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Oklahoma Board of Medical Licensure and Supervision
Issues & Answers - September 1998


Vol 9 No 4
September 1998

New Laws

by Gerald C. Zumwalt, M.D.
Board Secretary/Medical Advisor

The 1998 session of the Oklahoma Legislature has ended. Along with the widely publicized matters of hog and chicken farms and higher education, the lawmakers also passed bills which may directly affect M.D.'s licenses.

The Allopathic Medical and Surgical Licensure and Supervision Act was opened and amended. Most of the changes were housekeeping matters primarily removing archaic language and proceedings, and installing new wording which reflects current realities of licensing. Prior to revision, the Act still had the 1927 provisions for forming the Board and stating the staggered terms of the original members.

More meaningful alterations included new grounds for denial of an application for license. These grounds include suspension or revocation of a license in another state unless the license has been reinstated in that state, refusal of licensure in another state other than for examination failure, and multiple examination failures. A provision was inserted for summary suspension of a license upon conviction of a felony for violation of narcotic laws.

Two additional paragraphs of unprofessional conduct were added. One requires a record which reflects medical necessity for patient treatment and the other establishes a definition of patient abandonment.

Senate Bill 1243—Assisted Suicide Prevention Act—enacts civil enforcement by injunction and by allowing lawsuits for compensatory and punitive damages against any person helping another to commit suicide. It also establishes those persons who have standing to bring such a suit. The Act further directs the licensing agency to revoke or suspend the license upon receiving record of violation of the Act. All health professionals should familiarize themselves with this Act which also includes exemptions from the provisions (primarily the use of medications to alleviate pain and discomfort and allowing withdrawal or withholding of life-sustaining procedures). Previous laws covered the criminal act of assisting suicide and provided for imprisonment and fine. House Bill 2624 addresses pain management by use of appropriate CDS dosages. At first glance, this seems to be at odds with Senate Bill 1243 since it advocates even high dosages of such medications with the acknowledged increase in the risk of death. When considered together, it is evident that both bills address prescribing to improve quality of life and both prohibit prescribing to cause death. This Act also mandates guidelines for prescribing be formulated and followed.

An example of such guidelines has been published previously by this and other state boards and more recently by the Federation of State Medical Boards.

The Physician Assistant Act was amended by Senate Bill 1069 to allow PAs to prescribe Schedule III - V medications and to sign for and distribute professional samples. Those changes become effective on November 1, 1998.

Changes to the Medical Practice Act are now effective.

Licensure Application Questions

Medical licensing boards are caught in the dilemma of balancing society's need for protection from impaired practitioners and the individual physician's rights as defined in Title II of the Americans with Disabilities Act.

An article in the February 1998 issue of Psychiatric Services (Feb 1998, Vol 49, #2) contained materials gathered from multiple boards by a group in Oregon. The article analyzed changes in questions asked on initial and relicensing applications. In general, they found that medical boards still routinely ask questions about mental and physical illnesses and use of addicting substances. Recent changes in the wording now commonly emphasize impairment rather than occurrence and usually covers a limited time period.

This full article is available for review at our office.

Board Meeting

June 19, 1998

The Oklahoma State Board of Medical Licensure and Supervision met in special session on June 19 for the sole purpose of considering applications for full and special licenses.

Following personal appearances, seven full licenses were issued. An additional two full licenses with terms of probation were issued. Both cases involved prior chemical abuse. Probation terms were the standard mandatory affiliation with 12-Step programs, body fluid sampling, and maintaining sobriety.

One license was denied since the applicant for reinstatement currently has a license suspended in another state.

Thirteen special training licenses were issued after personal interviews. An additional two special training licenses with agreements were adopted. Both agreements mandated continuation of a long term history of sobriety.

Seven applications for special license were denied. All seven reflected multiple failures on licensing examination steps and some additionally involved education equivalency to the University of Oklahoma College of Medicine.

Advanced Practice Nurses
Oklahoma Statistics

[Source: Okla. Board of Nursing, 9-7-98]

# Recognized for Practice in Oklahoma 391 33 124 353
Total Recognized = 901

# with Prescriptive Authority

190 14 4 n/a*

Total with Prescriptive Authority = 208

*CRNAs do not have "prescriptive authority" as such. They have "select, order, obtain & administer authority" for certain anesthetic drugs only. There are 26 CRNAs registered in the state with this authority.


Board Meeting—July 23, 1998

During the regularly scheduled meeting of July 23, 1998, six full and unrestricted licenses were issued after personal appearance by the applicants. One was denied due to having a license currently suspended in another state. One license was reinstated with probationary terms, including use of duplicate, serially numbered prescriptions and restrictions on practice location.

Nine special licenses for training and one limited to disability determination were issued. One application for special license for training was denied.

Disciplinary hearings resulted in one Voluntary Submittal to Jurisdiction imposing a five month suspension, agreement to use a licensed, female chaperone and to allow no prescribing or dispensing medicines by unlicensed personnel. The case was based on sexual misconduct and improper dispensing. Another Voluntary Submittal to Jurisdiction imposed costs of investigation and a public letter of concern over failure to declare to patient that surgery would be performed by someone other than the attending physician. One probation was modified to allow attendance at 12-Step meetings other than in Oklahoma City. One physical therapy license was reinstated with terms of probation mandating continuing psychotherapy and affiliation with a 12-step program (90 meetings in 90 days).

The following information is provided to individuals who have been cited for violation of the Medical Practice Act.

Information upon Receiving a Complaint/Citation

1. Title 59 O.S., Supp 1997, Section 503 requires that a physician cited for hearing respond to the citation within twenty (20) days after the service of the Citation. The time may be extended by the Board Secretary at his discretion but not beyond the next meeting of the Board. You have the right to legal counsel and should consider retaining the services of an attorney of your choice.

2. Postponement of a hearing is not automatic. The Board is established to protect public health, safety and welfare, and it is the position of the Board that a prompt hearing on a complaint best serves all interests. Motion for a continuance may be filed with the Board office at least seven (7) days prior to the scheduled hearing.

3. At least fourteen (14) days before your hearing, all motions filed will be presented to the Trial Examiner who is authorized by the Board to rule on matters of discovery disputes, jurisdiction and venue, continuance, disqualifications, exhibits, nonessential witnesses, offers of proof and other preliminary matters. Motions to enter into stipulated agreements may be made at this time. Objections to the Trial Examiner's rulings may be filed, in writing, with the Board Secretary prior to the scheduled hearing.

4. By law, a record shall be preserved of all proceedings in hearings. Court reporters will not be provided by this agency; however, accommodations will be made for any such personnel you may provide for recording proceedings.

5. If the Board finds that you are guilty of unprofessional conduct as set forth in the complaint, any one or combination of the following range of *disciplinary actions may be imposed:

  • Revocation
  • Suspension
  • Probation
  • Stipulations, limitations, restrictions and conditions relating to practice
  • Censure
  • Reprimand
  • A period of free public or charity service
  • Satisfactory completion of education, training, and/or treatment program(s)

*As a condition of disciplinary action sanctions, you will be ordered to pay costs expended by the Board for any legal fees/costs and probation/monitoring fees, including but not limited to staff time, salary and travel expense, witness fees and attorney fees.

6. Disciplinary action administered by this Board is a matter of public record and will be reported to the national Practition-er Databank, Drug Enforcement Administration, State Bureau of Narcotics and Dangerous Drugs Control, Federation of State Medical Boards, and various agencies and organizations who, in turn, may contact hospitals, clinics, insurance carriers, etc. Information regarding possible criminal conduct is forwarded to the appropriate state or federal jurisdiction.

7. No staff member may render legal advice to you. Again, you have the right to legal representation. As you have been served with formal notice of hearing, disposition of the allegations in the complaint rests exclusively with the Board. Do not contact any member of the Board. By law, Board members are prohibited from having knowledge of your case outside a formal hearing.

8. Appeals to any and all Board decisions may be made to the Supreme Court of the State of Oklahoma.

9. Copies of the Board's rules are available upon request. Questions or requests for further information should be directed to:

Lyle R. Kelsey, CAE
Executive Director
Board of Medical Licensure & Supervision
5104 North Francis, Suite C or P.O. Box 18256
Oklahoma City, OK 73118 Oklahoma City, OK 73154-0256
(405) 848-6841, ext 114
(405) 848-8240 (fax)

Medical Board Composition Changes

Two Board members leave after years of service. Board members serve voluntarily as appointees of the Oklahoma Governor. Terms are for seven years.

George M. Brown, Jr., M.D., McAlester, left the Board in July after serving two terms including stints as President and Secretary/Medical Advisor. Dr. Brown enjoyed a private surgical practice in McAlester for many years. He currently is retired and owns/operates Golf'N Stuff in McAlester.

Frederick D. Cason, Jr., M.D. is leaving the Board after three years to further his career by accepting the position of Chair of the Department of Surgery, University of Alabama School of Medicine in Huntsville.

The new appointees are John C. Leatherman, M.D. and James D. Gormley, M.D. respectively.

Dr. Leatherman is a Board Certified family physician in private practice in Woodward since 1994. He is active in Medical Society business and in the past has participated in medical missions in South Africa.

Dr. Gormley is a Board Certified pediatrician trained at OU Medical School and has been in practice in Oklahoma City area for almost thirty years. Dr. Gormley will serve out the unexpired term of Dr. Cason. Both physicians will participate in their first Board meeting September 24-26, 1998.