Chapter 448

448.02(8) (8) Administrative warning.

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 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 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 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 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 or limit 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; 2017 a. 328; 2021 a. 23; 2023 a. 172, 214.

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 five-prong test to guide the Medical Examining Board in determining whether a physician improperly treated a patient. The board must provide a written decision that separately identifies the five elements and discusses the evidence that relates to each element and provides details of why the evidence supports the board’s findings. Gimenez v. 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.” Department of Regulation & Licensing v. Medical Examining Board, 215 Wis. 2d 188, 572 N.W.2d 508 (Ct. App. 1997), 97-0452.

448.02 Annotation The five-pronged test of Gimenez, 203 Wis. 2d 349 (1996), does not apply to cases in which fraud and misrepresentation are alleged. Gimenez expressly limits the application of the test to cases in which the medical professional is charged with choosing a course of treatment that is dangerous or detrimental to the professional’s 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. Dentistry Examining Board, 2006 WI App 73, 292 Wis. 2d 154, 713 N.W.2d 152, 05-1376.

448.02 Annotation The 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) (1) License required to practice.

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)(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, dental therapy, or dental hygiene or as an expanded function dental auxiliary under ch. 447, to practice optometry under ch. 449, to practice as a physician assistant under subch. IX, to practice acupuncture under ch. 451 or under any other statutory provision, to practice naturopathic medicine under ch. 466, or as otherwise provided by statute.

448.03 Note NOTE: The cross-reference to subch. IX of ch. 448 was changed from subch. VIII of ch. 448 by the legislative reference bureau under s. 13.92 (1) (bm) 2. to reflect the renumbering under s. 13.92 (1) (bm) 2. of subch. VIII of ch. 448.

448.03(2)(b) (b) The performance of official duties by a physician, a person who engages in the practice of a physician assistant, or a perfusionist of any of the armed services or federal health services of the United States.

448.03(2)(bm) (bm) The activities of military medical personnel, as defined in s. 440.077 (1) (d), while supervised under s. 440.077.

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 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)(g) (g) Ritual circumcision by a rabbi.

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 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(2)(p) (p) The provision of services by a health care provider under s. 257.03.

448.03(2)(q) (q) The administration of an epinephrine delivery system in accordance with s. 118.2925 or 255.07.

448.03(2)(qm) (qm) The administration of undesignated glucagon in accordance with s. 118.294.

448.03(2)(qr) (qr) The administration of a short-acting bronchodilator in accordance with s. 118.2915.

448.03 Note NOTE: Par. (qr) was created as par. (qm) by 2023 Wis. Act 195 and renumbered to par. (qr) by the legislative reference bureau under s. 13.92 (1) (bm) 2.

448.03(2)(r) (r) An individual who is exempt from licensure under sub. (2m).

448.03(2m) (2m) Sports physician licensure exemption.

448.03(2m)(a) (a)

448.03(2m)(a)1. 1. An individual who is licensed in good standing to practice medicine and surgery in another state may, subject to pars. (b) and (c), practice medicine and surgery without a license granted by the board if the individual has a written agreement with a sports team to provide care to team members and coaching staff traveling with the team for a specific sporting event to take place in this state.

448.03(2m)(a)2. 2. An individual who is licensed in good standing to practice medicine and surgery in another state may, subject to pars. (b) and (c), practice medicine and surgery without a license granted by the board if all of the following apply:

448.03(2m)(a)2.a. a. The individual has been invited by a national sport governing body to provide services to team members and coaching staff at a national sport training center in this state or to provide services to athletes and coaching staff at an event or competition in this state that is sanctioned by the national sport governing body.

448.03(2m)(a)2.b. b. The individual’s practice is limited to that required by the national sport governing body.

448.03(2m)(a)2.c. c. The services to be provided by the individual are within his or her training and expertise.

448.03(2m)(b) (b) An individual who is exempt from licensure under par. (a) 1. or 2. may not do any of the following while practicing under the exemption:

448.03(2m)(b)1. 1. Provide care or consultation to any person residing in this state, other than a person specified in par. (a) 1. or 2.

448.03(2m)(b)2. 2. Practice at a health care facility, as defined in s. 146.997 (1) (c), or at a clinic, as defined in s. 146.903 (1) (b).

448.03(2m)(b)3. 3. Prescribe drugs.

448.03(2m)(c) (c)

448.03(2m)(c)1. 1.

448.03(2m)(c)1.a. a. Subject to subd. 1. b., an exemption under par. (a) 1. shall be valid only while the individual is traveling with the sports team, subject to a limit of 10 days per sporting event.

448.03(2m)(c)1.b. b. Upon prior request to the board, the board may grant an individual an extension of 20 additional days per sporting event beyond the limitation specified in subd. 1. a., except that no individual may be exempted by the board under this subd. 1. b. for more than a total of 30 additional days in a given calendar year.

448.03(2m)(c)2. 2. An exemption under par. (a) 2. shall be valid during the time certified by the national sport governing body, subject to a limit of 30 days per exemption.

448.03(2m)(d) (d) The board may enter into agreements with medical or osteopathic licensing boards of other states to implement this subsection. Agreements under this paragraph may include procedures for reporting potential medical license violations.

448.03(2m)(e) (e) The board shall promulgate rules to implement this subsection.

448.03(3) (3) Use of titles.

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)(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 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(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; 2015 a. 35; 2017 a. 341; 2019 a. 148; 2021 a. 23, 130, 158, 218, 254; 2023 a. 27, 87, 193, 195; s. 13.92 (1) (bm) 2.

448.03 Cross-reference Cross-reference: See also Med, Wis. adm. code.

448.03 Annotation Discussing restrictions on business corporations providing medical, legal, and dental services. 75 Atty. Gen. 200.

448.033 448.033 Temporary practice at camps.

448.033(1) (1) Notwithstanding s. 448.03 (1) (a), a person may at a recreational and educational camp licensed under s. 97.67 (1) practice medicine and surgery to provide treatment to campers and staff for not more than 90 days in any year without holding a license granted under this subchapter if all of the following apply:

448.033(1)(a) (a) The person is licensed in good standing to practice medicine and surgery by another state or territory of the United States or a Canadian province or territory and the licensure standards in the jurisdiction where the person is licensed are substantially equivalent to the requirements for licensure as a physician under s. 448.04 (1) (a).

448.033(1)(b) (b) The person is not under active investigation by a licensing authority or law enforcement authority in any state, federal, or foreign jurisdiction.