Qualifications

• The licensing board of the state in which the physician practices medicine grants licenses. A physician licensed to practice medicine in the United States must have graduated from an accredited college or university and an accredited medical school, and completed a residency program or clinical program of instruction or a clinical rotation in a medical school hospital. In addition, the doctor must have done three years of post graduate residency in an accredited program and passed the United States Medical Licensing Examination. A flex licensing examination assesses the qualifications of doctor's from other countries.
  
  

Health Maintenance Organizations

• Health Maintenance Organizations (HMO) have rules and regulations regarding coverage decisions for physicians. HMOs reject treatment that is not of medical necessity under their service plan. The HMO has complaint and appeal procedures as well, and can conduct an independent review. The HMO requires additional certification of the doctor's expertise in the service or treatment rendered and actual clinical experience. If the physician suggests treatment that is denied by the HMO, the physician or the patient can ask for a review of the case to determine if treatment should be granted if the treatment is initially denied by the HMO for a specified list of reasons.
  
  

Regulatory Board

• The board has the authority to reprimand or suspend a license for unprofessional, dishonorable or unethical conduct, such as making false or misleading statements. A license is suspended, revoked or denied for misconduct after being guilty of fraud or deceit in obtaining admission to practice, or fraud or deceit in the practice of medicine. Gross malpractice, intoxication, repeated ignorance, negligence, or incompetence in the practice of medicine or abuse of controlled substances that adversely affect the physician's ability results in revocation of license as specified in the physicians practice act.
  
  

Revocation of License

• A physician's license may be revoked for illegally practicing abortion, and advertising untrue, incorrect, or misleading statements. Conviction of a felony or any offense of moral turpitude, signing a certificate knowing that the information in it is false, dispensing or prescribing drugs not in good faith, or not for a diagnosed condition, or prescribing controlled substances to an addicted patient without making an effort to cure the patient's addiction can result in revocation of a medical license. Using radiation in treatment without advising the patient of the risk of cancer from radiation can result in loss of license.
  
  A license is revoked for violating the rules of the Board of Medical Examiners after review by the licensing board that granted the physician's license. The board investigates the complaint. If the board determines that the physician is guilty of misconduct, the physician is called before the board if the board determines that the complaint has merit. A license is revoked for violating the rules of the Board of Medical Examiners. The physician can be criminally prosecuted following the investigation by the board if the case warrants prosecution.
  
  

Other Provisions

• Physician's Practice Acts vary by state but contain information about mandatory recording keeping, billing procedures, physicians in associations with others, physicians involved in workman's compensation cases and perhaps in administration of state insurance plans.
  
  Information regarding complaints and all lawsuits filed against a physician are maintained by the licensing board. The doctor must inform the board within 30 days of any such lawsuits.
  
  

Complaints Against Physician

• Each state has a procedure and a complaint form for filing a complaint against a physician, which you can obtain from the state licensing board. The form, instructions, and contact numbers are available to consumers.
  
  Each complaint will be investigated by the board. The licensing board will determine if the complaint has merit. The physician is only notified if the board determines that the complaint is founded. The doctor is then required to appear before the licensing board or comply with the licensing board's request. The physician can be reprimanded, be required to make restitution or have her license suspended or revoked by the state.