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State Medical Board of Ohio, Uncategorized

Physicians .. have you read the rules?

The practice of medicine in Ohio is outlined by one statute section, Ohio Revised Code 4731, and one set of rules drafted by the Medical Board, Ohio Administrative Code 4731. This Code section and these rule outline the requirements to be licensed as a physician, podiatrist, massage therapist or physician’s assistant in Ohio and also define the scope of practice of medicine in Ohio. However, I am always surprised that most physicians with whom I speak have no idea that these laws and rules even exist.

Ohio Revised Code Chapter 4731 is the law governing the practice of medicine in Ohio. The Ohio Administrative Code is drafted by the Medical Board members and is reviewed and approved through a rule making process. Physicians in Ohio are required to know, understand and follow the guidelines established in these laws and rules.

These laws and rules can be found at the Medical Board’s website at: http://www.med.state.oh.us. You can also follow the following link to find these sections: http://codes.ohio.gov/orc/4731
or for the administrative rules go to: http://codes.ohio.gov/oac/4731

Pertinent sections of these laws and rules include:

Basis for disciplinary action can be found at R.C. 4731.22(B) which can be found at: http://codes.ohio.gov/orc/4731.22.

To learn more about licensing and continuing education go to: OAC 4731-10, which can be found at: http://codes.ohio.gov/oac/4731-10.

To learn more about prescribing of controlled substances go to: OAC 4731-11, which can be found at: http://codes.ohio.gov/oac/4731-11.

To learn more about the Medical Board’s hearing process go to: OAC 4731-13, which can be found at: http://codes.ohio.gov/oac/4731-13.

To learn more about the duty to report to the Medical Board go to: OAC 4731-15, which can be found at: http://codes.ohio.gov/oac/4731-15.

To learn more about what to do if you believe you suffer from  chemical dependency go to: OAC 4731-17, which can be found at:  http://codes.ohio.gov/oac/4731-17.

As practicing medical professionals in Ohio, you are required to know, understand and follow the laws  and rules in ORC 4731 and OAC 4731. Take the time to read the rules and, if you have questions, contact experienced legal counsel to assist you.

As always, if you have any questions about this post, please feel free to contact me at beth@collislaw.com.

State Medical Board of Ohio

Physician, employer, friend, neighbor, lover … which hat are you wearing? Choose one.

A physician cannot have a sexual relationship with a patient that they are currently treating.  While most physicians will say that they see the “clear line in the sand” when it comes to the prohibition against having a sexual relationship with a patient, they often don’t see the other boundary violations they may be committing.  It is also a boundary violation to engage in a financial relationship with a patient or to prescribe a medication to a friend or employee without conducting a physical examination or maintaining a patient record. Professional boundaries are blurred in many ways aside from the obvious prohibition against sexual involvement with a patient.

It is important to keep in mind what role you play as a physician. If you have a doctor-patient relationship with a person, you should not employ that person in your practice, loan them money, enter into financial arrangements with them, agree to pick medications up for them at the pharmacy, agree to treat them privately for “free off the books” because they do not have insurance or for any other reason. You need to treat all persons to whom you provide medical care to the same. While you may have sympathy for a patient who does not have insurance or may not be able to get an appointment with their “regular treating doctor”, if you elect to treat someone as a patient, you must follow the accepted standards of care for such treatment.

There is no prohibition from a physician treating an employee of their practice. However, the employee needs to be treated exactly like every other patient in the practice. They need to be physically examined and a patient chart needs to be maintained for any treatment or prescribing that is done for the patient. They need to be referred out for consultation or sent for followup tests or evaluations. Their chart should also include the same history, physical and background information that you would include for any patient.

When treating friends or employees, physicians will often fail to maintain a patient record or fail to accurately record the examination and treatment that they provided to the patient. Any written record is better than no written record, however, you should prepare a written medical record for this friend/patient as you would for any other patient in your practice.

Too often, physicians allow themselves to be “cornered” by a neighbor to call them in a prescription over the weekend and then they fail to take the appropriate steps to examine the patient and document their treatment.  I have also seen physicians who have agreed to treat a patient for free and then not maintain any medical record for the patient. They have told me “I wasn’t billing insurance, so I did not create a record”. This is inappropriate. You may subject yourself to disciplinary action by the State Medical Board of Ohio if you do not maintain medical records when you treat a patient. It doesn’t matter if you are not billing insurance for your service. If you provide medical care to a patient, you need to have a medical record showing what treatment you provided.

Know what hat you are wearing. It is never a good idea to have multiple relationships with patients. However, if you choose to treat a friend or an employee, you still need to practice above the standard of care, which dictates that you record a history and physical and document the treatment you provided to the patient.

As always, if you have any questions about this post or the State Medical Board of Ohio in general, feel free check out my website at www.collislaw.com  or email me at beth@collislaw.com or call me at (614) 486-3909.

State Medical Board of Ohio

Ohio Courts will not reverse Medical Board decisions if the sanction seems too harsh

I recently read of a Medical Board disciplinary matter in the State of Illinois, in which the Illinois Medical Board revoked a physician’s medical license for engaging in a sexual relationship with a patient. Then, the Illinois Appeals court reversed the decision and sent the case back to the Illinois Board to issue an alternative sanction after finding the sanction was “overly severe” given the physician’s conduct. William Joel Kafin v. The Division of Professional Regulation of the Department of Financial and Professional Regulation.   I was struck by this case, as this would never happen in Ohio.

In Ohio, under Ohio Revised Code Chapter 119, decisions of the State Medical Board can be appealed to the Franklin County Courts. The Court will then determine if the decision of the Board was based on reliable, probative and substantial evidence and is in accordance with law. Pons v. Ohio St. Med. Bd., 66 Ohio St.3rd 619, 621. However, case-law exists in Ohio that the Courts will not reverse a decision of the Medical Board purely on the belief that the sanction is too harsh. Henry’s Cafe, Inc. v. Bd. of Liquor Control, (1950), 170 Ohio St.233. Even if the evidence is clear that the Ohio Medical Board imposed a sanction that was different or harsher than was imposed in other similarly situated cases, the Courts still not reverse a Medical Board decision.

The only way to obtain relief from a Medical Board decision by the Courts is to show that the Board based its decision on evidence that was contrary to law or was not reliable, probative or substantial. While it is not unheard of to have a Medical Board decision reversed by the Court, it is certainly an uphill battle.

It is the intent of Ohio administrative procedure law that state agencies be given the authority to regulate others in their profession. Arlen v. State Med. Bd (1980), 61 Ohio St.2d 168. Therefore, if a physician is issued a Notice of Opportunity for Hearing (citation letter), it is important to put your best case forward at the administrative hearing before the Medical Board.  The Court will rarely disturb the final decision of the Medical Board.  Unlike Illinois, Ohio courts will not reverse a Medical Board decision because the Court thinks the sanction is too harsh.

As always, if you have any questions about this post or the State Medical Board of Ohio in general, please feel free to email me at beth@collislaw.com or call me at (614) 486-3909 or see our firm website at www.collislaw.com.