Georgia Osteopathic Medical Association

1. Georgia Osteopathic Medical Association Barby Simmons, DO Georgia Composite Medical Board LaSharn Hughes, MBA Executive Director

2. Composition of the Board Sixteen Board Members • 15 appointed by the Governor • Four-year terms • 13 physicians (11 MDs, 2 DOs) • Licensed and actively practicing in GA • 2 consumers • No ties to the practice of medicine • 1 physician assistant (non-voting) • Appointed by the Board

3. Number of healthcare practitioners licensed in Georgia. • Licensing authority for 8 professions with over 52,672 licensees as of October 7, 2019: • Physicians, including residents 39,380 • Physician Assistants 5,413 • Respiratory Care Professionals 5,652 • Acupuncturists 276 • Orthotists and Prosthetists 220 • Clinical Perfusionists 167 • Cosmetic Laser Practitioners 903 • Pain Management Clinics 211 • Also the approving authority for APRN prescribing protocols

4. What does the Board Do? The Board is the licensing agency for physicians, physician assistants, respiratory care professionals, perfusionists, acupuncturists, orthotists, prosthetists, auricular (ear) detoxification specialists, residency training permits, cosmetic laser practitioners, and pain management clinics. The Medical Board investigates complaints and disciplines those who violate The Medical Practice Act or other laws governing the professional behavior of its licensees.

5. New Licensure Categories Legislation passed that would allow the Board to license the following new categories of licensure: • Genetic Counselors • Telehealth Licensure • Interstate Medical Compact

6. Board Committees • Advisory committee for each licensed profession and for APRN prescribing protocols • Recommends Board actions to approve or deny license applications and on other profession-specific matters • Wellness Committee • Recommends Board actions concerning impaired licensees • Investigative Committee • Recommends Board actions on enforcement matters • Rules Committee – develops rules that impact licensure.

7. Applying for a License Applying online is the quickest and easiest way to get licensed Go to: gcmb.mylicense.com/egov Submit your application online!

8. Applying for a License Most applications are completed within 60 days of the date the physician submits the application. In addition to the completed application and the $500 nonrefundable application fee, the applicant must provide some other documentation.

9. Licensure Process • Common reasons for the Physician Licensure Committee to review an application include: • Multiple unsuccessful attempts to pass the USMLE Step 3 • Out of clinical practice • Record of a conviction • Record of impairment issue • Discipline by school, residency program, licensing board, or other entity • Malpractice settlement/payout within past 10 years • Other more unique issues

10. License Renewal • Your license expires at the end of your birth month. • A ‘courtesy’ renewal notice is emailed 60 days before the license expiration date with notification that an on-line renewal is available on the Board’s website. • Renewal fee is currently $230.00 • Late Renewal is $455.00 • Requires thirty (40) hours of CME 3 in opioid prescribing if you have a DEA.

11. Inactive License • A person who wishes to maintain his/her license, but does not intend to practice may apply for inactive status, prior to the expiration of a license by submitting fee ($100) and application. • Reinstatement application, fee ($300), and job description.

13. Common Board Questions

14. The Complaints Process Complaint received and reviewed Response from physician requested/received Investigation conducted Dismissal Board review (through committee) Board action (sanction, reprimand, letter of concern, etc.)

15. Enforcement of Board Rules • The Board is authorized to take a variety of actions, including these most common actions: • Letter of concern (non-disciplinary) • Private reprimand (often with requirements such as additional specific CME) • Private consent order with conditions such as monitoring, drug/alcohol rehabilitation, etc. • Public consent order, often with a reprimand, practice restrictions, fines, etc. • Suspension and/or revocation of license

16. Prescription Drug Monitoring Program (PDMP) • Prescribers must enroll as a PDMP user by July 1, 2018. • Prescribers who obtain a DEA registration after January 1, 2018 must enroll with the PDMP within 30 days of obtaining a DEA registration for purposes of prescribing controlled substances in Georgia.

17. Prescription Drug Monitoring Program 404-463-1517. • Who is required to register in the Georgia PDMP? • Individuals with a DEA number must register in the PDMP including: physicians, physician assistants, pharmacists, licensed pharmacist delegates, dentists, optometrists, podiatrists, nurses with prescriptive authority, medical residents and interns with prescriptive authority.  $3,000 fine • Pubic reprimand for failure to register • Reprimand is reportable on the Board’s website and NPDB. pdmpsupport@dph.ga.gov

18. Opioid Prescribing Rules • Effective January 1, 2018, every physician who maintains an active DEA certificate and prescribes controlled substances, except those holding a residency training permit, shall complete at least one time three or more hours of AMA/AOA PRA Category 1 CME that is designed specifically to address controlled substance prescribing practices.

19. Protect your License

20. Your Medical License is Valuable! • Your license grants you the privilege – not the right – to practice medicine. • Other than your integrity and your ethics, your license is perhaps your most valuable asset. • Protect it! • Be cautious • Be thorough • Remember that your patients’ lives depend on you

22. How Licensees Get Into Trouble Boundary violations

23. Boundary Violations REMEMBER: • According to Rule 360-3-.02(8), committing any act of sexual intimacy, abuse, misconduct, or exploitation of any individual related to the physician’s practice is unprofessional conduct regardless of consent! • This rule applies also to former patients where the physician did not terminate the patient relationship in writing at least two years before the romantic or sexual relationship began.

24. Boundary Violations • It is ALWAYS the physician’s responsibility to maintain appropriate boundaries – no matter how difficult or boundary-testing the patient is • Crossing boundaries by a physician is ALWAYS a power differential • If you are unable to maintain appropriate boundaries, refer the patient for competent help or counsel

25. How Licensees Get Into Trouble • Practicing below minimum standards • Not updating profile on board website • Not signing death certificates • Not reading the rules • Not using a chaperone • Not releasing medical records

26. How Licensees Get Into Trouble Practicing below minimum standards

27. How Licensees Get Into Trouble Poor recordkeeping

28. How Licensees Get Into Trouble Poor communication with patients

29. How Licensees Get Into Trouble Inappropriate prescribing

30. Prescribing According to Rule 360-3-.02, unprofessional conduct includes: • Prescribing controlled substances for a known or suspected habitual drug abuser or other substance abuser in the absence of substantial medical justification • Prescribing controlled substances for personal use or for your spouse, children, siblings, or parents except for documented emergencies

31. Pain Clinic Requirements • A pain management clinic is any medical practice that advertises services in the treatment of pain, uses the word “pain” in the name of the clinic or practice, or has more than 50 percent of its annual patient population for chronic, non-terminal pain by the use of Schedule II or Schedule III controlled substances.  Each pain management clinic location must be licensed individually. • The application process includes payment of a $500 application fee, a criminal background check, and other documents & forms. Clinics must be wholly owned by licensed physicians. Clinics and practices owned or operated by hospitals do not need to be licensed, but must file an annual notification with the Board.

32. How Licensees Get Into Trouble Impairment due to drug or alcohol use

33. Professional Health Program • Program to help licensees deal with wellness issues without first dealing with the Board’s disciplinary process • Most common referral is for help with an addiction illness • Referral sources: Family members, colleagues, friends, and the licensee

34. Physician Health Program Clickwww.gaphp.orgto learn how your support can make a difference for your colleagues, friends, and Georgia’s patients, or contact Georgia PHP by phone at 1-855-MY-GAPHP or by email to info@gaphp.org.

35. Friendly Reminders • Do not work on an expired license. • This constitutes practicing medicine without a license • Use a chaperone when examining the breast and/or genitalia of a patient of the opposite gender • Effective communication with patients prevents complaints and could reduce risk of malpractice actions • Document, document, document!

36. OPEN YOUR MAIL !!!! The Board does not send junk mail. Please respond to all inquiries from the Board.

37. Become a Peer Reviewer! • The Board needs physician peer reviewers to assist in its investigative review process.

38. Become a Peer Reviewer! • To join other respected physicians in this important work, email us a copy of your current CV and a letter describing your practice, your specialty, and your certifications to Patricia.Zagorski@dch.ga.gov.

39. Contact Information Georgia Composite Medical Board 2 Peachtree Street, NW 6th Floor Atlanta, GA 30303 LaSharn Hughes, MBA Executive Director lhughes@dch.ga.gov (404) 463-1055