|
Having trouble viewing this email? View it as a Web page.
|
|
May 19, 2019
|
In This Issue:
From your Medical Board
We are doing our best to make sure everyone is PMP compliant. We recently received a list of licensees from OBNDD who may not be fully compliant and notified those individuals via e-mail. If you received a PMP Warning e-mail, please use the link provided in it to report your status to us so we can update it.
Back to Top
The new year is ushering in many new changes with a new Governor and continued legislative issues of dealing with the opioid crisis, expansion of Medicaid and of course more on Marijuana availability. There will be several discussions on the pill limit bill of last year SB1446 to make sure it continues to help Oklahomans with legitimate pain while still making an impact on the growing rate of dependence, addiction and unintended deaths. There seem to be indicators that the rate of opioid prescriptions and overdose deaths by prescription drugs are decreasing, but the evils of a buck to be made in the illegal drug trade lurk around every neighborhood corner. With the continued efforts of medical education and new tools of monitoring like the highly rated Oklahoma prescription monitoring program – PMP… prescribers are more conscientious about excessive doses and often deadly combinations of drugs like opioids and benzodiazepines and carisoprodol. Opioids, benzodiazepines, and carisoprodol all have some overlapping side effects in terms of drowsiness, respiratory depression (opioid), confusion, tremor, and seizures risk. When combined, these drugs are synergistic in causing respiratory depression and could collectively result in death. So there is still much work to be done in physician and public education.
SB1446 calls for a one-hour CME course annually on pain management or opioid use OR addiction and treatment. We have developed some guidelines for you to use in preparing a related CME or participating in a CME program. The guidelines are available in this newsletter and on our website under physician resources. The medical board does NOT intend to approve or disapprove every SB1446 CME program offered. If the CME course meets the intent of the guidelines, updates on the law [SB1446] and good safe clinical prescribing practice of opioids and other controlled dangerous substances – CDS… your CME compliance will be okay. NOTE: If you do NOT have active OBN & DEA Permits, you do NOT have to meet the SB1446 CME requirement.
Enter Medical Marijuana onto the Oklahoma healthcare scene and you are sure to stir up the conversations among citizens and health care professionals. Whatever your impression is of Medical Marijuana, it certainly has made the treatment of medical conditions more controversial. The end of the session is now weeks away so it is not too late to call your legislators and give them your thoughts on any subject… that is good government.
Lastly, I want to say an eternal goodbye to a sincere friend, longtime co-worker and a first class physician… Dr. Gerald Zumwalt. Dr. Zumwalt passed away earlier this year while skiing in Colorado. Skiing on the slopes at 87 years old… doing what he loved. He was an inspiration to me and for sure all the staff at the medical board and we remember him fondly. His memorial service was Friday February 8th in Sapulpa to a standing room overflow crowd. Dr. Gerald Zumwalt was a happy man with a life well lived… or as he often quoted his brother,
“Why be unhappy when with just a little more effort, you can be miserable?”
-Robert Zumwalt, MD OU ’53
|
Paul's Advice to Physicians
By Gerald C. Zumwalt, MD
Board Secretary/Medical Advisors
September 2006
There are certain portions of the Bible that are inevitably associated with certain times and events - the second chapter of Luke at Christmas, the entrance of Jesus to Jerusalem on Palm Sunday, the rolling away of the stone at Easter and the ascension on Pentecost. But the most familiar is 1st Corinthians 13, which is ubiquitously either read or sung at virtually every wedding.
But contained within that chapter, somewhere between “Though I speak” and “the greatest of these is love” is a portion Paul sneaked in to define the difference between a physician and a medically-educated charlatan.
Verse 4, “Love is patient, love is kind. It does not envy, it does not boast, it is not proud.” This is a textbook description of the doctor every patient in Oklahoma is seeking. A Doctor who has the time to sit and listen, listen without turning to a computer and typing away while a sick person is trying to explain their suffering, physical or emotional. A doctor who can take time to tickle an infant’s feet just to watch it laugh. A doctor who will return a telephone call with lab results instead of pushing that non-profit-making task off on the lowest paid employee in the office.
Verse 5, “It is not rude, it is not self-seeking, it is not easily angered.” My neighbor needs a cardiac ablation procedure due to recurrent ventricular arrhythmias. He consulted a well-trained and experienced cardiologist but was so offended by the physician’s rude speech and manner that he is searching for another practitioner.
Verse 7, “It always protects, always trusts, always hopes, always perseveres.” These phrases should be engraved on the threshold of every medical office, clinic and hospital. The patient’s welfare must be uppermost in our actions and decisions. We must believe in our patients if we are to expect they will believe in us. And despite government interference and red tape, paperwork and poor reimbursement, malpractice suits and long hours, quacks enriching themselves with useless “alternative medicine” and bad things happening to good people, we must continue to hope and persevere knowing that medicine is the noblest profession and that we are unbelievably lucky to be a member.
Back to Top
The country’s opioid epidemic had overshadowed the growing problem of inappropriate prescribing of benzodiazepines, such as alprazolam, clonazepam, diazepam and lorazepam, according to a February 22, 2018, article in the New England Journal of Medicine authored by Anna Lembke, MD, et.al.
Since three quarters of deaths related to benzodiazepines also involve an opioid, “the harms associated with benzodiazepines have been over looked,” according to the authors.
The Food and Drug Administration has long approved the use of benzodiazepines for treating anxiety, insomnia, seizures and acute alcohol withdrawal. The drugs are also prescribed “off label” for many conditions including depression. The number of prescriptions for benzodiazepines filled in the past 20 years has increased by nearly 70 percent. Overdose deaths involving the drugs have increased from 1,135 to 8,791 between the years 1999 and 2013.
Many physicians do not realize that benzodiazepines can be addictive. The authors also note that the drugs have “proven utility when used intermittently and for less than one month at a time.”
The authors recommend that physicians routinely consult their state’s Prescription Monitoring Program to check for dangerous drug combinations or doctor-shopping before prescribing benzodiazepines, just as they do for opioids.
“It would be a tragedy of measures to target overprescribing and overuse of opioids diverted people from one class of life-threatening drugs to another.”
Back to Top
Oklahoma physicians and other professions licensed by the Oklahoma State Board of Medical Licensure and Supervision (Medical Board) are individually responsible for all information contained on applications for new or renewed licenses. There are no excuses or exceptions.
Ideally, every licensee should personally read, complete and sign each application or renewal form.
However, it is becoming increasingly clear that many physicians in particular now allow staff, employers or “credentialing” services to complete the questionnaires which often are signed without careful review. Errors, omissions or inaccuracies on the forms could result in a mandated appearance before the Medical Board and, if serious enough, suspension or interruption of medical practice.
If there are errors or omissions on an application, the Medical Board Licensing Department will deal only with the physician or licensee, not a third party.
Answer all questions truthfully. Whether a licensee or designee completes the license application or renewal form, review it very carefully before signing and submitting it.
Back to Top
The Oklahoma Medical Practice Act does not require physicians to maintain specialty certifications as a condition of licensure. The Act states that Maintenance of Certification (MOC) shall not be “construed” a requirement as a “condition of licensure, reimbursement, employment or admitting privileges at a hospital in this state.” The law considers MOC as a “continuing education program measuring core competencies in the practice of medicine and surgery and approved by a nationally recognized accrediting organization.”
While MOC is not required for licensure, physicians are reminded that the Allopathic Practice Act does mandate completion of sixty (60) hours of Category I Continuing Medical Education every three (3) years for license renewal.
Physicians must attest to CME completion on license renewal forms. Physician renewals are randomly selected for audit for CME verification.
The Medical Board accepts as verification: AMA Physician Recognition Award; specialty board certification or re-certification by an American Board of Medical Specialties during the past three (3) years; proof of residency or fellowship training during the past three (3) years; or copies of Category I CME completion certificates.
Failure to submit verifiable records when requested constitutes an incomplete renewal application and at least temporary inability to practice. A license obtained or renewed through misrepresentation will result in Medical Board action.
Back to Top
Here’s another unfunded federal mandate and a possible remedy.
Federal civil rights law mandates that health care providers who accept federal money must provide “interpretation” for patients who cannot speak English. But there is no matching mandate in the law for the government or private insurers to pay for this service.
While there are companies that offer telephone interpretation for various languages, compliance with this law is not rigorously monitored nor enforced.
Oklahoma physicians faced with a language barrier may find assistance on the Oklahoma State Board of Medical Licensure and Supervision homepage, okmedicalboard.org, under “Find a Doctor-Search Licenses.”
By clicking on “Language,” physicians and the public can identify doctors who speak Arabic, Mandarin Chinese, Farsi, Hindi, Russian, Spanish and Vietnamese.
Oklahoma physicians who speak one of these or any other language are encouraged to update their profiles on the Board homepage.
Back to Top
The Federation of State Medical Boards (FSMB) recently honored two Oklahomans.
Lyle Kelsey, Executive Director of the Oklahoma State Board of Medical Licensure and Supervision (OSBMLS), received the group’s Distinguished Service Award.
John William “Bill” Kinsinger, M.D., was honored posthumously with FSMB’s John H. Clark M.D. Leadership Award.
The awards were presented during FSMB’s Annual Meeting in Charlotte, NC. FSMB represents seventy (70) state boards which regulate the practices of Medical Doctors and Doctors of Osteopathy.
A resident of Edmond, Kelsey has served as OSBMLS Executive Director for over 20 years. The Distinguished Service Award recognizes the highest level of service to FSMB and Kelsey’s dedication to the advancement of the profession of medical regulation and commitment to strengthening the protection of the public and enhancement of the medical arts through the credentialing, licensing, regulation and discipline of Oklahoma health care providers. In addition to nearly 10,000 medical doctors, OSBMLS regulates the licenses of over 12,000 other health care workers in 11 other professions including Physician Assistants, Physical Therapists and Occupational Therapists.
Kelsey formerly served on both the FSMB Board of Directors and its Editorial Board. He is also Past President of the Administrators in Medicine (AIM) which presented him with its Distinguished Service Award in 2004. AIM is the professional organization dedicated to enhance the ability of executives and staff of medical and osteopathic boards to advance public safety in the medical professions.
Dr. Kinsinger, an Oklahoma City anesthesiologist, graduated from the University of Oklahoma College Of Medicine and served on the OSBMLS Board since 2011, including a term as Board President in 2014. Dedicated to patient safety and consumer protection, Dr. Kinsinger was recognized for his advocacy for the work of medical licensing boards at both the state and national levels.
Dr. Kinsinger’s compassion was not limited to his patients. He passed away while flying a volunteer mission to transport a disabled dog to a new home. His wife, Kerri, accepted the M.D. Leadership Award for her late husband.
Back to Top
|
|
Click on licensee name link for details. Some actions are not final until approved by the Oklahoma Attorney General.
Jerry Hernandez, MD, Lic #29256
Cordell, Complaint Citation
Kimberlee Mixon, PA, Lic #1288
Owasso, Surrendered License in Lieu of Prosecution
Richard Wedel, MD, Lic #23316
Norman, Voluntary Surrender to Jurisdiction, $5000 Fine, Required Assessment, OHPP (5) Years, additional CME
Lee Rittenhouse, MD, Lic. #12365
Crescent, Reprimand, $5000 Fine, CME, periodic random chart and record review
Sara Collier, MD, Lic #31042
Edmond, Voluntary Surrender to Jurisdiction, Probation five (5) years, individual and couples therapy, Vivitrol therapy, OHPP (5) Years, CME Courses
Petrina Nesbitt, RC, Lic #1809
Moore, Indefinite Probation, submit to testing,attend meetings, notify CC of any changes, counselor to submit reports, employment pre-approved
Roger Miller, PR, Lic. #1841
Broken Arrow, Immediate Summary Suspension
Richard Johns II, PT, Lic. #4424
Glenpool, Revoked license
Moheb Hallaba, MD, Lic. #13018
Clinton, Revoked License
Dominic Losacco, MD, Lic. #10161
Tulsa, Pending Complaint Citation
Leslie A. Masters, MD, Lic. #21537
Tulsa, Revoked License w/o Right to Reapply
Albert Nguyen, MD, Lic. #28578
Oklahoma City, 30-day suspension, formal reprimand, $30,000 Fine, prohibited from supervising mid-level practitioners for 6 months, additional CME: May 9 Board appearance for failure to meet CME deadline
Floyd L. Smith, MD, Lic. #16142
Oklahoma City, Pending Complaint Citation
George S. Cohlmia, MD, Lic. #15023
Tulsa, Formal Reprimand, $25,000 Fine,Restricted to VSJ terms including employment approval, random records review, hospital reports & additional CME.
Sherif Ismail, MD, Lic. #22720
Lawton, VSJ w/ 5 years Probation, Lifetime contract with OHPP, addiction therapy, employment approval.
Tommy K. Jenkins, TA, Lic. #1141
Tonkawa, Probation reinstated, Indefinite probation, OHPP, AA
Steven Henson, MD, Lic. #23110
Wichita, KS, Pending Complaint Citation
Kirsten Marion, RC, Lic. #4850
Tulsa, Pending Complaint Citation
Susan A. Meyer, RC, Lic. #1225
Tulsa, Immediate Summary Suspension of License
Abolghasem Rezaei, MD, Lic. #23655
Lawton, Pending Complaint Citation
Zachariah J. Anderson, MD, Lic. #22198
Okmulgee, Surrendered License in lieu of Prosecution
Azuka Egbuniwe, MD, Lic. #28751
McLoud, Voluntary Submittal to Jurisdiction Reprimand, $5000 fine & Restricted license for two years w/o CDS prescribing, no supervision of PAs or APRNs & employment approved by Board secretary.
back to top
|
|
|
|
May 1 - Jun 30
Jul 1 - Aug 31
Sep 1 - Oct 31
Sep 1 - Oct 31
Back to Top
|
Valuable resources available on Medical Board Website:
|
|
|
This publication is electronically issued by the Board of Medical Licensure & Supervision. Copies have
not been printed but are available through the agency website and on documents.ok.gov. This publication,
in its entirety, produced by The Medical Board using in-house expertise at no cost and distributed by email
to all licensees under the jurisdiction of this Board and to other subscribers – approximately 21,525.
|
|
