State may require doctors to pass tests

Monday, March 24, 2003 | 11 a.m.

CARSON CITY -- Amid the debate over medical malpractice insurance, Nevada may become the first state in the nation to require periodic examinations of doctors to test their competency.

Nevada already has the highest standard for the initial licensing of a physician, but there is no continued testing. A license is automatically renewed every two years if the doctor completes 40 hours of education.

Donald Baepler, a member of the state Board of Medical Examiners, heads a committee that has been working on this proposed regulation for two years. He says it is partly to answer the claims of some people that there are a lot of doctors whose skills no longer measure up. "There can't be more than a handful," Baepler said Sunday.

There are more than 5,000 physicians licensed by the board.

Larry Matheis, executive director of the Nevada State Medical Association, which represents doctors, said he is not opposed to the proposal as long as the testing is relevant.

The board of medical examiners, which licenses and disciplines doctors, will hold workshops April 29 in Reno and April 30 in Las Vegas to take public comment on the proposed regulations. Baepler, of Las Vegas, said the board may take action at its meeting in late May.

The state requires a new physician to have three years of progressive medical education after receiving his doctorate, Baepler said. That is the highest standard in the nation for being admitted to practice. Several other states have since followed Nevada's lead, he said.

Physicians who are certified by the American Board of Medical Specialties would be exempt from regulation requirements. Those doctors are already examined periodically to maintain their certifications.

Also exempt would be physicians who have maintained active or associate hospital privileges at two nationally certified hospitals or medical centers for two years leading up to the testing.

Others would have to take a test every 10 years. Baepler estimated only 10 to 15 percent of the state's physicians would fall into this category.

Among the tests would be the Special Purpose Examination or one of the specialty examinations of the Federation of State Medical Board.

Matheis said the examiners board two years ago proposed that every physician should have to take this national examination.

This national examination is geared toward physicians just out of school. Some doctors in rural Nevada who have been practicing for a long time might have trouble passing the test, Matheis said. Matheis said his group has no opposition to the proposed regulation "as long as (the examination) realistically reflects" upon the competency of the doctor.

Baepler said about 25 states are considering competency examinations for doctors.

The Nevada Legislature is considering several bills in an effort to solve the problem of the high cost of medical malpractice insurance, especially for obstetricians, gynecologists and surgeons. One bill, Senate Bill 250, would impose stricter standards on new licenses if the physician had malpractice problems in prior practices in other states.

The bills are before various committees in the Assembly and Senate.