Under New Hampshire law, provisions relating to regulation of physicians are provided under RSA 329:10 through RSA 329:16. Accordingly, every applicant for licensure shall submit an application in the requisite form accompanied by a complete set of fingerprints and a notarized criminal history record release form pursuant to RSA 329:11-a to the board. RSA 329:11-a stipulates that every applicant for initial permanent licensure or reinstatement shall submit to criminal history record check. The board may also accept police clearances from every city, town, or county where the person has lived during the past 5 years if the fingerprint of the applicant is invalid due to insufficient pattern. The applicant shall bear the cost of a criminal history record check.
The applicant shall produce sufficient proof that s/he is 21 years of age or older, of good professional character and has completed at least 2 years of college course work or its equivalent[i]. The applicant must have studied in a medical school approved by the Accreditation Council for Medical Education and has graduated from such school. Alternatively, the applicant must have studied medicine in a medical school located outside the U.S. which is recognized by the United Nations World Health Organization (UNWHO) and had such studies confirmed by Educational Commission for Foreign Medical Graduates (ECFMG) Certification. The applicant must also have completed at least 2 years of postgraduate training approved by the Accreditation Council on Graduate Medical Education, or its equivalent as determined by the board. Each applicant who has graduated from an accredited medical school prior to January 1, 1970, is required to have satisfactorily completed at least 12 months in a graduate educational program approved by the Accreditation Council on Graduate Medical Education, the Canadian Medical Association, or the Royal College of Physicians and Surgeons of Canada[ii].
In addition, the applicant must have successfully passed one of the following sets of examinations, namely, National Board of Medical/Osteopathic Examiners examinations, Federation Licensing Examination (FLEX), United States Medical Licensing Examination (USMLE) or the Medical Council of Canada Examination (LMCC). It is to be noted that the board may waive the examination requirement for any applicant who has satisfactorily passed all examinations and requirements to become board certified by the American Board of Medical Specialties (ABMS) or by the American Osteopathic Association (AOA).[iii]
The board may issue different types of licenses such as courtesy licenses, training licenses and special licenses. The board shall issue special training licenses to persons of good professional character who are enrolled in a regular residency or graduate fellowship training program accredited by the Council on Graduate Medical Education, and who possess such further education and training as the board may require by rule[iv].
Training licenses issued by the board shall be confined to activities performed in the course of the qualifying residency or graduate fellowship training program. Such licenses shall expire automatically upon the licensee’s separation from the residency or graduate fellowship training program for any reason, and may be issued on a restricted or conditional basis[v]. Persons holding training licenses shall be subject to the disciplinary provisions of RSA 329:17. Special licenses are licenses containing conditions, limitations, or restrictions, including licenses limited to specific periods of time[vi]. Courtesy licenses authorize the practice of medicine under limited conditions as defined by the board by rule and shall not exceed 100 days and shall be limited in location. All applicants shall hold an active, unrestricted license in another state and meet the same character qualifications as other licensees. In addition, the board may issue licenses authorizing the practice of medicine limited to administrative medicine for physicians whose practice does not include the provision of clinical services to patients[vii].
The board will not issue license unless the board finds that the applicant possesses the necessary educational, character and other professional qualifications to practice medicine, and that no circumstances exist which would be grounds for disciplinary action against a licensed physician pursuant to RSA 329:17[viii].
Licenses are renewed on a biennial basis on payment of a renewal fee[ix]. As a condition of renewal of license, the board shall require each licensee to show proof at least at every biennial license renewal that the licensee has completed 100 hours of approved continuing medical education program within the preceding two years[x].
Any licensee who fails to renew his/her license by June 30 of the year shall be required to pay double the renewal fee if paid within 90 days of the expiration date[xi]. Any failure, neglect, or refusal on the part of licensee to renew the license shall automatically lapse the license. Such license shall not be reinstated except upon payment of a reinstatement fee as established by the board, and a showing of such evidence of professional competence as the board may reasonably require[xii].
The license notice requirements stipulate all licensees to provide the board with a copy of any notice of complaint, action for medical injury, or claim received from or disciplinary action taken in a jurisdiction outside of this state within 30 days of receipt of such notice or action[xiii].
A licensee who has been placed on inactive list can reactivate his/her license upon the filing of a written request, accompanied by the reinstatement fee, proof of satisfaction of continuing medical education requirements established by RSA 329:16-g, and such other evidence of professional competence[xiv].
The board may undertake disciplinary proceedings either suo motu or upon written complaint of any person regarding any malpractice by a licensed physician[xv]. The following are possible grounds for disciplinary action.
- Knowingly providing false information during any application for professional licensure.
- Drug abuse or habitual intoxication.
- Engaging in medical practice which is incompatible with the basic knowledge and competence expected of licensed medical practitioners.
- Dishonest or unprofessional conduct or gross negligence in practicing medicine or intentionally injuring a patient while practicing medicine.
- Employing or allowing an unlicensed person to practice in the licensee’s office.
- Failure to provide adequate safeguards with respect to aseptic techniques or radiation techniques.
- Deceptive advertising claiming professional superiority.
- Advertising the use of any drug or medicine of an unknown formula or any system of anesthetic that is unnamed, misnamed, misrepresented, or not in reality used.
- Conviction for felony.
- Failure to maintain adequate medical record documentation on diagnostic and therapeutic treatment provided or has unreasonably delayed medical record transfer, or violation of RSA 332-I.
- Knowingly obtaining or assisting a person in obtaining or attempting to obtain a prescription for a controlled substance without having formed a valid physician-patient relationship pursuant to RSA 329:1-c.
The board is authorized to take non-disciplinary remedial action against any licensee upon finding that the person is afflicted with physical or mental disability, disease, disorder, or condition deemed dangerous to the public health. The non-disciplinary remedial action may be in the form of suspension, limitation, or restriction of a license for a period of time as determined reasonable by the board or by revocation of license. Alternatively, the board may require the person to submit to the care, treatment, or observation of a physician, counseling service, health care facility, professional assistance program, or any combination thereof which is acceptable to the board. The board can also require the person to practice under the direction of a physician in a public institution, public or private health care program, or private practice for a period of time specified by the board[xvi]. Disciplinary or non-disciplinary remedial action taken by the board under this section may be appealed to the Supreme Court under RSA 541[xvii].
Upon receipt of an administratively final order from the licensing authority of another jurisdiction which imposes disciplinary sanctions against a licensee of the board, the board may issue any disciplinary sanction or take any action with regard to a license application[xviii].
In cases involving imminent danger to life or health, the board may order suspension of a license pending hearing for a period of no more than 120 days. In such cases, the basis for the board’s finding of imminent danger to life or health shall be reduced to writing and combined with a hearing notice which complies with RSA 329:18-a[xix].
A retired physician who has notified the board of such person’s intention to participate in a program for the education of the public in matters involving the practice of medicine shall be immune from civil liability for providing education in good faith, without compensation in public forums or in response to individual inquiries from members of the public[xx]. It is to be noted that education as used in this section does not include advice given to individual members of the public which is in the nature of diagnosis or treatment[xxi].
A person who engages in unlawful practice shall be guilty of a misdemeanor for the first offense and for any subsequent offense the person shall be guilty of a misdemeanor if a natural person, or guilty of a felony if an entity[xxii]. In the event of an unlawful practice, the board is authorized to pass a cease and desist order, or to impose an administrative fine not to exceed $50,000. In the event of continuation of unlawful practice the fine shall be $1,000 for each day the activity continues after notice from the board that the activity shall cease. In addition, the board can resort to a denial or conditional denial of a license application, application for renewal, or application for reinstatement. Moreover, the attorney general, the board, or the prosecuting attorney of any county or municipality where the act of unlawful practice takes place may maintain an action to enjoin any person or entity from continuing to do acts of unlawful practice. It is to be noted that the action to enjoin shall not replace any other civil, criminal, or regulatory remedy and the board can also seek an injunction without bond[xxiii].
[i] RSA 329:12
[iv] RSA 329:14.
[ix] RSA 329:16-a.
[x] RSA 329:16-g.
[xi] RSA 329:16-e.
[xiii] RSA 329:16-f.
[xiv] RSA 329:16-h.
[xv] RSA 329:17.
[xviii] RSA 329:17-c.
[xix] RSA 329:18-b.
[xx] RSA 329:25-a.
[xxii] RSA 329:24.