© 2013 Federation of State Medical Boards

© 2013 Federation of State Medical Boards

Handling Medical Complaints Fairly and

TransparentlyJ. Daniel Gifford, MD, Chair-ElectFederation of State Medical BoardsUnited Statesjdgifford@fsmb.org

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. Investigate4. Notify physician

and complainant5. Medical review

6. Board determines action

7. Case is set for hearing

8. Adjudication9. 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 ofMedical 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!