Medical license exception worries state medical board

Medical license exception worries state medical board

May 21st, 2010 by Emily Bregel in Politics State

The Tennessee Board of Medical Examiners is hoping to derail legislation that would allow a Florida-based physician who does not meet Tennessee's strict licensure standards to practice in the state anyway.

The legislation, which this week passed the Tennessee General Assembly and went to Gov. Phil Bredesen for consideration, would allow the pediatric neonatologist to practice at a pediatric intensive care unit in Jackson, Tenn., in a medically needy community clinic staffed by Vanderbilt University Medical Center.

Vanderbilt sought the exemption for this physician, whom officials declined to name, because of the difficulty in finding a specialist to handle critical care in small towns like Jackson, Tenn., said John Howser, director of news and communications at Vanderbilt.

"It's extremely challenging to get highly qualified physicians to go to work" in smaller communities, he said.

The board expressed its concern about the amendment to HB 1895 in an April 30 letter to Rep. Joe Armstrong, D-Knoxville. Rep. Armstrong crafted the amendment at the request of Vanderbilt.

"The Board cannot agree to this lowering of our standards. Therefore, we respectfully request that the amended bill be withdrawn or defeated," states the letter, signed by Dr. Mitchell Mutter, chairman of the Tennessee Board of Medical Examiners.

Dr. Mutter, a Chattanooga cardiologist, could not be reached for comment Thursday.

Lydia Lenker, spokeswoman for the governor's press office, said the governor has not received any communication from the board of medical examiners on the issue.

"The governor doesn't usually discuss his action on a bill before giving it full review and consideration," she said in an e-mail.

Under Tennessee licensure rules, physicians must have completed all medical board examinations within seven years of completing the first step of the exam process, which is a more stringent requirement than other states, many of which allow 10 years, Mr. Howser said.

The amendment, tailored to this particular physician, would grant an extension of that time limit to a physician who is licensed in three other jurisdictions and meets all other requirements for licensure in the state. The amendment would expire in 2013.

The Florida-based pediatric neonatologist is licensed in three states -- Georgia, Illinois and Michigan -- and he took longer than seven years to complete the three board examinations required for his specialty, Mr. Howser said.

To comply with Tennessee's current standard, the Florida-based doctor would have to spend the next year retaking board examinations, Mr. Howser said.

"I don't know that this physician is willing to put this on hold and go through all this," he said.

As of Thursday, Mr. Howser said he believed the physician still plans to come to Jackson, presuming the legislation is signed into law.

WHAT DOES THE AMENDMENT SAY?

A House amendment to HB 1895 amends a section of the Tennessee Code to state: "Applicants shall successfully complete the United States Medical Licensing Examination within seven (7) years from the date of whichever step of the exam was completed first; provided, however, the board shall grant an extension to an applicant who is licensed in good standing in at least three (3) other jurisdictions and who has otherwise met the requirements under this section."

Rep. Armstrong said Thursday he knew an earlier amendment had alarmed the board of medical examiners because it was too broad. He wrote the current amendment to ensure only this particular doctor would qualify for the exception, he said. He said similar exceptions for doctors have been made through changes to state law in the past.

"I thought this situation was defused and everybody was comfortable with the legislation, but obviously not," he said, when told of the medical board's continuing concerns. He stood by the Legislature's decision on the amendment.

"We have responded to the needs of a university and hospital in Jackson and taken care of this situation that is unique. ... I know that Vanderbilt does not come with frivolous requests," he said.

Earlier Thursday, Sen. Bo Watson, R-Hixson, said he also was not aware of any concerns about the bill, which passed the House and Senate easily.

"This attempted to address those kind of outlier situations and give the board some flexibility to say, 'Hey, look, this guy or this lady meets all the standards in this jurisdiction, and we can apply a little different standard to these folks'" in Tennessee, he said.