|
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
Revised and updated by:
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. Between 2004 and 2008 there were 98
board actions, including 21 that
resulted in the loss of license and 27 that resulted in restriction of
license, as defined by the Federation of State Medical Boards.
In 2009, there were 3,272 Board licensed physicians, with 1,986
practicing in Vermont.
In 2007 there were 105 Osteopathic physicians licensed and practicing in
Vermont, and the Board of Osteopathic Physicians took disciplinary
action in 5 cases between 2004 and 2008.
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 (Board).
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 from the Vermont Board of Medical
Practice?
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. At least 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 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, DPMs
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/research/HlthCarePrvSrvys/HealthCareProviderSurveys.aspx.
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 – or that person's representative, succeeding
health care professionals or institutions – copies of that person's
records in the possession or under the control of the licensed
practitioner when given proper written request and direction of the
person using professional health care services;
-
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 incompetence 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;
-
Use of
the services of a physician assistant that is inconsistent with the
physician assistant’s 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.
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:
·
Concluding the investigation;
·
Settlement;
·
Specification of charges;
·
Interim
suspension;
·
Summary
suspension.
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; and
-
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 web sites. These
state web sites 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.
Madeleine
Mongan
is deputy executive vice president for the Vermont Medical Society,
representing the interests of the physicians who 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 Area Health Education Centers Statewide Advisory
Board. She is a member of the American Health Lawyers Association and
the Vermont Bar Association where she is past chair of 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.
|
