In Search of a New Ethic for Treating Patients with Chronic Pain: What Can Medical Boards Do?

1998 ◽  
Vol 26 (4) ◽  
pp. 332-349 ◽  
Author(s):  
Ann M. Martino
Keyword(s):  
Chronic Pain ◽  
Opioid Analgesics ◽  
Conventional Wisdom ◽  
High Profile ◽  
Medical Board ◽  
Medical Establishment ◽  
The Press ◽  
Substantial Risk ◽  
State Medical Boards ◽  
State Medical Board

A decade ago, conventional wisdom in the medical establishment was that physicians treating chronic pain with opioid analgesics were at a substantial risk of being sanctioned for overprescribing by state medical regulatory boards. Dozens of articles written since have alluded to this risk as an obstacle to effective pain re1ief. In the early 1990s, a number of high profile cases in which physicians were disciplined by regulatory boards for overprescribing to patients with chronic pain were reported in the press. Although the board actions in many of these cases were eventually overturned by state judiciaries, the publicity heightened practitioners’. sensitivity to the regulatory risks associated with prescribing opioids.A review of the available data on state medical board actions nationwide for the period from 1990 to 1996 reveals that the perception of regulatory risk far exceeds the reality. Indeed, relatively few (less than 5 percent) of the disciplinary actions taken for overprescribing by state medical boards in any given year directly concern the treatment of chronic pain—malignant or nonmalignant—in patients.

State Medical Board Disciplinary Hearings as Tools for Teaching Professionalism in Medical Education

2011 ◽  
Vol 97 (3) ◽  
pp. 8-12
Author(s):  
Onelia G. Lage ◽  
Sydney F. Pomenti ◽  
Edwin Hayes ◽  
Kristen Barrie ◽  
Nancy Baker
Keyword(s):  
Medical Students ◽  
Ethics Education ◽  
Faculty Members ◽  
Specific Method ◽  
Pilot Studies ◽  
Medical Board ◽  
Medical Institutions ◽  
State Medical Boards ◽  
State Medical Board ◽  
The Impact

ABSTRACT This article proposes a partnership of state medical boards with medical schools to supplement professionalism and ethics education for medical students, residents, physicians and faculty members of medical institutions. The importance of professionalism has been recognized by several studies, but a specific method of teaching and developing professionalism has yet to emerge. Studies suggest that there is an association between a lack of professionalism in medical school and future disciplinary actions by medical boards. However, there has been little collaboration between these institutions in addressing unprofessional behaviors. One collaborative concept that holds promise, however, is the idea of inviting medical students to attend physician disciplinary hearings. Students and physicians alike report that watching a hearing can significantly impact attitudes about professionalism as a part of medical practice. While formal research is scarce, the positive response of individual students who experience disciplinary hearings firsthand suggests that further pilot studies may be useful. Presented in this paper are the perspectives of three individuals — a medical student, a faculty member and a medical board chair — who discuss the impact and potential of attending disciplinary hearings in developing professionalism and ethics. Also included is a review of the current literature.

Characteristics of Physicians Referred for a Competence Assessment: A Comparison of State Medical Board and Hospital Referred Physicians

2010 ◽  
Vol 96 (3) ◽  
pp. 8-15 ◽  
Author(s):  
Elizabeth S. Grace ◽  
Elizabeth J. Korinek ◽  
Zung V. Tran
Keyword(s):  
Clinical Competence ◽  
Competence Assessment ◽  
Average Performance ◽  
Medical Board ◽  
Key Characteristics ◽  
Different Types ◽  
Specialty Board ◽  
And Performance ◽  
State Medical Boards ◽  
State Medical Board

ABSTRACT This study compares key characteristics and performance of physicians referred to a clinical competence assessment and education program by state medical boards (boards) and hospitals. Physicians referred by boards (400) and by hospitals (102) completed a CPEP clinical competence assessment between July 2002 and June 2010. Key characteristics, self-reported specialty, and average performance rating for each group are reported and compared. Results show that, compared with hospital-referred physicians, board-referred physicians were more likely to be male (75.5% versus 88.3%), older (average age 54.1 versus 50.3 years), and less likely to be currently specialty board certified (80.4% versus 61.8%). On a scale of 1 (best) to 4 (worst), average performance was 2.62 for board referrals and 2.36 for hospital referrals. There were no significant differences between board and hospital referrals in the percentage of physicians who graduated from U.S. and Canadian medical schools. The most common specialties referred differed for boards and hospitals. Conclusion: Characteristics of physicians referred to a clinical competence program by boards and hospitals differ in important respects. The authors consider the potential reasons for these differences and whether boards and hospitals are dealing with different subsets of physicians with different types of performance problems. Further study is warranted.

State Medical Board Exposure to Threats of Violence

2013 ◽  
Vol 99 (3) ◽  
pp. 11-17
Author(s):  
Kelly C. Alfred ◽  
Timothy Turner ◽  
Aaron Young
Keyword(s):  
Threat Assessment ◽  
The State ◽  
Board Members ◽  
Security Level ◽  
Stressful Situation ◽  
Medical Board ◽  
Local Law Enforcement ◽  
Training Resources ◽  
State Medical Boards ◽  
State Medical Board

ABSTRACT Between 2010 and 2012, the Federation of State Medical Boards Research and Education Foundation (FSMB Foundation) conducted a survey of state medical boards in an effort to ascertain the extent to which state medical board members and staff have experienced threats of violence and the actions taken by state boards in response to such threats. The survey also assessed current and anticipated levels of security being provided by state boards. Of the 70 boards queried, 37 responded, with 73% (n=27) of these boards reporting that their board members and/or staff had experienced either explicit or implied threats of violence. These threats targeted board members (85%), board staff (78%) and others (15%). Many of the threats directed at board members occurred after board meetings and/or hearings and were made by either a physician or a family member of a physician. Most of the threats directed at board members, staff and others were verbal, including threats of death. Most boards provide a security presence at board meetings, ranging from local law enforcement agencies to private security firms, but less than half of the respondents in the survey expressed satisfaction with their present security level. The results of the survey suggest that the state medical board community should be aware of the potential for violence against board members and staff, and should formulate prevention and threat-assessment policies as a precaution. Educational and training resources may be needed at the state board level. This could include the development of educational modules to train state public officials in conflict management, the prevention and handling of acts of violence, and how to identify and assess the seriousness of a potentially violent or stressful situation.

scholarly journals The Effect of State Medical Board Action on ABMS Specialty Board Certification

2019 ◽  
Vol 105 (2) ◽  
pp. 33-41
Author(s):  
Michael L. Farrell
Keyword(s):  
Quality Of Care ◽  
Board Certification ◽  
Medical Board ◽  
Specialty Board ◽  
State Medical Boards ◽  
State Medical Board ◽  
Board Action

ABSTRACT State medical board action that is deemed a restriction by an ABMS specialty board can result in a loss of board certification, impacting a physician's ability to practice, and frustrating a medical board's efforts to rehabilitate the physician and improve the quality of care provided to patients. State medical boards have difficulty predicting what types of actions constitute a restriction by a specialty board and imposing appropriate discipline because specialty boards use varying criteria to evaluate state medical board action. ABMS specialty boards experience frustration of their own when attempting to interpret actions from 70 separate state medical boards, each governed by its own laws and using its own nomenclature. This article summarizes the inconsistency of both specialty boards and state medical boards, describes the efforts to resolve this issue, and proposes a series of steps that will bring a higher degree of predictability to this process and meet the needs of all stakeholders.

Improving State Medical Board Policies: Influence of a Model

2003 ◽  
Vol 31 (1) ◽  
pp. 119-129 ◽  
Author(s):  
Aaron M. Gilson ◽  
David E. Joranson ◽  
Martha A. Maurer
Keyword(s):  
Pain Management ◽  
Inappropriate Prescribing ◽  
Medical Knowledge ◽  
Opioid Analgesics ◽  
The United States ◽  
Long Term Effects ◽  
Controlled Substances ◽  
Regulatory Systems ◽  
State Medical Boards ◽  
State Medical Board

Despite advances in medical knowledge regarding pain management, pain continues to be significantly undertreated in the United States. There are many drug and nondrug treatments, but the use of controlled substances, particularly the opioid analgesics, is universally accepted for the treatment of pain from cancer. Although opioid analgesics are safe and effective in treating chronic pain, there is continued research and discussion about patient selection and long-term effects. A number of barriers in the health care and drug regulatory systems account for the gap between what is known about pain management and what is practiced. Among the barriers are physicians’ fears of being disciplined by state regulatory boards for inappropriate prescribing.State medical boards are in a unique position not only to address physicians’ concerns about being investigated, but also to encourage pain management. Prior to 1989, a few state medical boards had policies relating to controlled substances or pain. Subsequently, state medical boards began adopting policies regarding the prescribing of opioids for the treatment of pain; many of these specifically addressed physicians’ fear of regulatory scrutiny.

Improving Pain Management through Policy Making and Education for Medical Regulators

1996 ◽  
Vol 24 (4) ◽  
pp. 344-347 ◽  
Author(s):  
David E. Joranson ◽  
Aaron M. Gilson
Keyword(s):  
Pain Management ◽  
Board Members ◽  
Substantial Impact ◽  
Medical Board ◽  
Appropriate Prescribing ◽  
Regulatory Scrutiny ◽  
Regulatory Barriers ◽  
Effective Pain Relief ◽  
State Medical Boards ◽  
State Medical Board

Physician concern about regulatory scrutiny as a barrier to appropriate prescribing for pain management has been identified and studied. A 1991 Pain Research Group survey demonstrated a need to provide updated information about opioids and pain management to state medical board members. Indeed, a national survey even showed a need to provide more education about pain management to oncology Physicians. Two approaches for responding to these concerns have been undertaken in several states by the state medical boards and the pain management community: the development and adoption of administrative policies designed to bring disciplinary standards in line with clinical practice; and the creation of education programs for state medical board members and staffs. Each can have a substantial impact on removing real and perceived regulatory barriers to effective pain relief.

Expert Psychiatric Evidence in Sexual Misconduct Cases Before State Medical Boards

1992 ◽  
Vol 18 (3) ◽  
pp. 171-201
Author(s):  
Andrew L. Hyams
Keyword(s):  
Sexual Abuse ◽  
Child Sexual Abuse ◽  
Expert Testimony ◽  
Sexual Misconduct ◽  
The Public ◽  
Medical Board ◽  
Current State ◽  
Rules Of Evidence ◽  
State Medical Boards ◽  
State Medical Board

The growing problem of physician sexual misconduct has captured the attention not only of the medical and legal communities, but of the public as well. State medical boards, administrative agencies with generous rules of evidence and varying levels of expertise, face the difficult task of responding to patients’ allegations of physician sexual abuse. This Article, based in large part on the author's survey of current state medical board practice, reveals an increasing reliance on expert psychiatric testimony to explain the behavior of complainants and accused physicians. Drawing analogies from the use of psychiatric evidence in child sexual abuse cases, the author examines the factors that boards must consider in determining the admissibility of expert testimony in physician sexual misconduct cases, and calls upon states to establish clear evidentiary rules to govern the use of such testimony in administrative hearings.

Consumer background and composition on state medical boards: Who are these citizen members and do they adequately protect the public?

2021 ◽  
pp. 251604352110543
Author(s):  
Doug Wojcieszak
Keyword(s):  
Patient Safety ◽  
Public Perception ◽  
Medical Profession ◽  
The United States ◽  
Policy Recommendations ◽  
Medical Expertise ◽  
The Public ◽  
Medical Board ◽  
State Medical Boards ◽  
State Medical Board

The composition and background of members of state medical boards, including public or citizen members, can impact the functionality and public perception of medical boards in the United States. This study analyzed the number of public members on each state medical board and their professional backgrounds or expertise to regulate the medical profession. The findings show that for nearly half of state medical boards public members comprise at least a quarter of their voting members; however, more than half of public members for all state medical boards have no measurable medical experience or background, including in patient safety. The need for public members to have medical expertise or background – especially in patient safety -- is discussed along with potential policy recommendations.

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