Frequently Asked Questions
- What is the purpose of the personal data questions on the licensure application?
The personal data questions are to ensure the safety and protection of the public by ensuring applicants are safe to practice. When answering the question, “Do you have a medical condition which in any way impairs or limits your ability to practice your profession with reasonable skill and safety?” the board expects applicants to include only medical conditions that will impair their ability to perform the duties of the profession. For example, well-managed diabetes, well-managed depression, wearing of eye glasses, other treated physical or mental disorders would not necessarily require a “yes” answer to this question.
The board reviews any applications with positive personal data question answers to assess the nature, severity, and risk associated with the medical condition, and any ongoing treatment. The board then determines whether to issue the license, restrict the license, or deny the license. Once a board decision has been made on positive application personal data questions, those answers are not used for later discipline.
Safe and Effective Analgesia and Administration for Osteopathic Physicians in Office-based Settings
- Why was the rule put into effect?
In 2007 the legislature passed ESHB 1414 requiring facilities that use general anesthesia to be licensed by the Department of Health. The legislation authorized the Board of Osteopathic Medicine and Surgery to create rules governing office-based surgery using less than general anesthesia. The rule establishes enforceable standards for physicians who perform office-based surgery to reduce the risk of substandard care, inappropriate administration of anesthesia, infections and other serious complications. The rules currently in effect are WAC 246-853-650.
- What caused the legislation?
Over the past 25 years, advances in anesthesia and medical technology have made surgery outside of hospitals the preferred option for many patients. Outpatient surgeries account for an estimated 70 percent of all surgeries performed in the U.S. Of all outpatient operations, an estimated 20 percent are performed in physicians' offices. Patients may find that having surgery performed in the physician's office is more convenient and less expensive than having surgery in a hospital or ambulatory surgical facility. As a result, a significant volume of surgery is being transferred from large, regulated surgical centers to unregulated, small offices. Because of that, the department established office-based surgery rules to ensure physicians performing office-based surgery are meeting certain standards and keeping patients safe.
- How long does a physician have to become accredited or certified with either the Joint Commission, Accreditation Association for Ambulatory Health Care, the American Association for Accreditation of Ambulatory Surgery Facilities, the Centers for Medicare & Medicaid Services, Planned Parenthood or the National Abortion Federation?
The physician must receive accreditation within 365 calendar days from the effective date of this rule. Because the rule took effect on January 17, 2011, a facility must have been accredited by January 17, 2012.
- Who sets accreditation standards for appropriate equipment to ensure patient safety?
Physicians who performs a procedure under this rule must ensure they perform it in a facility that is appropriately equipped and maintained to ensure patient safety through accreditation or certification and in good standing from one of the following::
- The Joint Commission
- The Accreditation Association for Ambulatory Health Care
- The American Association for Accreditation of Ambulatory Surgery Facilities
- The Centers for Medicare and Medicaid Services
- Planned Parenthood Federation of America or the National Abortion Federation - for facilities limited to office-based surgery for abortion or abortion-related services.
- Are there exemptions to this rule?
Yes. WAC 246-853-650 outlines the exemptions for the osteopathic physician.
- May the physician who performs the surgery also administer the intravenous sedation?
No. The physician performing the surgical procedure must not administer the intravenous sedation or monitor the patient. Also, the licensed healthcare practitioner designated by the physician to administer intravenous medications and monitor the patient who is under moderate sedation, may assist the operating physician with minor, interruptible tasks of short duration once the patient's level of sedation and vital signs have been stabilized, provided that they maintain adequate monitoring of the patient's condition. The licensed healthcare practitioner who administers intravenous medications and monitors a patient under deep sedation or analgesia must not perform or assist in the surgical procedure.