448.08(5)(a)1.
1. Require the physician to be a member of or acceptable to and subject to the approval of the medical staff of the hospital or medical education and research organization.
448.08(5)(a)2.
2. Permit the physician to exercise professional judgment without supervision or interference by the hospital or medical education and research organization.
448.08(5)(b)
(b) If agreeable to the contracting parties, the hospital or medical education and research organization may charge the patient for services rendered by the physician, but the statement to the patient shall indicate that the services of the physician, who shall be designated by name, are included in the departmental charges.
448.08(5)(c)
(c) No hospital or medical education and research organization may limit staff membership to physicians employed under this subsection.
448.08(5)(d)
(d) The responsibility of physician to patient, particularly with respect to professional liability, shall not be altered by any employment contract under this subsection.
448.08 Annotation
A medical professional service corporation may bill patients for services by both a physician and a physical therapist if billing states an accurate figure for the respective services.
71 Atty. Gen. 108.
448.09
448.09
Penalties; appeal. 448.09(1)(1)
Penalties. A person who violates
s. 448.08 (3) may be fined not more than $250. Except as provided in
sub. (1m), a person who violates any other provision of this subchapter may be fined not more than $10,000 or imprisoned for not more than 9 months or both.
448.09(1m)
(1m) Physicians. A physician who violates any provision of this subchapter, except
s. 448.08 (3), or any rule promulgated under this subchapter may be fined not more than $25,000 or imprisoned not more than 9 months or both.
448.09(2)
(2) Appeal. Any person aggrieved by any action taken under this subchapter by the board, its officers or its agents may apply for judicial review as provided in
ch. 227, and shall file notice of such appeal with the secretary of the board within 30 days. No court of this state may enter an ex parte stay of any action taken by the board under this subchapter.
448.10
448.10
Previous practice. 448.10(1)(1)
Osteopathy. Sections 448.02 (1),
448.03 (1) and
(3),
448.04 and
448.05 shall not be construed to abrogate the existing rights, privileges and immunities of any person licensed to practice osteopathy and surgery, or osteopathy, who does not hold license to practice medicine and surgery.
448.10(4)
(4) Massage and hydrotherapy. Any person who, on July 11, 1953, was practicing massage and hydrotherapy in this state under a certificate of registration issued pursuant to s.
147.185, 1951 stats., as it existed prior to July 11, 1953, or who had applied for a certificate of registration in massage and hydrotherapy before said date, shall have the right to continue to so practice under such certificate, and the term "massage and hydrotherapy" shall be deemed to include the use of galvanic generator, diathermy, infrared ray and ultraviolet light for massage purposes. Nothing contained in this subsection shall limit the existing authority of the board to revoke such certificate for cause, and in addition, the board may require the holder of such certificate to demonstrate by examination fitness to use the instrumentalities enumerated in this subsection. A lack of such fitness shall constitute cause for revocation of such certificate. No such certificate holder shall treat a specific disease except on the advice of a licensed physician.
448.10(5)
(5) Midwifery. Any person who, on May 7, 1953, was practicing midwifery in this state under a certificate of registration issued by the board may continue to so practice under such certificate but subject to the provisions of ch.
150, 1951 stats., as in effect prior to such date and subject to the other provisions of this subchapter.
448.11
448.11
Injunction. If it appears upon complaint to the board by any person or if it is known to the board that any person is violating this subchapter, or rules adopted by the board under this subchapter, the board or the attorney general may investigate and may, in addition to any other remedies, bring action in the name and on behalf of the state against any such person to enjoin such person from such violation. The attorney general shall represent the board in all proceedings.
448.11 History
History: 1975 c. 383;
1997 a. 175.
448.12
448.12
Malpractice. Anyone practicing medicine, surgery, osteopathy, or any other form or system of treating the sick without having a license or a certificate of registration shall be liable to the penalties and liabilities for malpractice; and ignorance shall not lessen such liability for failing to perform or for negligently or unskillfully performing or attempting to perform any duty assumed, and which is ordinarily performed by authorized practitioners.
448.12 History
History: 1975 c. 383,
421.
448.13
448.13
Biennial training requirement. 448.13(1)
(1) Each physician shall, in each 2nd year at the time of application for a certificate of registration under
s. 448.07, submit proof of attendance at and completion of continuing education programs or courses of study approved for at least 30 hours of credit by the board within the 2 calendar years preceding the calendar year for which the registration is effective. The board may waive this requirement if it finds that exceptional circumstances such as prolonged illness, disability or other similar circumstances have prevented a physician from meeting the requirement.
448.13(1m)
(1m) The board shall, on a random basis, verify the accuracy of proof submitted by physicians under
sub. (1) and may, at any time during the 2 calendar years specified in
sub. (1), require a physician to submit proof of any continuing education programs or courses of study that he or she has attended and completed at that time during the 2 calendar years.
448.13(2)
(2) Each person licensed as a perfusionist shall, in each 2nd year at the time of application for a certificate of registration under
s. 448.07, submit proof of completion of continuing education requirements promulgated by rule by the board.
448.13 Cross-reference
Cross Reference: See also
Med, Wis. adm. code.
448.14
448.14
Annual report. Annually, no later than March 1, the board shall submit to the chief clerk of each house of the legislature for distribution to the appropriate standing committees under
s. 13.172 (3) a report that identifies the average length of time to process a disciplinary case against a physician during the preceding year and the number of disciplinary cases involving physicians pending before the board on December 31 of the preceding year.
448.14 History
History: 1997 a. 311.
448.20
448.20
Council on physician assistants; duties. 448.20(1)(1)
Recommend licensing and practice standards. The council on physician assistants shall develop and recommend to the examining board licensing and practice standards for physician assistants. In developing the standards, the council shall consider the following factors: an individual's training, wherever given; experience, however acquired, including experience obtained in a hospital, a physician's office, the armed services or the federal health service of the United States, or their equivalent as found by the examining board; and education, including that offered by a medical school and the technical college system board.
448.20(2)
(2) Advise board of regents. The council shall advise and cooperate with the board of regents of the University of Wisconsin System in establishing an educational program for physician assistants on the undergraduate level. The council shall suggest criteria for admission requirements, program goals and objectives, curriculum requirements, and criteria for credit for past educational experience or training in health fields.
448.20(3)
(3) Advise board. The council shall advise the board on:
448.20(3)(a)
(a) Revising physician assistant licensing and practice standards and on matters pertaining to the education, training and licensing of physician assistants.
448.20(3)(b)
(b) Developing criteria for physician assistant training program approval, giving consideration to and encouraging utilization of equivalency and proficiency testing and other mechanisms whereby full credit is given to trainees for past education and experience in health fields.
448.20(4)
(4) Adhere to program objectives. In formulating standards under this section, the council shall recognize that an objective of this program is to increase the existing pool of health personnel.
448.21
448.21
Physician assistants. 448.21(1)
(1)
Prohibited practices. No physician assistant may provide medical care, except routine screening, in:
448.21(1)(a)
(a) The practice of dentistry or dental hygiene within the meaning of
ch. 447.
448.21(1)(c)
(c) The practice of chiropractic within the meaning of
ch. 446.
448.21(1)(e)
(e) The practice of acupuncture within the meaning of
ch. 451.
448.21(2)
(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.
448.21(3)
(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.
448.30
448.30
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:
448.30(1)
(1) Information beyond what a reasonably well-qualified physician in a similar medical classification would know.
448.30(2)
(2) Detailed technical information that in all probability a patient would not understand.
448.30(3)
(3) Risks apparent or known to the patient.
448.30(4)
(4) Extremely remote possibilities that might falsely or detrimentally alarm the patient.
448.30(5)
(5) Information in emergencies where failure to provide treatment would be more harmful to the patient than treatment.
448.30(6)
(6) Information in cases where the patient is incapable of consenting.
448.30 History
History: 1981 c. 375.
448.30 Cross-reference
Cross Reference: See also ch.
Med 18, Wis. adm. code.
448.30 Annotation
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 (1995).
448.30 Annotation
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 (1995).
448.30 Annotation
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 (1996),
93-3099.
448.30 Annotation
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),
96-1632.
448.30 Annotation
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),
96-3676.
448.30 Annotation
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 (1999),
97-2181.
448.30 Annotation
In the absence of a persistent vegetative state, the right of a parent to withhold life-sustaining treatment from a child does not exist and the need for informed consent is not triggered when life-sustaining treatment is performed. Montalvo v. Borkovec, 2002 WI App 147,
256 Wis. 2d 472,
647 N.W.2d 413,
01-1933.
448.30 Annotation
A chiropractor has a duty of informed consent to make such disclosures as will enable a reasonable person under the circumstances confronting the patient to exercise the right to consent to, or to refuse the procedure proposed or to request an alternative treatment or method of diagnosis. Hannemann v. Boyson, 2005 WI 94,
282 Wis. 2d 664,
698 N.W.2d 714,
03-1527.
448.30 Annotation
This section provides that only the treating physician owes the responsibility of informed consent to the patient. A physician-patient relationship is a trust relationship. A doctor , who confirmed the treating doctor's diagnosis and agreed to see the patient for follow-up care, had no statutory duty to inform until he treated the patient. Bubb v. Brusky, 2008 WI App 104, ___ Wis. 2d ___, ___ N.W.2d ___,
07-0619.
448.30 Annotation
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 (1993).
448.40(1)(1) The board may promulgate rules to carry out the purposes of this subchapter.
448.40(2)
(2) The board shall promulgate all of the following rules:
448.40(2)(b)
(b) Establishing the scope of the practice of perfusion. In promulgating rules under this paragraph, the board shall consult with the perfusionists examining council.
448.40(2)(c)
(c) Establishing continuing education requirements for renewal of a license to practice perfusion under
s. 448.13 (2). In promulgating rules under this paragraph, the board shall consult with the perfusionists examining council.
448.40(2)(e)
(e) Establishing the criteria for the substitution of uncompensated hours of professional assistance volunteered to the department of health 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 services.
448.40(2)(f)
(f) Establishing requirements for prescription orders issued by physician assistants under
s. 448.21 (3).
448.40 Cross-reference
Cross Reference: See also
Med, Wis. adm. code.
PHYSICAL THERAPISTS AFFILIATED CREDENTIALING BOARD
Subch. III of ch. 448 Cross-reference
Cross Reference: See also
PT, Wis. adm. code.
448.50
448.50
Definitions. In this subchapter:
448.50(1)
(1) "Affiliated credentialing board" means the physical therapists affiliated credentialing board.
448.50(1r)
(1r) "Diagnosis" means a judgment that is made after examining the neuromusculoskeletal system or evaluating or studying its symptoms and that utilizes the techniques and science of physical therapy for the purpose of establishing a plan of therapeutic intervention, but does not include a chiropractic or medical diagnosis.
448.50(2)
(2) "Licensee" means a person who is licensed under this subchapter.
448.50(3)
(3) "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.
448.50(3m)
(3m) "Physical therapist assistant" means an individual who holds a license as a physical therapist assistant granted by the affiliated credentialing board.
