Rules
TITLE 4.
PROFESSIONS AND OCCUPATIONS
CHAPTER
38. BOARD OF HOMEOPATHIC MEDICAL EXAMINERS
(Authority: A.R.S. § 32-2904 et seq.)
ARTICLE 1.
GENERAL
Section
R4-38-101.
Definitions
R4-38-102.
Additional Requirements for
Applicants Graduated from an Unapproved School of
Medicine
R4-38-103.
Approval of Postgraduate
Coursework
R4-38-104.
Approval of Preceptorship
R4-38-105. Fees
R4-38-106. Examinations
R4-38-107. Waiver of
Written Examination
R4-38-108. Notification of
Address Changes
R4-38-109. Experimental Forms of
Diagnosis and
Treatment
R4-38-110. Repealed
R4-38-111. Peer Review
R4-38-112. Registering Use of
Experimental Forms of Diagnosis and Treatment
R4-38-113. Chelation Therapy
Practice Requirements
R4-38-114. Rehearing or Review of
Decision
R4-38-115. Use of Title and Abbreviation
ARTICLE 2.
LABELING, RECORDKEEPING, STORAGE, AND PACKAGING OF DRUGS
DISPENSED BY HOMEOPATHIC PHYSICIANS
Section
R4-38-201. Definitions
R4-38-202. General Provisions
R4-38-203. Repealed
R4-38-204. Repealed
R4-38-205. Repealed
R4-38-206. Packaging
ARTICLE 3.
EDUCATION, SUPERVISION, AND DELEGATION STANDARDS FOR
REGISTRATION OF MEDICAL ASSISTANTS BY HOMEOPATHIC
PHYSICIANS
Section
R4-38-301. Definitions
R4-38-302. Approved Formal Educational Programs
R4-38-303. Supervision of Formally Educated
Assistants
R4-38-304. Approved Practical Educational Programs
R4-38-305. Supervision of Practically Trained
Assistants
R4-38-306. Restrictions on Delegated Procedures
R4-38-307. Unprofessional Conduct
R4-38-308. Registration of Medical Assistants and
Practical Educational Programs
R4-38-309. Multiple Supervisors
R4-38-310. Previously Licensed Practitioners
R4-38-311. Deadlines for Compliance with Rules
ARTICLE 4.
APPLICATION AND RENEWAL PROCESS; TIME-FRAMES
Article 4, consisting of Sections R4-38-401 thru
R4-38-403, adopted effective September 24, 1998 (Supp.
98-3).
Section
R4-38-401. Definitions
R4-38-402. Application; Initial
License, Permit or Registration
R4-38-403. Application; Renewal of License, Permit or Registration
ARTICLE 1.
GENERAL
R4-38-101. Definitions.
In
addition to the definitions at A.R.S. § 32-2901, in this
Chapter:
1. “Beneficial clinical usage” means that usage results
of a therapy modality or treatment are documented by:
a. Clinical reports from national or international
organizations ;
b. Professionally recognized publications of clinical
indications and contraindications;
c. National or international instructional courses
providing training in the use of the therapy modality,
or treatment; or
d. Professional peer review presentations of
physicians' usage results with the therapy modality or
treatment at local, county, state, national or
international meetings.
2. “Classical homeopathy” means a system of medical
practice expounded by Samuel Hahnemann in the Organon
of Medicine that treats a disease by the
administration of minute doses of a remedy that would in
healthy persons produce symptoms of the disease treated.
3. “Complex homeopathy” means a system of medical
practice that combines one or more homeopathic remedies
that are not described in the Organon of Medicine.
4. “EAV” means electric acupuncture according to
Reinhard Voll.
5. “Fifth Pathway program” means an academic program
created by the Council on Medical Education of the
American Medical Association specifically for American
medical students studying abroad.
6. “Generally accepted experimental criteria in
homeopathy” means:
a. A protocol in which a therapy modality or treatment
is administered in the smallest amount necessary to
stimulate a healing response with a minimum of clinical
aggravation of symptoms or side effects;
b. A process of recording the clinical efficacy of a
therapy modality or treatment reflected by measurements
of symptom aggravation or improvement, laboratory
testing, and changes in physiologic functioning; or
c. A process by which innovative diagnostic
procedures and devices are analyzed and evaluated
according to their ability to assist a physician in
assessing the degree of electrical resistance or
conduction disturbance in the totality of a patient's
presenting signs, symptoms, and physiologic responses
and predict or monitor the totality of the patient’s
responses to a therapy modality or treatment.
7. “Homeopathic indication” means a recognized
standard of practice of homeopathic practitioners that
describes a sign, symptom, and physical finding that
leads to the recommendation of a particular substance or
therapeutic procedure.
8. “Metal poisoning” means a level of toxic metals
present in a patient that in the professional judgment
of a licensee is inconsistent with the patient’s ability
to achieve optimal health.
9. “Proving method of administration” means testing a
homeopathic drug on healthy volunteers by recording,
compiling, and organizing symptoms that are developed
into a repertory.
10. “Repertory” means a compilation, usually in book
form, of information categorized by the different
systems of the body and providing an index of symptoms
and a listing of corresponding homeopathic remedies.
11. “Rubric” means a guiding symptom leading to a
homeopathic remedy.
R4-38-102. Additional Requirements for Applicants
Graduated from an Unapproved School of Medicine
In addition to the requirements for a license prescribed
in A.R.S. §32-2912, an applicant who has not graduated
from an approved school of medicine shall meet the
following:
1. Hold a standard certificate issued by the
Educational Council for Foreign Medical Graduates; or
2. Complete a Fifth Pathway program of one academic
year of supervised clinical training under the direction
of an approved school of medicine in the United States
and upon completion of the Fifth Pathway program
complete a twenty-four month internship, residency, or
clinical fellowship program accredited by the
Accreditation Council on Graduate Medical Education (ACGME).
R4-38-103. Approval of Postgraduate Coursework
A. An applicant for licensure who does not have a
degree of doctor of medicine in homeopathy shall
identify on a form supplied by the Board completion of
at least 300 hours of formal postgraduate education in
one or more of the treatment modalities specified in
R4-38-103( C )(1) through (6) with at least 40 hours of
the 300 hour requirement in a course of classical
homeopathy. To receive credit for formal postgraduate
coursework, the applicant shall submit the following
with the application:
1. A statement showing completion of the coursework
and a brief description of the content; and
2. A certificate of attendance showing evidence of the
number of hours successfully completed.
B. The Board shall approve a postgraduate course if
the course content provides training in one or more of
the treatment modalities specified in subsection ( C
)(1) through (6), the educational qualifications of the
instructors demonstrate sufficient knowledge of the
subject matter, and the sponsor is recognized within the
homeopathic, osteopathic, or medical profession as a
provider of postgraduate training and continuing
education. The Board shall approve a course of
classical homeopathy if the course includes case-taking,
repertory use, materia medica, philosophy and history of
homeopathy, acute remedies, constitutional prescribing,
posology, homeopathy prescription policy, and remedy
handling policy.
C. An applicant who wishes to practice a
specific treatment modality listed in subsections ( C
)(1) through (6) shall demonstrate proficiency in the
modality by completing the indicated number of
postgraduate course hours or certification by the
indicated credentialing authority.
1. Acupuncture:
a. Classical
acupuncture:
i. Certification by the National Certification
Commission for Acupuncture and Oriental Medicine (NCCAOM),
or
ii. Completing at least 220 hours of postgraduate
courses recognized by the American Academy of Medical
Acupuncture or other sponsor approved by the Board that
provides equivalent training.
b. Electro-diagnosis:
Completing at least 50 hours of postgraduate courses in
electro-diagnosis that are approved by the Board.
2. Chelation therapy: Completing at least 16 hours of
postgraduate courses offered by the American Board of
Clinical Metal Toxicology, American College of
Alternative Medicine, International College of
Integrative Medicine, or the American Academy of
Environmental Medicine or other sponsor approved by the
Board that provides equivalent training.
3. Classical homeopathy: Completing at least 90 hours
of formal postgraduate courses in classical homeopathy
approved by the Board, or whose sponsor is recognized by
the Council on Homeopathic Education, the American
Institute of Homeopathy, the American Board of
Homeotherapeutics, the Homeopathic Association of
Naturopathic Physicians or the Council for Homeopathic
Certification.
4. Complex homeopathy and electro-therapeutics, EAV
and related: Completing at least 90 hours of formal
postgraduate courses in complex homeopathy approved by
the Board, or whose sponsor is recognized by the Council
on Homeopathic Education, the American Institute of
Homeopathy, the American Board of Homeotherapeutics, the
Homeopathic Association of Naturopathic Physicians, or
the Council for Homeopathic Certification.
5. Neuromuscular integration:
a. Completing a residency or fellowship in physical
medicine or graduation from an osteopathic medical
school; or
b. Completing at least 220 hours of formal
postgraduate courses in neuromuscular integration
therapies that are approved by the Board.
6. Orthomolecular therapy and nutrition: completing at
least 300 hours of postgraduate courses in
orthomolecular therapy and nutrition approved by the
Board.
R4-38-104 Approval of Preceptorship
Instead of evidence of formal postgraduate courses, an
applicant may qualify for licensure based on completion
of a preceptorship conducted by a preceptor qualified to
provide instruction in one or more of the treatment
modalities listed in A.R.S. §32-2901(22) by submitting
with the application the following:
1. A notarized affidavit from each preceptor on the
preceptor’s letterhead attesting to:
a. The
educational qualifications of the preceptor to include
the number of years the preceptor has been conducting
preceptorships;
b. The
dates of the preceptorship;
c. An
outline of the training conducted and each treatment
modality involved in the training;
d. The
number of hours of didactic and clinical training in
each treatment modality; and
e. The
general nature of the services performed during the
training.
2. A
summary from the applicant of each preceptorship
including:
a.
The name of each preceptor;
b.
The treatment modalities included in each preceptorship;
c. The
total number of hours claimed instead of formal
postgraduate courses.
R4-38-105. Fees
The Board may charge the following fees according to
A.R.S. §32-2914 and §32-2916:
1. Application for
license: $ 550.00
2. Issuance of initial
license: $ 250.00
3. Annual renewal of license:
$ 975.00
4. Late renewal penalty:
$ 350.00
5. Application for dispensing permit: $
200.00
6. Annual renewal of dispensing permit: $
200.00
7. Locum tenens registration application: $
200.00
8 Locum tenens registration issuance: $
100.00
9. Application for registration to conduct a practical
education
course for supervised medical assistants:
$150.00
10. Annual renewal of registration to conduct
a practical education course:
$ 50.00
11. Initial application for supervision of medical
assistant:
$
200.00
12. Triennial renewal of supervision of medical
assistant:
$ 50.00
13. Annual renewal for registration of medical
assistant:
$
200.00
14. Annual directory:
$ 25.00
15. Copies, per page:
$ 0.25
16. Copies, per audio
tape $ 35.00
17. Copies, per 1.44 M computer disk: $
100.00
18. Mailing lists - non-commercial (per name) $
0.05
19. Mailing lists - commercial (per name) $
0.25
20. Mailing list labels (per name)
$ 0.30
21. Copy of statutes or rules, each
$ 5.00
Historical Note
Permanent Fees adopted effective August 9, 2007
R4-38-106. Examinations
A. The examination for a license consists of
three parts:
1. A timed written examination with a passing grade of
70% that includes questions the Board deems appropriate
for the category of treatment modality for which the
applicant provides evidence under R4-38-103 that are
similar to those expected to be included in an
examination in an approved postgraduate course in the
treatment modality under R4-38-103;
2. An oral examination on one or more of the treatment
modalities in R4-38-103 based on an actual clinical case
history. The applicant shall present to the Board a
summary of the clinical management of the sample case;
and
3. A personal interview with the Board to examine the
applicant's personal and professional history as it
applies to homeopathic medicine. The Board may ask
questions to clarify issues regarding the applicant’s
competence to engage in the practice of medicine safely,
unprofessional conduct in the applicant's professional
record, and whether the scope of the applicant’s
practice falls within the definition of homeopathic
medicine.
B. An applicant who applies for licensure and provides
evidence of postgraduate education under R4-38-103(C)
may use a copy of Kent's Repertory or other repertory
with clinically updated rubrics as a reference during
the examination. An applicant shall not use a computer
or other written material during the examination.
R4-38-107. Waiver of Examination
A. The following applies to an applicant requesting
waiver under A.R.S. § 32-2913 (A).
1. The Board shall not issue a license based on a
waiver of the written examination without completion of
an oral examination and a personal interview.
2. At the Board’s discretion, an oral examination and
personal interview may be conducted by a telephone
conference call with a majority of the Board present.
B. Based on the application, oral examination, and
personal interview, the Board shall determine whether
the applicant qualifies for a waiver.
R4-38-108. Notification of Address Changes
A licensee shall advise the Board in writing within 45
days of opening an additional office address, a change
in office address, change in home address, or change in
telephone number.
R4-38-109. Experimental Forms of Diagnosis and
Treatment
A. The Board neither approves nor advocates specific
experimental therapies. The Board considers the
standards in this Section in determining whether
a licensee is in compliance with A.R.S. §32-2933(27).
The Board considers a therapy that is in
violation of applicable state or federal statutes, or
state or federal rules or regulations regarding
drugs and devices to be unprofessional conduct under
A.R.S. §32-2933(27).
B. Experimental forms of diagnosis or
treatment, within the meaning of
§32-
2933(27), include:
1. Administration of a pharmaceutical agent untested
for safety in humans;
2. Use of a physical agent or electromagnetic current
or field in a manner not supported by established
clinical usage; and
3. Therapy modalities and diagnostic methods that are
not included in the practice of homeopathic medicine as
defined in A.R.S. § 32-2901(22) and do not meet the
criteria of subsection (C).
C. The following are not an experimental form of
diagnosis or treatment under A.R.S. §32-2933(27):
1. A substance or therapy modality administered on a
homeopathic indication that has been in beneficial
clinical usage by professionally trained, legally
qualified physicians for at least 10 years;
2. Homeopathic medications listed in the Homeopathic
Pharmacopoeia of the United States;
3. Homeopathic medications that have been
characterized by toxicity studies or by the "proving"
method of administration on healthy volunteers to
determine the medication’s spectrum of action;
4. Administration of a pharmaceutical agent for a
therapeutic indication supported by clinical usage if
the agent is approved to be marketed publicly for
other therapeutic indications by the appropriate
regulatory agency; and
5. A procedure used for patient education,
preventative medicine, or general health assessment or
enhancement such as bio-terrain analysis, live blood
analysis, soft laser, magnetic therapy, oxidative
therapy, and microelectric therapy, and other procedures
considered by the Board to be in beneficial clinical
usage.
R4-38-110. Repealed
R4-38-111. Peer Review
A. A licensee using an experimental form of diagnosis
and treatment such as vaccine therapy for cancer without
affiliation with a recognized research institution,
institutional review board, or peer review committee
may request or the Board may require review of the
procedure by the Board or a Board-appointed peer review
committee.
B. In conducting the review, the Board or
Board-appointed peer review committee shall examine
protocols, recordkeeping, analyses of results,
and informed patient consent forms and procedures.
Based on the review, the Board shall determine the
licensee's compliance with generally accepted
homeopathic experimental criteria under A.R.S.
§32-2933(27).
C. As used in A.R.S. §32-2933(27), “periodic review by
a peer review committee” means peer review for
compliance with any form of experimental medicine occurs
at a minimum of five-year intervals through a recognized
research institution, institutional review board, or a
peer review committee. The chairperson of a
Board-appointed peer review committee shall be appointed
by the Board president and approved by the Board.
D. During a review of a licensee’s use of experimental
forms of diagnosis and treatment or at any other time
the Board deems appropriate, the licensee shall submit
informed patient consent forms and protocols and other
records indicating the licensee’s compliance with
generally accepted experimental criteria designated in
A.R.S. §32-2933(27).
R4-38-112. Registering Use of Experimental Forms of
Diagnosis and Treatment
As part of an initial licensing application and
subsequent annual renewal application, an applicant
shall designate on a form provided by the Board
the modalities of treatment used in the applicant’s
practice and forms of diagnosis and treatment used by
the applicant that are defined as experimental by
R4-38-109.
R4-38-113. Chelation Therapy Practice Requirements
A Before a licensee may practice chelation therapy
for other than the treatment of metal poisoning, the
licensee:
1. Shall document completion of the postgraduate
education required in R4-38-103(C)(2); and
2. File a sample of the informed patient consent form
and obtain approval of written disclosure from the Board
as required by A.R.S. §32-2933(27). As part of the
documentation submitted with the informed patient
consent form, the licensee shall include a copy of the
therapy protocol.
B. If the Board approves the written disclosure under
A.R.S.§32-2933(27), the licensee may practice chelation
therapy. The licensee shall ensure that detailed
records and periodic analysis of results on patients
consistent with the most recent informed consent and
protocol on file with the Board are maintained
consistent with A.R.S. §32-2933(27) and available for
periodic review by a peer review committee designated by
the Board. Retention of patient medical and treatment
records shall also conform with the requirements of
A.R.S. §12-2297.
R4-38-114. Rehearing or Review of Decision
A. Except as provided in subsection (G) in Code, any
party to an appealable agency action or a
contested case before the Board who is aggrieved by a
decision rendered in the case may file with the Board
not later than 30 days after service of the decision, a
written motion for rehearing or review of the decision,
specifying the particular grounds for the motion. A
decision is served when personally delivered or five
days after the date the decision is mailed to the party
at the party’s last known residence or place of
business.
B. A motion for rehearing may be amended at any time
before a ruling by the Board. Any other party may file
a response within fifteen days after the motion or
amended motion is filed. The Board may require the
filing of written briefs upon the issues raised in the
motion and may provide for oral argument.
C. The Board may grant a rehearing or review of the
decision for any of the following reasons materially
affecting the moving party's rights:
1. Irregularity in the administrative proceedings of
the Board or the hearing officer, or any order or abuse
of discretion, that results in the moving party being
deprived of a fair hearing;
2. Misconduct of the Board or the non-moving party;
3. Accident or surprise that could not have been
prevented by ordinary prudence;
4. Newly discovered material evidence that with
reasonable diligence could not have been discovered and
produced at the original hearing;
5. Excessive or insufficient penalties;
6. Error in the admission or rejection of evidence or
other errors of law occurring at the administrative
hearing; or
7. The decision is not justified by the evidence or is
contrary to law.
D. The Board may affirm or modify the decision or
grant a rehearing to all or any of the parties and on
all or part of the issues for any of the reasons set
forth in subsection (C). An order granting a rehearing
shall specify the ground or grounds on which the
rehearing is granted, and the rehearing shall cover only
those matters.
E. Not later than 30 days after a decision is
rendered, the Board may on its own initiative order a
rehearing or review of its decision for any reason for
which it might have granted a rehearing on motion of a
party. After giving the parties or their counsel notice
and an opportunity to be heard on the matter, the Board
may grant a motion for rehearing for a reason not stated
in the motion. In either case, the order granting the
rehearing shall specify the grounds for the rehearing.
F. When a motion for rehearing is based upon an
affidavit the party shall serve the affidavit with the
motion. Within 10 days after service, an opposing party
may serve an opposing affidavit . The Board may extend
the period to serve an opposing affidavit for an
additional 20 days for good cause shown or by written
stipulation of the parties. The Board may permit a
reply affidavit.
G. If the Board makes specific findings that the
immediate effectiveness of the decision is necessary for
the immediate preservation of the public peace, health,
or safety and that a rehearing or review of the decision
is impracticable, unnecessary, or contrary to the public
interest, the Board may issue the decision as a final
decision without an opportunity for a rehearing or
review. If a decision is issued as a final decision
without an opportunity for rehearing, any application
for judicial review of the decision shall be made within
the time limits permitted for applications for judicial
review of the Board's final decisions.
H. The terms "contested case" and "party" as used in
this Section are defined in A.R.S. §41-1001. The term
“appealable agency action” is defined in A.R.S.
§41-1092.
R4-38-115. Use of Title and Abbreviation.
A. The use of the abbreviation "M.D.(H.)" (with or
without periods), is equivalent to the written
designation, "Doctor of Medicine (Homeopathic)".
B. A Homeopathic physician practicing in this state
who is not licensed by the Arizona Board of Medical
Examiners or the Arizona Board of Osteopathic Examiners
in Medicine and Surgery shall not use any designation
other than the initials MD or DO to indicate a doctoral
degree, which shall
be followed by the full, written
designation, “Homeopathic Physician."
C. A physician licensed by the Board and any state
Board of Medical Examiners or the Board and any state
Board of Osteopathic Examiners in Medicine and Surgery
shall use one of the following designations, as
appropriate (with or without periods):
1.
“MD, MD(H)” or “DO, MD(H)”;
2.
“MD, Homeopathic Physician” or “DO, Homeopathic
Physician”; or
3.
“MD, Doctor of Medicine (Homeopathic)” or “DO, Doctor of
Medicine (Homeopathic)”.
D. A licensee
practicing in this state shall display the license or an
official duplicate license in a conspicuous location in
the reception area of each office facility.
Historical
Note
Adopted
effective July 2, 2005 (Supp. 05-2).
ARTICLE 2.
LABELING, RECORDKEEPING, STORAGE, AND PACKAGING OF DRUGS
DISPENSED BY HOMEOPATHIC PHYSICIANS
R4-38-201. Definitions
In addition
to the definitions in A.R.S.§§32-2901, 32-2933, 32-2951,
the following definitions apply in this Chapter:
1.
“Administer” means the direct application of a
controlled substance, prescription-only drug, dangerous
drug as defined in A.R.S. § 13-3401, narcotic drug
as defined in A.R.S. §13-3401, homeopathic medication, natural
substance, or non-prescription drug, whether by
injection, inhalation, ingestion or any other means, to
the body of a patient or research subject by a
homeopathic physician, a homeopathic physician’s nurse
or assistant, or by the patient or research subject at
a homeopathic physician’s direction.
2.
“Label” means a display of written, printed or graphic
matter on the immediate container of any article and,
on the outside wrapper or
container, if the display on the immediate wrapper or container
is not easily legible through the outside wrapper.
3.
“Labeling” means all labels and other written, printed
or graphic matter either:
1. On
any article or any of its containers or wrappers; and
2.
Accompanying thr article.
4.
“Manufacturer” means every person who
prepares, derives, produces, compounds, processes,
packages or repackages, or labels a drug in a place
devoted to manufacturing such drug, but does not
include a pharmacy, pharmacist or physician.
5.
“Natural substance” means herbal phytotherapeutic or
oxygen, carbon, or nitrogen-based therapeutic
agent, vitamin, mineral, and food factor concentrate isolated
from animal, vegetable or mineral sources for
nutritional augmentation.
6.
“Official compendium” means the latest revisions of the
Pharmacopoeia of the United States and the Homeopathic
Pharmacopoeia of the United States, the latest revision
of the National Formulary or any current supplement .
7.
“Packaging” means the act or process of placing
a drug in a container to dispense or distribute the
drug.
8.
“Pharmaceutical drug” means a drug intended for use in
preventing or curing disease or relieving pain.
Historical
Note
Adopted
effective July 5, 2003.
R4-38-202. General Provisions
A.
A
homeopathic physician shall not dispense unless the
physician obtains from the Board a permit to dispense.
The physician may renew the permit annually at the same
time the license is renewed. The physician shall
include the following on the permit application or
renewal form:
1. The
classes of drugs the physician will
dispense, including controlled substances,
pharmaceutical drugs, homeopathic medications,
prescription-only drugs, natural substances and
non-prescription drugs defined in A.R.S. §32-1901(46),
and devices defined in A.R.S. §32-1901(18);
2. The
location where the homeopathic physician will dispense;
and
3. A
copy of the physician’s current Drug
Enforcement Administration (DEA) registration or an
affidavit averring that the physician does not possess a
DEA registration and that the physician will not
precribe or dispense controlled substances.
B.
If a homeopathic physician determines that a shortage
exists in controlled substance maintained for
dispensing, the physician shall immediately notify the
Board, the local law enforcement agency, and the
Department of Public Safety by telephone. The physician
shall also provide written notification to the Board
within seven days of the date of the discovery of the
shortage.
Historical
Note
Adopted
effective July 5, 2003.
R4-38-203. Repealed
Repealed
effective
July 5, 2003.
R4-38-204. Repealed
Repealed
effective July 5, 2003.
R4-38-205. Repealed
Repealed
effective July 5, 2003.
R4-38-206. Packaging
In addition to the requirements of A.R.S. § 32-2951, a
dispensing homeopathic physician shall dispense a
controlled substance or prescription-only pharmaceutical
drug in a light-resistant container
with a consumer safety cap, unless the patient or
patient’s representative and the physician agree
otherwise.
Historical
Note
Adopted
effective July 5, 2003.
ARTICLE 3.
EDUCATION, SUPERVISION, AND DELEGATION STANDARDS FOR
REGISTRATION OF MEDICAL ASSISTANTS BY HOMEOPATHIC
PHYSICIANS
R4-38-301. Definitions
A.
“Assists” means performing delegated procedures within
the homeopathic physician’s practice according to a
written job description for which the Board has approved
the assistant’s educational program and the supervising
physician’s practice experience.
B.
“Commensurate with the assistant’s education and
training” means that the assistant’s education and
training in either a formal or practical educational
program meets Board standards for the specific
technical functions in the job description for which the
supervising physician makes application.
C.
“Delegated procedures” refers to technical functions
which are specifically outlined in the assistant’s
written job description and which may include any of the
following:
1.
Assisting in information-gathering functions, including
history taking, measuring patients’ vital signs,
measuring patients’ neuromuscular and
electro-physiologic responses, specimen collection, and
phlebotomy;
2.
Assisting in information-processing functions including
scoring of questionnaires, plotting of laboratory,
physical, and chemical measurements, and symptom
repertorization using standard homeopathic references
or software programs;
3.
Assisting in or administering patient treatments by
physical; hygienic, including colonic irrigation; and
electrical therapy modalities as ordered by the
physician;
4.
Assisting in delivery of drugs, devices, and natural
substances to patients;
5.
Assisting in patient health care education and
counseling including nutritional and stress-management
counseling;
6.
Assisting in explaining and reinforcing home follow-up
advice for physician-prescribed homeopathic therapy
programs; and
7.
Administration of skin tests and injections ordered by
the physician.
D.
“Educational program approved by the Board” means a
formal educational program or a practical educational
program which is recognized by the Board as sufficient
to qualify a Medical Assistant to perform specific
delegated procedures under the supervision of a
physician.
E.
“Formal educational program” means an organized course
of study or training program in a technical field which
includes didactic and supervised clinical experience and
whose curriculums are approved by the Board.
F.
“Physical medicine modalities” means hydrotherapy,
including colonic irrigation; application of heat and
cold; diathermy; electro-galvanic stimulation;
ultrasound; traction; massage therapies; neuromuscular
re-education procedures; application of transcutaneous
nerve stimulator units; and the use of electronic
micro-current devices for stimulation of nerve and
muscle tissue.
G.
“Practical educational program” means a course of study
organized and directed by the supervising physician who
conducts or verifies the didactic portion of the
training and personally oversees or verifies the
clinical experience portion of the training while the
assistant is on the job.
H.
“Under the supervision of ” means that:
1. The
supervising physician is physically on-site at the
practice location during the day the delegated
procedures are performed;
2. The
supervising physician provides specific written orders
for the medical Assistant for any treatment functions
delegated to the medical assistant;
3. The
medical assistant documents the performance of the
delegated function in the office medical record by
legible and identifiable notes;
4. An
office, laboratory, or therapy note is prepared which is
signed by the assistant and countersigned by the
supervising physician within one week of the date of
service for each visit in which a medical assistant
performs delegated procedures;
5. The
supervising physician has met Board-approved clinical
experience standards as set forth in R4-38-303(B) or
R4-38-305(B), for the procedure approved for delegation
to the medical assistant;
6. All
the delegated procedures and treatments could be legally
performed by the supervising physician; and
7. The
supervising physician ensures that there is regular
discussion with each medical assistant with regard to
individual patient’s, responses to treatments or
treatment programs delegated to that medical assistant.
Historical
Note
Adopted
effective January 27, 1995 (Supp. 95-1).
R4-38-302. Approved Formal Educational Programs
A.
Physicians requesting that their assistants be approved
for one or more of the following specified delegated
procedures on the basis of a formal educational program
shall submit evidence that the assistant has
successfully completed the specified educational
program:
1.
General medical office procedures require completion of
a course of instruction and training in a public or
private school, college, or technical institute designed
to place graduates in positions as General Office
Medical Assistants. Such course of instruction shall
consist of a minimum of the following:
a. 240
classroom hours in medical secretarial skills;
b. 240
classroom hours in back office assisting; and
c. 320
hours of supervised clinical experience.
2.
Neuromuscular Integration therapy procedures:
a.
Completion of a course of instruction and training in a
public or private school, college, or technical
institute designed to place graduates in positions as
qualified Physical Therapy Assistants in a United
States jurisdiction. Such course of instruction shall
consist of a minimum of the following:
i.
1200 classroom hours in hands-on 22 techniques,
sciences, theories and principles;
ii. 720 hours of supervised
clinical experience; and
iii. 580 classroom hours in
general studies; or
b.
Completion of a professional program in massage therapy
consisting of 1000 hours of didactic and clinical
training or examination and certification sponsored by
the American Massage Therapy Association; or
c.
Completion of a professional training or certification
program in Feldenkrais, Rolfing, Hellerwork, Trager,
Orthobionomy, Shiatsu, Reiki, Polarity, Jin Shin Jyutsu,
or similarly organized training program of at least 1000
hours of technical training and clinical supervision;
3.
Acupuncture therapy procedures: completion of a
didactic and clinical training program in acupuncture
and examination and certification by the National
Commission for the Certification of Acupuncturists (NCCA);
4.
Homeopathic repertorization procedures: completion of at
least 180 hours of a formal educational program as set
forth in R4-38-301(E) or preceptorship in a
homeotherapeutics program approved by the Board
including those certified by the Council for Homeopathic
Certification; or
5.
Nutritional counseling procedures require completion of
one of the following:
a.
Board-approved formal educational program in clinical
nutrition consisting of 500 hours or more of training;
or
b.
Certification by the International University for
Nutrition Education.
B.
Physicians proposing job descriptions for assistants in
general medical or homeopathic practices and procedures
not herein specified shall submit evidence that is
satisfactory to the Board that the assistant has
completed a degree of educational training and clinical
supervision that is substantially equivalent to the
formal educational requirements in the above areas.
Historical
Note
Adopted
effective January 27, 1995 (Supp. 95-1).
R4-38-303. Supervision of Formally Trained
Assistants
A.
In order for a homeopathic physician to delegate
specified homeopathic diagnostic and therapeutic
procedures, as described in this rule, his or her
qualifications shall be approved by the Board.
B.
Approval may be granted by the Board after its review of
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