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).
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).
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).
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).
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, ___ Wis. 2d ___,
647 N.W.2d 413.
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 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.
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.
448.50(4)
(4) "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.
Effective date note
NOTE: Sub. (4) is shown below as affected eff. 4-1-04 by
2001 Wis. Act 70.
Effective date text
(4) (a) "Physical therapy" means , except as provided in par. (b), any of the following:
448.50 Note
1. Examining, evaluating, or testing individuals with mechanical, physiological, or developmental impairments, functional limitations related to physical movement and mobility, disabilities, or other movement-related health conditions, in order to determine a diagnosis, prognosis, or plan of therapeutic intervention or to assess the ongoing effects of intervention. In this subdivision, "testing" means using standardized methods or techniques for gathering data about a patient.
448.50 Note
2. Alleviating impairments or functional limitations by instructing patients or designing, implementing, or modifying therapeutic interventions.
448.50 Note
3. Reducing the risk of injury, impairment, functional limitation, or disability, including by promoting or maintaining fitness, health, or quality of life in all age populations.
448.50 Note
4. Engaging in administration, consultation, or research that is related to any activity specified in subds. 1. to 3.
448.50 Note
(b) "Physical therapy" does not include using roentgen rays or radium for any purpose, using electricity for surgical purposes, including cauterization, or prescribing drugs or devices.
448.50(5)
(5) "Sexual misconduct with a patient" means any of the following:
448.50(5)(a)
(a) Engaging in or soliciting a consensual or nonconsensual sexual relationship with a patient.
448.50(5)(b)
(b) Making sexual advances toward, requesting sexual favors from, or engaging in other verbal conduct or physical contact of a sexual nature with a patient.
448.50(5)(c)
(c) Intentionally viewing a completely or partially disrobed patient during the course of treatment if the viewing is not related to diagnosis or treatment.
448.50(6)
(6) "Therapeutic intervention" means the purposeful and skilled interaction between a physical therapist, patient, and, if appropriate, individuals involved in the patient's care, using physical therapy procedures or techniques that are intended to produce changes in the patient's condition and that are consistent with diagnosis and prognosis.
448.50 History
History: 1993 a. 107;
2001 a. 70.
448.50 Annotation
Physical therapists and massage therapists are not prohibited from performing the activities that are within their respective scopes of practice, even if those activities extend in some degree into the field of chiropractic science.
OAG 1-01.
448.51
448.51
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.
Effective date note
NOTE: Sub. (1) is amended eff. 4-1-04 by
2001 Wis. Act 70 to read:
Effective date text
(1) Except as provided in s. 448.52, no person may practice physical therapy unless the person is licensed as a physical therapist under this subchapter.
448.51(1e)
(1e) No person may designate himself or herself as a physical therapist or use or assume the title "physical therapist," "physiotherapist," "physical therapy technician," "licensed physical therapist," "registered physical therapist," "master of physical therapy," "master of science in physical therapy," or "doctorate in physical therapy," or append to the person's name the letters "P.T.," "P.T.T.," "L.P.T.," "R.P.T.," "M.P.T.," "M.S.P.T.," or "D.P.T.," or any other title, letters, or designation that represents or may tend to represent the person as a physical therapist, unless the person is licensed as a physical therapist under this subchapter.
448.51(1s)
(1s) No person may designate himself or herself as a physical therapist assistant, use or assume the title "physical therapist assistant," or append to the person's name the letters "P.T.A." or any other title, letters, or designation that represents or may tend to represent the person as a physical therapist assistant unless the person is licensed as a physical therapist assistant under this subchapter.
448.51(2)(a)(a) 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.
Effective date note
NOTE: Par. (a) is amended eff. 4-1-04 by
2001 Wis. Act 70 to read:
Effective date text
(a) 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, client, or prospective patient or client who has requested the material.
448.51(2)(b)
(b) 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.
Effective date note
NOTE: Par. (b) is amended eff. 4-1-04 by
2001 Wis. Act 70 to read:
Effective date text
(b) Except as provided in s. 448.52 (2m), no person may claim to render physical therapy or physiotherapy services unless the person is licensed as a physical therapist under this subchapter.
448.51(2)(c)
(c) A chiropractor licensed under
ch. 446 may claim to render physical therapy or physiotherapy services only as follows:
448.51(2)(c)2.a.
a. 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) and
448.525 take effect.
448.51(2)(c)2.b.
b. 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) and
448.525 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.
