Wisconsin Medical Examining Board Newsletter

By Sheldon Wasserman, M.D., Chairperson

   A major challenge the Medical Examining Board faces is the issue of alleged sexual misconduct in medical practice. Every month DSPS receives complaints against physicians and other medical providers from touching inappropriately to other forms of sexual misconduct. All complaints are investigated, researched, and thoroughly discussed by the Board. This does not come at a nominal cost as hundreds of hours of legal counsel, paralegal, and support staff are used to evaluate each complaint. In addition, the respondent usually hires a defense counsel costing hundreds of dollars an hour. If you work for a corporation, your defense counsel also gets involved with the case to defend you. Hours of time will be taken from your practice and your life, in additional to the emotional toll the accusations have on yourself, your family, and your practice. Any accusation carries a possible stigma where friends and colleagues may treat you differently. These accusations are increasing and society is watching what we do about them.

   The case of Dr. Larry Nassar, the Olympic physician who was employed by Michigan State University and allegedly assaulted hundreds of female gymnasts, resulted in a $500 million settlement. Dr. George Tyndall of USC allegedly assaulted thousands of women and resulted in a $1.1 billion settlement. These cases and others have brought shame to our profession. They have financially drained resources that could have gone to improving the lives of students on their campuses rather than pay for relief that their survivors have suffered. Almost every specialty is being accused and the entire scenario is getting worse and demands action. For the first time a major health care system hired a private investigator to perform surveillance and recognizance on a complaint of alleged sexual misconduct. The intelligence they gathered proved beyond a shadow of a doubt the complainant provided a false accusation against a Wisconsin physician. Our investigation was immediately closed, and the physician exonerated. Will hiring a private detective be the new norm?

   The American College of OB/GYN’s (ACOG) announced and instituted a new standard of care starting January 1, 2020 for all OB/GYN’s. The key component of this new standard states:

“…given the profoundly negative effect of sexual misconduct on patients and the medical profession and the association between misconduct and the absence of a chaperone, ACOG now believes that the routine use of chaperones is needed for the protections of patients and obstetrician-gynecologists. Therefore, it is recommended that a chaperone be present for all breast, genital, and rectal examinations. The need for a chaperone is irrespective of the sex or gender of the person performing the examination and applies to examinations performed in the outpatient and inpatient settings.”¹

   At this time the MEB is considering expansion to all medical specialties and the need for a chaperone has been clearly outlined above. Exceptions will be made in circumstances in which it is likely that failure to examine the patient would result in significant and imminent harm to the patient, such as during a medical emergency. If a patient declines a chaperone, it should be explained that the chaperone is an integral part of the clinical team whose role includes assisting with the examination and protecting the patient and the physician. Any concerns the patient has regarding the presence of a chaperone should be elicited and addressed, if feasible. If, after counseling, the patient refuses the chaperone, this decision should be respected and documented in the medical record.²

   The patient-physician relationship is damaged when there is either confusion regarding professional roles and behavior or clear lack or integrity that allows sexual exploitation and harm. Sexual misconduct by physicians is an abuse of professional power and a violation of patient trust. Although sexual misconduct is uncommon in clinical care, even one episode is unacceptable. Routine use of chaperones will help assure patients and the public that physicians are maximizing efforts to create a safe environment for all patients.³

   These proposed administrative rule changes will change practice procedures but the profoundly negative effects of sexual misconduct on patients and the medical profession demand the routine use of chaperones.

^1,2,3 Referenced from ACOG Committee Opinion NO. 796  Vol. 135, NO. 1, January 2020

Wisconsin Physician Assistant
Practice Update

By Jennifer Jarrett, MPAS, PA-C
Chairperson, Council on Physician Assistants

   On March 27, 2021, 2021 Wisconsin Act 23​ was published, creating the Physician Assistant Affiliated Credentialing Board. This is the first comprehensive update to the Physician Assistant (PA) practice in Wisconsin since 1970. Pursuant to Section 73 of the Act, this board will replace the Council on Physician Assistants as of April 1, 2022. The Board will consist of eight physician assistants (licensed under subchapter VIII of chapter 448 of the Wisconsin statutes) and one public member.

   There are multiple updates to Wisconsin’s PA practice and below are two important highlights:

• The Physician/PA relationship will change from “supervisory” to “collaborative”. This written agreement outlines the PA’s scope of practice, when to consult and refer patients to a physician’s care. All written documentation of this collaborative agreement will be maintained at the site level.
• The newly created Board will grant licensure, have disciplinary and regulatory authority. The regulatory authority of this Board cannot exceed a broader scope of practice than is already set forth in Act 23. The current Council on Physician Assistants will dissolve on March 31, 2022.

   Wisconsinites interested in serving on the Physician Assistant Affiliated Credentialing Board may complete an application. Current members of the Council on Physician Assistants are eligible to apply.

   For more information on Wisconsin Physician Assistant practice updates please refer to the following links:

1. 2021 Wisconsin Act 23:
   https://docs.legis.wisconsin.gov/2021/related/acts/23
2. 2021 Wisconsin Act 23 summary memo:
   https://docs.legis.wisconsin.gov/2021/related/lcactmemo/act023.pdf  
3. Council on Physician Assistant web page:
   https://dsps.wi.gov/Pages/BoardsCouncils/MEB/PhysicianAssistants/Default.aspx