Protecting the public and assuring high practice and professional standards in the physician community: The Rhode Island Board of Medical Licensure and Discipline

Medicine and Health Rhode Island, Sep 2003 by Crausman, Robert S

"The health and dignity of my patient will ever be my first concern. I will hold in confidence all that my patient relates to me. I will not permit consideration of race, gender, sexual preference, religion, nationality or social standing to come between me and my duty to anyone in need of my services. This pledge I make freely and upon my honor"

- Excerpt from the Physician's Oath recited by graduating students of the Brown Medical School.

Few professions involve the unique privileges and responsibilities that medicine and osteopathy require of practitioners in modern American society. Upon entering the profession we pledge to uphold a high standard of behavior that places our patients' interests above our own. So extraordinary is this role and so necessary is this commitment, that every state monitors and enforces the professional conduct of physicians. Little did I realize, when I recited the Physicians Oath after completing medical school at Brown that I would one day take on a key responsibility for this process in my home state of Rhode Island.

In September 2003 Governor Donald Carcieri approved my appointment as Chief Administrator of the Rhode Island Medical Board of Licensure and Discipline (the Board), based on the recommendation of Dr. Patricia A. Nolan, Director of Health. As residency program Director at the Memorial hospital (Pawtucket, RI) since 1995, I had frequently interacted with the Board. During the summer, I attended several Board sessions and met individually with members. As the summer unfolded, I developed a more complete understanding of the Board, its role and vision-an understanding that I would like to share with my colleagues.

THE RHODE ISLAND BOARD OF MEDICAL LICENSURE AND DISCIPLINE

The Board is an agency of state government established to protect the public and to assure high practice and professional standards in the nearly 4000-member physician community. The Board discharges these responsibilities primarily through the licensing process, receiving and investigating complaints, and serving as a disciplinary body. It also assesses professional practices and develops remedial programs for specific physicians. Among other activities, the Board provides public information on physician licenses in Rhode Island, serves as a resource to government concerning the foreign-trained physician waiver program, assures the achievement of continuing medical education standards and educates the health care and lay community regarding the role of the Board and medical professionalism. These tasks require not only the efforts of a serious and dedicated Board, but also the support and participation of health care professionals, and the Rhode Island public.

THE STATUTE

Chapter 5-37 of the RI General Laws describes the Board's composition, the appointment of its members, its mandate, powers and functions.

http://www.rilin.state.ri.us/Statutes/TITLE5/5-37/INDEX.HTM.

BOARD COMPOSITION

The Governor appoints members with input from the appropriate medical or osteopathic societies. Members include:

* Six licensed physicians, including

* One full-time medical school faculty member

* Two osteopathic physicians

* Five public members, including

* one attorney experienced as a plaintiffs counsel in medical malpractice

* one a member of the general public who is at least 60 years of age

* three public members not associated with the medical field

* One hospital administrator

The Director of the RI Department of Health (HEALTH) serves as chairperson. The Board's Chief Administrator and Legal Counsel serve as ex officio, non-voting members. RI law protects members of the Board from civil or criminal legal action related to activities conducted in good faith.

BOARD ACTIVITIES

Licensing

A license to practice medicine in the Rhode Island is considered a privilege, not a right, granted to qualified physicians. The essential requirements for licensure include the following:

* graduation from a school of medicine

* successful completion of no less then one year of postgraduate training

* three years of postgraduate training for ECFMG (Education Commission for Foreign Medical Graduates) certified international graduates

* successful completion of the USMLE licensing examination

* evidence of a high moral and ethical standard

* payment of the application fee

The Board endeavors to render a decision on a complete license application within 90 days. However, the verification of credentials, which requires information from multiple sources such as medical schools, graduate medical education programs, hospitals and professional references, often extends the processing time. For physicians previously licensed in Rhode Island, the Board mails out the annual application for renewal in March. The application is due on June 1; renewal takes effect on July 1. Soon the Board will be implementing a two-year application cycle.

Complaints and discipline

The Board serves as a clearinghouse for written complaints regarding unprofessional conduct. Complaints may come from individuals, institutions, public officers, other physicians, healthcare professionals or anyone else who has contact with medical professionals-including the Board itself. All complaints and investigations remain confidential prior to final Board action.