LLR-BOARD OF MEDICAL EXAMINERS
Approved by the Board: August 3-6, 2003 Board meeting
Service Area: Licensure, Physicians
Subject: Out-of-state physicians - Requirements for S.C. Licensure of out-of-state physicians teaching and learning in South Carolina
In accordance with Section 1-23-40 of the 1976 Code of Laws of South Carolina, as amended, notice is hereby given that the State Board of Medical Examiners of South Carolina has adopted the following statement as guidance for physicians in the practice of medicine under the South Carolina Medical Practice Act and the Principles of Medical Ethics as adopted by the Board. For purposes of discipline and licensure in matters before the Board, practice in compliance with this statement will not be considered a violation of the Medical Practice Act (§40-47-5, et seq).
REQUIREMENTS FOR S.C. LICENSURE OF OUT-OF-STATE PHYSICIANS TEACHING AND LEARNING IN SOUTH CAROLINA
This statement is intended to clarify the situations in which a South Carolina license to practice medicine is required in order for physicians licensed in other states to teach and learn in South Carolina.
South Carolina law specifically defines the practice of medicine, stating in Section 40-47-40 of the 1976 Code of Laws of South Carolina, as amended, that:
Any person shall be regarded as practicing medicine within the meaning of this article who (a) shall as a business treat, operate on or prescribe for any physical ailment of another (b) shall engage in any branch or specialty of the healing art or (c) shall diagnose, cure, relieve in any degree or profess, or attempt to diagnose, cure or relieve any human disease, ailment, defect, abnormality or complaint, whether of physical or mental origin, by attendance or advice, by prescribing, using or furnishing any drug, appliance, manipulation, adjustment or method or by any therapeutic agent whatsoever.
Section 40-47-60 states that:
No person shall practice medicine, surgery or osteopathy within the state unless he is twenty-one years of age and has been authorized to do so pursuant to the provisions of this article.
That same Code section allows some basic exceptions to the requirement of a license, including:
(1) ...in cases of emergency or the domestic administration of family remedies;
(2) ...those who practice the religious tenets of their church without pretending a knowledge of medicine...;
(3) ...licensed druggists ...selling, using and dispensing drugs in their places of business, respectively;
(4) ...task[s] or function[s] performed by an assistant to a physician certified by the Board of Medical Examiners... [under certain circumstances];
(5) ...[delegated] tasks to unlicensed personnel in [a licensed physician's]...employ and on his premises ...[under certain circumstances].
State law further exempts certain physicians from licensure, stating in part in Section 40-47-240 that:
This article shall not apply to ...physicians or surgeons of other states or territories in actual consultation with a licensed physician or surgeon of this State, nor shall it be construed to apply to or to change the laws relating to dentists, trained nurses, pharmaceutists, opticians, and optometrists or midwives.
In considering the exemptions of Section 40-47-240, the Medical Board has interpreted the law to include certain specific situations:
1. The Board has further defined "actual consultation" as "involving teaching or advice to licensed physicians only and does not include prescribing, treating, operating on, or in any other way, managing the health care of a specific patient."
2. The Board has further determined that a visiting teacher or professor whose instruction includes prescribing, treating, operating on, or in any way, managing the health care of a specific patient must be licensed by the Board. The physician(s) would have to apply for a 14-day limited license. This type of license may be issued to a physician up to 4 times per calendar year.
3. The Board determined that physicians not licensed in South Carolina who come into the state for a specific event to learn a medical/surgical treatment procedure from a licensed South Carolina physician by active participation in the treatment procedure on a patient must be licensed by the South Carolina Medical Board. The physician(s) would have to apply for a 14-day limited license. This type of license may be issued to a physician up to 4 times per calendar year.
Physicians not licensed in South Carolina who come into the state for a specific event to learn a medical/surgical treatment procedure from a licensed South Carolina physician solely by observation of the procedure with no active participation in the patient treatment procedure itself are not considered to be practicing medicine and, therefore, are not required to be licensed by the South Carolina Medical Board.
Although a physician who conducts himself in accordance with the policy will avoid disciplinary action by the Board of Medical Examiners, a physician may still face civil liability under some circumstances and should, therefore, consult private counsel where doubt exists as to what actions are appropriate.