The practice of chiropractic within the meaning of ch. 446
The practice of acupuncture within the meaning of ch. 451
(2) Employee status.
No physician assistant may be self-employed. The employer of a physician assistant shall assume legal responsibility for any medical care provided by the physician assistant during the employment. The employer of a physician assistant, if other than a licensed physician, shall provide for and not interfere with supervision of the physician assistant by a licensed physician.
(3) Prescriptive authority.
A physician assistant may issue a prescription order for a drug or device in accordance with guidelines established by a supervising physician and the physician assistant and with rules promulgated by the board. If any conflict exists between the guidelines and the rules, the rules shall control.
Information on alternate modes of treatment.
Any physician who treats a patient shall inform the patient about the availability of all alternate, viable medical modes of treatment and about the benefits and risks of these treatments. The physician's duty to inform the patient under this section does not require disclosure of:
Information beyond what a reasonably well-qualified physician in a similar medical classification would know.
Detailed technical information that in all probability a patient would not understand.
Risks apparent or known to the patient.
Extremely remote possibilities that might falsely or detrimentally alarm the patient.
Information in emergencies where failure to provide treatment would be more harmful to the patient than treatment.
Information in cases where the patient is incapable of consenting.
History: 1981 c. 375
A one to three in 100 chance of a condition's existence is not an "extremely remote possibility" under sub. (4) when very serious consequences could result if the condition is present. Martin v. Richards, 192 Wis. 2d 156
, 531 N.W.2d 70
A doctor has a duty under this section do advise of alternative modes of diagnosis as well as of alternative modes of treatment for diagnosed conditions. Martin v. Richards, 192 Wis. 2d 156
, 531 N.W.2d 70
What constitutes informed consent emanates from what a reasonable person in the patient's position would want to know. What a physician must disclose is contingent on what a reasonable person would need to know to make an informed decision. When different physicians have substantially different success rates with a procedure and a reasonable person would consider that information material, a court may admit statistical evidence of the relative risk. Johnson v. Kokemoor, 199 Wis. 2d 615
, 545 N.W.2d 495
A hospital does not have the duty to ensure that a patient has given informed consent to a procedure performed by an independent physician. Mathias v. St. Catherine's Hospital, Inc. 212 Wis. 2d 540
, 569 N.W.2d 330
(Ct. App. 1997).
The onset of a procedure does not categorically foreclose withdrawal of a patient's consent. Withdrawal of consent removes the doctor's authority to continue and obligates the doctor to conduct another informed consent discussion. If the patient's choice of treatment, based on disclosure of all pertinent information to the patient, is known, the objective test of what a reasonable person would have chosen is not relevant. Schreiber v. Physicians Insurance Co. 223 Wis. 2d 417
, 588 N.W.2d 26
(Ct. App. 1999).
As a general rule, patients have a duty to exercise ordinary care for their own health. Under limited ,enumerated circumstances, contributory negligence may be a defense in an informed consent case. A doctor is not restricted to only the defenses listed under this section, but a court should be cautious in giving instructions on nonstatutory defenses. Brown v. Dibbell, 227 Wis. 2d 28
, 595 N.W.2d 358
The doctrine of informed consent is limited to apprising the patient of risks that inhere to proposed treatments. It does not impose a duty to apprise a patient of any knowledge the doctor may have regarding the condition of the patient or of all possible methods of diagnosis. McGeshick v. Choucair 9 F.3d 1229
The board may promulgate rules to carry out the purposes of this subchapter.
The board shall promulgate all of the following rules:
Establishing the criteria for the substitution of uncompensated hours of professional assistance volunteered to the department of health and family services for some or all of the hours of continuing education credits required under s. 448.13 (1)
for physicians specializing in psychiatry. The eligible substitution hours shall involve professional evaluation of community programs for the certification and recertification of community mental health programs, as defined in s. 51.01 (3n)
, by the department of health and family services.
Establishing requirements for prescription orders issued by physician assistants under s. 448.21 (3)
PHYSICAL THERAPISTS AFFILIATED CREDENTIALING BOARD
In this subchapter:
"Affiliated credentialing board" means the physical therapists affiliated credentialing board.
"Licensee" means a person who is licensed under this subchapter.
"Physical therapist" means an individual who has been graduated from a school of physical therapy and holds a license to practice physical therapy granted by the affiliated credentialing board.
"Physical therapy" means that branch or system of treating the sick which is limited to therapeutic exercises with or without assistive devices, and physical measures including heat and cold, air, water, light, sound, electricity and massage; and physical testing and evaluation. The use of roentgen rays and radium for any purpose, and the use of electricity for surgical purposes including cauterization, are not part of physical therapy.
History: 1993 a. 107
License required. 448.51(1)(1)
Except as provided in s. 448.52
, no person may practice physical therapy or designate himself or herself as a physical therapist or use or assume the title "physical therapist" or "physiotherapist" or "physical therapy technician" or append to the person's name the letters "P.T.", "P.T.T." or "R.P.T." or any other title, letters or designation which represents or may tend to represent the person as a physical therapist unless the person is licensed under this subchapter.
In this subsection, "advertisement" includes advertisements that appear on outdoor signs, in print or electronic media, and in material mailed to a person other than a patient or prospective patient who has requested the material.
Except as provided in par. (c)
, no person may claim to render physical therapy or physiotherapy services unless the person is licensed under this subchapter.
A chiropractor licensed under ch. 446
may claim to render physical therapy or physiotherapy services only as follows:
If, anytime before October 17, 1995, the chiropractor claimed in an advertisement to render physical therapy or physiotherapy services, the chiropractor may continue to claim to render physical therapy or physiotherapy services in an advertisement until the rules promulgated under ss. 446.02 (10)
The chiropractor may claim to render physical therapy or physiotherapy services in private communications with an individual who is a patient or prospective patient until the rules promulgated under ss. 446.02 (10)
take effect. This subd. 2. b.
also applies to an employee or agent of the chiropractor who claims that the chiropractor renders physical therapy or physiotherapy services.
History: 1993 a. 107
; 1995 a. 166
This subchapter does not require a license under this subchapter for any of the following, if the person does not claim to render physical therapy or physiotherapy services as prohibited under s. 448.51 (2) (b)
Any person lawfully practicing within the scope of a license, permit, registration or certification granted by this state or the federal government.
Any person assisting a physical therapist in practice under the direct, on-premises supervision of the physical therapist.
A physical therapist assistant assisting a physical therapist in practice under the general supervision of the physical therapist. In this subsection, "physical therapist assistant" means an individual who has graduated from a physical therapist assistant associate degree program approved by the American Physical Therapy Association. The affiliated credentialing board shall promulgate rules defining "general supervision" for purposes of this subsection.
A physical therapy student practicing physical therapy within the scope of the student's education or training.
A physical therapist who is licensed to practice physical therapy in another state or country and is providing a consultation or demonstration with a physical therapist who is licensed under this subchapter.
History: 1993 a. 107
; 1995 a. 166
Rules concerning claims to render physical therapy or physiotherapy services. 448.525(1)
The affiliated credentialing board and the chiropractic examining board acting under s. 446.02 (10)
shall jointly promulgate rules that establish the circumstances under which and the extent to which a chiropractor licensed under ch. 446
may claim to render physical therapy or physiotherapy services within the scope of the practice of chiropractic.
The affiliated credentialing board may promulgate rules relating to the circumstances under which and the extent to which a chiropractor licensed under ch. 446
may claim to render physical therapy or physiotherapy services within the scope of the practice of chiropractic only as provided under sub. (1)
History: 1995 a. 166
; 1997 a. 35
Licensure of physical therapists. 448.53(1)
The affiliated credentialing board shall grant a license as a physical therapist to a person who does all of the following:
Submits an application for the license to the department on a form provided by the department.
Subject to ss. 111.321
, submits evidence satisfactory to the affiliated credentialing board that the applicant does not have an arrest or conviction record.
Submits evidence satisfactory to the affiliated credentialing board that the applicant is a graduate of a school of physical therapy approved by the affiliated credentialing board, unless the affiliated credentialing board waives this requirement under sub. (3)
The affiliated credentialing board may promulgate rules providing for various classes of temporary licenses to practice physical therapy.
The affiliated credentialing board may waive the requirement under sub. (1) (d)
for an applicant who establishes, to the satisfaction of the affiliated credentialing board, all of the following:
That he or she is a graduate of a physical therapy school.
That he or she is licensed as a physical therapist by another licensing jurisdiction in the United States.
That the jurisdiction in which he or she is licensed required the licensee to be a graduate of a school approved by the licensing jurisdiction or of a school that the licensing jurisdiction evaluated for education equivalency.
That he or she has actively practiced physical therapy, under the license issued by the other licensing jurisdiction in the United States, for at least 3 years immediately preceding the date of his or her application.
History: 1993 a. 107
The affiliated credentialing board shall conduct or arrange for examinations for physical therapist licensure at least semiannually and at times and places determined by the affiliated credentialing board.
Except as provided in sub. (3)
, examinations shall consist of written or oral tests, or both, requiring applicants to demonstrate minimum competency in subjects substantially related to the practice of physical therapy.
The affiliated credentialing board may not require an applicant to take an oral examination or an examination to test proficiency in the English language for the sole reason that the applicant was educated at a physical therapy school that is not in the United States if the applicant establishes, to the satisfaction of the affiliated credentialing board, that he or she satisfies the requirements under s. 448.53 (3)
History: 1993 a. 107
Issuance of license; expiration and renewal. 448.55(1)(1)
The department shall issue a certificate of licensure to each person who is licensed under this subchapter.
The renewal dates for licenses granted under this subchapter, other than temporary licenses granted under rules promulgated under s. 448.53 (2)
, are specified under s. 440.08 (2) (a)
. Renewal applications shall be submitted to the department on a form provided by the department and shall include the renewal fee specified in s. 440.08 (2) (a)
History: 1993 a. 107
Practice requirements. 448.56(1)
Except as provided in this subsection and s. 448.52
, a person may practice physical therapy only upon the written referral of a physician, chiropractor, dentist or podiatrist. Written referral is not required if a physical therapist provides services in schools to children with disabilities, as defined in s. 115.76 (5)
, pursuant to rules promulgated by the department of public instruction; provides services as part of a home health care agency; provides services to a patient in a nursing home pursuant to the patient's plan of care; provides services related to athletic activities, conditioning or injury prevention; or provides services to an individual for a previously diagnosed medical condition after informing the individual's physician, chiropractor, dentist or podiatrist who made the diagnosis. The affiliated credentialing board may promulgate rules establishing additional services that are excepted from the written referral requirements of this subsection.
(2) Fee splitting.
No licensee may give or receive, directly or indirectly, to or from any other person any fee, commission, rebate or other form of compensation or anything of value for sending, referring or otherwise inducing a person to communicate with a licensee in a professional capacity, or for any professional services not actually rendered personally by the licensee or at the licensee's direction.
(3) Billing by professional partnerships and corporations.
If 2 or more physical therapists have entered into a bona fide partnership or have formed a service corporation for the practice of physical therapy, the partnership or corporation may not render a single bill for physical therapy services provided in the name of the partnership or corporation unless each physical therapist who provided services that are identified on the bill is identified on the bill as having rendered those services.
Disciplinary proceedings and actions. 448.57(1)
Subject to the rules promulgated under s. 440.03 (1)
, the affiliated credentialing board may make investigations and conduct hearings to determine whether a violation of this subchapter or any rule promulgated under this subchapter has occurred.