448.01(9)(d)
(d) To offer, undertake, attempt or do or hold oneself out in any manner as able to do any of the acts described in this subsection.
448.01(9s)
(9s) "Scene of an emergency" means an area not within the confines of a hospital or other institution which has hospital facilities or the office of a person licensed, certified or holding a limited permit under this chapter.
448.01(10)
(10) "Treat the sick" means to examine into the fact, condition or cause of human health or disease, or to treat, operate, prescribe or advise for the same, or to undertake, offer, advertise, announce or hold out in any manner to do any of the aforementioned acts, for compensation, direct or indirect, or in the expectation thereof.
448.01(12)
(12) "Warn" means to privately apprise the holder of a license or certificate of the unprofessional nature of the holder's conduct and admonish the holder that continued or repeated conduct of such nature may give the medical examining board or an attached affiliated credentialing board cause to reprimand the holder or to limit, suspend or revoke such license or certificate.
448.01 Note
NOTE: Chapter 383, laws of 1975, which repealed and recreated chapter 448 of the statutes contains a statement of legislative policy in section 1.
448.01 Annotation
A physician, subject to certain limitations, may advise a patient whether or not continued chiropractic care is necessary without engaging in the unauthorized practice of chiropractic. 68 Atty. Gen. 316.
MEDICAL EXAMINING BOARD
448.015
448.015
Definitions. In this subchapter:
448.015(1)
(1) "Board" means medical examining board.
448.015(2)
(2) "Respiratory care" means that branch or system of treating the sick which is limited to assisting in the prevention, diagnosis and therapeutic treatment of respiratory disorders by various means, including the administration of medical gases, oxygen therapy, ventilation therapy, artificial airway care, bronchial hygiene therapy, aerosolization of pharmacological agents, respiratory rehabilitation therapy and other treatment, testing, evaluation and rehabilitation procedures performed under the direction of a physician, but not including the use of general anesthetic agents.
448.015(3)
(3) "Respiratory care practitioner" means an individual who practices respiratory care.
448.015(4)
(4) "Unprofessional conduct" means those acts or attempted acts of commission or omission defined as unprofessional conduct by the board under the authority delegated to the board by
s. 15.08 (5) (b) and any act by a physician or physician assistant in violation of
ch. 450 or
961.
448.015 History
History: 1997 a. 175 ss.
16,
23,
24,
25,
27;
1999 a. 32.
448.02(1)(1)
License. The board may grant licenses, including various classes of temporary licenses, to practice medicine and surgery and to practice as a physician assistant.
448.02(2)
(2) Certificate. The board may certify respiratory care practitioners.
448.02(3)
(3) Investigation; hearing; action. 448.02(3)(a)(a) The board shall investigate allegations of unprofessional conduct and negligence in treatment by persons holding a license, certificate or limited permit granted by the board. An allegation that a physician has violated
s. 253.10 (3),
448.30 or
450.13 (2) or has failed to mail or present a medical certification required under
s. 69.18 (2) within 21 days after the pronouncement of death of the person who is the subject of the required certificate or that a physician has failed at least 6 times within a 6-month period to mail or present a medical certificate required under
s. 69.18 (2) within 6 days after the pronouncement of death of the person who is the subject of the required certificate is an allegation of unprofessional conduct. Information contained in reports filed with the board under
s. 49.45 (2) (a) 12r.,
50.36 (3) (b),
609.17 or
632.715, or under
42 CFR 1001.2005, shall be investigated by the board. Information contained in a report filed with the board under
s. 655.045 (1), as created by
1985 Wisconsin Act 29, which is not a finding of negligence or in a report filed with the board under
s. 50.36 (3) (c) may, within the discretion of the board, be used as the basis of an investigation of a person named in the report. The board may require a person holding a license, certificate or limited permit to undergo and may consider the results of one or more physical, mental or professional competency examinations if the board believes that the results of any such examinations may be useful to the board in conducting its investigation.
448.02(3)(b)
(b) After an investigation, if the board finds that there is probable cause to believe that the person is guilty of unprofessional conduct or negligence in treatment, the board shall hold a hearing on such conduct. The board may use any information obtained by the board or the department under
s. 655.17 (7) (b), as created by
1985 Wisconsin Act 29, in an investigation or a disciplinary proceeding, including a public disciplinary proceeding, conducted under this subsection and the board may require a person holding a license, certificate or limited permit to undergo and may consider the results of one or more physical, mental or professional competency examinations if the board believes that the results of any such examinations may be useful to the board in conducting its hearing. A unanimous finding by a panel established under s.
655.02, 1983 stats., or a finding by a court that a physician has acted negligently in treating a patient is conclusive evidence that the physician is guilty of negligence in treatment. A finding that is not a unanimous finding by a panel established under s.
655.02, 1983 stats., that a physician has acted negligently in treating a patient is presumptive evidence that the physician is guilty of negligence in treatment. A certified copy of the findings of fact, conclusions of law and order of the panel or the order of a court is presumptive evidence that the finding of negligence in treatment was made. The board shall render a decision within 90 days after the date on which the hearing is held or, if subsequent proceedings are conducted under
s. 227.46 (2), within 90 days after the date on which those proceedings are completed.
448.02(3)(c)
(c) Subject to
par. (cm), after a disciplinary hearing, the board may, when it determines that a panel established under s.
655.02, 1983 stats., has unanimously found or a court has found that a person has been negligent in treating a patient or when it finds a person guilty of unprofessional conduct or negligence in treatment, do one or more of the following: warn or reprimand that person, or limit, suspend or revoke any license, certificate or limited permit granted by the board to that person. The board may condition the removal of limitations on a license, certificate or limited permit or the restoration of a suspended or revoked license, certificate or limited permit upon obtaining minimum results specified by the board on one or more physical, mental or professional competency examinations if the board believes that obtaining the minimum results is related to correcting one or more of the bases upon which the limitation, suspension or revocation was imposed.
448.02(3)(cm)
(cm) The board may initiate disciplinary action against a physician no later than one year after initiating an investigation of an allegation involving the death of a patient and no later than 3 years after initiating an investigation of any other allegation, unless the board shows to the satisfaction of the secretary that a specified extension of time is necessary for the board to determine whether a physician is guilty of unprofessional conduct or negligence in treatment. For purposes of this paragraph, the date that a matter is reopened under
sub. (8) (c) is considered the date that an investigation of the matter is initiated.
448.02(3)(e)
(e) A person whose license, certificate or limited permit is limited under this subchapter shall be permitted to continue practice upon condition that the person will refrain from engaging in unprofessional conduct; that the person will appear before the board or its officers or agents at such times and places as may be designated by the board from time to time; that the person will fully disclose to the board or its officers or agents the nature of the person's practice and conduct; that the person will fully comply with the limits placed on his or her practice and conduct by the board; that the person will obtain additional training, education or supervision required by the board; and that the person will cooperate with the board.
448.02(3)(f)
(f) Unless a suspended license or certificate is revoked during the period of suspension, upon the expiration of the period of suspension the license or certificate shall again become operative and effective. However, the board may require the holder of any such suspended license or certificate to pass the examinations required for the original grant of the license or certificate before allowing such suspended license or certificate again to become operative and effective.
448.02(3)(g)
(g) The board shall comply with rules of procedure for the investigation, hearing and action promulgated under
ss. 440.03 (1) and
448.40.
448.02(3)(h)
(h) Nothing in this subsection prohibits the board, in its discretion, from investigating and conducting disciplinary proceedings on allegations of unprofessional conduct by persons holding a license, certificate or limited permit granted by the board when the allegations of unprofessional conduct may also constitute allegations of negligence in treatment.
448.02(4)
(4) Suspension pending hearing. The board may summarily suspend any license, certificate or limited permit granted by the board for a period not to exceed 30 days pending hearing, when the board has in its possession evidence establishing probable cause to believe that the holder of the license, certificate or limited permit has violated the provisions of this subchapter and that it is necessary to suspend the license, certificate or limited permit immediately to protect the public health, safety or welfare. The holder of the license, certificate or limited permit shall be granted an opportunity to be heard during the determination of probable cause. The board may designate any of its officers to exercise the authority granted by this subsection to suspend summarily a license, certificate or limited permit, but such suspension shall be for a period of time not to exceed 72 hours. If a license, certificate or limited permit has been summarily suspended by the board or any of its officers, the board may, while the hearing is in progress, extend the initial 30-day period of suspension for an additional 30 days. If the holder of the license, certificate or limited permit has caused a delay in the hearing process, the board may subsequently suspend the license, certificate or limited permit from the time the hearing is commenced until a final decision is issued or may delegate such authority to the hearing examiner.
448.02(5)
(5) Voluntary surrender. The holder of any license, certificate or limited permit granted by the board may voluntarily surrender the license, certificate or limited permit to the secretary of the board, but the secretary may refuse to accept the surrender if the board has received allegations of unprofessional conduct against the holder of the license, certificate or limited permit. The board may negotiate stipulations in consideration for accepting the surrender of licenses.
448.02(6)
(6) Restoration of license, certificate or limited permit. The board may restore any license, certificate or limited permit which has been voluntarily surrendered or revoked under any of the provisions of this subchapter, on such terms and conditions as it may deem appropriate.
448.02(7)(a)(a) Within 30 days of receipt of a report under
s. 50.36 (3) (c), the board shall notify the licensee, in writing, of the substance of the report. The licensee and the licensee's authorized representative may examine the report and may place into the record a statement, of reasonable length, of the licensee's view of the correctness or relevance of any information in the report. The licensee may institute an action in circuit court to amend or expunge any part of the licensee's record related to the report.
448.02(7)(b)
(b) If the board determines that a report submitted under
s. 50.36 (3) (c) is without merit or that the licensee has sufficiently improved his or her conduct, the board shall remove the report from the licensee's record. If no report about a licensee is filed under
s. 50.36 (3) (c) for 2 consecutive years, the licensee may petition the board to remove any prior reports, which did not result in disciplinary action, from his or her record.
448.02(7)(c)
(c) Upon the request of a hospital, the board shall provide the hospital with all information relating to a licensee's loss, reduction or suspension of staff privileges from other hospitals and all information relating to the licensee's being found guilty of unprofessional conduct. In this paragraph, "hospital" has the meaning specified under
s. 50.33 (2).
448.02(8)(a)(a) After an investigation by the board under
sub. (3) (a) or by the department under
s. 440.03 (3m) or
(5), the board may issue a private and confidential administrative warning to a holder of a license, certificate or limited permit if the board determines that there is evidence of misconduct by him or her. The board may issue an administrative warning under this paragraph only if the board determines that no further action is warranted because the matter involves a first occurrence of minor misconduct and the issuance of an administrative warning adequately protects the public by putting the holder of the license, certificate or limited permit on notice that any subsequent misconduct may result in disciplinary action. The board shall review the determination if the holder of the license, certificate or limited permit makes a personal appearance before the board. Following the review, the board may affirm, rescind or modify the administrative warning. A holder of a license, certificate or limited permit may seek judicial review under
ch. 227 of an affirmation or modification of an administrative warning by the board.
448.02(8)(b)
(b) An administrative warning issued under
par. (a) does not constitute an adjudication of guilt or the imposition of discipline and may not be used as evidence that the holder of a license, certificate or limited permit is guilty of misconduct.
448.02(8)(c)
(c) Notwithstanding
par. (b), if the board receives a subsequent allegation of misconduct about a holder of a license, certificate or limited permit to whom the board issued an administrative warning under
par. (a), the board may reopen the matter that resulted in the issuance of the administrative warning or use the administrative warning in any subsequent disciplinary hearing under
sub. (3) (b) as evidence that he or she had actual knowledge that the misconduct that was the basis for the administrative warning was contrary to law.
448.02(8)(d)
(d) The record that an administrative warning was issued under
par. (a) shall be a public record. The contents of an administrative warning shall be private and confidential.
448.02(9)
(9) Judicial review. No injunction, temporary injunction, stay, restraining order or other order may be issued by a court in any proceeding for review that suspends or stays an order of the board to discipline a physician under
sub. (3) (c) or to suspend a physician's license under
sub. (4), except upon application to the court and a determination by the court that all of the following conditions are met:
448.02(9)(a)
(a) The board has received notice of the application and the court has provided advance notice to the board of the date of the court hearing on the application.
448.02(9)(b)
(b) There is a substantial likelihood that the applicant will prevail in the proceeding for review.
448.02(9)(c)
(c) The applicant will suffer irreparable harm if the order is not suspended or stayed.
448.02(9)(d)
(d) There is no substantial likelihood of harm to patients of the applicant if the board's order is suspended or stayed.
448.02 History
History: 1975 c. 383,
421;
1977 c. 418;
1981 c. 135,
375,
391;
1983 a. 188 s.
10;
1983 a. 189 s.
329 (5);
1983 a. 253,
538;
1985 a. 29;
1985 a. 146 s.
8;
1985 a. 315,
332,
340;
1987 a. 27,
399,
403;
1989 a. 229;
1991 a. 186;
1993 a. 105,
107;
1995 a. 309;
1997 a. 67,
175,
191,
311;
1999 a. 32,
180.
448.02 Annotation
Reading sub. (3) (b) in conjunction with s. 227.46 (2), a "hearing" for purposes of computing the time period for decision includes the taking of evidence and all subsequent proceedings. Sweet v. Medical Examining Board,
147 Wis. 2d 539,
433 N.W.2d 614 (Ct. App. 1988).
448.02 Annotation
There is a 5-prong test to guide the Board in determining whether a physician improperly treated a patient. The Board must provide written decision that separately identifies the 5 elements and discusses the evidence which relates to each element and provides details of why the evidence supports the Board's findings. Gimenez v. State Medical Examining Board,
203 Wis. 2d 349,
552 N.W.2d 863 (Ct. App. 1996).
448.02 Annotation
As used in this section, "negligence in treatment" means medical negligence, as defined by Wisconsin courts, which holds a doctor to the standard of reasonable care. The "reasonable physician" is not synonymous with the "average physician". Dept. of Regulation and Licensing v. Medical Examining Board,
215 Wis. 2d 187,
572 N.W.2d 508 (Ct. App. 1997).
448.02 AnnotationThe 90-day direction in sub. (3) (b) for rendering a decision is mandatory.
72 Atty. Gen. 147.
448.02 Annotation
The medical examining board does not deny due process by both investigating and adjudicating a charge of professional misconduct. Withrow v. Larkin, 421 US 35.
448.03
448.03
License or certificate required to practice; use of titles; civil immunity; practice of Christian Science. 448.03(1)(a)(a) No person may practice medicine and surgery, or attempt to do so or make a representation as authorized to do so, without a license to practice medicine and surgery granted by the board.
448.03(1)(b)
(b) No person may practice as a physician assistant unless he or she is licensed by the board as a physician assistant.
448.03(1m)
(1m) Certificate required to practice. No person may practice respiratory care, or attempt to do so or make a representation as authorized to do so, without a certificate as a respiratory care practitioner granted by the board.
448.03(2)
(2) Exceptions. Nothing in this subchapter shall be construed either to prohibit, or to require, a license or certificate under this subchapter for any of the following:
448.03(2)(a)
(a) Any person lawfully practicing within the scope of a license, permit, registration, certificate or certification granted to practice professional or practical nursing or nurse-midwifery under
ch. 441, to practice chiropractic under
ch. 446, to practice dentistry or dental hygiene under
ch. 447, to practice optometry under
ch. 449, to practice acupuncture under
ch. 451 or under any other statutory provision, or as otherwise provided by statute.
448.03(2)(b)
(b) The performance of official duties by a physician of any of the armed services or federal health services of the United States.
448.03(2)(c)
(c) The activities of a medical student, respiratory care student or physician assistant student required for such student's education and training, or the activities of a medical school graduate required for training as required in
s. 448.05 (2).
448.03(2)(d)
(d) Actual consultation or demonstration by licensed physicians or certified respiratory care practitioners of other states or countries with licensed physicians or certified respiratory care practitioners of this state.
448.03(2)(e)
(e) Any person other than a physician assistant who is providing patient services as directed, supervised and inspected by a physician who has the power to direct, decide and oversee the implementation of the patient services rendered.
448.03(2)(h)
(h) The gratuitous domestic administration of family remedies.
448.03(2)(i)
(i) Any person furnishing medical assistance or first aid at the scene of an emergency.
448.03(2)(j)
(j) Any person assisting a respiratory care practitioner in practice under the direct, immediate, on-premises supervision of the respiratory care practitioner.
448.03(2)(k)
(k) Any persons other than physician assistants who assist physicians.
448.03(3)(a)(a) No person may use or assume the title "doctor of medicine" or append to the person's name the letters "M.D." unless one of the following applies:
448.03(3)(a)1.
1. The person possesses the degree of doctor of medicine.
448.03(3)(a)2.
2. The person is licensed as a physician under this subchapter because the person satisfied the degree requirement of
s. 448.05 (2) by possessing a medical degree that was conferred by a medical school recognized and listed as such by the World Health Organization of the United Nations.
448.03(3)(b)
(b) No person not possessing the degree of doctor of osteopathy may use or assume the title "doctor of osteopathy" or append to the person's name the letters "D.O.".
448.03(3)(e)
(e) No person may designate himself or herself as a "physician assistant" or use or assume the title "physician assistant" or append to the person's name the words or letters "physician assistant" or "P.A." or any other titles, letters or designation which represents or may tend to represent the person as a physician assistant unless he or she is licensed as a physician assistant by the board.
448.03(5)
(5) Civil liability; certain medical procedures and reports. 448.03(5)(a)(a) No person licensed or certified under this subchapter shall be liable for any civil damages resulting from such person's refusal to perform sterilization procedures or to remove or aid in the removal of a human embryo or fetus from a person if such refusal is based on religious or moral precepts.
448.03(5)(b)
(b) No physician shall be liable for any civil damages for either of the following:
448.03(5)(b)1.
1. Reporting in good faith to the department of transportation under
s. 146.82 (3) a patient's name and other information relevant to a physical or mental condition of the patient which in the physician's judgment impairs the patient's ability to exercise reasonable and ordinary control over a motor vehicle.
448.03(5)(b)2.
2. In good faith, not reporting to the department of transportation under
s. 146.82 (3) a patient's name and other information relevant to a physical or mental condition of the patient which in the physician's judgment does not impair the patient's ability to exercise reasonable and ordinary control over a motor vehicle.
448.03(5)(c)
(c) A physician who in good faith provides the board with information concerning an allegation that another physician has engaged in unprofessional conduct or acted negligently in treating a patient is immune from liability for any damage that results from any act or omission in providing the information and may not be disciplined by the board for providing the information. In any administrative or court proceeding, the good faith of a physician who provides such information shall be presumed.
448.03(6)
(6) Practice of Christian Science. No law of this state regulating the practice of medicine and surgery may be construed to interfere with the practice of Christian Science. A person who elects Christian Science treatment in lieu of medical or surgical treatment for the cure of disease may not be compelled to submit to medical or surgical treatment.
448.03 Annotation
Restrictions on business corporations providing medical, legal and dental services is discussed.
75 Atty. Gen. 200.
448.04
448.04
Classes of license; certificate of licensure. 448.04(1)(a)(a)
License to practice medicine and surgery. A person holding a license to practice medicine and surgery may practice as defined in
s. 448.01 (9).
448.04(1)(b)
(b)
Temporary license to practice medicine and surgery. 448.04(1)(b)1.1. An applicant for license to practice medicine and surgery who has passed an examination satisfactory to the board, or who is a graduate of a medical school in this state, and who more than 30 days prior to the date set by the board for the holding of its next examination has complied with all the requirements of
s. 448.05 (2) and
(7) may, at the discretion of the board, be granted a temporary license to practice medicine and surgery. Such temporary license shall expire 60 days after the next examination for license is given or on the date following the examination on which the board grants or denies such applicant a license, whichever occurs first; but the temporary license shall automatically expire on the first day the board begins its examination of applicants after granting such license, unless its holder submits to examination on such date. The board may require an applicant for temporary licensure under this subdivision to appear before a member of the board for an interview and oral examination. A temporary license shall be granted under this subsection only once to the same person.
448.04(1)(b)2.
2. An applicant who is a graduate of a foreign medical school and who, because of noteworthy professional attainment, is invited to serve on the academic staff of a medical school in this state as a visiting professor, may be granted a temporary license to practice medicine and surgery if the applicant does not have an arrest or conviction record, subject to
ss. 111.321,
111.322 and
111.335. Such license shall remain in force only while the holder is serving full-time on the academic staff of a medical school, and the holder's entire practice is limited to the duties of the academic position. Such license shall expire 2 years after its date of granting and may be renewed at the discretion of the board. The board may require an applicant for licensure under this subdivision to appear before a member of the board for an interview.
448.04(1)(b)3.
3. The board may grant a temporary license to practice medicine and surgery for a period not to exceed 90 days to a nonresident physician who is serving on a full-time or temporary basis in a camp or other recreational facility, or to a physician temporarily maintaining the practice of another physician. In either case, the applicant for such temporary license must satisfy the board that the applicant is needed in the area in which the applicant wishes to serve and that the applicant holds a license granted upon written examination in another licensing jurisdiction of the United States or Canada. The board may renew such temporary license for additional periods of 90 days each but may not renew such license more than 3 consecutive times. The board may require an applicant for such temporary license to appear before a member of the board for interview.
448.04(1)(c)
(c)
Temporary educational permit to practice medicine and surgery. Application for a temporary educational permit to practice medicine and surgery may be made to the board by a person who meets the requirements of
s. 448.05 (2). Such permit may be issued for a period not to exceed one year and may be renewed annually for not more than 4 years. Such permit shall entitle the holder to take postgraduate educational training in a facility approved by the board. The holder of such permit may, under the direction of a person licensed to practice medicine and surgery in this state, perform services requisite to the training authorized by this section. Acting under such direction, the holder of such permit shall also have the right to prescribe drugs other than narcotics and to sign any certificates, reports or other papers for the use of public authorities which are required of or permitted to persons licensed to practice medicine and surgery. The holder of such permit shall confine training and practice to the facility in which the holder is taking the training. The purpose of this paragraph is solely to provide opportunities in this state for the postgraduate education of certain persons having training in medicine and surgery satisfactory to the board, without compliance with the licensure requirements of this subchapter. Nothing in this paragraph changes in any respect the requirements for licensure to practice medicine and surgery in this state. The violation of this paragraph by the holder of such permit shall constitute cause for the revocation of the permit. All holders of such permits shall be subject to such provisions of this subchapter as the board, by rule, determines are appropriate and to any penalties applicable to those with a temporary or regular license to practice medicine and surgery. The board may require an applicant for licensure under this paragraph to appear before a member of the board for an interview and oral examination.
