Effective date note
NOTE: Par. (a) is amended eff. 4-1-17 by
2013 Wis. Act 240 to read:
Effective date text
(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 or certificate 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 or certificate on notice that any subsequent misconduct may result in disciplinary action. The board shall review the determination if the holder of the license or certificate 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 or certificate 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.
Effective date note
NOTE: Par. (b) is amended eff. 4-1-17 by
2013 Wis. Act 240 to read:
Effective date text
(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 or certificate 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.
Effective date note
NOTE: Par. (c) is amended eff. 4-1-17 by
2013 Wis. Act 240 to read:
Effective date text
(c) Notwithstanding par. (b), if the board receives a subsequent allegation of misconduct about a holder of a license or certificate 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;
2001 a. 89;
2009 a. 382;
2011 a. 160;
2013 a. 240.
448.02 Cross-reference
Cross-reference: See also
Med, Wis. adm. code.
448.02 Annotation
Reading sub. (3) (b) in conjunction with s. 227.46 (2), a "hearing" for purposes of computing the time period for rendering a 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 a written decision that separately identifies the 5 elements and discusses the evidence that 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),
95-2641.
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 188,
572 N.W.2d 508 (Ct. App. 1997),
97-0452.
448.02 Annotation
The 5-pronged test of
Gimenez does not apply to cases in which fraud and misrepresentation are alleged.
Gimenez expressly limits the application of the test to cases where the medical professional is charged with choosing a course of treatment that is dangerous or detrimental to his or her patient or the public. It does not apply to allegations of unprofessional conduct by perpetrating a fraud on a patient in an attempt to obtain compensation. Krahenbuhl v. Wisconsin Dentistry Examining Board,
2006 WI App 73,
292 Wis. 2d 154,
713 N.W.2d 152,
05-1376.
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 U.S. 35,
95 S. Ct. 1456,
43 L. Ed. 2d 712 (1975).
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(1)(c)
(c) No person may practice perfusion, attempt to do so, or make a representation as authorized to do so, without a license to practice perfusion granted by the board.
448.03(1)(d)
(d) No person may practice as an anesthesiologist assistant unless he or she is licensed by the board as an anesthesiologist 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 midwifery under
subch. XIII of ch. 440, 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 or perfusionist 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, perfusion student, anesthesiologist assistant 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 perfusionists or certified respiratory care practitioners of other states or countries with licensed physicians or perfusionists or certified respiratory care practitioners of this state.
448.03(2)(e)
(e) Any person other than a physician assistant or an anesthesiologist 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, anesthesiologist assistants, or perfusionists, who assist physicians.
448.03(2)(L)
(L) A person performing autotransfusion or blood conservation techniques under the direction and supervision of a licensed physician.
448.03(2)(m)
(m) A person practicing perfusion for not more than 30 days in a year, if the person is certified or eligible to be certified as a clinical perfusionist by the American Board of Cardiovascular Perfusion.
448.03(2)(n)
(n) A person employed as a perfusionist by a federal agency, as defined in
s. 59.57 (2) (c) 1., if the person provides perfusion services solely under the direction or control of the federal agency by which he or she is employed.
448.03(3)(a)(a) Except as provided in
s. 257.03, 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) Except as provided in
s. 257.03, 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) Except as provided in
s. 257.03, 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(3)(f)
(f) A person who is not licensed to practice perfusion by the board may not designate himself or herself as a perfusionist, use or assume the title "licensed perfusionist" or the abbreviation "L.P.," or use any other title, letters, or designation that represents or may tend to represent the person as a perfusionist. This paragraph does not apply to any of the following:
448.03(3)(f)1.
1. Any person employed as a perfusionist by a federal agency, as defined in
s. 59.57 (2) (c) 1., if the person provides perfusion services solely under the direction or control of the federal agency by which he or she is employed.
448.03(3)(f)2.
2. Any person pursuing a supervised course of study leading to a degree or certificate in perfusion under an accredited or approved educational program, if the person is designated by a title that clearly indicates his or her status as a student or trainee.
448.03(3)(f)3.
3. Any person practicing perfusion under a temporary license issued under
s. 448.04 (1) (e), if the person is designated by a title that clearly indicates that he or she is practicing under a temporary license.
448.03(3)(g)
(g) No person may designate himself or herself as an "anesthesiologist assistant" or use or assume the title "anesthesiologist assistant" or append to the person's name the words or letters "anesthesiologist assistant" or "A.A." or any other titles, letters, or designation that represents or may tend to represent the person as an anesthesiologist assistant unless he or she is licensed as an anesthesiologist assistant by the board. An anesthesiologist assistant shall be clearly identified as an anesthesiologist assistant.
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 or physician assistant 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 or physician assistant'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 or physician assistant'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(7)
(7) Supervision of anesthesiologist assistants. An anesthesiologist may not supervise more than the number of anesthesiologist assistants permitted by reimbursement standards for Part A or Part B of the federal Medicare program under Title XVIII of the federal Social Security Act,
42 USC 1395 to
1395hhh.
448.03 History
History: 1975 c. 383,
421;
1977 c. 164;
1979 c. 317;
1985 a. 29;
1987 a. 40,
399;
1989 a. 31,
229;
1991 a. 23;
1993 a. 105,
107,
490;
1995 a. 27,
201;
1997 a. 67,
175,
311;
1999 a. 32,
180;
2001 a. 89;
2005 a. 96,
292;
2007 a. 97;
2009 a. 42,
282;
2011 a. 160,
161;
2013 a. 239.
448.03 Cross-reference
Cross-reference: See also
Med, Wis. adm. code.
448.03 Annotation
Restrictions on business corporations providing medical, legal and dental services is discussed.
75 Atty. Gen. 200.
448.035
448.035
Expedited partner therapy. 448.035(1)(a)
(a) "Certified advanced practice nurse prescriber" means a nurse who is certified under
s. 441.16 (2).
448.035(1)(b)
(b) "Antimicrobial drug" means a drug identified for the treatment of a chlamydial infection, gonorrhea, or trichomoniasis in the most current guidelines for the treatment of sexually transmitted diseases of the federal centers for disease control and prevention. "Antimicrobial drug" does not include a substance listed in the schedules in
ss. 961.14,
961.16,
961.18,
961.20, and
961.22 or substances added to these schedules by the controlled substances board acting under
s. 961.11 (1).
448.035(1)(c)
(c) "Expedited partner therapy" means to prescribe, dispense, or furnish to a patient an antimicrobial drug to be used by a sexual partner of the patient to treat a chlamydial infection, gonorrhea, or trichomoniasis without physical examination of the sexual partner.
448.035(2)
(2) Notwithstanding the requirements of
s. 448.30, a physician, physician assistant, or certified advanced practice nurse prescriber may provide expedited partner therapy if the patient is diagnosed as infected with a chlamydial infection, gonorrhea, or trichomoniasis and the patient has had sexual contact with a sexual partner during which the chlamydial infection, gonorrhea, or trichomoniasis may have been transmitted to or from the sexual partner. The physician, physician assistant, or certified advanced practice nurse prescriber shall attempt to obtain the name of the patient's sexual partner. A prescription order for an antimicrobial drug prepared under this subsection shall include the name and address of the patient's sexual partner, if known. If the physician, physician assistant, or certified advanced practice nurse prescriber is unable to obtain the name of the patient's sexual partner, the prescription order shall include, in ordinary bold-faced capital letters, the words, "expedited partner therapy" or the letters "EPT."
448.035(3)
(3) The physician, physician assistant, or certified advanced practice nurse prescriber shall provide the patient with a copy of the information sheet prepared by the department of health services under
s. 46.03 (44) and shall request that the patient give the information sheet to the person with whom the patient had sexual contact.
448.035(4)(a)(a) Except as provided in
par. (b), a physician, physician assistant, or certified advanced practice nurse prescriber is immune from civil liability for injury to or the death of a person who takes any antimicrobial drug if the antimicrobial drug is prescribed, dispensed, or furnished under this section and if expedited partner therapy is provided as specified under this section.
448.035(4)(b)
(b) The immunity under
par. (a) does not extend to the donation, distribution, furnishing, or dispensing of an antimicrobial drug by a physician, physician assistant, or certified advanced practice nurse prescriber whose act or omission involves reckless, wanton, or intentional misconduct.
448.035 History
History: 2009 a. 280.
448.037
448.037
Prescriptions for and delivery of opioid antagonists. 448.037(2)(a)(a) A physician or physician assistant may, directly or by the use of a standing order, prescribe an opioid antagonist to a person in a position to assist an individual at risk of undergoing an opioid-related drug overdose and may deliver the opioid antagonist to that person. A prescription order under this paragraph need not specify the name and address of the individual to whom the opioid antagonist will be administered, but shall instead specify the name of the person to whom the opioid antagonist will be delivered.
448.037(2)(b)
(b) A physician or physician assistant who prescribes or delivers an opioid antagonist under
par. (a) shall ensure that the person to whom the opioid antagonist will be delivered has the knowledge and training necessary to safely administer the opioid antagonist to an individual undergoing an opioid-related overdose and that the person demonstrates the capacity to ensure that any individual to whom the person further delivers the opioid antagonist has or receives that knowledge and training.
448.037(3)
(3) A physician or physician assistant who, acting in good faith, prescribes or delivers an opioid antagonist in accordance with
sub. (2), or who, acting in good faith, otherwise lawfully prescribes or dispenses an opioid antagonist, shall be immune from criminal or civil liability and may not be subject to professional discipline under
s. 448.02 for any outcomes resulting from prescribing, delivering, or dispensing the opioid antagonist.
