In Colorado, regulations with respect to physicians are set forth in C.R.S. 12-36-101 through 12-36-139. Pursuant to C.R.S. 12-36-106, “practice of medicine” means:
- Holding out one’s self to the public within this state as being able to diagnose, treat, prescribe for, palliate, or prevent any human disease, ailment, pain, injury, deformity, or physical or mental condition, whether by the use of drugs, surgery, manipulation, electricity, telemedicine, the interpretation of tests, including primary diagnosis of pathology specimens, images, or photographs, or any physical, mechanical, or other means whatsoever;
- Suggesting, recommending, prescribing, or administering any form of treatment, operation, or healing for the intended palliation, relief, or cure of any physical or mental disease, ailment, injury, condition, or defect of any person with the intention of receiving therefor, either directly or indirectly, any fee, gift, or compensation whatsoever;
- The maintenance of an office or other place for the purpose of examining or treating persons afflicted with disease, injury, or defect of body or mind;
- Using the title M.D., D.O., physician, surgeon, or any word or abbreviation to indicate or induce others to believe that one is licensed to practice medicine in this state and engaged in the diagnosis or treatment of persons afflicted with disease, injury, or defect of body or mind, except as otherwise expressly permitted by the laws of this state enacted relating to the practice of any limited field of the healing arts;
- Performing any kind of surgical operation upon a human being; or
- The practice of midwifery, except:
(I) Services rendered by certified nurse-midwives properly licensed and practicing in accordance with the provisions of article 38 of this title; or
(II) Services rendered by a person properly registered as a direct-entry midwife and practicing in accordance with the provisions of article 37 of this title.
Furthermore, pursuant to the statute, nothing in paragraph (g) shall be construed to authorize physicians to deliver services outside their scope of practice nor to limit the delivery of health services by other licensed professionals, within the professional’s scope of practice, using advanced technology, including, but not limited to, interactive audio, interactive video, or interactive data communication. If any person who does not possess and has not filed a license to practice medicine within this state, as provided in this article, and who is not exempted from the licensing requirements under this section, shall do any of the acts mentioned in this section as constituting the practice of medicine, he shall be deemed to be practicing medicine without complying with the provisions of this article and in violation thereof. Nothing in this section shall be construed to prohibit, or to require a license or a physician training license under this article with respect to, any of the following acts:
- The gratuitous rendering of services in cases of emergency;
- The rendering of services in this state by a physician lawfully practicing medicine in another state or territory, whether or not such physician is in Colorado, but if any such physician does not limit such services to an occasional consultation or case or if such physician has any established or regularly used hospital connections in this state or if such physician is party to any contract, agreement, or understanding to provide the services described in paragraph (a) of subsection (1) of this section or if such physician maintains or is provided with for his or her regular use any office or other place for the rendering of such services, such physician shall possess a license to practice medicine in this state;
- The practice of dentistry under the conditions and limitations defined by the laws of this state;
- The practice of podiatry under the conditions and limitations defined by the laws of this state;
- The practice of optometry under the conditions and limitations defined by the laws of this state;
- The practice of chiropractic under the conditions and limitations defined by the laws of this state;
- The practice of religious worship;
- The practice of Christian Science, with or without compensation;
- The performance by commissioned medical officers of the armed forces of the United States of America or of the United States public health service or of the United States veterans administration of their lawful duties in this state as such officers;
- The rendering of nursing services and delegated medical functions by registered or other nurses in the lawful discharge of their duties as such;
- The rendering of services by students currently enrolled in an approved medical college;
- The rendering of services, other than the prescribing of drugs, by persons qualified by experience, education, or training, under the personal and responsible direction and supervision of a person licensed under the laws of this state to practice medicine, but nothing in this exemption shall be deemed to extend or limit the scope of any license, and this exemption shall not apply to persons otherwise qualified to practice medicine but not licensed to so practice in this state;
- The practice by persons licensed or registered under any law of this state to practice a limited field of the healing arts not specifically designated in this section, under the conditions and limitations defined by such law;
- The rendering of acupuncture services subject to the conditions and limitations provided in article 29.5 of this title;
- The administration of nutrition or fluids through gastrostomy tubes as provided in section 27-10.5-103 (2) (k), C.R.S., as a part of residential or day program services provided through service agencies approved by the department of human services pursuant to section 27-10.5-104.5, C.R.S.;
- The administration of topical and aerosol medications within the scope of physical therapy practice as provided in section 12-41-113 (2);
- The performance of wound debridement under a physician’s order within the scope of physical therapy practice as provided in section 12-41-113 (3);
- The rendering of services by an athletic trainer subject to the conditions and limitations provided in article 29.7 of this title;
- The rendering of prescriptions by an advanced practice nurse pursuant to section 12-38-111.6.
All licensees who are licensed to practice a limited field of the healing arts, shall confine themselves strictly to the field for which they are licensed and to the scope of their respective licenses, and shall not use any title, word, or abbreviation mentioned in paragraph (d) of subsection (1) of this section, except to the extent and under the conditions expressly permitted by the law under which they are licensed. A person licensed under the laws of this state to practice medicine may delegate to a physician assistant licensed by the board the authority to perform acts that constitute the practice of medicine to the extent and in the manner authorized by rules and regulations promulgated by the board, including the authority to prescribe medication, including controlled substances, and dispense only such drugs as designated by the board. Such acts shall be consistent with sound medical practice. Each prescription issued by a physician assistant licensed by the board shall have imprinted thereon the name of his or her supervising physician.Nothing in this subsection (5) shall limit the ability of otherwise licensed health personnel to perform delegated acts. The dispensing of prescription medication by a physician assistant shall be subject to the provisions of section 12-22-121 (6).
The statute further provides that if the authority to perform an act is delegated pursuant to paragraph (a) of this subsection (5), the act shall not be performed except under the personal and responsible direction and supervision of a person licensed under the laws of this state to practice medicine, and said person shall not be responsible for the direction and supervision of more than two physician assistants at any one time without specific approval of the board. The board may define the appropriate direction and supervision pursuant to the rules and regulations. Subject to the other conditions and provisions of this article, a license to practice medicine shall be granted by the board to an applicant therefor only upon the basis of:
(a) The passing by the applicant of an examination approved by the board;
(b) A certification of record or other certificate of examination issued to or for the applicant by the national board of medical examiners, the national board of examiners for osteopathic physicians and surgeons, or the federation of state medical boards certifying that the applicant has passed examinations, including but not limited to examinations in the basic sciences, given by the respective boards;
(c) Any combination of the examinations provided in paragraphs (a) and (b) of this subsection (1) approved by the board;
(d) A valid, unsuspended, and unrevoked license or certificate issued to the applicant on the basis of an examination, by a duly constituted examining board, under the laws of any other state or of any territory of the United States or of the District of Columbia whose licensing standards at the time such license or certificate was issued were not substantially lower than those of the state of Colorado at that time for the granting of a license to practice medicine if:
(I) Under the scope of such license or certificate the applicant was authorized to practice medicine in all its branches, as defined in this article;
(II) Such examining board grants licenses, without further examination and otherwise on a substantially equal reciprocal basis, to applicants who possess a license to practice medicine granted by the board or heretofore granted by the state board of medical examiners as constituted under any prior law of this state;
(III) The medical school from which the applicant graduated was approved by this or such prior board at the time of the issuance of such license or certificate.
(2) No person shall be granted a license to practice medicine as provided by subsection (1) of this section unless such person:
(a) Is at least twenty-one years of age;
(b) Is a graduate of an approved medical college, as defined in section 12-36-108; and
(c) Has completed either an approved internship of at least one year, as defined in section 12-36-109, or at least one year of postgraduate training approved by the board.
(3) (a) (I) Notwithstanding any other provision of this article, an applicant of noteworthy and recognized professional attainment who is a graduate of a foreign medical school and who is licensed in a foreign jurisdiction if that jurisdiction has a licensing procedure may be granted a distinguished foreign teaching physician license to practice medicine in this state, upon application to the board in the manner determined by the board, if the following conditions are met:
(A) The applicant has been invited by a medical school in this state to serve as a full-time member of its academic faculty for the period of his appointment, at a rank equal to an associate professor or above;
(B) The applicant’s medical practice is limited to that required by his academic position and the limitation is so designated on the license in accordance with board procedure and is also limited to the core teaching hospitals affiliated with the medical school, as identified by the board, on which he is serving as a faculty member.
(II) An applicant who meets the qualifications and conditions set forth in subparagraph (I) of this paragraph (a) but is not offered the rank of associate professor or above may be granted a temporary license, for one year only, to practice medicine in this state, as a member of the academic faculty, at the discretion of the board and in the manner determined by the board; but if such person is granted a temporary license, he shall practice only under the direct supervision of a person who has the rank of associate professor or above.
Such a distinguished foreign teaching physician license shall remain in force only while the holder is serving on the academic staff of a medical school. Such license shall expire one year after its date of issuance and may be renewed annually only after it has specifically been determined that the conditions specified in paragraph (a) of this subsection (3) will continue during the ensuing period of licensure. The board may require an applicant for licensure under this subsection (3) to present himself or herself to the board for an interview. The board may withdraw a license granted by these provisions prior to the expiration of such license for unprofessional conduct as defined in section 12-36-117. The board may establish and charge a fee for such distinguished foreign teaching physician license pursuant to section 24-34-105, C.R.S., not to exceed the amount of the fee for a two-year renewal of a physician’s license. The board shall promulgate rules specifying standards related to the qualification and supervision of distinguished foreign teaching physicians.
(4) (a) Notwithstanding any other provision of this article, an applicant lawfully practicing medicine in another state or territory may be granted a temporary license to practice medicine in this state, upon application to the board in the manner determined by the board, if:
(I) The applicant has been invited by the United States Olympic committee to provide medical services at the Olympic training center at Colorado Springs or to provide medical services at an event in this state sanctioned by such committee; and
(II) The United States Olympic committee certifies to the board the name of the applicant, the state or territory of the applicant’s licensure, and the dates within which the applicant has been invited to provide medical services; and
(III) The applicant’s practice is limited to that required by the United States Olympic committee. Such medical services shall only be provided to athletes or team personnel registered to train at the Olympic training center or registered to compete in an event conducted under the sanction of the United States Olympic committee.
(b) Such temporary license shall remain in force while the holder is providing medical services at the invitation of the United States Olympic committee and only during the time certified to the board but not longer than ninety days without extension by the board. The board may establish and charge a fee for such temporary license pursuant to section 24-34-105, C.R.S., not to exceed one-half the amount of the fee for a two-year renewal of a physician’s license. No physician shall be required to pay more than one temporary license fee in each calendar year. Physicians temporarily licensed under this subsection (4) are subject to discipline by the board for unprofessional conduct as defined in section 12-36-117.
(5) (a) Notwithstanding any other provision of this article, an applicant lawfully practicing medicine in another state or territory may be granted a limited license to practice medicine in this state, upon application to the board in the manner determined by the board, if:
(I) The applicant has been invited by the administrator of a hospital to provide medical services relative to the evaluation and treatment of children as potential patients, patients, or out-patients of Shriners hospitals for children; and
(II) The state or territory where the applicant is actively licensed to practice medicine certifies to the board the name of the applicant and that the applicant is licensed in good standing; and
(III) The applicant certifies in the manner prescribed by the board to the board that such applicant’s license to practice medicine in any other state or territory has not been restricted, suspended, or revoked; and
(IV) The applicant’s practice is limited to evaluation of children who are potential patients of a Shriners hospital and treatment of children who are patients or out-patients of a Shriners hospital and the applicant shall only provide services to children under twenty-one years of age.
(b) Such limited license shall remain in force for a period of two years, subject to renewal at the end of each two-year period. The board may establish and charge an application and renewal fee for such limited license pursuant to section 24-34-105, C.R.S., not to exceed one-half the amount of the fee for a two-year renewal of a physician’s license and not to exceed the cost of administering the license. Any renewal of a limited license shall be subject to the renewal requirements set forth in section 12-36-123[i].
C.R.S. 12-36-111 provides that every person desiring a license to practice medicine shall make application to the board, such application to be verified by oath and to be in such form as shall be prescribed by the board. Such application shall be accompanied by the license fee and such documents, affidavits, and certificates as are necessary to establish that the applicant possesses the qualifications prescribed by this article, apart from any required examination by the board. The burden of proof shall be upon the applicant, but the board may make such independent investigation as it may deem advisable to determine whether the applicant possesses such qualifications and whether the applicant has at any time committed any of the acts or offenses defined in this article as unprofessional conduct.
An applicant for a license on the basis of an examination by the board shall file an application at least ninety days prior to the announced date of the examination. If an applicant is not a graduate of an approved medical college at the time of filing an application, such applicant shall submit to the board, in lieu of required evidence of graduation, a written statement from the dean or other authorized representative of the approved medical college in which such applicant is in attendance stating that the applicant will receive a diploma at the end of the then current school term; except that the applicant shall not be permitted to take the examination until acceptable evidence of graduation has been filed with the board and the applicant has complied with the requirements of subsection (1) of this section. No license shall be issued to an applicant until the board is satisfied that such applicant has completed at least one year of approved internship or approved postgraduate training and has otherwise met the requirements for the issuance of a license under this article.
Pursuant to C.R.S. 12-36-114, if the board determines that an applicant possesses the qualifications required by this article and is entitled thereto, the board shall issue a license to practice medicine which shall be signed by the president or vice-president, attested by the secretary, and sealed with the seal of the board. Prior to the approval of such license, the applicant shall not engage in the practice of medicine in this state, and any person who practices medicine in this state without first obtaining approval of such license shall be deemed to have violated the provisions of this article. All holders of a license to practice medicine granted by the board, or by the state board of medical examiners as constituted under any prior law of this state, shall be accorded equal rights and privileges under all laws of the state of Colorado, shall be subject to the same duties and obligations, and shall be authorized to practice medicine, as defined by this article in all its branches.
C.R.S. 12-36-129 provides that any person who practices or offers or attempts to practice medicine within this state without an active license issued under this article commits a class 2 misdemeanor and shall be punished as provided in section 18-1.3-501, C.R.S., for the first offense, and, any person committing a second or subsequent offense commits a class 6 felony and shall be punished as provided in section 18-1.3-401, C.R.S. Any person who presents as his or her own the diploma, license, certificate, or credentials of another, or who gives either false or forged evidence of any kind to the board, or any member thereof, in connection with an application for a license to practice medicine, or who practices medicine under a false or assumed name, or who falsely impersonates another licensee of a like or different name commits a class 6 felony and shall be punished as provided in section 18-1.3-401, C.R.S. Any person who violates section 12-36-117 (1) (w) commits a class 5 felony, and any person committing a second or subsequent violation commits a class 3 felony; and such persons shall be punished as provided in section 18-1.3-401, C.R.S.
No action may be maintained against an individual who has been the recipient of services constituting the unlawful practice of medicine for the breach of a contract involving the unlawful practice of medicine or the recovery of compensation for services rendered under such a contract. When an individual has been the recipient of services constituting the unlawful practice of medicine, whether or not he knew that the rendition of the services was unlawful:
(a) He or his personal representative is entitled to recover the amount of any fee paid for the services; and
(b) He or his personal representative may also recover a reasonable attorney fee as fixed by the court, to be taxed as part of the costs of the action.
No specialty society, association of physicians, or licensed physician may discriminate against any person licensed to practice medicine if such physician is qualified for membership in the specialty society or association. If board certification or eligibility in a specialty is a membership requirement, certification or eligibility by either the American board of medical specialties or the American osteopathic association based upon the applicant’s training as a doctor of medicine or doctor of osteopathy, is sufficient. Notwithstanding any other remedies provided under this article, a licensed physician who is discriminated against in violation of this section shall have a private right of action against the licensed physician or specialty society or association that so discriminates. Any licensed physician, specialty society, or association of physicians held liable for a violation of this subsection (5) shall pay the costs and reasonable attorney fees incurred by the aggrieved physician associated with his pursuit of any claim for relief authorized by this subsection (5).
[i] C.R.S. 12-36-107.