To become licensed, a physician was required to show his or her diploma from a medical school or pass a Board examination. A “grandfather" clause in the Board creation bill allowed practitioners already in the state to become licensed by signing their county registry of physicians and surgeons within 60 days of the bill's passage into law.
The Legislature strengthened the Medical Practice Act in 1895. Board membership was expanded to include five representatives: “(T)hree regulars, one eclectic and one homeopathic." All applicants for a medical license were required to submit data on their educational backgrounds and pass an examination covering all branches of medicine. Physicians who were licensed under the old law were again exempted from the new regulations.
For the first time, the law defined unprofessional conduct. Unethical behavior included the “employment of cappers or steerers (payment of a patient for a testimonial), moral turpitude, betraying professional secrets and obtaining a fee for the care of an incurable disease."
The next significant change came in 1907, when the Legislature extended the Board's responsibilities to include the regulation of osteopathic medicine and physicians. Lawmakers also added an osteopathic physician to the Board, increasing the size of the Board to six members.
In 1929, the Oregon State Medical Society circulated a statewide ballot initiative proposing that each applicant for a license in the healing arts be required to take and pass a uniform examination on their knowledge of the basic sciences. The test would be prepared and administered by a group of non-partisan educators from the state-accredited institutions of higher education. The new Basic Science Law would not affect persons already licensed. The Society's proposal failed to make the ballot, but the 1931 Legislature adopted a version of the initiative.
In 1973, the Legislature added acupuncturists to the Board's regulatory responsibilities, and the Acupuncture Advisory Committee met for the first time the following year. One of the original committee members, Joel Seres, MD, of Portland, served for three decades before retiring in 2004.
Emergency Medical Services (EMS) providers came under Board supervision in 1975. The 1989 Legislature transferred much of that program to the Oregon Health Division (now the Oregon Health Authority). However, the Board still has the responsibility for EMS provider scope of practice.2
The 1981 Legislature dissolved the 56-year-old State Board of Podiatry Examiners and placed its licensees under the Board's jurisdiction. By 1989, all statutory provisions governing podiatry had been transferred from their separate ORS chapter into the Medical Practice Act.
Nurse practitioners with prescription privileges were placed under Board authority in 1979, but removed to the Board of Nursing eight years later.
In 1991, lawmakers expanded the practice of optometry to include topical application of pharmaceutical agents to the eye for the purpose of diagnosis and treatment. The Board, with the advice and consent of the Board of Optometry, created a formulary of allowable topical agents for optometrists' use. Two years later, the Legislature reversed the order of responsibility for the optometric formulary. The Board of Optometry, with the advice and consent of the Oregon Medical Board, now designates the pharmaceutical agents for topical use by optometrists.
Also in 1991, the Board was given jurisdiction over Respiratory Care Practitioners (RCP). In 1997, the RCP program was transferred to the Oregon Health Authority.Medical Practice Act
The Medical Practice Act was amended in 1975 to substantially increase the Board's powers in disciplinary matters. For example, it became possible to summarily suspend the license of a physician if he or she posed an immediate danger to the public. It also became possible for the Board to suspend or revoke a physician's license for failure to appear for an informal hearing with the Board.
The 1975 Legislature also approved a law assuring confidentiality for persons filing complaints against licensees. As a result, complaints increased dramatically, and their number continues to rise. That same year, lawmakers passed a mandatory reporting law, requiring physicians to report to the Board any actions by colleagues which might raise questions regarding their ability to practice medicine. Insurance companies were also required to report any malpractice claim filed against a provider.
Two years later, the Legislature extended the mandatory reporting law to hospitals, which were required to report changes in privileges or any disciplinary actions taken against staff members. Insurance companies were also required to report medical malpractice claims against Oregon physicians to the Board. Ultimately, the 2009 Legislature increased reporting requirements to all licensed health care providers. This includes nurses, dentists, pharmacists, and chiropractors. Board Members and Staff
In 1979, the Legislature added a public member to the Board, bringing the total number of members to nine. 10 years later, lawmakers added a second public member and another physician (MD) member, enlarging the Board to an 11-member panel.
In 1986, the Board hired its first medical director, Donald Dobson, MD, an anesthesiologist from Portland.
Into the New Millennium
The Board continued to adapt to changing times and technologies. In 2001, the Board issued a formal Statement of Philosophy regarding the medical use of lasers. The Board declared the use of lasers and other, similar devices to be surgery, requiring appropriate training and supervision.
The 2003 Legislature made a number of changes in Oregon health care law, including changes in reporting requirements for individuals, hospitals, and health care systems. The Medical Practice Act now specifies a period of 10 working days within which OMB licensees, health care facilities, and certain professional associations (including the OMA) must report detrimental physician conduct to the OMB. Self-reporting of such conduct is also now required within 10 working days of the incident or event.
Also in 2003, the Legislature created a semi-independent Oregon Patient Safety Commission, which is charged with receiving reports and complaints about cases in which patient safety might be compromised or jeopardized. However, the law continues to give the OMB subpoena power, even if a case is reported to the commission.
Additionally, Physician assistants were also granted the privilege of prescribing and administering Schedule II controlled substances after fulfilling specific educational and certification requirements.
Interest in professionalism and continuing competency increased among medical educators and regulators during this period. In January 2005, the Board held a full-day retreat to discuss these issues and the Board's role in furthering them. As a result, the Board adopted a Statement of Philosophy on Professionalism in May 2005.
In 2005, the Legislature gave the OMB authority to conduct fingerprint and national criminal record background checks on applicants for licensure.3
The 2006 Legislature added a podiatric physician to the Board as a 12th
member and abolished the 24-year-old Advisory Council on Podiatry.4
The podiatric physician member was originally barred by statute from voting on matters not concerning podiatry, but the 2007 Legislature overturned that prohibition effective January 1, 2008.
A New Name
Previously known as the Oregon Board of Medical Examiners, on January 1, 2008, the agency name changed to the Oregon Medical Board. The Board-requested name change5
reflects the fact that the Board no longer administers an examination to candidates for licensure. The new name also helps avoid confusion between the OMB and the Office of the State Medical Examiner.
A Dynamic Profession
The medical profession continues to evolve with new opportunities and challenges. The Board has addressed these developments in medicine with administrative rules, Statements of Philosophy, participation in the statewide Health Professionals' Services Program (HPSP), and technological advances to OMB processes.
The foremost mission of the Oregon Medical Board is the protection of Oregon's citizens from the practice of medicine by unqualified, incompetent, or impaired medical providers. Secondarily, the Board supports its licensees in remaining in or returning to the safe practice of medicine. HPSP, a rehabilitation and monitoring program for licensees with substance abuse or mental health disorders, was established in July 2010 as a statewide, confidential resource.
The program provides information and education to employers, licensee associations and support networks, treatment programs, and other stakeholders. Topics include an overview of HPSP and its services; the value of HPSP for self-referrals; signs and symptoms of substance abuse disorders, mental health disorders, and relapse; and effective workplace supervision.
In 2011, House Bill 224 led to sweeping changes to the regulation of physician assistants. For the first time, physician assistant licensure was separated from the establishment of a supervisory relationship with a physician.
Also in 2011, the Board saw an increase in the number of health care professionals returning to practice after a period of clinical inactivity. To encourage re-entry into the health care workforce, a Statement of Philosophy on Re-Entry to Clinical Practice was adopted later that year.
Statements of Philosophy on Telemedicine (2012), the Use of Unlicensed Health Care Personnel (2012), and Pain Management (2013) also gave providers guidance in rapidly changing areas of practice. In addition, a Statement of Philosophy on Cultural Competency was adopted in 2013 to address the changing population of Oregon and health care consumers following the Affordable Care Act.
In October 2013, the Board amended its 2006 rules on office-based surgery to meet the need for additional regulation of the ever-increasing number and complexity of procedures performed outside of licensed ambulatory surgery centers and hospitals.
The OMB streamlined its process for practice agreements and terminations in the Spring of 2012. Supervising physicians and physician assistants now make all practice agreement submissions and terminations electronically through the OMB website. Additionally, online renewals were reformatted to improve the user experience, particularly on mobile devices.
In the fall of 2013, the OMB proudly announced the launch of its new website, www.Oregon.gov/OMB. The completely renovated site provided enhanced access to public information that users can view from any device, including tablets and mobile phones. The task-driven site layout, design, and content were based on user metrics, caller feedback, and public testing throughout the development process. The OMB was the first agency in Oregon to fully redesign its website and acted as a prototype for other state agencies. The significant effort was recognized by the Wall Street Journal on October 17, 2013.
Celebrating 125 Years of Patient Safety
The Oregon Medical Board celebrated its 125th
year of regulating the practice of medicine in Oregon through licensing, education, investigation and discipline in 2014. Then-Governor John Kitzhaber, MD, called the work done by the Board to protect the health, safety, and wellbeing of Oregonians "inspiring" in his commemorative letter, available to read in full here
Today's Medical Board
The Oregon Medical Board's mission of patient safety through medical regulation is now more than 130 years old. Nevertheless, the OMB has earned a reputation for staying current and relevant as medicine and society evolve.
The successful passage of Senate Bill 905 in 2015 established a new physician assistant (PA) seat on the Board, providing representation to the more than 2,500 PAs licensed in Oregon. This Board seat works to advance the PA profession and the collaborative PA/physician approach to health care.
In 2015, the Board's IT team made several technological improvements to the way licensees and members of the public interact with the Board. Email distribution of the OMB Report began, a Secure Upload Portal was implemented so licensees and applicants could upload documents directly through the web portal, and the online Status Report was made available for license renewals. The following year, license reactivations were made available online, and the online services pages was completely redesigned for easier use and mobile optimization. The Board also created Statements of Philosophy on Electronic Health Records (2015) and Social Media (2016) to offer guidance to providers as technology shaped new digital methods of record keeping and communication among practitioners, patients, and family.
In 2017, the board debuted its new seal, which maintains the essence of the Medical Board's foundation but with a modern design (pictured at the top of this page). Blue and gold are the dominant colors, which represent the OMB as an agency of the State of Oregon. Blue also symbolizes integrity and accountability while gold symbolizes excellence and customer service – the OMB's four core values. The Rod of Asclepius represents the Greek god of medicine and healing who had the power to heal the dead. The modern use of the Rod of Asclepius began in 1910 when the American Medical Association adopted it as a symbol. The rod is depicted as a physician's staff with a single snake wrapped around it.
Additionally in 2017, the OMB published Cultural Competency: A Practical Guide for Medical Professionals. The booklet was mailed to all Board licensees practicing in Oregon. The practical guide included new perspectives and resources to assist licensees in providing the very best care to each of their uniquely individual patients. The modern physician's oath promises to not allow “considerations of age, disease or disability, creed, ethnic origin, gender, nationality, political affiliation, race, sexual orientation, social standing or any other factor" to interfere with the patient relationship. At the same time, it is known that disparities in health and access to care exist among population groups. Oregon health care providers have the power to effect significant change for these Oregonians.
The successful passage of Senate Bill 60 in 2017 allowed a Board member who has recently ended his or her term to fill an absent member's seat during a committee or Board meeting. As a result, the statue directs the OMB chairperson to select up to three former Board members to serve as “emeritus Board members." In the event that a currently serving Board member provides advance notice of an absence, one of the selected emeritus members who holds the same license, or who fulfills the same public role, may serve as a substitute. This process improves the Board's ability to achieve its mission of patient safety by providing full representation of each position on the Board, even when currently-appointed members may be unable to attend.
The Board supports a proactive, broad approach to licensee wellness. The Board's prevention, treatment, and rehabilitation efforts have led to the inception of a statewide initiative known as the Oregon Wellness Program. This program "promotes the wellness of health care professionals through education, coordinated regional counseling services, telemedicine services, and research." Since 2017, the Board has contributed $300,000 to the program.
Technology continued to advance in 2018 when the Board added automated email messaging, such as biweekly application status reminders, application/initial registration/renewal submissions, and application received to assist licensees and applicants with application and renewal processes. Later that year, in keeping with the Board's commitment to diversity, equity, and inclusion, a Non-Binary gender option was added to license application and renewal forms.
After 24 years of service, Kathleen Haley, JD, (pictured left) retired as OMB Executive Director in 2018. Over the course of her career, Ms. Haley earned the profound respect of health care professionals and policy makers in Oregon, as well as nationally and internationally. During her tenure, Ms. Haley was a leader in medical regulation, serving on the Board of Directors of the Federation of State Medical Boards and Administrators in Medicine. In 2016, the Citizens Advocacy Center of Washington, D.C., awarded her the prestigious Ben Shimberg Public Service Award, and in 2020, she was a recipient of the FSMB's Distinguished Service Award. Past Board Chair, K. Dean Gubler, DO, said, “Ms. Haley's enduring legacy of exceptional leadership will continue to inspire Board members and staff to carry on the Board's distinguished work."