448.12 History
History: 1975 c. 383,
421.
448.13
448.13
Biennial training requirement. 448.13(1)(a)
(a) Except as provided in
par. (b), 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 all of the following:
448.13(1)(a)1.
1. 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.
448.13(1)(a)2.
2. Professional development and maintenance of certification or performance improvement or continuing medical education programs or courses of study required by the board by rule under
s. 448.40 (1) and completed within the 2 calendar years preceding the calendar year for which the registration is effective.
448.13(1)(b)
(b) The board may waive any of the requirements under
par. (a) if it finds that exceptional circumstances such as prolonged illness, disability or other similar circumstances have prevented a physician from meeting the requirements.
448.13(1m)
(1m) The board shall, on a random basis, verify the accuracy of proof submitted by physicians under
sub. (1) (a) and may, at any time during the 2 calendar years specified in
sub. (1) (a), require a physician to submit proof of any continuing education, professional development, and maintenance of certification or performance improvement or continuing medical 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
A patient's consent to treatment is not categorically immutable once it has been given. A physician must initiate a new informed consent discussion when there is a substantial change in circumstances, be it medical or legal. Here, the decedent's postoperative complications did not at some point became a substantial change in medical circumstances necessitating a second informed consent discussion, because it was undisputed that the decedent was informed of the risks he later faced. Hageny v. Bodensteiner, 2009 WI App 10,
316 Wis. 2d 240,
762 N.W.2d 452,
08-0133.
448.30 Annotation
This section requires any physician who treats a patient to inform the patient about the availability of all alternate, viable medical modes of treatment, including diagnosis, as well as the benefits and risks of such treatments. Although the jury determined a physician was not negligent in his standard of care for failing to employ an alternative when treating the defendant, that did not relieve the physician of the duty to inform the patient about the availability of all alternate, viable medical modes of treatment. Bubb v. Brusky, 2009 WI 91,
321 Wis. 2d 1,
768 N.W.2d 903,
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, including rules requiring the completion of continuing education, professional development, and maintenance of certification or performance improvement or continuing medical education programs for renewal of a license to practice medicine and surgery.
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) (a) 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 THERAPY EXAMINING 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(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(1v)
(1v) "Examining board" means the physical therapy examining board.
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 examining board.
448.50(3m)
(3m) "Physical therapist assistant" means an individual who holds a license as a physical therapist assistant granted by the examining board.
448.50(4)(a)(a) "Physical therapy" means, except as provided in
par. (b), any of the following:
448.50(4)(a)1.
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(4)(a)2.
2. Alleviating impairments or functional limitations by instructing patients or designing, implementing, or modifying therapeutic interventions.
448.50(4)(a)3.
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(4)(a)4.
4. Engaging in administration, consultation, or research that is related to any activity specified in
subds. 1. to
3.
448.50(4)(b)
(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 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 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.
