© 2013 Federation of State Medical Boards

Handling Medical Complaints Fairly and Transparently J. Daniel Gifford, MD, Chair-Elect Federation of State Medical Boards United States

3 © 2013 Federation of State Medical Boards The FSMB: Who Are We? We represent all 70 state medical & osteopathic licensing boards in the U.S.A. and its territories We are a “Non-Profit” association, founded in 1912 Located in Euless, Texas, and in Washington, D.C. 183 full-time employees We co-own the USMLE (United States Medical Licensing Exam) We own the FCVS (Federation Credentials Verification Service) We have published our Journal of Medical Regulation since 1915

4 © 2013 Federation of State Medical Boards FSMB Census of U.S. Physicians (2012)  There are 878,194 physicians with an active license to practice medicine in the United States and the District of Columbia  93% are M.D. and 7% D.O.  They graduated from 1,881 schools in 166 countries  76% graduates of U.S. or Canadian medical schools  24% (196,573) are international medical graduates (IMGs) who completed GME training in the U.S.  Primarily from India, Philippines, Pakistan, and the Caribbean

5 © 2013 Federation of State Medical Boards FSMB Support of State Medical Boards Protecting the public by advocating for rigorous medical regulation and licensing standards: –Providing examination and credentials verification services –Providing public information about physician discipline –Providing a disciplinary alert system to keep state boards apprised of physician misconduct –Drafting and promoting best practices in medical regulatory procedures –Educating and advocating for state medical boards to have sufficient authority and resources to protect the public

6 © 2013 Federation of State Medical Boards A Snapshot of FSMB Support Services… USMLE Physician Data Center FCVS Legislative and Legal Research and Support Policy Development and Education

7 © 2013 Federation of State Medical Boards The Purpose of Medical Regulation Limiting the practice of medicine to qualified practitioners Protecting the public from the unprofessional, improper, unlawful or incompetent practice of medicine “The practice of medicine is a privilege, not a right”

8 © 2013 Federation of State Medical Boards U.S. Legal Authority – Medical Practice Act Medical Licensure –Assure physicians (and other health practitioners under the board’s jurisdiction) are competent and qualified to render health care services safely to the public –Evaluate education, training, examination and character Discipline –Authorized to accept and investigate complaints and sanction licensees who fail to maintain competency and professional conduct License revocation, restriction, remediation etc. –Establish and promulgate standards for medical practice

9 © 2013 Federation of State Medical Boards Complaint Process 1.Assess for jurisdiction 2.Prioritize based on potential for patient harm 3.Investigate 4.Notify physician and complainant 5.Medical review 6.Board determines action 7.Case is set for hearing 8.Adjudication 9.Public Notice

10 © 2013 Federation of State Medical Boards Sources of Complaint Information and Evidence Sources: –Patients/Family Members –Physicians/Nurses/Other Health Professionals –Hospitals –Liability Carriers –3rd Party Payers –PHPs (Physician Health Programs) –Law Enforcement/Courts –Press/Media Methods of Intake: –Written, telephone, online complaint submission

11 © 2013 Federation of State Medical Boards

12 © 2013 Federation of State Medical Boards Examples of Medical Board Disciplinary Sanctions Non-disciplinary Advisory Letter – may be public/non-public Informal Conference Letter of Reprimand Decree of Censure Probation with or without Terms (used for treatment) Restrictions on License (refrain from procedure) Suspension of License – regular or emergency License Revocation – completed or stayed

13 © 2013 Federation of State Medical Boards Transparency: Providing Information to the Public Online Physician Profiles –Medical licenses (whether active or inactive) –Final disciplinary orders –Final suspensions or revocations of hospital privileges –Criminal convictions –Malpractice (legal) payment information –Medical schools attended and graduation dates –Graduate medical education and completion dates –Specialty board certifications, if any –Area(s) of practice

© 2013 Federation of State Medical Boards Thank you!