32-1401

32-1401. Definitions

In this chapter, unless the context otherwise requires:

1. "Active license" means a valid and existing license to practice medicine.

2. "Adequate records" means legible medical records containing, at a minimum,
sufficient information to identify the patient, support the diagnosis, justify the
treatment, accurately document the results, indicate advice and cautionary warnings
provided to the patient and provide sufficient information for another practitioner to
assume continuity of the patient's care at any point in the course of treatment.

3. "Advisory letter" means a nondisciplinary letter to notify a licensee that
either:

(a) While there is insufficient evidence to support disciplinary action, the board
believes that continuation of the activities that led to the investigation may result in
further board action against the licensee.

(b) The violation is a minor or technical violation that is not of sufficient merit
to warrant disciplinary action.

(c) While the licensee has demonstrated substantial compliance through
rehabilitation or remediation that has mitigated the need for disciplinary action, the
board believes that repetition of the activities that led to the investigation may result
in further board action against the licensee.

4. "Approved hospital internship, residency or clinical fellowship program" means a
program at a hospital that at the time the training occurred was legally incorporated and
that had a program that was approved for internship, fellowship or residency training by
the accreditation council for graduate medical education, the association of American
medical colleges, the royal college of physicians and surgeons of Canada or any similar
body in the United States or Canada approved by the board whose function is that of
approving hospitals for internship, fellowship or residency training.

5. "Approved school of medicine" means any school or college offering a course of
study that, on successful completion, results in the degree of doctor of medicine and
whose course of study has been approved or accredited by an educational or professional
association, recognized by the board, including the association of American medical
colleges, the association of Canadian medical colleges or the American medical
association.

6. "Board" means the Arizona medical board.

7. "Completed application" means that the applicant has supplied all required fees,
information and correspondence requested by the board on forms and in a manner acceptable
to the board.

8. "Direct supervision" means that a physician, physician assistant licensed
pursuant to chapter 25 of this title or nurse practitioner certified pursuant to chapter
15 of this title is within the same room or office suite as the medical assistant in
order to be available for consultation regarding those tasks the medical assistant
performs pursuant to section 32-1456.

9. "Dispense" means the delivery by a doctor of medicine of a prescription drug or
device to a patient, except for samples packaged for individual use by licensed
manufacturers or repackagers of drugs, and includes the prescribing, administering,
packaging, labeling and security necessary to prepare and safeguard the drug or device
for delivery.

10. "Doctor of medicine" means a natural person holding a license, registration or
permit to practice medicine pursuant to this chapter.

11. "Full-time faculty member" means a physician employed full time as a faculty
member while holding the academic position of assistant professor or a higher position at
an approved school of medicine.

12. "Health care institution" means any facility as defined in section 36-401, any
person authorized to transact disability insurance, as defined in title 20, chapter 6,
article 4 or 5, any person who is issued a certificate of authority pursuant to title 20,
chapter 4, article 9 or any other partnership, association or corporation that provides
health care to consumers.

13. "Immediate family" means the spouse, natural or adopted children, father,
mother, brothers and sisters of the doctor and the natural or adopted children, father,
mother, brothers and sisters of the doctor's spouse.

14. "Letter of reprimand" means a disciplinary letter that is issued by the board
and that informs the physician that the physician's conduct violates state or federal law
and may require the board to monitor the physician.

15. "Limit" means taking a nondisciplinary action that alters the physician's
practice or professional activities if the board determines that there is evidence that
the physician is or may be mentally or physically unable to safely engage in the practice
of medicine.

16. "Medical assistant" means an unlicensed person who meets the requirements of
section 32-1456, has completed an education program approved by the board, assists in a
medical practice under the supervision of a doctor of medicine, physician assistant or
nurse practitioner and performs delegated procedures commensurate with the assistant's
education and training but does not diagnose, interpret, design or modify established
treatment programs or perform any functions that would violate any statute applicable to
the practice of medicine.

17. "Medical peer review" means:

(a) The participation by a doctor of medicine in the review and evaluation of the
medical management of a patient and the use of resources for patient care.

(b) Activities relating to a health care institution's decision to grant or
continue privileges to practice at that institution.

18. "Medically incompetent" means a person who the board determines is incompetent
based on a variety of factors, including:

(a) A lack of sufficient medical knowledge or skills, or both, to a degree likely
to endanger the health of patients.

(b) When considered with other indications of medical incompetence, failing to
obtain a scaled score of at least seventy-five per cent on the written special purpose
licensing examination.

19. "Medicine" means allopathic medicine as practiced by the recipient of a degree
of doctor of medicine.

20. "Office based surgery" means a medical procedure conducted in a physician's
office or other outpatient setting that is not part of a licensed hospital or licensed
ambulatory surgical center.

21. "Physician" means a doctor of medicine licensed pursuant to this chapter.

22. "Practice of medicine" means the diagnosis, the treatment or the correction of
or the attempt or the claim to be able to diagnose, treat or correct any and all human
diseases, injuries, ailments, infirmities, deformities, physical or mental, real or
imaginary, by any means, methods, devices or instrumentalities, except as the same may be
among the acts or persons not affected by this chapter. The practice of medicine includes
the practice of medicine alone or the practice of surgery alone, or both.

23. "Restrict" means taking a disciplinary action that alters the physician's
practice or professional activities if the board determines that there is evidence that
the physician is or may be medically incompetent or guilty of unprofessional conduct.

24. "Special purpose licensing examination" means an examination developed by the
national board of medical examiners on behalf of the federation of state medical boards
for use by state licensing boards to test the basic medical competence of physicians who
are applying for licensure and who have been in practice for a considerable period of
time in another jurisdiction and to determine the competence of a physician under
investigation by a state licensing board.

25. "Teaching hospital's accredited graduate medical education program" means that
the hospital is incorporated and has an internship, fellowship or residency training
program that is accredited by the accreditation council for graduate medical education,
the American medical association, the association of American medical colleges, the royal
college of physicians and surgeons of Canada or a similar body in the United States or
Canada approved by the board whose function is that of approving hospitals for
internship, fellowship or residency training.

26. "Teaching license" means a valid license to practice medicine as a full-time
faculty member of an approved school of medicine or a teaching hospital's accredited
graduate medical education program.

27. "Unprofessional conduct" includes the following, whether occurring in this state
or elsewhere:

(a) Violating any federal or state laws, rules or regulations applicable to the
practice of medicine.

(b) Intentionally disclosing a professional secret or intentionally disclosing a
privileged communication except as either act may otherwise be required by law.

(c) False, fraudulent, deceptive or misleading advertising by a doctor of medicine
or the doctor's staff, employer or representative.

(d) Committing a felony, whether or not involving moral turpitude, or a misdemeanor
involving moral turpitude. In either case, conviction by any court of competent
jurisdiction or a plea of no contest is conclusive evidence of the commission.

(e) Failing or refusing to maintain adequate records on a patient.

(f) Habitual intemperance in the use of alcohol or habitual substance abuse.

(g) Using controlled substances except if prescribed by another physician for use
during a prescribed course of treatment.

(h) Prescribing or dispensing controlled substances to members of the physician's
immediate family.

(i) Prescribing, dispensing or administering schedule II controlled substances as
defined in section 36-2513 including amphetamines and similar schedule II sympathomimetic
drugs in the treatment of exogenous obesity for a period in excess of thirty days in any
one year, or the non-therapeutic use of injectable amphetamines.

(j) Prescribing, dispensing or administering any controlled substance or
prescription-only drug for other than accepted therapeutic purposes.

(k) Signing a blank, undated or predated prescription form.

(l) Conduct that the board determines is gross malpractice, repeated malpractice or
any malpractice resulting in the death of a patient.

(m) Representing that a manifestly incurable disease or infirmity can be
permanently cured, or that any disease, ailment or infirmity can be cured by a secret
method, procedure, treatment, medicine or device, if this is not true.

(n) Refusing to divulge to the board on demand the means, method, procedure,
modality of treatment or medicine used in the treatment of a disease, injury, ailment or
infirmity.

(o) Action that is taken against a doctor of medicine by another licensing or
regulatory jurisdiction due to that doctor's mental or physical inability to engage
safely in the practice of medicine or the doctor's medical incompetence or for
unprofessional conduct as defined by that jurisdiction and that corresponds directly or
indirectly to an act of unprofessional conduct prescribed by this paragraph. The action
taken may include refusing, denying, revoking or suspending a license by that
jurisdiction or a surrendering of a license to that jurisdiction, otherwise limiting,
restricting or monitoring a licensee by that jurisdiction or placing a licensee on
probation by that jurisdiction.

(p) Sanctions imposed by an agency of the federal government, including
restricting, suspending, limiting or removing a person from the practice of medicine or
restricting that person's ability to obtain financial remuneration.

(q) Any conduct or practice that is or might be harmful or dangerous to the health
of the patient or the public.

(r) Violating a formal order, probation, consent agreement or stipulation issued or
entered into by the board or its executive director under this chapter.

(s) Violating or attempting to violate, directly or indirectly, or assisting in or
abetting the violation of or conspiring to violate any provision of this chapter.

(t) Knowingly making any false or fraudulent statement, written or oral, in
connection with the practice of medicine or if applying for privileges or renewing an
application for privileges at a health care institution.

(u) Charging a fee for services not rendered or dividing a professional fee for
patient referrals among health care providers or health care institutions or between
these providers and institutions or a contractual arrangement that has the same effect.
This subdivision does not apply to payments from a medical researcher to a physician in
connection with identifying and monitoring patients for a clinical trial regulated by the
United States food and drug administration.

(v) Obtaining a fee by fraud, deceit or misrepresentation.

(w) Charging or collecting a clearly excessive fee. In determining if a fee is
clearly excessive, the board shall consider the fee or range of fees customarily charged
in the state for similar services in light of modifying factors such as the time
required, the complexity of the service and the skill requisite to perform the service
properly. This subdivision does not apply if there is a clear written contract for a
fixed fee between the physician and the patient that has been entered into before the
provision of service.

(x) Fetal experiments conducted in violation of section 36-2302.

(y) The use of experimental forms of diagnosis and treatment without adequate
informed patient consent, and without conforming to generally accepted experimental
criteria, including protocols, detailed records, periodic analysis of results and
periodic review by a medical peer review committee as approved by the federal food and
drug administration or its successor agency.

(z) Engaging in sexual conduct with a current patient or with a former patient
within six months after the last medical consultation unless the patient was the
licensee's spouse at the time of the contact or, immediately preceding the
physician-patient relationship, was in a dating or engagement relationship with the
licensee. For the purposes of this subdivision, "sexual conduct" includes:

(i) Engaging in or soliciting sexual relationships, whether consensual or
nonconsensual.

(ii) Making sexual advances, requesting sexual favors or engaging in any other
verbal conduct or physical contact of a sexual nature.

(iii) Intentionally viewing a completely or partially disrobed patient in the
course of treatment if the viewing is not related to patient diagnosis or treatment under
current practice standards.

(aa) Procuring or attempting to procure a license to practice medicine or a license
renewal by fraud, by misrepresentation or by knowingly taking advantage of the mistake of
another person or an agency.

(bb) Representing or claiming to be a medical specialist if this is not true.

(cc) Maintaining a professional connection with or lending one's name to enhance or
continue the activities of an illegal practitioner of medicine.

(dd) Failing to furnish information in a timely manner to the board or the board's
investigators or representatives if legally requested by the board.

(ee) Failing to allow properly authorized board personnel on demand to examine and
have access to documents, reports and records maintained by the physician that relate to
the physician's medical practice or medically related activities.

(ff) Knowingly failing to disclose to a patient on a form that is prescribed by the
board and that is dated and signed by the patient or guardian acknowledging that the
patient or guardian has read and understands that the doctor has a direct financial
interest in a separate diagnostic or treatment agency or in nonroutine goods or services
that the patient is being prescribed and if the prescribed treatment, goods or services
are available on a competitive basis. This subdivision does not apply to a referral by
one doctor of medicine to another doctor of medicine within a group of doctors of
medicine practicing together.

(gg) Using chelation therapy in the treatment of arteriosclerosis or as any other
form of therapy, with the exception of treatment of heavy metal poisoning, without:

(i) Adequate informed patient consent.

(ii) Conforming to generally accepted experimental criteria, including protocols,
detailed records, periodic analysis of results and periodic review by a medical peer
review committee.

(iii) Approval by the federal food and drug administration or its successor agency.

(hh) Prescribing, dispensing or administering anabolic-androgenic steroids to a
person for other than therapeutic purposes.

(ii) Lack of or inappropriate direction, collaboration or direct supervision of a
medical assistant or a licensed, certified or registered health care provider employed
by, supervised by or assigned to the physician.

(jj) Knowingly making a false or misleading statement to the board or on a form
required by the board or in a written correspondence, including attachments, with the
board.

(kk) Failing to dispense drugs and devices in compliance with article 6 of this
chapter.

(ll) Conduct that the board determines is gross negligence, repeated negligence or
negligence resulting in harm to or the death of a patient.

(mm) The representation by a doctor of medicine or the doctor's staff, employer or
representative that the doctor is boarded or board certified if this is not true or the
standing is not current or without supplying the full name of the specific agency,
organization or entity granting this standing.

(nn) Refusing to submit to a body fluid examination or any other examination known
to detect the presence of alcohol or other drugs as required by the board pursuant to
section 32-1452 or pursuant to a board investigation into a doctor of medicine's alleged
substance abuse.

(oo) Failing to report in writing to the Arizona medical board or the Arizona
regulatory board of physician assistants any evidence that a doctor of medicine or a
physician assistant is or may be medically incompetent, guilty of unprofessional conduct
or mentally or physically unable to safely practice medicine or to perform as a physician
assistant.

(pp) The failure of a physician who is the chief executive officer, the medical
director or the medical chief of staff of a health care institution to report in writing
to the board that the hospital privileges of a doctor of medicine have been denied,
revoked, suspended, supervised or limited because of actions by the doctor that appear to
show that the doctor is or may be medically incompetent, is or may be guilty of
unprofessional conduct or is or may be unable to engage safely in the practice of
medicine.

(qq) Claiming to be a current member of the board, its staff or a board medical
consultant if this is not true.

(rr) Failing to make patient medical records in the physician's possession promptly
available to a physician assistant, a nurse practitioner, a person licensed pursuant to
this chapter or a podiatrist, chiropractor, naturopathic physician, osteopathic physician
or homeopathic physician licensed under chapter 7, 8, 14, 17 or 29 of this title on
receipt of proper authorization to do so from the patient, a minor patient's parent, the
patient's legal guardian or the patient's authorized representative or failing to comply
with title 12, chapter 13, article 7.1.

(ss) Prescribing, dispensing or furnishing a prescription medication or a
prescription-only device as defined in section 32-1901 to a person unless the licensee
first conducts a physical examination of that person or has previously established a
doctor-patient relationship. This subdivision does not apply to:

(i) A physician who provides temporary patient supervision on behalf of the
patient's regular treating licensed health care professional.

(ii) Emergency medical situations as defined in section 41-1831.

(iii) Prescriptions written to prepare a patient for a medical examination.

(iv) Prescriptions written or prescription medications issued for use by a county
or tribal public health department for immunization programs or emergency treatment or in
response to an infectious disease investigation, public health emergency, infectious
disease outbreak or act of bioterrorism. For the purposes of this item, "bioterrorism"
has the same meaning prescribed in section 36-781.

(v) Prescriptions written or antimicrobials dispensed to a contact as defined in
section 36-661 who is believed to have had significant exposure risk as defined in
section 36-661 with another person who has been diagnosed with a communicable disease as
defined in section 36-661 by the prescribing or dispensing physician.

(tt) Performing office based surgery using sedation in violation of board rules.

(uu) Practicing medicine under a false or assumed name in this state.