other disciplinary action in March 2016 as well. The final consent order entered against a physician’s assistant accused of incompetence, improper prescribing, inadequate record keeping, and assisting in the care of a patient without consent of that patient. The physician’s assistant substantially complied with the educational requirements imposed by the Board and complied with the prohibition from performing urological surgery. However, the Board imposed, and the physician’s assistant did not oppose, the condition that he have a prescription monitor for an additional year.
The Board approved a second consent order in March 2016. This order was issued against the certificate of a physical therapy assistant. The assistant was convicted of a second offense for driving while intoxicated after a motor vehicle accident. The assistant waived her rights to a hearing and voluntarily entered into a consent order. The terms of the consent order are for two years. Many of the terms of the order are redacted from public record as “confidential.”

The Board exercised its statutory authority to issue an ex parte emergency order against a doctor of osteopathy. The Board issued the emergency order after finding that the physician may harm the public if allowed to practice. The facts giving rise to the emergency order are redacted as “confidential.” The Board ordered the physician to immediately cease the practice of urgent or emergency care of patients.
The Board issued two further decisions. The Board summarily canceled the license of a radiological technician who failed to timely pay her reinstatement fee. Finally, a physician’s license to practice medicine and surgery was revoked by the Board for malpractice and failure to participate in the complaint process. The physician, after being duly subpoenaed, failed to appear for a deposition. The physician also failed to answer interrogatories and disclose witnesses. Thus the physician’s failure to participate precluded the physician an opportunity to be heard and fight to retain the privilege to practice medicine in Kansas.

Seek Immediate Assistance
If you have been given notice of a complaint pending against you, call Kansas Professional Licensing Attorney Danielle Sanger immediately. Attorney Sanger has dedicated her practice to representing licensees in Kansas and Missouri who are facing discipline. Call 785-979-4353 today to schedule your free consultation.

University of Missouri Hospital and Clinics School Offers Guidance On Withholding Futile Treatments

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Health care providers can grapple with the decision to withhold treatments that may be futile for their patients. The ethical decision influencing that decision can be daunting. Assisting patients, or their health care proxies, make these decisions must be made with consideration of several factors. If the patient reaches the point of “biomedical futility” the physician need not administer the treatment. Understanding “biomedical futility” and its implications is vital in making an ethical decision. Physicians and other health care providers can face ethical complaints if the patient or family disagrees with the decision to withhold futile medical treatments. Missouri professional licensing attorney Danielle Sanger has devoted her career to representing licensees such as physicians and other health providers who face potential licensing discipline.

The University of Missouri Hospital and Clinics (“the University”) issued guidelines relating to withholding futile treatments. The University’s directive was based upon the desire to assist physicians and their team in decisions regarding when to “withhold or withdraw” biomedically futile treatments. Biomedical futility is a judgment the physician must make. The University defines biomedical futility as a treatment that cannot meet its goals and is therefore “medically ineffective.” The physician must determine to a “reasonable degree of medical certainty” that the treatment cannot prevent or slow the patient’s decline or cannot prevent impending death of the patient. Those conditions seem obvious. However, a medically ineffective treatment is also one that cannot change the course of a disease in a meaningful way. It is critical to note that a treatment that is medically effective but may diminish the quality of life of the patient is not defined as a biomedically futile treatment.

The University established a procedure for physicians and their health care teams to follow in the event they are faced with making a decision of whether a treatment is medically futile. At the outset, the physician must determine that a treatment is medically ineffective to a reasonable degree of medical certainty. If so, then the physician must discuss treatment goals with the patient and/or the health care proxy. This consultation must include a discussion regarding the medical ineffectiveness of a proposed treatment, the potential or lack thereof for patient improvement, and the burden a given treatment may have upon the patient. Physicians must closely document this procedure in the patient’s medical record.

Once this discussion occurs, then a team meeting must be held. The meeting includes interdisciplinary treatment providers, the patient, the patient’s health care proxy, and the patient’s family. Any decision made during this team meeting must be documented in the patient’s medical record. The patient, their proxy, and staff should be afforded an opportunity to meet with Pastoral Care and/or the Ethics committee in reaching this decision.

At times, the patient and physician may disagree on whether the treatment should be administered. The physician is not required to administer a treatment that is medically ineffective. The physician should advise the patient to seek an alternative opinion. The physician must not abandon the patient if such a disagreement occurs. The physician should arrange for alternate care and take steps to ensure the patient is safe. The physician should consult other health care providers and the ethics committee if the physician determines the treatment must be discontinued. It is also important to note that this decision must be made between the health care providers and the patient. Any opinion offered by a third party of whether the treatment is medically effective must not be considered.

Where To Turn For Help

Missouri Professional Licensing Attorney Danielle Sanger vigorously fights for her clients to protect their livelihood. Attorney Sanger understands that a physician’s decisions can be second guessed, which can lead to facing an ethics complaint. Call Attorney Sanger today at 785-979-4353 to schedule a free consultation and mount your defense today.

Kansas Board of Healing Arts Complaint Process

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The Kansas Board of Healing Arts (“the Board”) has an established procedure for investigating and adjudicating complaints of wrongdoing lodged against one of its members. The procedure is a natural progression from intake of complaint to investigation and either closure of the investigation or adjudication. Each step in the process is critical to both the complainant and the health care provider under investigation. Any caregiver who learns of an investigation must retain counsel as soon as possible. Failure to hire counsel timely could have dire consequences and lead to disciplinary action that may have been avoided. Kansas professional licensing attorney Danielle Sanger will zealously fight to protect your professional license from discipline.

The Board has developed a standardized procedure to handle complaints against its members. Most commonly, complaints are filed by patients. The Board may receive a complaint from any number of sources. However, information from complaints may be forwarded by other healthcare agencies, other healthcare providers, data bank reports, malpractice information, and adverse findings from other licensing boards. Once that happens, the complaint is added to the Board’s complaint database and is forwarded to disciplinary counsel. Disciplinary counsel reviews the complaint to determine whether the disclosed allegations may violate the Healing Arts Act. If disciplinary counsel determines that there is no violation of the Healing Arts Act based upon the factual allegations in the complaint, then the complaint is closed and no further action on the complaint is taken. At that point, the complaint is forwarded to an investigator for closer examination and investigation.

The assigned investigator is responsible for gathering information from various sources. The investigator will accumulate records from the licensee and all other relevant agencies. The investigator will also interview several individuals, if warranted, by the investigation. The investigator may interview the licensee or at least try to obtain a response to the allegations. The investigator should speak with patients, complainants, and other witnesses who may possess relevant information. The matter is referred back to disciplinary counsel when the investigation is complete.

Disciplinary counsel reviews the investigation to determine whether the complaint should proceed. If the complaint lacks support from “credible evidence” and the allegations are unsupported, then the complaint may be closed. At this juncture, the process proceeds toward adjudication if the complaint is supported by competent evidence.
The path the matter takes to adjudication depends upon the nature of the proceedings. If the complaint is based upon a violation of the standard of care, then the disciplinary counsel forwards it to the complaint review committee or professional council. Standard-of-care issues are reviewed by practitioners from the same profession or initial peer-review board. Conduct issues are those that do not involve an alleged breach of the standard of care. Conduct issues include the business of medical practice, practicing without a license, billing issues/complaints, practice by an impaired healthcare professional, and criminal convictions. Conduct issues are referred to litigation counsel by the Board. If the review board or committee determines the matter should proceed, then disciplinary counsel refers the matter to the disciplinary panel.

The disciplinary panel makes a recommendation to initiate discipline or close the case. The recommendation to close or initiate discipline is reviewed by the Board. Each level of review is independent of the previous and is not bound by those decisions. Initiating disciplinary action may take the form of a professional development plan or letter of public concern. The licensee may also agree to a resolution such as a consent order. The licensee may also contest the panel’s recommendation. The Board ultimately reviews and may approve all actions by the disciplinary panel. The Board may also seek further review of closed matters.

Protect Your Livelihood
Kansas Professional Licensing Attorney Danielle Sanger will vigorously fight to protect your ability to make a living. She understands the sacrifices made to achieve professional licenses and the devastation discipline can cause. Do not go it alone. Call Attorney Sanger today at 785-979-4353 to schedule your free consultation.

Kansas State Board of Healing Arts and Board of Nursing Collaborate On Pain Management Initiative

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In February of 2016, two critical policy-making agencies collaborated to revise their approach to combating opioid addiction in Kansas. Delegates from Kansas’s State Board of Healing Arts and the Board of Nursing met to discuss a proposed redrafting of a “Joint Pain Management Policy.” The draft serves as an attempt to devise pain management plans that address each patient’s individual needs while countenancing and interdicting addictive behavior. The draft purports to expand the health care provider’s role in administering pain medication to impose greater oversight over the patient’s treatment with opioids.  Any health care provider licensed by either Board is now on notice that each respective licensing authority is carefully monitoring narcotics dispensing practices. A breach of this policy may result in disciplinary action. Kansas professional licensing attorney Danielle Sanger advises all of her clients to carefully monitor their opioid dispensing practice consistent with a health care provider’s duty of care.

The current Joint Pain Management Policy promulgated by the State Board of Healing Arts and the Board of Nursing was issued in 2002. Since that time, opioid abuse and addiction has spiked to levels heretofore unseen, not only in Kansas but nationwide. Accordingly, the Boards have undertaken the responsibility to craft a new policy that addresses the new reality of opioid addiction. The most recent draft of the policy circulated by the Boards emphasizes appropriate pain management for the individual patient by a team of health care providers. One of the problems facing health care providers today is the treatment of chronic and/or acute pain. The Boards recognize that many patients’ pain is improperly managed due to under- or over-prescription, or ineffective treatment. Because the reporting of symptoms of pain is subjective, the Board strives to balance the appropriate treatment of pain with the specter of drug-seeking and addictive behavior.

The Board proposes that health care providers should be wary of potential drug-seeking behavior. Recognizing the risks and the benefits of opioid prescription is critical to appropriately addressing a patient’s pain management. Health care professionals must be aware of the dangers that inure to long-term opioid use. These complications include addiction and abuse of the medication. Health care providers must understand that a patient may need opioid medication to combat pain and that a request for an increased dose is not necessary a symptom of drug dependency. It is therefore incumbent upon the health care provider to understand the signs of addictive behaviors and address those accordingly.

The draft emphasizes the growing need to investigate health care professionals who “treat pain inappropriately.” While proper investigation is necessary, the draft is very clear that a request for information concerning prescription practices does not equate with a formal complaint. To be sure, the draft stipulates that prior to filing of any allegations the information gathered during the investigation will be subject to peer review and health care providers should not “fear disciplinary actions” if they appropriately manage their patients’ pain.

Interestingly, the draft policy purports to not create a new standard of practice or claim to be a so-called “best practice.” However, the Boards’ stated intention is to delineate practices that are “within the boundaries” of professional practice and is not designed to usurp a health care provider’s judgment exercised consistent with a competent health care provider. Disclaimer notwithstanding, the Boards counsel that patients must be individually assessed for pain level, tolerance, and likelihood of recovery, and that instruments should be used to obtain an objective pain threshold. Additionally, the patient must be evaluated to determine whether the patient is a candidate to abuse prescribed narcotics. The use of baseline testing is recommended. The Board recommends using a written treatment plan and that every patient should have one health care provider who controls prescribing pain medication. The Boards counsel utilizing a written agreement with the patient who will agree to be strictly monitored while on prescribed narcotics.

Whom To Call For Help

Call Kansas professional licensing attorney Danielle Sanger if you are under investigation for dispensing pain medication. Despite claims to the contrary, an investigation into your medical practice is never meaningless.  Kansas Professional Licensing Defense Attorney Sanger has the experience to vigorously defend your rights and defend you against allegations of wrong-doing. Call Attorney Sanger today at 789-979-4353 to schedule your free consultation.

Kansas Amends The Healing Arts Statute

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The Kansas legislature amended the Healing Arts Statute in 2015. The statutory amendments are designed to address certain failings of the previous statutory provisions. Furthermore, the amended sections align statutory regulations with the reality of the practice of medicine today.  The amendments impose more severe criminal punishments for practicing medicine without a license as well as augments the rules governing unprofessional conduct exposing a practitioner to potential licensing discipline.  Kansas professional licensing attorney Danielle Sanger counsels practitioners of the healing arts in Kansas to become well versed in the changes in the law and to be wary of conduct potentially subjecting oneself to discipline.

The statutory amendments cover a wide range of conduct. At the outset, the definition of healing arts was expanded to include medical treatment with the purpose of “alteration or enhancement of a condition or appearance.”  Additionally, the criminal penalty for practicing a healing art without a license—be it suspended, revoked, or otherwise—was increased from a Class B misdemeanor to a Level 10, non-person felony. This crime carries the potential for imprisonment of up to 6 months and probation for at least 12 months. The statute also authorized a more severe civil penalty of $1,000 per day for practicing without a license. The costs of prosecution may be included in addition to the daily fine. The Board of Healing Arts is permitted to seek an injunction against any person found to be practicing medicine without a license as well.

Significantly, the statutory amendments introduced new grounds for disciplinary action. The amendments added two criminal dispositions to the list of criminal dispositions presumptively mandating discipline. A conviction by either a special or a general court martial irrespective of a conviction of a Class A misdemeanor or felony or a similar crime in another jurisdiction will now warrant discipline. The amendment created the presumption of revocation following the conviction of a felony or like offense in another jurisdiction and for a conviction at a general court martial. The Board may decline to revoke if the Board determines by 2/3 vote that the practitioner is not a danger to anyone and that the person has been rehabilitated so as to not violate the public trust.

The statutory amendments also reflect the growing need to monitor health care professionals who are suffering an inability to competently practice a healing art. The amendments alter the language of the previous statute. Ostensibly in an effort to maintain the public trust, the previous safeguards afforded to the professions have been omitted. The statute now reads the “licensee’s ability … is impaired” by illness or drugs.  The previous statutory language referred to the licensee’s inability to practice. All documents obtained through an investigation shall remain confidential and will not be released to anyone for any purpose other than by use for the Board.

The amendments expanded upon the definition of professional incompetence. Interfering with a Board investigation is now included within that definition. Acts considered obstructing or interfering are

  1. falsifying or concealing a material fact;
  2. knowingly making or causing to be made any false or misleading statement or writing; or
  3. other acts or conduct likely to deceive or defraud the Board.

Furthermore, the newly passed statute has revised certain aspects of disciplinary procedure for licensees. The amendment expands the professional designations subject to discipline from merely licensees to include registrants, certificate holders, and permit holders. These additional professional designations may receive the benefit of a professional development plan in lieu of discipline. All of these professions are also subject to the Board of Healing Art’s subpoena power. This power was expanded to have the authority to compel production of evidence if the person previously failed to comply with a subpoena. The person subpoenaed may contest the subpoena but must first rely on the administrative remedy of appealing to the Board prior to appealing the ruling to the district court. Importantly, every person practicing a healing art is now obligated to report a violation of the law related to practicing the healing arts to the Board of which they have knowledge.

Consult An Experienced Professional Licensing Attorney For More Information

 Kansas Professional License Defense Lawyer Danielle Sanger is a dedicated advocate for all practitioners of the healing arts. She will vigorously and zealously fight to protect your livelihood. Call Attorney Sanger today at 785-979-4353 for your free consultation.

 

Recently Enacted Statute Permits Collaborative Practice Arrangements

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A recently enacted bill allows medical school graduates to practice medicine in collaboration with supervising physicians. The statute, known as Section 334.036, permits assistant physicians to practice medicine in rural or underserved locations in Missouri. The law facilitates delivery of health care services to citizens who have little or no opportunity to avail themselves of quality health care while providing aspiring physicians with a forum for practical skill development. The law delineates the practices an assisting physician may undertake as well as identifies the ethical responsibilities of the assisting physician and supervising physician. Missouri professional licensing attorney Danielle Sanger advises that physicians who agree to supervise a student physician under a collaborative practice arrangement must familiarize themselves with the requisite ethical standards to avoid potential pitfalls.

An assistant physician may practice medicine only in compliance with strict adherence to established guidelines. An assistant physician must be licensed in Missouri. An applicant must have graduated from medical school and be a citizen of the United State or a legal alien. Moreover, the applicant must have successfully completed Steps 1 and 2 of the United States Medical Licensing Examination within two years of applying to become an assistant physician.  However, the applicant is ineligible if applying to be an assistant physician more than three  years after graduation. A person is also eligible to apply if the postgraduate residency has not been completed but has passed Step 2. Moreover, the applicant must be fluent in English.

The assistant physician is limited in practice. The assistant physician’s medical practice is limited to primary care in rural or underserved areas or as part of a pilot project area. The assistant physician may self-identify as an assistant physician but is permitted to use the terms “doctor” or “doc.”  The assistant may administer medical treatment in an emergency situation; however, the practice of medicine is prohibited unless the assistant physician is a signatory to a collaborative practice arrangement with a supervising physician. The assistant physician may prescribe narcotics listed in Schedules III, IV, and V of Section 195.017 once they properly obtain a certificate to prescribe drugs and have appropriate registrations filed with the Federal Drug Administration as well as the Missouri bureau of dangerous drugs. The assistant may only prescribe medications listed in Schedule II if the medication contains hydrocodone and the prescription is limited to a five-day course. Moreover, the assistant physician may not prescribe medication for personal use or to members of their families.

A collaborative practice arrangement must be executed between assistant physician and supervising physician. To be valid, the collaborative practice agreement must be in writing and contain agreed-upon protocols or “standing orders for the delivery of medical services.”  In addition, the collaborative practice agreement can give the assistant physician authority to administer treatment and write prescriptions, consistent with statutory limitations, provided that the care administered is consistent with the assistant physician’s skills, training, and experience. The arrangement must include a provision indicating that a notice shall be displayed in the physician’s office including a list of prescriptions the assistant physician may prescribe and a notice that the patient may be seen by an assistant physician. The notice must include a statement that the patient has the right to be examined by a physician and not the assistant.

The collaborating physician has many obligations when undertaking the role of supervising physician.  The supervising physician must review a minimum of 10 percent of the assistant physician’s charts every 14 days. Additionally, the collaborating physician must review a minimum of 20 percent of the assistant’s charts in which prescriptions were written.  Moreover, the collaborating physician must document a one-month time frame during which the assistant practices exclusively with the collaborating physician before the assistant can see patients alone.  Additionally, the assistant must practice with the collaborating physician for 120 hours in a four-month period before the assistant is permitted to prescribe medications.

Attention To Detail Will Prevent Disciplinary Action

The assistant physician is practicing medicine on the license of the collaborating physician. Any ethical transgressions committed by the assistant may be attributed to the collaborating physician. Contact Missouri Professional Licensing Attorney Danielle Sanger at 785-979-4353 to schedule a no-obligation consultation to discuss disciplinary issues you face as a result of a collaborative practice arrangement.

Physician Assistants In Kansas Must Be Aware Of New Regulations

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On January 11, 2016, amendments to the regulations governing physician assistants in Kansas became effective. Generally speaking, the new regulations permit greater flexibility to physician assistants in some aspects while placing greater responsibility on the attending physician. The goal of the amendments is better patient care. Being aware of the changes is vitally important to both the physician and the physician’s assistant. Failing to follow the new changes may jeopardize your physician assistant’s license. Kansas professional licensing attorney Danielle Sanger stakes her reputation on fighting for licensees who are facing the specter of discipline.

The new amendments to the regulations governing physician assistants introduce a series of definitions for terms of art currently used in the profession to describe the relationship between a physician’s assistant and the supervising physician. For instance, the amendments define “supervision” as overseeing delegated medical care to the physician’s assistant. A substitute supervising physician is defined as the physician who agrees to take a supervisory role of the physician’s assistant when the primary supervising physician is unavailable. The phrase “different practice location” is a place where medical treatment is dispensed to patients where the supervising physician or substitute supervising physician practices less than 20% of the time. A medical care facility is exempted from this definition. “Direct supervision” is defined in the amendments as the supervising or substitute supervising physician being physically present and able to take over immediate care of the patient if so required. This is in contrast to the situation when the supervising physician is communicating with the physician’s assistant telephonically or via electronic communication.  That method of supervision is defined as “off-site supervision.” However, “indirect supervision” means that the supervising physician or substitute supervising physician can be on site to take over care of the patient in 15 minutes or less.

The amendments to the regulations define the limits on the scope of a physician assistant’s practice. The regulations allow a physician assistant to administer medical treatment to a patient when the supervising physician or substitute supervising physician authorizes and coordinates such treatment when the supervisor is physically present.  The physician assistant is also allowed to treat a patient when authorized and coordinated with the supervisor through “verbal or electronic communication.” The physician assistant may also render care to a patient consistent with the active practice request form which is required to be filed with the Kansas Board of Healing Arts. Lastly, the physician assistant may medically treat a patient in an emergency situation.

The physician assistant must file an active practice request form with the Kansas Board of Healing Arts. The physician assistant must disclose a significant amount of information on the active practice request form. Information such as identifying supervising and substitute supervising physicians, a disclosure of the nature of the medical services to be provided, and whether the supervising physicians will be present at the same location as the physician assistant. If not, the physician assistant must state that they have practiced at least 80 hours under the direct supervision of the supervising physician. The physician assistant and the supervising physician must also file a written agreement with the active practice request form. The agreement must contain a list of services the physician assistant may and may not perform. A list of prescription drugs the physician assistant is authorized to dispense must also be included in the agreement.  The practice request form must also memorialize the physician’s and substitute physician’s consent to be available for communication with the physician assistant during business hours.  It is important to note that the active request form must be filed with the Kansas Board of Healing Arts on or before July 1, 2016.

For More Information, Contact the Sanger Law Office Now

Keeping current in your field of practice is vital to satisfying the ethical standards of a physician assistant. It is critical, therefore, that you read and understand your obligations as a physician assistant. Kansas Professional Licensing Attorney Danielle Sanger advises physician assistants and other medical arts practitioners. Call Attorney Sanger today at 785-979-4353 for your no-obligation consultation.