Information for Consumers

This page is where you will find information for consumers about health issues.



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Information for Consumers

Questions To Ask Your Doctor Before Having An Office-Based Medical Procedure

Increasingly, the Board of Registration receives inquiries about the safety of certain procedures to be performed in a physician's office instead of in a hospital. Each procedure has individual risks and benefits - there is no single answer.

As a service to the public, the Board's Clinical Care Staff created a list of questions that a patient should ask before agreeing to any procedure. These suggested questions are the product of the staff's experience analyzing consumer complaints and medical malpractice data.

This is not a list of every appropriate question, but these topics represent the type of information every patient should have before agreeing to a major medical procedure in a physician's office. These suggestions do not represent formal Board opinions or regulations.

Informed Consent

Prior to all procedures, the patient should have appropriate informed consent that includes the reason s/he is having the procedure, the alternatives to the procedure, the expected outcome, the associated risks, benefits and possible complications. Topics that might not be included in informed consent, but that the patient might discuss are the following:

Is this procedure of the type that is routinely performed in an office setting? (Obtaining a second opinion would be one way to check.)

What are the physician's credentials? Ideally, the physician should be Board certified in the specialty s/he is practicing. (Specialty Board Certification can be confirmed by on the Physician Profiles page.)

  • How many procedures of this type has the physician performed?
  • What is her/his complication rate? (Ask the physician whether there are any satisfied patients who would be willing to contact you.)
  • What is the physician's specialty training for this exact procedure? (It should be more than a weekend course.)
Hospital Privileges

There are many reasons that a patient may need to know about the physician's hospital privileges. This information can be confirmed by reviewing the doctor's Profile by clicking here.

Among the questions regarding hospital privileges are:

  • Does the physician have hospital privileges?
  • Do those privileges allow her/him to perform the same procedure in a hospital? (The answer should always be yes. Call the hospital's medical staff office to verify the physician's information.)
  • Has the physician performing the surgery insisted that you get general medical clearance for the procedure and for the sedation s/he is planning? (The answer should always be yes.)
Medications & Anesthesia

Patients should discuss all aspects of anesthesia and other medications with the physician before undergoing a medical procedure. Patients should make a complete list of prescription, non-prescription, and herbal substances taken on a regular basis, including dosage, and bring the list to the doctor to review and discuss.

  • What are the drugs that the physician plans to use during the procedure?
  • Will any of the drugs used - either at the site of the surgery or for sedation - react with any medications the patient is routinely taking? (It is important for patients to tell physicians all the medications they are taking, including aspirin, ibuprofen, acetaminophen, and herbal remedies.)
  • What type of anesthesia/sedation is planned?
  • What are the complications or side-effects of this anesthesia or sedation?

If the physician is going to use conscious sedation:

  • Who will be assisting the operating physician to monitor the patient during the procedure?
  • Who is going to actually administer the anesthetic during the procedure?
  • Has that person received formal training? (The physician cannot perform the procedure and adequately monitor the patient at the same time. The person monitoring the patient should be a licensed professional, such as a Registered Nurse, Physician Assistant, etc.)
  • What type of monitoring will be done during the procedure? (At a minimum, monitoring should include blood pressure, pulse, cardiac monitor, and oxygen saturation. All monitoring should be documented every 10 minutes.)
Emergency Plans

Even the best physician can have a problem with a procedure. The doctor and patient must discuss what procedures and resources are in place to respond to a possible emergency.

  • What is the physician's plan in case of an emergency?
  • Where is the physician's emergency equipment located? When was it last checked? By whom?
  • When did the physician and her/his staff last undergo emergency certification and training? (ACLS {advanced cardiac life support} or equivalent.)
  • Who will monitor the patient after the procedure and where will the monitoring take place?
  • What kind of emergency training does the post-procedure monitoring person have? (A patient who underwent conscious sedation should be monitored by a licensed person – RN, LPN, PA – for at least one hour after the procedure. Vital signs – blood pressure, pulse, respirations, oxygen saturation – should be monitored and recorded every 15 minutes for this period of time.)
After the Procedure

Even though the physician may have finished the procedure, there are still patient care issues to be resolved.

  • If sedation is used, will the patient need a ride home?
  • What are the post procedure signs and symptoms that should be expected? What signs and symptoms are worrisome?
  • Who is the person that should be called about any problems after surgery.
  • If the person who will take the call is a nurse or physician's assistant, will the physician who performed the surgery be notified of a problem?
  • Will the physician who performed the procedure be available for emergencies?
  • If the problem requires an emergency room visit, will the physician who performed the procedure meet the patient there? Does the physician have privileges in the hospital where the patient is likely to go for an emergency?
  • If the patient is having a lesion (mole, lump, etc.) removed:
  • Will the tissue that is removed be sent to a pathology lab for biopsy? If not, why not?
  • How will the patient be notified of the results? Should s/he contact the physician, or should s/he wait for the physician to contact the patient with the results? How long a wait is anticipated?
  • What are the possible results from the biopsy and what could each one mean to the patient?
Pediatric Patients
  • What is the physician's experience with pediatric patients? What specialized pediatric training and experience does the person who is administering the anesthetic have? Does the physician have pediatric emergency equipment and drugs available? Are the surgeon and any assistants PALS (pediatric advanced life support) certified in pediatric emergencies? What is the date of the last certification?

Other Issues

In general, unless the planned procedures are closely tied together, such as removal of multiple skin lesions, only one procedure should be performed on a single patient, especially in an office setting.

  • Does the physician have office policies regarding surgical procedures? (Ask to see them.)

 

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Information for Consumers

Tips for Choosing a Doctor

The Commonwealth of Massachusetts Board of Registration in Medicine does not provide a referral service for consumers who need to choose a doctor. The following information, however, may be helpful to you when choosing a doctor for you and your family.

Locating Doctors
  • Find out how you can reach the doctor after hours if you have an emergency. Ask if the doctor sets aside time The first place to check is with your insurer or your employer's benefits office. Many insurance plans now limit your choice to a list of doctors who agree to certain requirements. Many plans also require you to select a primary care physician (PCP) from their list. The primary care physician is then responsible for your care and must make any necessary referrals to specialists or other health professionals in consultation with and the consent of the insurance carrier.
  • If you are not limited to a list of doctors, most physicians are listed in the telephone yellow pages, and in larger communities, they are listed by specialty. For your main physician, you should consider a Family Practitioner, General Practitioner, or Internal Medicine Specialist (Internist). You also may want to choose an Obstetrician/Gynecologist if you are a woman, or a Pediatrician for your children. All of these doctors are considered primary care practitioners as they can provide overall management of your health care. If you are elderly and have conditions associated with aging you may want to seek a specialist in gerontology as your PCP. Regardless of which type of PCP you need, be sure your insurance will cover the doctor's services before you incur any charges.
  • Talk with friends or co-workers about physicians they like, especially if your insurance carrier limits you in your choice to their list of recommended and/or approved physicians. Ask why they like the physician they use.
  • Most county medical societies will give you names of physicians in your area who are in the specialty you select.
  • Another good idea would be to do a search engine search. Quite often, you may receive an important piece of information from blogs and related news material.
  • Call the doctors and ask if they are accepting new patients. Be sure to ask if they will accept your insurance plan (insurance plan lists often are outdated, as physicians are added or deleted from the plan).
Research the doctor’s background and training
  • Contact your health plan or look in your plan’s provider directory to find out whether or not your doctor has the Tier 1 designation, which designates that he or she is a high-quality, cost effective physician.  Physician tiering applies to all employee and retiree non-Medicare GIC plans.  You will save money with lower office visit co-pays when you see a Tier 1 physician.
  • Learn as much as you can about the doctor’s background and training. A good place to go for information is the Massachusetts Board of Registration in Medicine’s website.  Another source of information is WebMD’s physician directory , which  provides hospital affiliation and lists other physicians in a particular doctor’s practice.
  • Check other quality and care reports.  An excellent source is the Massachusetts Health Quality Partners website.
  • Ideally, you should meet the physician and discuss your health concerns while you are well. This may be a good time to have an annual physical, but again make sure your insurance will cover the cost of your visit as well as the cost of an annual physical. Most plans will not cover an informal visit just to get acquainted or for you to see if you like the doctor's "bed side manner."
  • Before you make an appointment, verify that he or she has a current Massachusetts license or visit the Physician Profiles section on our web site. Check for any disciplinary actions against the physician.
Logistics
  • Find out how long it takes to get an appointment. Make sure the doctor can see you without a long delay.
  • Find out how you can reach the doctor after hours if you have an emergency. Ask if the doctor sets aside time for patients in need of urgent care—or makes arrangements with other physicians to cover his patients to make sure you are seen when needed.
  • Ask who will be part of your health care team. Find out what other medical staff are available to see you (such as physician assistants or nurse practitioners), if the doctor is not available.
  • Ask if the office is open in the evening or on weekends. Longer office hours may be more convenient for you.
  • Find out what happens when the doctor is on vacation. Ask if there are other doctors who can see you if your doctor is away.
  • Check to see if the doctor’s office is easy to get to. Find out if you can take public transportation. If you drive, ask about parking.
  • Ask if you can use e-mail to contact the doctor. This can be a quick and easy way for you to ask questions or share any concerns.

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Information for Consumers

A Consumer Guide To Filing a Complaint

Complaints Brochure PDF

When a consumer contacts the Board of Registration in Medicine to file a complaint against a specific Massachusetts physician or acupuncturist, the Consumer Protection Unit sends that consumer an intake form. The intake form should be filled out completely and clearly. The complaint intake form can be downloaded from the Board’s web site at www.massmedboard.org. The Board may provide a copy of the completed complaint intake form to the physician or acupuncturist.

When the Board receives a complaint intake form, it reviews the informatin to determine if the matter falls within the Board's jurisdiction. if the matter does fall within the Board's jurisdiction, a complaint will be docketed and the matter investigated by Board staff. The Board notifies the consumer by letter of this decision.

When the Board dockets a complaint, the complaint may be sent to the physician for a response, which is due 30 days from the date of the Board’s request. The consumer may receive a copy of the response.

The Board may undertake additional investigation, such as obtaining and reviewing medical records and interviewing witnesses. Then the complaint and physician response and other pertinent materials are presented to the Board’s Complaint Committee, along with a synopsis of all the other information about the doctor in the Board’s files. The Complaint Committee is a subcommittee of the Board, consisting of at least two Board members, one of whom is a physician.

At this stage, the Complaint Committee can take a number of actions, including the closure of the complaint; closure with a letter of advice, concern or warning to the physician; a request for further investigation; or a recommendation to the full Board for disciplinary action against the physician. If the Complaint Committee recommends disciplinary charges against the physician, the physician is entitled to due process of law, including an administrative hearing, before any final disciplinary action is taken by the Board.

After Closure, Then What?

After the Board has concluded its investigation, the complaint, the physician’s response, and many of the investigative materials developed during the Board’s review of the case, become part of the physician’s file and may be accessible to the public. Any member of the public may request a copy of the closed complaint file by contacting the Board’s Public Information Call Center at 1-800-377-0550, and paying a nominal charge.

A decision by the Complaint Committee to close a complaint is final and cannot be appealed. Complainants must keep in mind that the decision to close a complaint indicates only that further investigation is not likely to result in discipline of the physician, and therefore is not the best use of public resources. The Complaint Committee’s action is not a comment on the reality, pain or frustration of a complainant’s experience.

Disclaimer

The preceding information is an interpretation of the Board’s regulations and advice given by the Education and Outreach Division. The information is provided for the benefit of consumers and is subject to change. You may refer to the Board’s regulations, 243 CMR, for more information.

A full copy of the Regulations, along with other information, is available at no charge to the consumer on the Board’s web site by clicking here

The Board also operates a toll-free consumer information line at 1-800-377-0550.

 

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Information for Consumers

Guía Del Consumidor Para Someter Una Queja

Forma Para QuejasPDF

Cuando un consumidor contacta la Junta de Licenciatura Médica (Board of Registration in Medicine) para someter una queja en contra de un médico o un acupunturista, la Unidad de Protección al Consumidor le envía una forma. Ésta forma debe ser completada en su totalidad y de manera legible. Es de suma importancia que el consumidor complete y firme la autorización para obtener récords medicos, la cual está localizada en la parte de atrás de la forma. La forma para someter una queja también se encuentra en el internet en la página electrónica de la Junta, www.massmedboard.org.

Investigación Formal De Una Queja

Cuando la Junta recibe una queja por escrito, el personal examina la información y decide si se va a comenzar una investigación formal. El personal a cargo de esta tarea tiene experiencia en las áreas de medicina, leyes, investigaciones y salud pública. La junta no comenzará una investigación formal en casos donde el consumidor alega alguna conducta que no esta bajo la jurisdicción de la Junta. La Junta le notificará al consumidor, por escrito, aproximadamente dos semanas después de haberse tomado esta decisión.

Cuando la Junta decide comenzar una investigación formal, se le envía una copia de la queja al médico y se le pide que responda a las alegaciones. El médico tiene 30 días para responder. El paciente recibirá una copia de la respuesta del médico.

Presentación de la Queja al Comité de Quejas

Luego de que se recibe la respuesta del médico, la Junta puede continuar la investigación, por ejemplo solicitando y examinando récords médicos y entrevistando testigos. Entonces la queja, la respuesta del médico y los materiales investigativos relevantes son presentados al Comité de Quejas de la Junta. Igualmente se presenta al Comité una sinopsis de la información que la Junta tiene archivada bajo el nombre del médico. El Comité de Quejas es un sub-comité de la Junta y consiste de al menos dos miembros de la Junta, uno de los cuales es un médico.

A este punto, el Comité de Quejas puede tomar un número de decisiones, incluyendo el cerrar la investigación. Esta acción puede conllevar alguna carta de información, consejo, preocupación o advertencia al médico. El Comité también puede recomendar que se continúe la investigación o puede recomendar a la Junta que se tome acción disciplinaria en contra del médico. Si el Comité de Quejas recomienda cargos disciplinarios en contra del médico, el médico tiene derecho al debido proceso de ley, incluyendo una audiencia administrativa antes de que la Junta imponga cualquier acción disciplinaria.

Qué Sucede Después Que Se Cierra La Investigación?

Después que la Junta concluye el processo investigativo, la queja, la respuesta del médico y muchos de los materiales que se produjeron durante la investigación del caso forman parte del archivo del médico y éstos son accesibles al público. Cualquier miembro del público puede comunicarse con el Centro de Llamadas al 1-800-377-0550 y por un cargo mínimo pedir una copia del archivo de investigaciones cerradas.

La decisión de cerrar una investigación por parte del Comité no puede ser apelada. El consumidor debe entender que la decisión de cerrar una investigación solamente indica que mayor investigación no va a resultar en acción disciplinaria y por lo tanto no es el mejor uso de recursos públicos. La acción del Comité de Quejas no es un comentario en la realidad, dolor o frustración de la persona haciendo la queja.

Aclaración

La información arriba mencionada es una interpretación de las regulaciones de la Junta y las opiniones vertidas por parte de la División de Educación. Esta información ha sido proveída para el beneficio de los consumidores y está sujeta a cambios. Para más información, vea las regulaciones de la Junta, 243 CMR.

Usted puede accesar las regulaciones de la Junta, e información adicional, a través de la página electrónica de la Junta en http://www.massmedboard.org. La información allí contenida es libre de costo.

La Junta opera una linea gratuita de información al consumidor, 1-800-377-0550.

 

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Information for Consumers

How to Make a Public Information Request

Any member of the public may request a copy of a closed complaint file or disciplinary actions regarding physicians by submitting the request in writing to the Public Information Coordinator. However, if the documents on a disciplinary action exceeds 25 pages, you may be charged $.20 per page (over 25 pages) and an hourly rate of $14.70 for clerical services.

Please send requests to:

Board of Registration in Medicine
Attn: Public Information Coordinator
560 Harrison Ave., Ste. G-4
Boston, MA 02118

 

Information for Consumers

Speakers Bureau Request

Executive Director
Board Members
Enforcement Division
Division of Law and Policy
Licensing Division
Patient Care Assessment Unit
Physician Profiles Unit

 Your Name:


 Your Email Address (for confirmation only):


 Your Group, Hospital, or Professional Committee Name:


Mail address, phone number, best time to reach you:


Topics of Interest to your group:


Information for Consumers

Medical Spa Task Force

The materials available through the following links were distributed at meetings of the Medical Spa Task Force, and are documents available for public inspection.

These links to the Literature, Handouts, and Other State Frameworks related to Medical Spas are provided solely as a service by the Massachusetts Board of Registration in Medicine. These links do not constitute endorsement of these documents by the Board and none should be inferred.

Email submissions of materials to the Task Force may be made here:
webmaster@massmedboard.org

Meeting Minutes - October 24, 2007 (draft) PDF
Meeting Minutes - September 26, 2007 (draft) PDF
Meeting Minutes - August 29, 2007 (draft) PDF
Meeting Minutes - July 18, 2007 (draft) PDF
Staff Subgroup Presentation - June 21, 2007 PowerPoint
Meeting Minutes - June 21, 2007 PDF
Meeting Minutes - May 23, 2007 PDF
Meeting Minutes - April 25, 2007 PDF
Meeting Minutes - March 28, 2007 PDF
Meeting Minutes - February 28, 2007 PDF
Meeting Minutes - January 17, 2007 PDF
Meeting Minutes - December 13, 2006 PDF
Meeting Minutes - November 22, 2006 PDF
Agendas - Updated for Feb. 28, 2007 Meeting PDF
Other State Frameworks PDF
Professional Society Guidelines PDF
Cosmeceuticals PDF
Medical Literature PDF
Handouts PDF
Meeting Schedule PDF

 

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