The Arizona regulations with respect to physicians are found in A.R.S. §§ 32-1421 through 32-1436. Pursuant to A.R.S. § 32-1822, on a form and in a manner prescribed by the board, an applicant for licensure shall submit proof that the applicant:
1. Is the person named on the application and on all supporting documents submitted.
2. Is a citizen of the United States or a resident alien.
3. Is a graduate of a board approved school of osteopathic medicine.
4. Has completed an approved internship, the first year of an approved multiple year residency or board approved equivalency.
5. Has passed the approved examinations for licensure within seven years of application or has the board approved equivalency of practice experience.
6. Has not engaged in any conduct that, if it occurred in this state, would be considered unprofessional conduct or, if the applicant has engaged in unprofessional conduct, is rehabilitated from the underlying conduct.
7. Is physically, mentally and emotionally able to practice medicine, or, if limited, restricted or impaired in the ability to practice medicine, consents to contingent licensure pursuant to subsection E of this section or to entry into a program prescribed in section 32-1861.
8. Is of good moral character.
An applicant must submit with the application the application fee prescribed in section 32-1826 and pay the prescribed license issuance fee to the board at the time the license is issued. The board or the executive director may require an applicant to submit to a personal interview, a physical examination or a mental evaluation or any combination of these at a reasonable time and place as prescribed by the board if the board determines that this is necessary to provide the board adequate information regarding the applicant’s ability to meet the licensure requirements of this chapter. An interview may include medical knowledge questions and other matters that are relevant to licensure. The board may deny a license for any unprofessional conduct that would constitute grounds for disciplinary action pursuant to this chapter or as determined by a competent domestic or foreign jurisdiction. The board may issue a license that is contingent on the applicant entering into a stipulated order that may include a period of probation or a restriction on the licensee’s practice. The executive director may issue licenses to applicants who meet the requirements of this section. A person whose license has been revoked, denied or surrendered in this or any other state may apply for licensure not sooner than two years after the revocation, denial, or surrender. A license issued pursuant to this section is valid for the remainder of the calendar year in which it was issued, at which time it is eligible for renewal.
A.R.S. § 32-1825 provides that except as provided in section 32-4301, each licensee shall renew the license every other year on or before January 1 on an application form approved by the board. At least sixty days before that renewal date the executive director shall notify each licensee of this requirement. The executive director shall send this notification by first class mail to the licensee at the licensee’s address. With the application prescribed pursuant to subsection A of this section, the licensee shall furnish to the executive director a statement of having attended before the license renewal date educational programs, approved by the board, totaling at least twenty clock hours during each of the two preceding years, and a statement that the licensee reported any conduct that may constitute unprofessional conduct in this state or elsewhere. The application must also include the prescribed renewal fee. The executive director shall then issue a renewal receipt to the licensee. The board may require a licensee to submit documentation of continuing medical education. The board shall not renew the license of a licensee who does not fully document the licensee’s compliance with the continuing education requirements of subsection B of this section unless that person receives a waiver of those requirements. The board may waive the continuing education requirements of subsection B of this section for a particular period if it is satisfied that the licensee’s noncompliance was due to the licensee’s disability, military service or absence from the United States or to other circumstances beyond the control of the licensee. If a licensee fails to attend the required number of clock hours for reasons other than those specified in this subsection, the board may grant an extension until May 1 of that year for the licensee to comply.
Unless the board grants an extension pursuant to subsection C of this section, a licensee who fails to renew the license within thirty days after the renewal date shall pay a penalty fee and a reimbursement fee in addition to the prescribed renewal fee. Except as provided in sections 32-3202 and 32-4301, a license expires if a person does not renew the license within four months after the renewal date. A person who practices osteopathic medicine after that time is in violation of this chapter. A person whose license expires may reapply for a license pursuant to this chapter. The board by a formal vote at its annual January meeting shall establish fees not to exceed the following:
1. For an application to practice osteopathic medicine, four hundred dollars.
2. For issuance of a license, two hundred dollars, prorated by each month remaining in the calendar year of issuance.
3. For biennial renewal of a license, eight hundred dollars.
4. For locum tenens registration or extension, three hundred dollars.
5. For issuance of a duplicate license, one hundred dollars.
6. For annual registration of an approved internship, residency, clinical fellowship program or short-term residency program, one hundred dollars.
7. For an annual teaching license issued pursuant to section 32-1831, four hundred dollars.
8. For a five day educational teaching permit at an approved school of medicine or at an approved teaching hospital’s accredited graduate medical education program, two hundred dollars.
9. For the sale of those copies of the annual osteopathic medical directory that are not distributed free of charge, seventy-five dollars.
10. For the sale of computerized tapes or diskettes that do not require programming, one hundred dollars.
11. For initial and annual registration to dispense drugs and devices, two hundred fifty dollars, prorated by each month remaining in the calendar year of issuance.
The board shall charge a one hundred fifty dollar penalty fee for late renewal of a license and a twenty-five dollar reimbursement fee to cover the board’s expenses in collecting late renewal fees. The board shall deposit this fee in the board fund. The board may charge additional fees for services the board determines are necessary and appropriate to carry out this chapter. These fees shall not exceed the actual cost of providing the services[i].
A.R.S. § 32-1832 provides that the board may waive a physician’s biennial renewal fee if the physician has paid all past fees and presents an affidavit to the board stating that the physician has permanently retired from the practice of osteopathic medicine. A retired physician whose biennial fee has been waived by the board pursuant to this section is not required to comply with any continuing medical education requirements of this chapter. A retired physician who has had the biennial renewal fee waived by the board pursuant to this section and who engages in the practice of osteopathic medicine is subject to the same penalties that are imposed pursuant to this chapter on a person who practices medicine without a license or without being exempt from licensure. The board may reinstate a retired physician to active status on payment of the biennial renewal fee and presentation of evidence satisfactory to the board that the physician meets the qualifications prescribed pursuant to section 32-1822. If an applicant for reinstatement to active status has not been licensed and actively practicing in another jurisdiction of the United States or Canada in the three years immediately preceding the application, the board may issue a limited license that requires general or direct supervision by another licensed osteopathic physician for not more than one year. A retired physician who has had the biennial renewal fee waived by the board pursuant to this section may perform volunteer work of not more than ten hours each week and may teach or provide instruction at an approved school of osteopathic medicine.
The following acts are prohibited:
1. Practicing medicine and surgery as an osteopathic physician and surgeon without holding a license issued by the board under the provisions of this chapter.
2. Misusing the designation “D.O.” in a way that leads the public to believe that a person is licensed to practice medicine in this state.
3. Using the designation “doctor of osteopathy”, “osteopathic physician”, “osteopathic surgeon”, “osteopathic physician and surgeon” or any combination of these terms unless the designation additionally contains the description of another branch of the healing arts.
4. Using the designation “doctor of osteopathy” by a member of another branch of the healing arts unless there is set forth with each designation the other branch of the healing arts concerned.
5. Using any other words, initials or symbols or a combination of these which leads the public to believe a person is licensed to practice medicine in this state[ii].
Pursuant to A.R.S. § 32-1855, the board on its own motion may investigate any information that appears to show that an osteopathic physician and surgeon is or may be guilty of unprofessional conduct or is or may be mentally or physically unable safely to engage in the practice of medicine. Any osteopathic physician or surgeon or the Arizona osteopathic medical association or any health care institution as defined in section 36-401 shall, and any other person may, report to the board any information the physician or surgeon, association, health care institution or other person may have that appears to show that an osteopathic physician and surgeon is or may be guilty of unprofessional conduct or is or may be mentally or physically unable safely to engage in the practice of medicine. The board shall notify the doctor about whom information has been received as to the content of the information as soon as reasonable after receiving the information. Any person who reports or provides information to the board in good faith is not subject to civil damages as a result of that action. If requested the board shall not disclose the informant’s name unless it is essential to the disciplinary proceedings conducted pursuant to this section. It is an act of unprofessional conduct for any osteopathic physician or surgeon to fail to report as required by this section. The board shall report any health care institution that fails to report as required by this section to that institution’s licensing agency. A person who reports information in good faith pursuant to this subsection is not subject to civil liability.
The board may require a physician under investigation pursuant to subsection A of this section to be interviewed by the board or its representatives. The board or the executive director may require a licensee who is under investigation pursuant to subsection A of this section to undergo at the licensee’s expense any combination of medical, physical or mental examinations the board finds necessary to determine the physician’s competence. If the board finds, based on the information it received under subsections A and B of this section, that the public health, safety or welfare imperatively requires emergency action and incorporates a finding to that effect in its order, the board may order a summary suspension of a license pending proceedings for revocation or other action. If an order of summary suspension is issued, the licensee shall also be served with a written notice of complaint and formal hearing setting forth the charges made against the licensee and is entitled to a formal hearing on the charges pursuant to title 41, chapter 6, article 10. Formal proceedings shall be promptly instituted and determined. If, after completing its investigation, the board finds that the information provided pursuant to this section is not of sufficient seriousness to merit direct action against the physician’s license, it may take any combination of the following actions:
1. Dismiss if, in the opinion of the board, the information is without merit.
2. File a letter of concern.
3. In addition to the requirements of section 32-1825, require continuing medical education on subjects and within a time period determined by the board.
4. Issue a nondisciplinary order requiring the licensee to complete a prescribed number of hours of continuing education in an area or areas prescribed by the board to provide the licensee with the necessary understanding of current developments, skills, procedures or treatment.
If, in the opinion of the board, it appears that information provided pursuant to this section is or may be true, the board may request an investigative hearing with the physician concerned. At an investigative hearing the board may receive and consider sworn statements of persons who may be called as witnesses in a formal hearing and other pertinent documents. Legal counsel may be present and participate in the meeting. If the physician refuses the request or if the physician accepts the request and the results of the investigative hearing indicate suspension of more than twelve months or revocation of the license may be in order, a complaint shall be issued and an administrative hearing shall be held pursuant to title 41, chapter 6, article 10. If, after the investigative hearing and a mental, physical or medical competence examination as the board deems necessary, the board finds the information provided pursuant to this section to be true but not of sufficient seriousness to merit suspension or revocation of the license, it may take any of the following actions:
1. Dismiss if, in the opinion of the board, the information is without merit.
2. File a letter of concern.
3. In addition to the requirements of section 32-1825, require continuing medical education on subjects and within a time period determined by the board.
4. Issue a decree of censure, which constitutes an official action against a physician’s license.
5. Fix a period and terms of probation best adapted to protect the public health and safety and rehabilitate or educate the physician concerned. Any costs incidental to the terms of probation are at the physician’s own expense.
6. Restrict or limit the physician’s practice in a manner and for a time determined by the board.
7. Suspend the physician’s license for not more than twelve months.
8. Impose a civil penalty of not to exceed five hundred dollars for each violation of this chapter.
9. Issue a nondisciplinary order requiring the licensee to complete a prescribed number of hours of continuing education in an area or areas prescribed by the board to provide the licensee with the necessary understanding of current developments, skills, procedures or treatment.
10. Issue an administrative warning.
If, in the opinion of the board, it appears the charge is of such magnitude as to warrant suspension for more than twelve months or revocation of the license, the board shall immediately initiate formal revocation or suspension proceedings pursuant to title 41, chapter 6, article 10. The board shall notify a licensee of a complaint and hearing by certified mail addressed to the licensee’s last known address on record in the board’s files. If the physician wishes to be present at the investigative or administrative hearing in person or by representation, or both, the physician shall file with the board an answer to the charges in the complaint. The answer shall be in writing, verified under oath and filed within twenty days after service of the summons and complaint. A physician who complies with subsection G of this section may be present at the hearing in person with counsel and witnesses. A physician who, after an investigative or administrative hearing, is found to be guilty of unprofessional conduct or is found to be mentally or physically unable safely to engage in the practice of osteopathic medicine is subject to any combination of censure, probation, suspension of license, revocation of license, an order to return patient fees, imposition of hearing costs, imposition of a civil penalty of not to exceed five hundred dollars for each violation for a period of time, or permanently, and under conditions the board deems appropriate for the protection of the public health and safety and just in the circumstances. The board may charge the costs of an investigative or administrative hearing to the licensee if pursuant to that hearing the board determines that the licensee violated this chapter or board rules.
If the board acts to modify a physician’s prescription writing privileges, it shall immediately notify the state board of pharmacy and the federal drug enforcement administration in the United States department of justice of the modification. The board shall report allegations of evidence of criminal wrongdoing to the appropriate criminal justice agency. Notice of a complaint and administrative hearing is effective when a true copy of the notice is sent by certified mail to the licensee’s last known address of record in the board’s files and is complete on the date of its deposit in the mail. The board shall hold an administrative hearing within one hundred twenty days after that date. The board may accept the surrender of an active license from a licensee who admits in writing to having committed an act of unprofessional conduct or to having violated this chapter or board rules. An osteopathic physician may dispense drugs and devices kept by the physician if all drugs are dispensed in packages labeled with the following information:
(a) The dispensing physician’s name, address and telephone number.
(b) The date the drug is dispensed.
(c) The patient’s name.
(d) The name and strength of the drug, directions for its use and any cautionary statements.
The dispensing physician enters into the patient’s medical record the name and strength of the drug dispensed, the date the drug is dispensed and the therapeutic reason. The dispensing physician keeps all drugs in a locked cabinet or room, controls access to the cabinet or room by a written procedure and maintains an ongoing inventory of its contents. The dispensing physician annually registers with the board to dispense drugs and devices. The dispensing physician pays the registration fee prescribed by the board pursuant to section 32-1826. This paragraph does not apply if the physician is dispensing in a nonprofit practice and neither the patient nor a third party pays or reimburses the physician or the nonprofit practice for the drugs or devices dispensed. The dispensing physician labels dispensed drugs and devices and stores them according to rules adopted by the board.
Except in an emergency situation, a physician who dispenses drugs without being registered by the board to do so is subject to a civil penalty by the board of not less than three hundred dollars and not more than one thousand dollars for each transaction and is prohibited from further dispensing for a period of time as prescribed by the board. Prior to dispensing a drug pursuant to this section, the patient shall be given a written prescription on which appears the following statement in bold type:
“This prescription may be filled by the prescribing physician or by a pharmacy of your choice.”
A physician shall dispense only to the physician’s patient and only for conditions being treated by that physician. The board shall enforce this section and shall establish rules regarding labeling, record keeping, storage and packaging of drugs that are consistent with the requirements of chapter 18 of this title. The board may conduct periodic inspections of dispensing practices to assure compliance with this section and applicable rules. If a physician fails to renew a registration to dispense or ceases to dispense for any reason, within thirty days that physician must notify the board in writing of the remaining inventory of drugs and devices and the manner in which they were disposed[iii].
[i] A.R.S. § 32-1826.
[ii] A.R.S. § 32-1851.
[iii] A.R.S. § 32-1871.
