In Massachusetts, provisions relating to the regulation of physicians are provided under ALM GL ch. 112, § 2 through ALM GL ch. 112, § 9B. Pursuant to the statutes, applications for registration as qualified physicians, signed and sworn to by the applicants, can be made upon blanks furnished by the board of registration in medicine.  Each applicant has to furnish the board with satisfactory proof that:

• s/he is 18 years of age or over and of good moral character;
• that s/he has completed two years of premedical studies in a college or university;
• s/he has attended courses of instruction for four years or courses which in the opinion of the board are equivalent thereto, in one or more legally chartered medical schools; and
• s/he has received the degree of doctor in medicine, or its equivalent, from a legally chartered medical school in the U.S. or commonwealth of Puerto Rico or Canada having the power to confer degrees in medicine.

After payment of a fee which is determined annually by the commissioner of administration and, if found qualified by the board, the applicant will be registered as a qualified physician and entitled to a certificate in testimony thereof, signed by the chairman and secretary.

However, an applicant who has received a degree of doctor of medicine or its equivalent from a medical school, legally chartered in a sovereign state other than the U.S., the commonwealth of Puerto Rico or Canada, will be required to furnish to the board such documentary evidence as the board may require that his/her education is substantially the equivalent of that of graduates of medical schools in the U.S. and such other evidence as the board may require as to his/her qualifications to practice medicine.

In addition, the board may without examination grant certificates of registration of qualified physicians to such graduates of medical schools:

1. who furnishes with their applications satisfactory proof that they have the qualifications required in the commonwealth to entitle them to be examined and have been licensed or registered upon a written examination in another state whose standards, in the opinion of the board, are equivalent to those in the commonwealth;
2. who are diplomats of specialty boards recognized by the American Medical Association or the American Osteopathic Association; provided that any person who has previously attempted unsuccessfully to secure registration in the commonwealth shall be registered without examination only at the discretion of the board.

The board may also without examination grant a certificate of registration of qualified physician to such person who furnishes with his/her application satisfactory evidence that:

1. s/he is a graduate of a Canadian medical school, or a medical school legally chartered in a sovereign state other than the U.S. or the commonwealth of Puerto Rico, and is licensed by the Medical Council of Canada and by a provincial licensing authority;
2. s/he is licensed in the commonwealth of Puerto Rico or in the province of Saskatchewan in Canada upon obtaining a grade of seventy-five percent or better in the federation licensing examination of the federation of state medical boards of the U.S.
3. In addition, the board may adopt, amend and rescind such rules and regulations as it deems necessary.

The board requires all physicians registered in the commonwealth to renew their certificates of registration with the board at two year intervals.  The renewal application will include the physician’s name, license number, home address, office address, his/her specialties, the principal setting of his/her practice, and whether s/he is an active or inactive practitioner.

The board is also authorized to promulgate regulations requiring physicians to obtain professional malpractice liability insurance or a suitable bond or other indemnity against liability for professional malpractice in such amounts as may be determined by the board.

The board will mail a renewal application to each registered physician 60 days prior to the renewal date.  The certification of registration of any physician who does not file a completed renewal application together with the fee will be automatically revoked, but will be revived upon completion of the renewal process[i].

Qualifications necessary for registration as a qualified physician are determined by the board and may at its discretion accept the certificate of the National Board of Medical Examiners of the U.S., or the certificate of the National Board of Examiners for Osteopathic Physicians and Surgeons of the American Osteopathic Association, in place of and as equivalent to its own professional examination[ii].

Examinations are in whole or in part in writing, in English, and will include the subjects of anatomy, surgery, chemistry, biology, physics, physiology, pathology, obstetrics, gynecology, psychiatry, practice of medicine and hygiene and will be sufficiently thorough to test the applicants’ fitness to practice medicine.  The board may employ expert assistance in conducting hospital and laboratory tests[iii].

In addition, a disciplinary unit established will be responsible for investigating complaints and prosecuting disciplinary actions against licensees.  The board will collect the following information to create individual profiles on licensees, in a format created by the board that will be available for dissemination to the public[iv]:

• a description of any criminal convictions for felonies and serious misdemeanors as determined by the board, within the most recent ten years.  For the purposes of this subsection, a person is deemed to be convicted of a crime if s/he pleaded guilty or if s/he was found or adjudged guilty by a court of competent jurisdiction;
• a description of any charges where sufficient facts of guilt were found and the matter was continued without a finding by a court of competent jurisdiction;
• a description of any final board disciplinary actions within the most recent ten years;
• a description of any final disciplinary actions by licensing boards in other states within the most recent ten years;

The board will provide individual licensees with a copy of their profiles prior to release to the public.  A licensee will be provided a reasonable time to correct factual inaccuracies that appear in such profile.

However, a physician may elect to have his/her profile omit certain information inclusive, concerning academic appointments and teaching responsibilities, publication in peer-reviewed journals and professional and community service awards[v].

The board can revoke, suspend, or cancel the certificate of registration and also impose fine in a manner and at a time and place to be determined by the board upon looking into the following factors:

• the physician fraudulently procured said certificate of registration;
• the physician is guilty of an offense against any provision of the laws of the commonwealth relating to the practice of medicine, or any rule or regulation adopted there under;
• the physician is guilty of conduct which places into question the physician’s competence to practice medicine, including but not limited to gross misconduct in the practice of medicine or of practicing medicine fraudulently, or beyond its authorized scope, or with gross incompetence, or with gross negligence on a particular occasion or negligence on repeated occasions;
• the physician is guilty of practicing medicine while the ability to practice is impaired by alcohol, drugs, physical disability or mental instability;
• the physician is guilty of being habitually drunk or being or having been addicted to, dependent on, or a habitual user of narcotics, barbiturates, amphetamines, hallucinogens, or other drugs having similar effects;
• the physician is guilty of knowingly permitting, aiding or abetting an unlicensed person to perform activities requiring a license for purposes of fraud, deception or personal gain, excluding activities permissible under any provision of the laws of the commonwealth relative to the training of medical providers in authorized health care institutions and facilities;
• the physician has been convicted of a criminal offense which reasonably calls into question his/her ability to practice medicine;
• the physician is guilty of violating any rule or regulation of the board, governing the practice of medicine.

If a physician is found not guilty, the board will forthwith order a dismissal of the charges and the exoneration of the accused.  If the board finds that there is reason to believe that a physician committed a criminal offense, the board will notify the district attorney having jurisdiction over such individual or occurrence[vi].

The board will make all reasonable efforts to ensure that the victim has the opportunity to make any oral impact statement in the presence of the physician.[vii]

Under ALM GL ch. 112, § 5A, the board is authorized to impose restrictions on a physician’s license prohibiting the physician from performing certain medical procedures or operations, or from performing procedures except under certain conditions.  The board through the regulations specifies the bases for such restrictions.

ALM GL ch. 112, § 5H states that, whenever it appears that any physician licensed in the commonwealth may be incompetent or unable to practice medicine with reasonable skill and safety because such physician’s ability to practice is impaired due to mental illness or physical illness, the board may order such physician to be examined by one or more physicians and surgeons designated by the board and at the board’s expense.

Whoever, not being lawfully authorized to practice medicine practices or attempts to practice medicine in any of its branches, or whoever practices medicine under a false or assumed name or under a name other than that by which s/he is registered; or whoever personates another practitioner, or whoever practices or attempts to practice any fraud in connection with the filing of an application, or whoever files an application under a false or assumed name or under a name other than his/her own; or whoever personates or attempts to personate another applicant for registration during an examination will be punished by a fine of not less than one hundred nor more than one thousand dollars or by imprisonment for not less than one month nor more than one year, or both.  Therefore, a person rendering medical service in violation will recover no compensation[viii].

A person is prohibited from using the title “physician” directly or indirectly, or display or use the term physician in any title, advertisement, listing of affiliations, communication with the public or in any other manner to indicate or imply in any way that such person offers to engage or engages in the practice of medicine or in the provision of health care services to patients within the commonwealth who is not registered by the board of registration in medicine as a physician[ix]

Pursuant to ALM GL ch. 112, §9B, temporary registration as a qualified physician may be granted:

• to a visiting physician holding a license to practice in another state or territory or in the District of Columbia or in another country and having a temporary faculty appointment certified by the dean of a medical school in the commonwealth for purposes of medical education in an accredited hospital associated with the medical school, such registration to terminate automatically upon termination of the faculty appointment and, in any event, at the end of three years;
• to a physician holding a license to practice in another state or territory or in the District of Columbia to permit him/her to act as a substitute physician for a registered physician in the commonwealth, to be granted only upon written request of said registered physician and to be limited to three months or less;
• to a physician eligible for examination or registration in the commonwealth who is a diplomat of a specialty board approved by the American Medical Association or the American Osteopathic Association to permit him/her to act as a substitute physician for a registered physician in the commonwealth to be granted only upon written request of said registered physician, to be limited to the specialty in which the applicant is certified and to be limited to three months or less;
• to a physician holding a license to practice in another state or territory or in the District of Columbia or in another country and enrolled in a course of continuing medical education, such registration to terminate automatically upon termination of the course and, in any event, at the end of three months.

[i] ALM GL ch. 112, § 2.

[ii] ALM GL ch. 112, § 2A.

[iii] ALM GL ch. 112, § 3.

[iv] ALM GL ch. 112, § 5.

[v] Id.

[vi] Id.

[vii] Id.

[viii] ALM GL ch. 112, § 6.

[ix] ALM GL ch. 112, § 8A.