In This Issue:
From your Medical Board
To Medical Board Licensees & guests:
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The medical board wants to acknowledge and thank the tireless efforts of the many, many health professionals who have spent endless hours on patient care and are currently riding out the ravages of the Covid-19 Pandemic. The total social and economic impact of this terrible incident will remain for years.
The medical board also wants to express their hope and prayers for an enjoyable Holiday Season for you and your family. You and all Oklahoma health care providers have earned a special place in so many hearts of the patients and families you have touched and shared emotional time with each day.
May the God of Healing and Love Bless you at this time.
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"Preserve the Finest Traditions of My Calling”
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Susan L. Chambers, MD, Oklahoma City OB/GYN, served as Board President in 2019-2020. |
James M. Brinkworth, MD, Oklahoma City Pathologist, recently completed his term as Board President in 2020-2021. |
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SERVING PATIENTS AND PHYSICIANS
One aspired to be a pharmacist, the other a chemical engineer.
Fortunately for Oklahoma physicians and their patients, life led them to medicine where they responded to a challenge presented in the modern Hippocratic Oath to “preserve the finest traditions of my calling” by volunteering to serve on the Oklahoma State Board of Medical Licensure and Supervision.
Susan L. Chambers, MD, Oklahoma City OB/GYN, served as Board President in 2019-2020.
James M. Brinkworth, MD, Oklahoma City Pathologist, recently completed his term as Board President in 2020-2021.
Dr. Chambers attended Southern Methodist University with the thought of becoming a pharmacist. At the time, women were underrepresented in the medical profession. While studying the pharmacy curriculum, she encountered a legendary SMU Professor of Organic Chemistry, Dr. Harold Jeskey. who encouraged her to consider a career in medicine by joining the handful of other women pre-meds.
Can I do it?
“Yes you can,” Professor Jeskey said.
And so she did by attending the OU College of Medicine after college graduation and completing an OB/GYN Residency at OU. Just a year after her Residency, Dr. Chambers and OB/GYN colleagues Laura L. Mackie, MD, and Deborah L. Huff, MD, put together and led a medical, legal and financial team that established what became a historic partnership.
Apropos of the times, there was skepticism on the future success of a group comprised of young, female physicians. “An office full of women, now that will never work,” thought some experienced practitioners. But it did. Lakeside Women’s Hospital became the first facility in Oklahoma to specialize in women’s health services.
The rest of the story is to follow a stunning medical career as Susan L. Chambers, M.D., co-founder of MedEncentive, has been inducted into the Oklahoma Women’s Hall of Fame for her many outstanding accomplishments. These accomplishments include her numerous international medical missions, plus her leadership of World Neighbors and the Institute for Economic Empowerment of Women, which helps women in Afghanistan and Rwanda build sustainable futures. Previously, Dr. Chambers was named the state’s Woman of the Year.
Dr. Brinkworth began his college career at Oklahoma State University majoring in Chemical Engineering. Toward the end of his sophomore year, he realized that chemical engineering was “just not shaping up to be what I thought it would be.” One day another student in his OSU dorm was extolling his enjoyment of a cooking class he was taking. What are you majoring in? Pre-med was the answer. A lengthy discussion followed which peaked the once would-be engineer’s interest in medicine.
(Why was the premed down the hall taking a cooking class? “You need a lot of ‘As’ to get into medical school”). :)
Dr. Brinkworth transferred to OU and switched majors to Zoology. In the summer of his junior year, he was hired as a phlebotomist at St. Anthony Hospital. This sparked the interest in pathology and served as an introduction to future mentors William Snoddy, MD, and Theodore Violett, MD. After graduating from the OU College of Medicine, Dr. Brinkworth was one of the last physicians to complete an Anatomic and Clinical Pathology Residency at St. Anthony Hospital.
Dr. Brinkworth did not limit his time to the pathology lab at St. Anthony. He served as President of the Pathology Group, Director of Clinical Pathology and Chief of Staff of St. Anthony Hospital. He also volunteered with the Oklahoma Health Professionals Program (OHPP), ultimately serving as President of the group that seeks to assist and return to practice physicians suffering from addiction, substance abuse and other mental or physical issues.
Both physicians had busy clinical practices in addition to significant administrative responsibilities. Neither anticipated service on the Medical Board.
However, when asked to consider appointment to the Medical Board, both physicians acknowledge that perhaps even more than clinical issues, it was their experience with the complexity of the administrative, legal and simply human aspects of medicine and doctor/patient relationships that made them realize how important Board service would be.
The experience and observations of Dr. Chambers and Dr. Brinkworth about their tenure on the Medical Board are quite similar.
The Medical Board exists to protect the public by ensuring patients receive safe, quality medical care provided by properly educated, licensed, competent and ethical health care providers.
It took some time and orientation from Medical Board Staff and attorneys for both physicians to learn and become comfortable with the fact that as members of a quasi-judicial entity, they serve as jurors and often judges who are responsible not only for the safety of patients but also the careers of physicians and the other health professionals supervised by the Medical Board.
Medical Board members are volunteers. The Board meets in person seven times a year to hear cases, issue licenses and discuss rules, regulations and legislation that may effect health care and medical practice. Dr. Chambers and Dr. Brinkworth may spend two to three hours a week between meetings to review case material and the credentials of license applicants.
The expansion of telemedicine is an issue of concern for both Dr. Chambers and Dr. Brinkworth. There is the potential for enormous good but no one is sure exactly where it will lead eventually.
Dr. Brinkworth also notes the increase in the number of out-of-state physicians applying for Oklahoma medical licenses.
He has also been surprised during his time on the Board by the lack of judgment used by many who appear before the panel. This coincides with Dr. Chambers recommendation that medical students and resident physicians receive more education in the business of medicine, the importance of documentation in medical records and establishment of meaningful doctor/patient relationships.
While it is independent of the Medical Board, both Past Board Presidents have high praise for the Oklahoma Health Professionals Program. It has not only helped restore the sobriety and/or health to hundreds of physicians throughout the years but returned most back to productive practice.
Drs. Chambers and Brinkworth continue to enjoy their service on the Medical Board and consider their work necessary and rewarding. They encourage their colleagues to “step up” and consider Board service. It is an important job which Dr. Chambers and Dr. Brinkworth have done well.
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The Oklahoma State Board of Medical Licensure and Supervision Executive Director Lyle Kelsey will serve as a Commissioner on the Interstate Medical Licensure Compact Commission (IMLC).
The Federation of State Medical Boards (FSMB) established IMLC in 2014 to facilitate physicians who wished to be licensed in more than one state. The first compact license was issued in 2017. Access the IMLC website at imlcc.org.
The Oklahoma Legislature sanctioned Oklahoma’s participation in IMLC during its last session. Currently 31 states, the District of Columbia and Guam are members of IMLC.
According to the latest FSMB figures, of the nearly one million licensed physicians in the United States, 15.5 percent have two licenses and 6.6 percent have three or more.
With the proliferation of telemedicine and other forms of long-distance and electronic patient contact, IMLC will facilitate the process of obtaining a medical license in multiple states.
More importantly, IMLC will help insure the principles that the practice of medicine occurs where the patient is located and that states are responsible for the regulation of physicians.
Since 2017, IMLC has issued nearly 21,000 licenses to some 10,000 physicians. A survey this year of IMLC applicants found the most common board certified physicians seeking to use the service were Internists (30%), followed by Family Physicians (11%), Psychiatrists and Neurologists (10%) and Radiologists (8%).
IMLCC Data Study – Year 4 The Interstate Medical Licensure Compact Commission (IMLCC) has conducted its annual data study of selected completed applications. To use the expedited licensure process, a physician must meet nine requirements and hold an active, unrestricted license in a member state where they live or are employed. Of special note are the impacts of the COVID-19 pandemic, specifically two direct impacts that are believed to have influenced the outcomes of the 2021 results.
Those impacts are:
- Physician access to fingerprint-based background check sites. During for several months between April and November 2020, many states did not have any facilities available for physicians to have their fingerprints taken for submission to the FBI. Obtaining a fingerprint-based background check is a statutory requirement to participate.
- Quarantine and Work-From-Home orders impacted member board staff’s access to information. The State of Principal License (SPL) is required to verify the physician’s application from primary source from the board’s archives. Often these archives kept as physical documents not available for view remotely. Additionally, many member boards furloughed or reduced working staff numbers or hours and required staff to work from home, impacting the processing time, especially for a State of Principal License (SPL).
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It has been three years since Oklahoma joined 32 other U.S. States in legalizing the use of medical marijuana. In that time, Oklahoma has reached one of the highest percentages of medical marijuana participation rates in the nation.
The rapid growth of medical marijuana in the State has continued to increase since its implementation in 2018. The Oklahoma Medical Marijuana Authority (OMMA) has already issued over 384,645 medical licenses to patients. Additionally, the agency has approved licenses for 9,178 marijuana grows, 2,431 dispensaries, and 1617 processors. The agency further reports that since SFY 2019, medical marijuana has generated more than fifty-three million dollars for Education, fifteen million dollars for Rehabilitation services, one hundred and thirty-one million dollars in total excise tax and over one hundred and sixty-six million dollars in State and Local taxes.
In July of 2021, Senate Bill 229, commonly known as the “Redbud Bill,” went into effect and apportionments of generated funds was amended. Now, from the first sixty-five million dollars of revenue, 59.23% will be appointed to the State Public Common Building Equalization School Fund, 6.15% will be distributed to OSDH and earmarked for drug and alcohol rehabilitation, and 34.62% will distribute to the OMMA Budget. Any surplus funds will be apportioned to the State General Revenue Fund.
Any licensed Oklahoma Medical Doctor or Doctor of Osteopathy who has completed one year of post-graduate training is eligible to recommend a medical marijuana license to a patient. Moreover, this last state legislative session, a new law passed which requires a recommending physician must also be in “good standing” with the State Board of Medical Licensure and Supervision or the State Board of Osteopathic Examiners. (OAC 310:681-1-9.1(a)). During this period of continued growth, it is imperative that physicians closely monitor any changes in Oklahoma State law as it pertains to medical marijuana recommendations. Physicians remain the gatekeepers for medical marijuana in Oklahoma and must be vigilant in maintaining compliance with State law.
In recent months, the agency has experienced growth and new leadership in numerous departments. In August of 2021, Governor Kevin Stitt appointed Adria Berry as the Executive Director of the Medical Marijuana Authority. The agency is currently expanding several departments ensure the proper inspections of dispensaries and grows. As always, the agency continues to staff departments with quality employees to continue to meet our top goal of maintaining patient safety.
We look forward to continue to serving the State of Oklahoma and its citizens. If you have any questions regarding the completing of the physician registry, eligibility guidelines for recommending medical marijuana, or general questions for the Oklahoma Medical Marijuana Authority, please email OMMAPhysicians@ok.gov
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The Oklahoma State Board of Medical Licensure and Supervision credentials and oversees the practices of some 13,000 Medical Doctors (MD) and Physician Assistants (PA) and 11,000 other health professionals ranging from Physical Therapists and Athletic Trainers to Respiratory Care Practitioners and Occupational Therapists.
The public can review the qualifications and any disciplinary action of licensees on the Medical Board homepage, okmedicalboard.org “Search Licensees.”
While all licenses and disciplinary actions are ultimately granted or adjudicated in bi-monthly open meetings of the Medical Board (consisting of seven physicians and four lay people), the critical work of compiling, verifying and updating the educational and professional histories of all practitioners and new applicants is accomplished by the 9 staff members of the Medical Board Licensing Department.
In addition to securing original source verification for educational and professional experience, the Licensing Department queries the National Practitioner Data Bank for all applicants for MD or PA licenses and out-of-state applicants for the other professions licensed by the Medical Board. If the Licensing Department notes discrepancy or “red flag” of any kind, the applicant’s file is immediately referred the Medical Board’s physician Board Secretary. Each Medical Board member also receives all discrepancy referrals from the Licensing Department and may request more information or personal appearances in addition to any recommendations by the Board Secretary.
The Medical Board’s Investigation Department responds to over 900 complaints yearly and then works with the Legal Department to determine facts and make appropriate recommendations for final Medical Board disciplinary action. The Oklahoma Medical Board is respected as one of the most active in the country.
The Oklahoma Medical Board recognizes that every practitioner is an individual with a unique history and story. The Board Secretary personally investigates each aberrant application with the assistance of the Investigation and Legal staff when necessary. If an issue cannot be resolved to the satisfaction of the Board Secretary, it is referred to the entire Medical Board for action which requires a personal appearance by the licensee at a Board Meeting.
The Oklahoma Medical Board encourages all to visit and utilize its home page, call with questions. The dates of official Oklahoma Medical Board meetings are listed on the homepage. All meetings are open to the public.
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In an article published by UPI.com's Health News on Aug. 9, 2021, author Brian P. Dunleavy reported that a study published that same month by JAMA Internal Medicine showed that states with laws limiting the duration of initial opioid prescriptions to no more than 7 days reduced the overall duration of the prescription. For 2018, Medicare beneficiaries who were prescribed opioids had an average duration of 33 days. In 2013, the duration was 44 days, a difference of about 26%. In states that had no limitations on initial opioid prescriptions, the average number of days dropped from 43 in 2013 to 33 in 2018 - a reduction of 23%.
The overall duration of opioid prescriptions for Medicare recipients declined nationally in that period, which might be attributed to increased awareness of addiction risk by both patients and prescribers. Dunleavy quoted researchers from the study as saying the findings show that laws limiting duration have significant impact. These laws were designed to prevent over-prescribing and improper prescribing of opioids which have resulted in increased incidence of addiction, overdose and death nationwide.
Dunleavy quoted study co-author Dr. Michael J. Brenner as saying "Older patients being treated for pain do have a variety of risks from opioids, but the goal [of these laws] is to achieve appropriate pain control for older patients while minimizing risk...The recent laws are mainly directed at curbing new opioid dependence in patients undergoing surgery, dental procedures or [those] with other new-onset pain...We increasingly recognize that the opioid crisis is a societal problem that affects individuals, families and communities...Minimizing the incidence of dependency, and specifically opioid use disorder, is among the top priorities in limiting opioid prescribing,"
Read the full article and the original study at the links below:
Sources: Brian P. Dunleavy writing for UPI.com Health News - Aug 9,2021
JAMA Internal Medicine August 9,2021
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