448.05(6)(a)(a) The board shall examine each applicant it finds eligible under this section in such subject matters as the board deems applicable to the class of license or certificate which the applicant seeks to have granted. Examinations may be both written and oral. In lieu of its own examinations, in whole or in part, the board may make such use as it deems appropriate of examinations prepared, administered, and scored by national examining agencies, or by other licensing jurisdictions of the United States or Canada. The board shall specify passing grades for any and all examinations required.
448.05(6)(b)
(b) The board may require an applicant who fails to appear for or to complete the required examinations to reapply for licensure or certification before being admitted to subsequent examinations.
448.05(6)(c)
(c) An applicant who fails to achieve a passing grade in the required examinations may request reexamination, and may be reexamined not more than twice at not less than 4-month intervals, and shall pay a reexamination fee for each such reexamination. An applicant who fails to achieve a passing grade on the 2nd such reexamination may not be admitted to further examination until the applicant reapplies for licensure or certification and also presents to the board evidence of further professional training or education as the board may deem appropriate.
448.05(7)
(7) Application. Application for any class of license or certificate shall be made as a verified statement in a form provided by the department and at such time and place as the board may designate, and shall be accompanied by satisfactory evidence setting out the qualifications imposed by this section. Application for any class of license to practice medicine and surgery also shall be accompanied by a verified statement that the applicant is familiar with the state health laws and the rules of the department of health and family services as related to communicable diseases.
448.06
448.06
License, certificate or limited permit granted, denied. 448.06(1)(1)
Grant of license, certificate or limited permit. If three-fourths of the members of the board find that an applicant who has passed the required examinations is qualified, the board shall so notify the applicant and shall grant the license, certificate or limited permit.
448.06(1m)
(1m) Grant of limited license or certificate. If the board finds, based upon considerations of public health and safety, that the applicant has not demonstrated adequate education, training or performance on examinations or in past practice, if any, to qualify for full licensure or certification under
sub. (1), the board may grant the applicant a limited license or certificate and shall so notify the applicant.
448.06(2)
(2) Denial of license or certificate. The board may deny an application for any class of license or certificate and refuse to grant such license or certificate on the basis of unprofessional conduct on the part of the applicant, failure to possess the education and training required for that class of license or certificate for which application is made, or failure to achieve a passing grade in the required examinations.
448.065
448.065
Permanent license for certain professors. A person who possesses a temporary license under
s. 448.04 (1) (b) 2. and who has practiced under such license for 4 or more years may apply for a license to practice medicine and surgery under
s. 448.04 (1) (a). If the applicant achieves a passing grade in the examination for a license to practice medicine and surgery and three-fourths of the board find that the applicant is qualified, notwithstanding
s. 448.05 (1) (b) and
(2), the board may grant the license. The board may limit the license and, notwithstanding
s. 448.02 (3) (e), may continue such limits indefinitely or may remove the limits when it is satisfied that the reasons for the limits no longer exist, except that the board shall remove any limitations on the geographical areas of this state in which the physician may practice and any limitations on the persons with whom the physician may associate, after a period of 5 years of continuous medical practice within this state by the physician.
448.07(1)(a)(a) Every person licensed or certified under this subchapter shall register on or before November 1 of each odd-numbered year following issuance of the license or certificate with the board in such manner as the board shall designate and upon forms the board shall provide. The secretary of the board, on or before October 1 of each odd-numbered year, shall mail or cause to be mailed to every person required to register a registration form. The board shall furnish to each person registered under this section a certificate of registration, and the person shall display the registration certificate conspicuously in the office at all times. No person may exercise the rights or privileges conferred by any license or certificate granted by the board unless currently registered as required under this subsection.
448.07(1)(b)
(b) The board shall maintain the register required by
s. 440.035 (4), which shall be divided according to the activity for which the registrant is licensed or certified. The board shall make copies available for purchase at cost.
448.07(1)(c)
(c) Every registration made as provided in this section shall be presumptive evidence in all courts and other places that the person named therein is legally registered for the period covered by such registration, and shall be deemed to fulfill any statutory requirement for renewal of license or certificate.
448.07(1)(d)
(d) No registration may be permitted by the secretary of the board in the case of any physician who has failed to meet the requirements of
s. 448.13 or any person whose license, certificate or limited permit has been suspended or revoked and the registration of any such person shall be deemed automatically annulled upon receipt by the secretary of the board of a verified report of such suspension or revocation, subject to the licensee's or permittee's right of appeal. A person whose license, certificate or limited permit has been suspended or revoked and subsequently restored shall be registered by the board upon tendering a verified report of such restoration of the license, certificate or limited permit, together with an application for registration and the registration fee.
448.07(2)
(2) Fees. The fees for examination and licenses granted or renewed under this subchapter are specified in
ss. 440.05 and
440.08.
448.08
448.08
Fee splitting; separate billing required, partnerships and corporations; contract exceptions. 448.08(1)(1)
Definitions. As used in this section:
448.08(1)(a)
(a) "Hospital" means an institution providing 24-hour continuous service to patients confined therein which is primarily engaged in providing facilities for diagnostic and therapeutic services for the surgical and medical diagnosis, treatment and care, of injured or sick persons, by or under the supervision of a professional staff of physicians and surgeons, and which is not primarily a place of rest for the aged, drug addicts or alcoholics, or a nursing home. Such hospitals may charge patients directly for the services of their employee nurses, nonphysician anesthetists, physical therapists and medical assistants other than physicians or dentists, and may engage on a salary basis interns and residents who are participating in an accredited training program under the supervision of the medical staff, and persons with a temporary educational certificate issued under
s. 448.04 (1) (c).
448.08(1)(b)
(b) "Medical education and research organization" means a medical education and medical research organization operating on a nonprofit basis.
448.08(1m)
(1m) Fee splitting. Except as otherwise provided in this section, no person licensed or certified under this subchapter may give or receive, directly or indirectly, to or from any person, firm or corporation 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 or at his or her direction.
448.08(2)
(2) Separate billing required. Any person licensed under this subchapter who renders any medical or surgical service or assistance whatever, or gives any medical, surgical or any similar advice or assistance whatever to any patient, physician or corporation, or to any other institution or organization of any kind, including a hospital, for which a charge is made to such patient receiving such service, advice or assistance, shall, except as authorized by Title 18 or Title 19 of the federal social security act, render an individual statement or account of the charges therefor directly to such patient, distinct and separate from any statement or account by any physician or other person, who has rendered or who may render any medical, surgical or any similar service whatever, or who has given or may give any medical, surgical or similar advice or assistance to such patient, physician, corporation, or to any other institution or organization of any kind, including a hospital.
448.08(3)
(3) Billing for tests performed by the state laboratory of hygiene. A person other than a state or local government agency who charges a patient, other person or 3rd party payer for services performed by the state laboratory of hygiene shall identify the actual amount charged by the state laboratory of hygiene and shall restrict charges for those services to that amount.
448.08(4)
(4) Professional partnerships and corporations permitted. Notwithstanding any other provision in this section, it is lawful for 2 or more physicians, who have entered into a bona fide partnership for the practice of medicine, to render a single bill for such services in the name of such partnership, and it also is lawful for a service corporation to render a single bill for services in the name of the corporation, provided that each individual licensed, registered or certified under this chapter or
ch. 446,
449,
450,
455,
457 or
459 that renders billed services is individually identified as having rendered such services.
448.08(5)
(5) Contract exceptions; terms. Notwithstanding any other provision in this section, when a hospital and its medical staff or a medical education and research organization and its medical staff consider that it is in the public interest, a physician may contract with the hospital or organization as an employee or to provide consultation services for attending physicians as provided in this subsection.
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.
448.14
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 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).
