MEDICAL LICENSURE IN THE STATE OF NEW JERSEY

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1 MEDICAL LICENSURE IN THE STATE OF NEW JERSEY UMDNJ-SOM Stratford, New Jersey Presented by: William V. Roeder, J.D. Executive Director New Jersey State Board of Medical Examiners

2 What is the Board s Responsibility? 1894 Medical Practice Act BME authorized to regulate the practice of medicine Protection of the public health, safety and welfare Public assurance that licensees are Qualified Competent Honest

3 Who is on the New Jersey State Board of Medical Examiners? 12 Physicians 1 Podiatrist 1 Certified Nurse Midwife 3 Public members 1 Physician Assistant 1 Bioanalytical Lab Director NJDHSS Commissioner or designee Executive Department Designee

4 What Does the BME Do? License Discipline Set Regulatory Parameters Statute implementation through regulations Policies and Procedures

5 CUSTOMER SERVICE CENTER Call Center 39,123 Incoming Telephone Calls 2,117 Telephone Calls Abandoned 95% of Calls Answered by Customer Service Representative Pieces of Mail Received 25,000 License Verifications Processed 3,522 Documents Scanned In House 362,793

6 LICENSING

7 Application Process Document Management Unit Application Fiscal Unit Reviewer Approval Criminal History Background Check Third Party Documents Data Bank Check Licensure Fees Issue License Number

8

9 NOT A TRICK QUESTION!!!!!

10 If Address Changes, Notify Board Print Clearly

11 Licenses and Permits Issued 120 Day Average 3,800 3,700 3,600 3,500 Applications 3,400 Issued 3,300 3,200 3,100 3,

12 Active Status Physician Population

13 Mandatory Orientation Course Within Two Years of Licensure

14 DISCIPLINE

15 So You ve Been Reported to the Board... The Board Consumer Complaint Impairment Review Committee Self-Report/Colleague Reporting Reports from the Board Medical Practitioner Review Panel Adverse Action Report Medical Malpractice Payment Report

16 Consumer Complaints Receive approximately Complaints per month Sources Consumer Other Governmental Agencies Law Enforcement and Court Officials

17 Investigate each and every one Nature of the allegations dictates type/depth of investigation Kept me waiting too long to he overdosed my father vast majority ask for the Doctor s response

18 Observation When a patient feels that the patient is not the most important, the patient in turn begins to question the quality of care that the patient has been receiving. Patients who perceive their doctor is uncaring are more likely to question their care and complain to the Board.

19 Complaint Process Complaint Received Preliminary Review Doctor s Response Materials Reviewed Additional Materials Needed Screening Committee Further Investigation Warranted Matter is Closed Doctor s Appearance Investigation Complete Referred to Committee Recommend to Board to Close Matter Board Closes Matter Recommend further Board Action Referred to Attorney General for Prosecution Settlement

20 Number of Complaints Total Closed

21 Complaint Allegations Type Quality of Care 25% 25% Prof. Miscond. 17% 17% Fees/Billing 15% 14% Bedside Manner 8% 10% Medical Record 7% 8% Arrests/Convict 5% 4% Fail. Diagnose 5% 3% Prescribing 3% 2% Terminate Doctor/PT 3% 2% Sexual Misconduct 2% 2% Lying/Misrepresent. 2% 3% Unlicensed Practice 2% 2% Insurance Fraud 1% 1% Impairment Issues 1% 1% Refuse to Treat 1% 1% IME.5%.5% Unsanitary Office.5%.5% Other 4% 4%

22 Impairment Review Committee IRC makes recommendations to the BME with the assistance of the PAP on who is eligible for the ARP Impairment Review Committee Issues related to Impairments Makes recommendations to full Board on impaired physician eligibility for Alternative Resolution Program Membership 2 Board Members 2 PAP representatives 1 NJDHSS Commissioner designee Medical Director/Executive Director (non voting) PAP Staff

23 DISEASES OF IMPAIRMENT Drug Abuse Alcohol Psychiatric Disorders Physical Disabilities Cognitive Issues Emotional Stress (e.g. Situational Stress) Personality Disorders/Disruptive Physicians Impacts on the ability to safely practice Requisite skill and safety

24 IN A HEALTHCARE SETTING BEHAVIOR THAT UNDERMINES A CULTURE OF SAFETY

25 Behavior that Includes WORDS OR ACTIONS OVERT ACTIONS PASSIVE ACTIVITIES Verbal outbursts Physical Threats Refusing to perform tasks Exhibiting uncooperative attitudes BY PREVENTING/INTERFERING WITH TEAM WORK Intentionally ignoring questions from co worker Not returning telephone calls or pages related to Patient care Publically criticizing other members of the team

26 Condescending language or voice tone Impatience Behavior that undermines team effectiveness

27 Results Fosters Medical Errors Contributes to Poor Patient Satisfaction Contributes to adverse outcomes that were preventable Increases the cost of healthcare Causes qualified workers to move to new environments 12% Undermines Team Effectiveness

28 IRC Process PAP makes initial report to IRC Code number Information sufficient for meaningful review Nature of impairment While providing patient care? Criminal behavior Previous rehabilitation program Proposed plan of treatment

29 COLLEAGUE REPORTING LICENSEE REQUIRED TO REPOR ANOTHER PRACTIONER WHO DEMONSTRATES AN IMPAIRMENT (NJSA 45:9-19.5) Report to the IRC or to the PAP satisfies statutory reporting requirements Reporting physician not liable for damages unless he knowingly reported false information Failure to make report may subject licensee to disciplinary action and civil penalties

30 Medical Practitioner Review Panel Nine Members Physicians Consumers Hospital Administrator Board Member (ex officio) Medical Malpractice Payment Settlement Awards Judgments Adverse Action Reports Health Care Facilities/HMO s

31 2011 Sanctions Taken Revocation Suspension Reprimand Vol. Surrender Cease/Desist Monitoring Chaperone

32

33 Mandatory Reporting Malpractice payments - Five years Date, dollar amount and type (judgment, settlement, arbitration) New Jersey disciplinary actions - Ten years Any current restrictions/limitations against the practitioner's New Jersey license Other state or licensing entity disciplinary actions - Ten years

34 Mandatory Reporting Hospital and health care facility privilege actions - Ten years Convictions of crimes of the first through fourth degree - Ten years

35 BME Website New Web Address Board member identification Contact Information Links to useful Sites

36 www.

37 Statutes and Regulations Alerts

38 Change of Address

39 Contact Information Mailing Address 140 East Front Street (overnight) P.O. Box 183 Trenton, New Jersey Telephone Facsimile (609) (609) (License) (609) (General)

40 MEDICAL LICENSURE IN THE STATE OF NEW JERSEY UMDNJ-SOM Stratford, New Jersey Presented by: William V. Roeder, J.D. Executive Director New Jersey State Board of Medical Examiners

41 What is the Board s Responsibility? 1894 Medical Practice Act BME authorized to regulate the practice of medicine Protection of the public health, safety and welfare Public assurance that licensees are Qualified Competent Honest

42 Who is on the New Jersey State Board of Medical Examiners? 12 Physicians 1 Podiatrist 1 Certified Nurse Midwife 3 Public members 1 Physician Assistant 1 Bioanalytical Lab Director NJDHSS Commissioner or designee Executive Department Designee

43 What Does the BME Do? License Discipline Set Regulatory Parameters Statute implementation through regulations Policies and Procedures

44 CUSTOMER SERVICE CENTER Call Center 39,123 Incoming Telephone Calls 2,117 Telephone Calls Abandoned 95% of Calls Answered by Customer Service Representative Pieces of Mail Received 25,000 License Verifications Processed 3,522 Documents Scanned In House 362,793

45 LICENSING

46 Application Process Application Reviewer Approval Document Management Unit Fiscal Unit Criminal History Background Check Third Party Documents Data Bank Check Licensure Fees Issue License Number

47

48 NOT A TRICK QUESTION!!!!!

49 If Address Changes, Notify Board Print Clearly

50 Licenses and Permits Issued 120 Day Average 3,800 3,700 3,600 3,500 Applications 3,400 Issued 3,300 3,200 3,100 3,

51 Active Status Physician Population

52 Mandatory Orientation Course Within Two Years of Licensure

53 DISCIPLINE

54 So You ve Been Reported to the Board... The Board Consumer Complaint Impairment Review Committee Self-Report/Colleague Reporting Reports from the Board Medical Practitioner Review Panel Adverse Action Report Medical Malpractice Payment Report

55 Consumer Complaints Receive approximately Complaints per month Sources Consumer Other Governmental Agencies Law Enforcement and Court Officials

56 Investigate each and every one Nature of the allegations dictates type/depth of investigation Kept me waiting too long to he overdosed my father vast majority ask for the Doctor s response

57 Observation When a patient feels that the patient is not the most important, the patient in turn begins to question the quality of care that the patient has been receiving. Patients who perceive their doctor is uncaring are more likely to question their care and complain to the Board.

58 Complaint Process Complaint Received Preliminary Review Doctor s Response Materials Reviewed Additional Materials Needed Screening Committee Further Investigation Warranted Matter is Closed Doctor s Appearance Investigation Complete Referred to Committee Recommend to Board to Close Matter Board Closes Matter Recommend further Board Action Referred to Attorney General for Prosecution Settlement

59 Number of Complaints Total Closed

60 Complaint Allegations Type Quality of Care 25% 25% Prof. Miscond. 17% 17% Fees/Billing 15% 14% Bedside Manner 8% 10% Medical Record 7% 8% Arrests/Convict 5% 4% Fail. Diagnose 5% 3% Prescribing 3% 2% Terminate Doctor/PT 3% 2% Sexual Misconduct 2% 2% Lying/Misrepresent. 2% 3% Unlicensed Practice 2% 2% Insurance Fraud 1% 1% Impairment Issues 1% 1% Refuse to Treat 1% 1% IME.5%.5% Unsanitary Office.5%.5% Other 4% 4%

61 Impairment Review Committee IRC makes recommendations to the BME with the assistance of the PAP on who is eligible for the ARP Impairment Review Committee Issues related to Impairments Makes recommendations to full Board on impaired physician eligibility for Alternative Resolution Program Membership 2 Board Members 2 PAP representatives 1 NJDHSS Commissioner designee Medical Director/Executive Director (non voting) PAP Staff

62 DISEASES OF IMPAIRMENT Drug Abuse Alcohol Psychiatric Disorders Physical Disabilities Cognitive Issues Emotional Stress (e.g. Situational Stress) Personality Disorders/Disruptive Physicians Impacts on the ability to safely practice Requisite skill and safety

63 IN A HEALTHCARE SETTING BEHAVIOR THAT UNDERMINES A CULTURE OF SAFETY

64 Behavior that Includes WORDS OR ACTIONS OVERT ACTIONS PASSIVE ACTIVITIES Verbal outbursts Physical Threats Refusing to perform tasks Exhibiting uncooperative attitudes BY PREVENTING/INTERFERING WITH TEAM WORK Intentionally ignoring questions from co worker Not returning telephone calls or pages related to Patient care Publically criticizing other members of the team

65 Condescending language or voice tone Impatience Behavior that undermines team effectiveness

66 Results Fosters Medical Errors Contributes to Poor Patient Satisfaction Contributes to adverse outcomes that were preventable Increases the cost of healthcare Causes qualified workers to move to new environments 12% Undermines Team Effectiveness

67 IRC Process PAP makes initial report to IRC Code number Information sufficient for meaningful review Nature of impairment While providing patient care? Criminal behavior Previous rehabilitation program Proposed plan of treatment

68 COLLEAGUE REPORTING LICENSEE REQUIRED TO REPOR ANOTHER PRACTIONER WHO DEMONSTRATES AN IMPAIRMENT (NJSA 45:9-19.5) Report to the IRC or to the PAP satisfies statutory reporting requirements Reporting physician not liable for damages unless he knowingly reported false information Failure to make report may subject licensee to disciplinary action and civil penalties

69 Medical Practitioner Review Panel Nine Members Physicians Consumers Hospital Administrator Board Member (ex officio) Medical Malpractice Payment Settlement Awards Judgments Adverse Action Reports Health Care Facilities/HMO s

70 2011 Sanctions Taken Revocation Suspension Reprimand Vol. Surrender Cease/Desist Monitoring Chaperone

71

72 Mandatory Reporting Malpractice payments - Five years Date, dollar amount and type (judgment, settlement, arbitration) New Jersey disciplinary actions - Ten years Any current restrictions/limitations against the practitioner's New Jersey license Other state or licensing entity disciplinary actions - Ten years

73 Mandatory Reporting Hospital and health care facility privilege actions - Ten years Convictions of crimes of the first through fourth degree - Ten years

74 BME Website New Web Address Board member identification Contact Information Links to useful Sites

75 www.

76 Statutes and Regulations Alerts

77 Change of Address

78 Contact Information Mailing Address 140 East Front Street (overnight) P.O. Box 183 Trenton, New Jersey Telephone Facsimile (609) (609) (License) (609) (General)

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