A Publication of the federation of state medical boards OF THE UNITED STATES IN THIS ISSUE: of JJoouurrnnaall of Legal Issues Medical Regarding LLiicceennssuurree Unlicensed Health Care and Practices and DDiisscciipplliinnee Nutritional Supplements the role of state medical boards in regulating physician participation in executions MEDICAL STUDENT SUBSTANCE ABUSE INTERVENTION volume 95 number 3 2009 contents quote . .1 information for authors . 2 message from the chair . 3 message from the president and ceo . 5 legal issues regarding unlicensed health care practices and nutritional supplements Bruce W. McIntyre, J.D., Alexandra O. Binek, Stephanie S. DelPonte, Eric Greenberg . 9 the r ole of state medical boards in regulating physician participation in e xecutions Ty Alper . 16 medical student substance abuse intervention: a case report and literature review, Daniel M. Avery, M.D., Gabriel H. Hester, M.D., Rane McLaughlin, M.D., and Gregory E. Skipper, M.D. 27 from our international exchanges . 36 from our member board exchanges . 39 medicolegal decisions . 43 JOURNAL OF MEDICAL LICENSURE AND DISCIPLINE Published Continuously Since 1915 Volume 95, Number 3, Fall 2009 All articles published, including editorials, letters and book reviews, represent the opinions of the authors and do not necessarily reflect the official policy of the Federation of State Medical Boards of the United States Inc. or the institutions or organizations with which the authors are affiliated unless clearly specified. Editor-in-Chief FSMB Officers Subscriptions and Correspondence William E. Wargo, J.D., M.S.W. Chair: Martin Crane, M.D. Subscriptions and correspondence about Chair-elect: Freda M. Bush, M.D. subscriptions should be addressed to Editorial Committee Treasurer: James M. Andriole, D.O. the Journal of Medical Licensure and John W. Graves, J.D. President/Chief Executive Officer: Discipline, P.O. Box 619850, Dallas, TX Michael K. Helmer Humayun J. Chaudhry, D.O., M.S., 75261-9850. Subscriptions for individuals Ruth Horowitz, Ph.D. FACP, FACOI are $70 per year; single copies are $18 Susan R. Johnson, M.D., M.S. Immediate Past Chair: each. Subscriptions for libraries and C. Grant La Farge, M.D., FACC, Regina M. Benjamin, M.D., M.B.A. institutions are $140 per year; single FACP, FAPS copies are $36 each. Notification of Michael E. Norins, M.D., M.P.H. FSMB Board of Directors change of address should be made at least Sandra L. Osborn, M.D. Hedy L. Chang six weeks in advance. Enclose new and Sindy Paul, M.D., M.P.H. Leslie A. Gallant old addresses, including ZIP code. Leticia J. San Diego, Ph.D. Galicano F. Inguito, Jr., M.D., M.B.A. Danny M. Takanishi Jr., M.D. Ram R. Krishna, M.D. Authorization to Reproduce William A. Walker, M.D. Kim Edward LeBlanc, M.D., Ph.D. For authorization to photocopy or Bruce W. McIntyre, J.D. otherwise reproduce material under cir- Editor Emeritus Tully C. Patrowicz, M.D. cumstances not within fair use as defined Dale G Breaden Janelle A. Rhyne, M.D., FACP by United States Copyright Law, contact Lance A. Talmage, M.D. the Federation of State Medical Boards of © Copyright 2009 Jon V. Thomas, M.D., M.B.A. the United States, Inc. Such photocop- The Federation of State Medical Boards Cheryl A. Vaught, J.D. ies may not be used for advertising or of the United States Inc. promotional purposes, for creating new FSMB Executive Staff collective works or for resale. President/Chief Executive Officer: Humayun J. Chaudhry, D.O., M.S., Submissions FACP, FACOI Manuscripts, letters to the editor and Senior Vice President, Advocacy and other materials to be considered for Member Services: Lisa A. Robin, publication should be addressed to: M.L.A. Editor The Journal of Medical Licensure and Journal of Medical Licensure and Discipline (ISSN 1547-48IX, publication Discipline number 189-120) is published quarterly Federation of State Medical Boards by the Federation of State Medical P.O. Box 619850 Boards of the United States Inc., P.O. Dallas, TX 75261-9850 Box 619850, Dallas, TX 75261-9850 Telephone: (817) 868-4000 Submit by e-mail to: Fax: (817) 868-4098 [email protected] Postmaster AMA PRA Category 2 Credit™ Send address changes to the Journal of The Journal of Medical Licensure and Medical Licensure and Discipline, P.O. Discipline qualifies as “authoritative Box 619850 Dallas, TX 75261-9850 medical literature” and reading the Journal is a valid activity for AMA PRA Periodicals postage paid at Euless, Texas, Category 2 Credit™. and additional mailing offices. Cover: © Peter Christopher/Masterfile “each generation must, out of relative obscurity, discover its mission, fulfill it, or betray it .” — Frantz Fanon journal of medical licensure and discipline vol 95 number 3 2009 page 1 information for authors The Journal accepts original manuscripts for consideration of publication in the Journal of Medical Licensure and Discipline. The Journal is a peer-reviewed journal, and all manuscripts are reviewed by Editorial Committee members prior to publication. (The review process can take up to eight weeks.) Manuscripts should focus on issues of medical licensure and discipline or related topics of education, examination, postgraduate training, ethics, peer review, quality assurance and public safety. Queries and manuscripts should be sent by e-mail to [email protected] or by mail to: Editor Journal of Medical Licensure and Discipline Federation of State Medical Boards P.O. Box 619850 Dallas, TX 75261-9850 Manuscripts should be prepared according to the following guidelines: 1. An e-mail or letter should introduce the manuscript, name a corresponding author and include full address, phone, fax and e-mail information. The e-mail or letter should disclose any financial obligations or conflicts of interest related to the information to be published. 2. The title page should contain only the title of the manuscript. A separate list of all authors should include full names, degrees, titles and affiliations. 3. The manuscripts pages should be numbered, and length should be between 2,750 and 5,000 words, with refer- ences (in Associated Press style) and tables attached. 4. The manuscript should include an abstract of 200 words or less that describes the purpose of the article, the main finding(s) and conclusion. Footnotes or references should not be included in the abstract. 5. Any table or figure from another source must be referenced. Any photos should be marked by label on the reverse side and up direction noted. Tables and figures can be supplied in EPS, TIF, Illustrator, Photoshop (300 dpi or better) or Microsoft PowerPoint formats. 6. The number of references should be appropriate to the length of the text, and references should appear as end- notes, rather than footnotes. 7. Commentary, letters to the editor and reviews are accepted for publication. Such submissions and references should be concise and conform to the format of longer submissions. 8. If sent by mail, a PC- or Mac OS-compatible CD-ROM should accompany a printed copy of the manuscript. Microsoft Word format is the preferred file format. 9. Manuscripts are reviewed in confidence. Only major editorial changes will be submitted to the corresponding author for approval. The original manuscript and CD-ROM will be returned if the submission is not accepted for publication only if a SASE is supplied with sufficient postage. page 2 journal of medical licensure and discipline vol 95 number 3 2009 message from the chair State Medical Boards: Developing Solutions to Improve Our Nation’s Health Care Martin Crane, M.D., Chair, Federation of State Medical Boards of the United States As the United States engages in a vigorous debate about for State Medical Licensure, or UA. This application health care reform, state medical boards continue to make consists of one primary form common to all states with major strides in developing solutions to improve the qual- state-specific addendums – allowing states to maintain ity and safety of our country’s health care. By tapping into autonomy while gaining the efficiencies associated with a the latest technological advances and data standardization standard electronic application. Centralizing credentials procedures, medical boards are building a robust informa- verification is another important part of improving the li- tional infrastructure that should serve our national health censure process. Since 1996, the FCVS has enabled phy- care system well for years to come. sicians to establish a lifetime portfolio of verified medical credentials that can be forwarded to any medical board Our progress has not been limited to technological ad- or health care entity. I’m pleased to report that significant vancements, as important as those are. The FSMB and its progress is being made in the development of a new, en- membership are also making outstanding progress in de- hanced version of FCVS, with more complete and power- veloping effective public policy and building important re- ful features to streamline the credentialing process. The lationships at the state, national and international levels. newly enhanced FCVS is due to be launched in 2010. This progress is occurring because of the extremely high Improved license portability has tremendous upside for ev- level of collaboration and creativity happening across the eryone involved: state medical boards, physicians and the country within the state medical board community. Fol- patients we serve. By participating in this national effort, lowing is a brief overview of some of the initiatives current- medical boards are helping address some of the signifi- ly propelling us forward as together we pursue solutions to cant health care issues we now face, including the need to positively impact our nation’s health care. lower costs, provide care to underserved populations and facilitate telemedicine. Improving the Portability of Medical Licensure FSMB as a Data and Information U.S.