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Regulation of
Physicians
Topics Covered on This Page
Licensing
Standard of
Conduct
Complaint
Process
Discipline
Appellate
Avenues
Public Access to Disciplinary and Licensing
Information
About the
Authors
Footnotes
By Carl Olson
Vermont Medical Society
Chapter Editor:
Madeleine Mongan, Esq.
Vermont Medical Society
Note: This information is provided to assist interested persons in
becoming familiar with the law pertaining to the regulation of
physicians in Vermont. It is not an official interpretation or statement
of policy by the Department of Health or the Vermont Board of Medical
Practice and does not constitute legal advice.
Overview
What state
agency is responsible for licensing and disciplining physicians,
podiatrists, physician assistants, and anesthesiologist assistants in
Vermont?
The Vermont Board of Medical Practice, which was transferred from
the Secretary of State’s Office to the Vermont Department of Health in
2002, licenses physicians and podiatrists, and certifies
physician assistants and anesthesiologist assistants. The Board also
investigates complaints and issues findings and actions regarding
unprofessional conduct. The Board’s stated mission is to
evaluate the fitness of professionals to practice in Vermont, and to
take prompt action where needed to protect the public health and safety.
The Board consists of 17 members: nine physicians, one physician
assistant, one podiatrist, and six public members. Members are
appointed by the governor and may serve for up to two five-year terms.
In 2005, there were 31 board actions, including seven
that resulted in the loss of license and seven that resulted in
restriction of license, as defined by the Federation of State Medical
Boards.
In 2005, there were 3,095 Board licensed physicians, with 1,855
practicing in Vermont.
What state
agency is responsible for licensing and disciplining doctors of
osteopathy, advance practice registered nurses and other health care
professionals in Vermont?
The Office of Professional Regulation, part of the Secretary of State’s
office, is responsible for overseeing discipline of many licensed,
certified and registered health care professionals, including
osteopathic physicians and nurses.
Osteopathic physicians, dentists and nurses have boards which function
similarly to the the Board of Medical Practice, but they are regulated
by different laws.
Note: the discussion of licensing and discipline below applies to the
physicians and other health care professionials licensed by the Vermont
Board of Medical Practice.
The
information regarding the Board’s Rules was obtained from Rules that are
currently being revised to conform to statutory changes made in 2002.
Licensing
How do I obtain a Vermont
Medical License?
In order to be granted a license to practice medicine the applicant
must present evidence satisfactory to the Board that the applicant:
- Is at least 18 years of
age;
- Is competent in speaking,
writing and reading the English language;
- Has completed high school
and two years of college or the equivalent;
- Is a graduate of a
Board-approved medical school, or a medical school accredited by the
LCME or CACMS;
- Has met the Board's
criteria for postgraduate training;
- Has met the Board's
criteria for license by examination; license by reciprocity; or
license by appointment to the faculty of a Vermont medical college;
- Has presented reference
forms as to moral character and professional competence; and
- Has been interviewed by a
Board member, the licensing committee, and/or the Board.
All application material can
be found at:
http://healthvermont.gov/hc/med_board/application.aspx.
It is the applicant’s personal responsibility to ensure complete and
accurate responses to all application questions.
What does the renewal
process consist of?
Licenses are renewed on a fixed biennial schedule. A physician must
renew his or her license before it lapses. The date on which a license
shall lapse is printed on the license. One month before such date, the
Board will mail each licensed physician a renewal application and notice
of the renewal fee to the address last provided to the Board. It is the
licensee’s personal responsibility to ensure complete and accurate
responses to all renewal application questions. If a physician does not
return the completed renewal application and fee to the Board by the
date on which the license shall lapse, the physician's license will
lapse automatically. Licensees have a continuing obligation during each
two-year renewal period to promptly notify the Board of any change or
new information regarding disciplinary or other action limiting or
conditioning their license or ability to practice in any licensing
jurisdiction. Failure to do so may subject the licensee to disciplinary
action by the Board.
If a license has not been
renewed by the required date, it has lapsed. A physician may not legally
practice in Vermont after a license has lapsed. The physician must halt
the practice of medicine until the license has been reinstated.
What are the Clinical
Practice Questions that are required to be submitted with the Renewal
Application?
The Clinical Practice Questions are survey questions that describe
your clinical practice setting, location and specialties; the amount of
time you spend providing direct patient care; and whether your practice
is open to new patients, including new Medicaid and Medicare patients.
The Clinical Practice Questions also ask about where you did your
training, when you began to practice in Vermont and whether you are
planning to retire or reduce your patient care hours in the next five
years.
Who
participates in this survey?
The Board sends the Clinical Practice Questions survey to all MDs
and PAs at the time of their license renewal. The DO Board also sends
the survey to DOs with their renewal applications and the DO data is
combined with the MD data to produce the final Physician Survey report.
While all Vermont licensed physicians who provide patient care in
Vermont are included in the survey, physicians who maintain their
Vermont licenses, but do not practice in Vermont are excluded. Also
excluded are federally employed physicians who only provide patient care
in federal facilities and who do not have a Vermont license. Residents,
clinical fellows and research fellows are not included in the report
since not all physicians participating in residency programs are
required to have a Vermont license. The Nursing and Dental Boards survey
advance practice registered nurses and dentists, respectively.
What purpose does
collecting the information in the Clinical Practice Questions survey
serve?
The data collected through the survey is analyzed by the Department
of Health and used to create survey and statistical reports. The data in
the reports is important to the Department of Health, the Vermont
Medical Society (VMS) and others because it provides accurate
information about the supply of physicians and other health care
professionals in Vermont and their distribution by geography and
specialty. This information is also important to establish the shortage
area designations that are used to obtain federal grants for critical
access hospitals, federally qualified health centers and rural health
clinics. The data are also used for recruitment and retention activities
throughout Vermont, including allocation of loan repayment funds. The
information is also used to document the relationship between the level
of Medicaid reimbursement and patient access to health care services
reflected in the declining numbers of practices that are open to
Medicaid patients.
Where can I see the results of the Clinical Practice Questions surveys?
Results from the physician surveys and surveys of other health
professionals including dentists, physician assistants, and advance
practice registered nurses are available on the Department of Health web
site at
http://healthvermont.gov/pubs/Publications.aspx#phstat.
How do I reinstate my
lapsed license?
To seek reinstatement after failing to renew, a physician must
complete in full the renewal application and tender it to the Board with
a late fee in addition to the fee required for renewal. The Board may
stay the decision on the application pending investigation of charges or
allegations of unprofessional conduct against the renewal applicant. The
Board may seek or request such additional information as it deems needed
to make a determination as to the renewal application. The Board may
deny the renewal of a license on grounds of unprofessional conduct as
set forth under Vermont law, after notice and opportunity to be heard
has been provided to the physician.
If a license is lapsed for one
year or more the physician must complete a reinstatement application in
full and pay the application fee. The reinstatement application requires
additional information beyond that required in the standard renewal
application. A chronological accounting of the physician's professional
activities in other jurisdictions during the period the license was
lapsed in Vermont must be presented. The physician must include:
- A letter from the chief of
staff of each hospital at which he or she held privileges during the
period in which the Vermont license was lapsed; and
- A license verification from
each state in which he or she held an active license during the period
in which the Vermont license was lapsed.
In addition, he or she must
appear for a personal interview. Reinstatement may be denied on grounds
of unprofessional conduct as set forth under Vermont law or for other
good cause, after notice and opportunity to be heard has been provided
to the physician.
How are physician
assistants certified?
Physician assistants receive a certification that authorizes them to
practice only within the employment contract and scope of practice
submitted and approved by the Board. They must file the necessary
documents and obtain Board approval in advance to change or add a new
employer, to change their supervising physician(s), to add new practice
sites or to otherwise make any changes to their scope of practice as
approved by the Board. Their certification and authority to practice
terminates immediately upon dissolution of the employment contract that
was approved for a particular certification and does not resume unless
and until a new certification is issued by the Board.
What actions constitute
unprofessional conduct?
The following actions constitute unprofessional conduct:
- Fraudulent or deceptive
procuring or use of a license;
- All advertising of medical
business which is intended or has a tendency to deceive the public or
impose upon credulous or ignorant persons and so be harmful or
injurious to public morals or safety;
- Abandonment of a patient;
- Addiction to narcotics,
habitual drunkenness or rendering professional services to a patient
if the physician is intoxicated or under the influence of drugs;
- Promotion by a physician of
the sale of drugs, devices, appliances or goods provided for a patient
in such a manner as to exploit the patient for financial gain of the
physician or selling, prescribing, giving away or administering drugs
for other than legal and legitimate therapeutic purposes;
- Conduct which evidences
unfitness to practice medicine;
- Willfully making and filing
false reports or records in his or her practice as a physician;
- Willful omission to file or
record, or willfully impeding or obstructing a filing or recording, or
inducing another person to omit to file or record medical reports
required by law;
- Failure to make available
promptly to a person using professional health care services, that
person's representative, succeeding health care professionals or
institutions, when given proper written request and direction of the
person using professional health care services, copies of that
person's records in the possession or under the control of the
licensed practitioner;
- Solicitation of
professional patronage by agents or persons or profiting from the acts
of those representing themselves to be agents of the licensed
physician;
- Division of fees or
agreeing to split or divide the fees received for professional
services for any person for bringing to or referring a patient;
- Agreeing with clinical or
bio-analytical laboratories to make payments to such laboratories for
individual tests or test series for patients, unless the physician
discloses on the bills to patients or third party payors the name of
such laboratory, the amount or amounts to such laboratory for
individual tests or test series and the amount of his or her
processing charge or procurement, if any, for each specimen taken;
- Willful misrepresentation
in treatments;
- Practicing medicine with a
physician who is not legally practicing within the state, or aiding or
abetting such physician in the practice of medicine; except that it
shall be legal to practice in an accredited preceptorship or residency
training program;
- Gross overcharging for
professional services on repeated occasions, including filing of false
statements for collection of fees for which services are not rendered;
- Offering, undertaking or
agreeing to cure or treat disease by a secret method, procedure,
treatment or medicine;
- Consistent improper
utilization of services;
- Consistent use of
nonaccepted procedures which have a consistent detrimental effect upon
patients;
- Professional incompetency
resulting from physical or mental impairment;
- Permitting one's name or
license to be used by a person, group, or corporation when not
actually in charge of or responsible for the treatment given;
- In the course of practice,
gross failure to use and exercise on a particular occasion or the
failure to use and exercise on repeated occasions, that degree of
care, skill and proficiency which is commonly exercised by the
ordinary skillful, careful and prudent physician engaged in similar
practice under the same or similar conditions, whether or not actual
injury to a patient has occurred;
- Revocation of a license to
practice medicine or surgery in another jurisdiction;
- Failure to comply with the
provisions of the Vermont Bill of Rights for Hospital Patients;
- Failure to comply with an
order of the Board or violation of any term or condition of a license
which is restricted or conditioned by the Board;
- Any physician who, in the
course of a collaborative agreement with a nurse practitioner allows
the nurse practitioner to perform a medical act which is outside the
usual scope of the physician's own practice or which the nurse
practitioner is not qualified to perform by training or experience, or
which the ordinary reasonable and prudent physician engaged in a
similar practice would not agree should be written into the scope of
the nurse practitioner's practice;
- Failure to comply with
provisions of federal or state statutes or rules governing the
practice of medicine or surgery;
- Practice of profession when
medically or psychologically unfit to do so;
- Delegation of professional
responsibilities to a person whom the licensed professional knows, or
has reason to know, is not qualified by training, experience,
education or licensing credentials to perform them;
- Conviction of a crime
related to the practice of the profession or conviction of a felony,
whether or not related to the practice of the profession;
- Use of the services of an
anesthesiologist assistant by an anesthesiologist that is inconsistent
with the assistants’ certification;
- The board may also find
that failure to practice competently by reason of any cause on a
single occasion or on multiple occasions constitutes unprofessional
conduct. Failure to practice competently includes, as determined by
the board, performance of unsafe or unacceptable patient care or
failure to conform to the essential standards of acceptable and
prevailing practice;
- The use of the services of
a physician's assistant or a physician's assistant trainee by a
physician that is inconsistent with the assistant’s certification is
also classified as unprofessional conduct.
Additionally, the Board may
suspend or revoke a license for the following:
- Conviction of the practice
of criminal abortion;
- Having obtained or sought
to obtain through fraudulent representations money or any other thing
of value, or assuming names other than their own;
- Immoral, unprofessional or
dishonorable conduct;
- Admission to a mental
hospital;
- Becoming incompetent by
reason of senility.
Can failure to comply
with the Hospital Patients’ Bill of Rights result in disciplinary action
against physicians?
The Vermont Patients’ Bill of Rights, set out below, also creates
standards of conduct that physicians must follow when treating patients
admitted to hospitals on an inpatient basis. The violation of the
following patients’ rights may be reported to the Board and may
constitute unprofessional conduct.
1)
The patient has the right to considerate and respectful care at all
times and under all circumstances with recognition of his or her
personal dignity.
(2)
The patient shall have an attending physician who is responsible for
coordinating a patient's care.
(3)
The patient has the right to obtain, from the physician coordinating his
or her care, complete and current information concerning diagnosis,
treatment, and any known prognosis in terms the patient can reasonably
be expected to understand. If the patient consents or if the patient is
incompetent or unable to understand, immediate family members, a
reciprocal beneficiary or a guardian may also obtain this information.
When it is not medically advisable to give such information to the
patient, the information shall be made available to immediate family
members, a reciprocal beneficiary or a guardian. The patient has the
right to know by name the attending physician primarily responsible for
coordinating his or her care.
(4)
Except in emergencies, the patient has the right to receive from the
patient's physician information necessary to give informed consent prior
to the start of any procedure or treatment, or both. Such information
for informed consent should include but not necessarily be limited to
the specific procedure or treatment, or both, the medically significant
risks involved, and the probable duration of incapacitation. Where
medically significant alternatives for care or treatment exist, or when
the patient requests information concerning medical alternatives, the
patient has the right to such information. The patient also has the
right to know the name of the person responsible for the procedures or
treatment, or both.
(5)
The patient has the right to refuse treatment to the extent permitted by
law. In the event the patient refuses treatment, the patient shall be
informed of the medical consequences of that action and the hospital
shall be relieved of any further responsibility for that refusal.
(6)
The patient has the right to every consideration of privacy concerning
the patient's own medical care program. Case discussion, consultation,
examination, and treatment are confidential and shall be conducted
discreetly. Those not directly involved in the patient's care must have
the permission of the patient to be present. This right includes the
right, upon request, to have a person of one's own sex present during
certain parts of a physical examination, treatment or procedure
performed by a health care professional of the opposite sex; and the
right not to remain disrobed any longer than is required for
accomplishing the medical purpose for which the patient was asked to
disrobe. The patient has the right to wear appropriate personal clothing
and religious or other symbolic items so long as they do not interfere
with diagnostic procedures or treatment.
(7)
The patient has the right to expect that all communications and records
pertaining to his or her care shall be treated as confidential. Only
medical personnel, or individuals under the supervision of medical
personnel, directly treating the patient, or those persons monitoring
the quality of that treatment, or researching the effectiveness of that
treatment, shall have access to the patient's medical records. Others
may have access to those records only with the patient's written
authorization.
(8)
The patient has the right to expect that within its capacity a hospital
shall respond reasonably to the request of a patient for services. The
right shall include if physically possible a transfer to another room or
place if another person in that room or place is disturbing the patient
by smoking or other unreasonable actions. When medically permissible a
patient may be transferred to another facility only after receiving
complete information and explanation concerning the needs for and
alternatives to such a transfer. The institution to which the patient is
to be transferred must first have accepted the patient for transfer.
(9)
The patient has the right to know the identity and professional status
of individuals providing service to him or her, and to know which
physician or other practitioner is primarily responsible for his or her
care. This includes the patient's right to know of the existence of any
professional relationship among individuals who are treating him or her,
as well as the relationship to any other health care or educational
institutions involved in his or her care.
(10)
The patient has the right to be advised if the hospital proposes to
engage in or perform human experimentation affecting the patient's care
or treatment. Participation by patients in clinical training programs or
in the gathering of data for research purposes shall be voluntary. The
patient has the right to refuse to participate in such research
projects.
(11)
The patient has the right to expect reasonable continuity of care. The
patient has the right to be informed by the attending physician of any
continuing health care requirements following discharge.
(12)
The patient has the right to receive an itemized, detailed and
understandable explanation of charges regardless of the source of
payment.
(13)
The patient has the right to know what hospital rules and regulations
apply to his or her conduct as a patient.
(14)
Whenever possible, guardians or parents have the right to stay with
their children 24 hours per day. Whenever possible, agents, guardians,
reciprocal beneficiaries or immediate family members have the right to
stay with terminally ill patients 24 hours a day.
(15)
A patient who does not speak or understand the predominant language of
the community has a right to an interpreter if the language barrier
presents a continuing problem to patient understanding of the care and
treatment being provided. A patient who is hearing impaired has a right
to an interpreter if the impairment presents a continuing problem to
patient understanding of the care and treatments being provided.
(16)
The patient has the right to receive professional assessment of pain and
professional pain management.
(17)
The patient has the right to be informed in writing of the availability
of hospice services and the eligibility criteria for those services.
(18)
The patient has the right to know the maximum patient census and the
full-time equivalent numbers of registered nurses, licensed practical
nurses, and licensed nursing assistants who provide direct care for each
shift on the unit where the patient is receiving care.
Does the Board have a
policy on termination of the physician-patient relationship?
The Board has issued a policy statement in 1999 to provide
clarification on the termination of the physician-patient relationship.
Abandonment of a patient constitutes unprofessional conduct, and the
Board has stated that when presented with a complaint of abandonment,
the Board will consider:
- Whether the physician gave
the patient timely notice of the termination (at least 30 days);
- Whether the physician
provided necessary treatment for an existing problem and/or emergency
care during the transition period (at least 30 days); and
- Whether the physician
diligently transferred records to another physician chosen by the
patient.
The notice of termination
should be in writing and delivered to ensure that the patient receives
the notice, and all records should be transferred promptly regardless of
any outstanding bills.
Does the Board have a
policy on the use of controlled substances for the treatment of pain?
The Board adopted a policy regarding the use of controlled
substances for the treatment of pain in 1996 and updated it in 2005.
Recognizing both that appropriate treatment of pain includes prescribing
controlled substances and that controlled substances are subject to
abuse, the Board stated that it would consider the prescribing,
ordering, dispensing or administering of controlled substances for pain
to be for a legitimate medical purpose if based on a sound clinical
judgment. The policy describes guidelines with respect to each of the
following:
- An evaluation of the
patient;
- A written treatment plan;
- The informed consent and
agreement for treatment from the patient;
- Periodic review by the
physician of the treatment plan;
- Consultation with
appropriate specialists;
- Accurate documentation in
the patient’s medical record;
- Evaluation of patient
behaviors that may indicate prescription medication abuse or
diversion; and
- Compliance with controlled
substances laws and regulations.
The Board policy also includes
two sample contracts physicians can use with patients who are being
treated with controlled substances for chronic conditions, and a sample
tracking sheet for prescriptions of controlled substances.
Complaint
Process
What kind of complaints
does the Board investigate?
The Board investigates all complaints of unprofessional conduct.
Anyone wishing to make a complaint of unprofessional conduct against a
physician, podiatrist, physician assistant, or anesthesiologist
assistant may file a written complaint with the Board.
A complaint must be signed and include a release of medical records
form. Additionally, any hospital, clinic, community mental health center
or other health care institution in which a licensee performs
professional services shall report to the commissioner of health, along
with supporting information and evidence, any disciplinary action taken
by it or its staff which significantly limits the licensee's privilege
to practice or leads to suspension or expulsion from the institution,
and an insurer must also report judgments or settlements involving a
claim of professional negligence by a licensee.
Additionally, the Board has authority to undertake any actions and
procedures to carry out its duties, which includes the ability to open
an investigation on its own initiative to evaluate instances of possible
unprofessional conduct prior to sending a formal notice of complaint to
the respondent.
How does the Board conduct
its investigation?
The Board will send the respondent a copy of the complaint, a copy
of the release of medical records signed by the patient or other
authorized person, a copy of the grounds of unprofessional conduct, and
a standard letter stating that:
- This complaint has been
lodged against him or her;
- The letter is not a notice
of a formal hearing;
- The matter will be
investigated by a committee of the Board working with the Attorney
General's Office; and
- Respondent's answer should
be addressed to the North, Central or South Committee at the address
of the Board and filed with the Board within 10 days of the date of
the letter.
The Board may also require the
physician to submit to a mental or physical examination, and an
evaluation of medical knowledge and skill if the Board has a reasonable
basis to believe a licensee or applicant may be incompetent or unable to
practice medicine with reasonable skill and safety.
One of the three geographic
investigating committees, or one specially appointed, and an assistant
attorney general, will investigate each complaint and recommend
disposition to the Board. An investigator from the Board will assist the
committee.
Each committee consists of Board members, including at least one public
member.
After the file is received, the committee will discuss the complaint and
plan the investigation. All complaints are investigated.
What happens when the Board
finishes its investigation?
Once the committee is satisfied that the investigation is complete,
it shall present its recommendation for final disposition to the Board.
The committee may recommend one of five possible dispositions depending
on the results of the investigation:
If, after investigating the
complaint, the committee and the assistant attorney general are
convinced that the alleged misconduct does not constitute unprofessional
conduct, then the committee must recommend that the Board conclude the
investigation. A concluded investigation may be reopened if new evidence
is received or an additional complaint is made.
Under what circumstances
might the Board issue a stipulated settlement and consent order?
When an investigation demonstrates a case of unprofessional conduct,
the committee may recommend disposition, including the possibility of
stipulated settlements and consent orders.
Recommended settlements
include a concession of wrongdoing by the licensee, terms and
conditions, an understanding that the concession may be relied on by the
Board in case the licensee is later found to have engaged in
unprofessional conduct, and an understanding that this final disposition
of the complaint is public and that the Board shall notify the
Federation of State Medical Boards Board Action Data Bank, the National
Practitioner Data Bank and the Healthcare Integrity and Protection Data
Bank, and may notify other states of its contents. The entire agreement
as drafted by the committee and the assistant attorney general will be
expressly conditioned on acceptance by the Board.
Under what circumstances
might the Board summarily suspend a physician’s license?
The committee may find that certain alleged misconduct poses so
grave a threat to the public health, safety, or welfare that emergency
action must be taken. In such a case, the committee will promptly
schedule a hearing, and recommend that the Board order summary
suspension of the respondent's license, pending a hearing under the
authority of 3 V.S.A. § 814(c). If the Board orders summary suspension,
a hearing will be scheduled as soon as practical, and the assistant
attorney general will present the case against the suspended licensee.
Under what circumstances
might the Board file a formal specification of charges?
If the complaint alleges unprofessional conduct and the committee
believes a settlement cannot be reached or is not warranted on the
facts, the committee shall recommend the filing of a specification of
charges with the Board, setting out the allegations against the licensee
in accordance with 3 V.S.A. § 809.
The assistant attorney general will draft the charges and file them with
the Board. The Board secretary shall prepare the charges for service by
signing them. The charges, together with a notice of hearing, shall be
served upon the respondent.
What happens once a formal
specification of charges is filed?
The Board commences disciplinary proceedings by serving a
specification of charges and a notice of hearing upon the respondent.
The hearing is scheduled no sooner than 30 days after service. The
notice shall tell the respondent that he or she may file a response
within 20 days of service, and state that the respondent has a right to
appear at the hearing with counsel and produce their own witnesses and
evidence.
If the respondent does not
respond to charges or appear at a hearing, after proper notice, the
allegations of the charges shall be treated as proven, and the Board may
take disciplinary action. Upon a request by the respondent and a showing
of good cause, the Board may remove a default judgment and schedule a
new hearing.
After a specification of
charges has been filed, the Board, or its legal counsel on its behalf,
shall have authority to conduct a prehearing conference or discovery
conference and to issue orders regulating discovery and depositions,
scheduling, motions by the parties, and such other matters as may be
necessary to ensure orderly preparation for hearing.
The hearing will be conducted
according to the contested case provisions of the Administrative
Procedure Act [3 V.S.A. §809-815]. The Board may authorize its legal
counsel to preside at hearings for the purpose of making procedural and
evidentiary rulings. A presiding officer may administer oaths and
affirmations, rule on offers of proof and receive relevant evidence,
regulate the course of the hearing, convene and conduct prehearing
conferences, dispose of procedural requests and similar matters, and
take any other action authorized by the Administrative Procedure Act.
The burden of proof in a disciplinary action shall be on the state to
show by a preponderance of the evidence that the person has engaged in
unprofessional conduct.
Board legal counsel will
prepare the written decision and order in accordance with the Board's
instructions, within a reasonable time of the closing of the record in
the case. A decision and order is effective upon entry. Notice of the
decision and order will be sent to the respondent by certified mail and
to the respondent's attorney, the complainant, and the prosecuting
attorney by regular mail.
On what other basis might
the Board bring unprofessional conduct charges against a physician?
Upon receipt of a certified
copy of a judgment of criminal conviction, the Board may order an
interim suspension pending a disciplinary hearing before the Board. A
disciplinary hearing following such suspension shall not be held until
the judgment of conviction has become final, unless respondent requests
that the disciplinary hearing be held without delay. The sole issue to
be determined at the hearing shall be the nature of the disciplinary
action to be taken by the Board. The respondent, within 90 days of the
effective date of the order of interim suspension, may request a hearing
concerning the interim suspension at which respondent shall have the
burden of demonstrating why the interim suspension should not remain in
effect. The interim suspension shall automatically terminate if
respondent demonstrates that the judgment of conviction has been
reversed or otherwise vacated.
Upon receipt of a certified
copy of an order or statement regarding a relevant out-of-state
disciplinary action, the Board may order an interim suspension pending a
disciplinary hearing before the Board. The respondent, within 90 days of
the effective date of the order of interim suspension, may request a
hearing concerning the interim suspension at which respondent shall have
the burden of demonstrating why the interim suspension should not remain
in effect. The interim suspension shall automatically terminate if
respondent demonstrates that the out-of-state disciplinary action has
been reversed or vacated.
What are potential board
actions for unprofessional conduct?
Physicians found guilty of unprofessional conduct either after a
hearing or by entering into a settlement can face a range of actions
that the Board determines proper, including but not limited to:
- Reprimands;
- Conditioning of license;
- Limiting of license;
- Suspension of license;
- Revocation of license.
What does an appeal consist
of?
A party aggrieved by a final order of the Board may, within 30 days
of the order, appeal that order to the Vermont Supreme Court on the
basis of the record created before the Board.
Resources:
Vermont
Medical Society
134 Main Street
P.O. Box 1457
Montpelier, Vermont 05601
802-223-7898
http://www.vtmd.org/
Vermont Board of Medical
Practice
PO Box 70
101 Cherry Street – physical location
108 Cherry Street – mailing address
Burlington, VT 05402-0070
802-657-4220
medicalboard@vdh.state.vt.us
http://healthvermont.gov/hc/med_board/bmp.aspx
What information about
physicians is published by the Vermont Department of Health on the
Department website?
Vermont requires the Department of Health to maintain a data repository
and to publish profiles of all health care
professionals
licensed, certified, or registered by the department. The information is
collected through the physicians’ license renewal applications, and
physicians must update the Department of Health with any changes.
The Vermont Physician Profile, which can be viewed at
http://healthvermont.gov/hc/med_board/profile_search.aspx, is
comprised of the following information provided by physicians:
1)
A description of any criminal convictions for felonies and serious
misdemeanors, as determined by the commissioner of health, within the
most recent 10 years. For the purposes of this subdivision, a person
shall be deemed to be convicted of a crime if he or she pleaded guilty
or was found or adjudged guilty by a court of competent jurisdiction.
2) A
description of any charges to which a health care professional pleads
nolo contendere or where sufficient facts of guilt were found and the
matter was continued without a finding by a court of competent
jurisdiction.
3)
A description of any formal charges served,
findings, conclusions, and orders of the licensing authority, and final
disposition of matters by the courts within the most recent 10 years.
4)
A description of any formal charges served
by licensing authorities, findings, conclusions, and orders of such
licensing authorities, and final disposition of matters by the courts in
other states within the most recent 10 years.
5) A
description of revocation or involuntary restriction of hospital
privileges for reasons related to competence or character that has been
issued by the hospital's governing body or any other official of the
hospital after procedural due process has been afforded, or the
resignation from, or nonrenewal of, medical staff membership or the
restriction of privileges at a hospital taken in lieu of, or in
settlement of, a pending disciplinary case related to competence or
character in that hospital. Only cases that have occurred within the
most recent 10 years shall be disclosed by the board to the public.
6) All
medical malpractice court judgments and all medical malpractice
arbitration awards in which a payment is awarded to a complaining party
during the last 10 years, and all settlements of medical malpractice
claims in which a payment is made to a complaining party within the last
10 years. The following statement shall accompany information concerning
all settlements: "Settlement of a claim may occur for a variety of
reasons which do not necessarily reflect negatively on the professional
competence or conduct of the health care professional. A payment in
settlement of a medical malpractice action or claim should not be
construed as creating a presumption that medical malpractice has
occurred."
7) The
names of medical professional schools and dates of graduation.
8) Graduate
medical education.
9) Specialty
board certification.
10)
The number of years in practice.
11)
The names of the hospitals where the health
care professional has privileges.
12) Appointments
to medical school or professional school faculties, and indication as to
whether the health care professional has had a responsibility for
teaching graduate medical education within the last 10 years.
13)
Information regarding publications in
peer-reviewed medical literature within the last 10 years.
14) Information
regarding professional or community service activities and awards.
15)
The location of the health care
professional's primary practice setting.
16)
The identification of any translating
services that may be available at the health care professional's primary
practice location.
17)
An indication of whether the health care
professional participates in the Medicaid program, and is currently
accepting new patients.
The department shall provide
individual health care professionals with a copy of their profiles prior
to the initial release to the public and each time a physician's profile
is modified or amended. A health care professional shall be provided a
reasonable time to correct factual inaccuracies that appear in such
profile, and may elect to have his or her profile omit the information
required under subdivisions (a)(12) through (14) of this section.
What information about
physicians is available on the Internet?
Physician profiles, similar to those provided by the Vermont
Department of Health, can be found on most state Medical Board websites.
These state websites contain various information ranging from
demographic profiles to malpractice settlements. In addition to the
state funded profiles, many private organizations provide information
about their members. Each individual organization should be contacted to
correct any information. Below are some sources of information available
on the Internet.
The American Medical
Association maintains DoctorFinder at
http://webapps.ama-assn.org/doctorfinder/home.html, and
contains physician listings based on their Physician Masterfile.
The Association of State
Medical Board Executive Director’s maintains DocFinder at
http://www.docboard.org/docfinder.html,
and searches licensure and discipline decisions of multiple
participating states.
The Federation of State
Medical Boards maintains DocInfo at
http://www.docinfo.org/, and
makes publicly available a Disciplinary History Report service from its
nationally consolidated data bank of disciplinary histories on
U.S.-licensed physicians.
Carl Olson graduated from Brown
University with a BA in History in 2002. From 2002-2005, he worked as a
Project Associate at John Snow, Inc. in Denver, Colorado, working on
various public health projects including family planning training
assistance and health information technology implementation. Carl is
currently a second year law student at Case Western Reserve Law School
in Cleveland, Ohio.
Madeleine
Mongan
is counsel and vice president for policy for the Vermont Medical
Society,
representing the interests of the physicians who live and practice in
Vermont.
She works with the Vermont Legislature, state agencies and insurers on
health care policy and provides education and technical assistance to
Vermont physicians on legal issues. Her practice addresses a range of
health law issues including confidentiality, licensing, managed care,
public health, contracting, and fraud and abuse. She represents Vermont
physicians on the steering committee of the Vermont Bar Association Drug
Policy Committee, the Area Health Education Centers Advisory Board, and
the Vermont Health Resource Allocation Plan Board. She is a member of
the American Health Lawyers Association and the Vermont Bar Association
where she co-chairs the Health Law Committee. She received her B.A.
from the University of Delaware, M.A. from Stanford University and J.D.
from the University of California at Davis.
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