Md. Code, Health Occ. § 14-306

Current with changes from the 2024 Legislative Session, chs. 2--407, effective on or before 7/1/2024

Section 14-306 - Duties delegated by a licensed physician

(a) To the extent permitted by the rules, regulations, and orders of the Board, an individual to whom duties are delegated by a licensed physician may perform those duties without a license as provided in this section.

(b) The individuals to whom duties may be delegated under this section include any individual authorized to practice any other health occupation regulated under this article or § 13-516 of the Education Article.

(c) The Board shall adopt rules and regulations to delineate the scope of this section. Before it adopts any rule or regulation under this section, the Board shall invite and consider proposals from any individual or health group that could be affected by the rule or regulation.

(d)

(1) If a duty that is to be delegated under this section is a part of the practice of a health occupation that is regulated under this article by another board, any rule or regulation concerning that duty shall be adopted jointly by the Board of Physicians and the board that regulates the other health occupation.

(2) If the two boards cannot agree on a proposed rule or regulation, the proposal shall be submitted to the Secretary for a final decision.

(e) Except as otherwise provided in this section, an individual may perform X-ray duties without a license only if the duties:

(1) Do not include:

(i) Computerized or noncomputerized tomography;

(ii) Fluoroscopy;

(iii) Invasive radiology;

(iv) Mammography;

(v) Nuclear medicine;

(vi) Radiation therapy; or

(vii) Xerography;

(2) Are limited to X-ray procedures of the:

(i) Chest, anterior-posterior and lateral;

(ii) Spine, anterior-posterior and lateral; or

(iii) Extremities, anterior-posterior and lateral, not including the head; and

(3) Are performed:

(i) By an individual who is not employed primarily to perform X-ray duties;

(ii) In the medical office of the physician who delegates the duties; and

(iii)

1. By an individual who, before October 1, 2002, has:

A. Taken a course consisting of at least 30 hours of training in performing X-ray procedures approved by the Maryland Radiological Society in consultation with the Maryland Society of Radiologic Technologists; and

B. Successfully passed an examination based on that course that has been approved by the Maryland Radiological Society in consultation with the Maryland Society of Radiologic Technologists; or

2. By a licensed physician assistant who has completed a course that includes anterior-posterior and lateral radiographic studies of extremities on at least 20 separate patients under the direct supervision of the delegating physician or radiologist using a mini C-arm or similar low-level radiation machine to perform nonfluoroscopic X-ray procedures, if the duties:

A. Include only the X-ray procedures described in paragraph (2)(iii) of this subsection; and

B. Are performed pursuant to a Board-approved delegation agreement that includes a request to perform advanced duties under § 15-302(c)(2) of this article.

(f)

(1) In accordance with regulations adopted by the Board, a licensed physician may delegate duties to a registered cardiovascular invasive specialist assisting in the physician's performance of fluoroscopy if:

(i) The delegated duties are limited to a cardiac catheterization procedure performed in a hospital cardiac catheterization laboratory;

(ii) The physician is physically present and personally directs each act performed by the registered cardiovascular invasive specialist;

(iii) The registered cardiovascular invasive specialist has completed the training and education and has the experience required by regulations adopted by the Board; and

(iv) The hospital in which the cardiac catheterization laboratory is located has verified and documented that the registered cardiovascular invasive specialist has completed the training and education and has the experience required by regulations adopted by the Board.

(2) The hospital in which the cardiac catheterization laboratory is located and the physician delegating duties to a registered cardiovascular invasive specialist under this subsection are responsible for ensuring that all requirements of this subsection are met for each procedure.

(3) A disciplinary panel may impose a civil penalty of up to $5,000 for each instance of a hospital's failure to comply with the requirements of this subsection.

(g)

(1)

(i) In this subsection the following words have the meanings indicated.

(ii) "Direct supervision" means oversight exercised by a delegating physician who is:

1. Personally treating the patient;

2. In the same medical office as the patient and the supervised medical graduate; and

3. Immediately available to provide assistance and guidance to the supervised medical graduate for the duration of the completion of a delegated duty.

(iii) "Supervised medical graduate" means an individual who:

1. Has a degree of:

A. Doctor of medicine from a medical school that is accredited by an accrediting organization that the Board recognizes in its regulations; or

B. Doctor of osteopathy from a school of osteopathy in the United States, its territories or possessions, Puerto Rico, or Canada that has standards for graduation equivalent to those established by the American Osteopathic Association; and

2. Has passed parts 1 and 2 of the United States Medical Licensing Examination.

(2) Subject to paragraph (3) of this subsection and in accordance with regulations adopted by the Board, a supervised medical graduate may perform delegated duties under direct supervision.

(3) An individual may not practice as a supervised medical graduate for a period of more than 2 years.

(4) For the purposes of this subsection, a delegating physician is not required to be in the presence of a patient and a supervised medical graduate during the completion of a delegated duty.

Chapter 445 of the Acts of 2019

SECTION 4. AND BE IT FURTHER ENACTED, That this Act shall take effect October 1, 2019.

Md. Code, HO § 14-306

Amended by 2024 Md. Laws, Ch. 286,Sec. 1, eff. 4/25/2024.

Amended by 2020 Md. Laws, Ch. 613, Sec. 1, eff. 5/8/2020.

Amended by 2020 Md. Laws, Ch. 612, Sec. 1, eff. 5/8/2020.

Amended by 2019 Md. Laws, Ch. 445, Sec. 2, eff. 10/1/2019.

Amended by 2013 Md. Laws, Ch. 359, Sec. 1, eff. 10/1/2013.