Back to School for Physicians

This article was written for Birmingham Medical News and was published Aug. 17, 2021.

It is back-to-school time. Although it is still hot outside, many schools have opened, we have taken first day of school pictures, and football practice is underway. As we enter this new season, it’s a good time for physicians to review some practice fundamentals. To that end, I offer 10 reminders about regulatory compliance fundamentals that can help to avoid legal liability and an unwanted invitation to Montgomery.

1. Keep close tabs on the current state of emergency rules promulgated in response to the COVID-19 pandemic. Waivers of regulatory requirements governing telehealth and practice across state lines have come and gone. With the delta and lambda variants emerging, it is likely that regulators will respond with additional emergency rules. Physicians need to be aware of those responses and when they expire in order to remain compliant with their requirements.
2. Never, ever sign blank, undated or predated prescription forms. The prohibition on signing blank prescription forms has been around for a long time, yet it still happens occasionally. The Alabama Medical Licensure Commission rules classify the signing of a blank, undated or predated prescription form to be unprofessional conduct. Just don’t do it.
3. When renewing your registration with the Alabama Medical Licensure Commission or applying to be credentialed by any organization, read the fine print before you sign. It is your license or credentialing application, not your office manager’s. In my law practice, I have seen inadvertent errors on licensure and credentialing applications create problems that might have been avoided if the physician had carefully reviewed the application before it was submitted. 
4. If you practice through a limited liability partnership, remember to file a certified copy of the registration paperwork with the Alabama Board of Medical Examiners. Further, if there is a change to the registration, a certified copy of the change in registration must be filed with the Alabama Board of Medical Examiners within 30 days after the change is made.
5. If you retire, terminate your employment, or otherwise leave your medical practice, you are responsible to ensure that active patients are given reasonable notification and are given the opportunity to arrange for transfer of their medical records.
6. Review the rules regarding contact with patients before prescribing. Knowing these rules is especially important where controlled substances are concerned. Prescribing medications for a patient you have not personally examined is allowed in certain circumstances but prohibited in others. Medical judgment is also involved in determining when it is appropriate. Know the rules.
7. When you receive a request for medical records that is associated with a properly executed authorization from the patient, respond promptly. Failure to do so can be considered information blocking under federal rules and is considered to be unprofessional conduct by the Alabama Medical Licensure Commission.
8. Do not prescribe or dispense a controlled substance to yourself, your spouse, your child or your parent except in the case of a bona fide emergency. 
9. Maintain professional boundaries with patients. The Alabama Board of Medical Examiners and the Alabama Medical Licensure Commission have issued a detailed joint statement of policy and guidelines prohibiting sexual misconduct in the practice of medicine. An incident or allegation of sexual misconduct can be devastating to the patient and physician. In order to minimize the possibility of a misunderstanding or misperception during a patient interaction, the physician should explain the need for the various aspects of the examination or procedure in words that are clear, appropriate, and professional. Also, the fact that a person is not actively receiving treatment or professional services is not determinative of whether the person is still a patient. In some circumstances they still may be considered a patient.
10. If you know a colleague with a drug, alcohol or psychiatric problem, encourage them to get help. The Alabama Physician Health Program was developed to render assistance to physicians who voluntarily seek intervention, treatment and rehabilitation for their impairment. An impaired physician’s career, and possibly their life, may depend on it.

Remembering these ten fundamentals can help you start this new season on the right note. Please contact Jim Henry or any member of Phelps' Health Care team if you have questions or need advice and guidance.