T:\Licensing\New License Applications and forms\New License Application\Revised 2018\IMLCC Application Supplemental Form 03.18.2018
3. Professional Connection
Scenario: Your friend "Bob" wants to open a laser clinic and perform varicose vein removal. Bob is not a licensed doctor in Arizona, but he holds a medical
license in New Mexico. You are confident that Bob has the education and training to safely perform varicose vein removal, even though it is considered to be
the practice of medicine in Arizona. You decide to help Bob out and let him operate his laser clinic under your name. Is this appropriate?
A. Yes. Even though Bob is not licensed in Arizona, he is a doctor and you know he will do a good job.
B. Yes. The clinic operates under your name and you know Bob will call you with any problems.
C. No. Varicose vein removal is considered to be the practice of medicine and Bob is not licensed to practice medicine in Arizona.
D. No. The state where Bob is licensed may have different regulations for operating a laser clinic than Arizona and you can't be sure if Bob's clinic will
meet Arizona regulations.
Answer: C. No. Varicose vein removal is considered to be the practice of medicine and Bob is not licensed to perform medicine in Arizona.
A.R.S. 32-1401(27)(cc) states that it is unprofessional conduct to maintain a professional connection with or lend one's name to enhance or continue the
activities of an illegal practitioner of medicine.
4. False or Fraudulent Statements
Scenario: You are applying for privileges at a hospital and one of the questions asked of you is whether your license has ever been revoked or suspended.
Knowing that the hospital will likely deny you privileges if you answer affirmatively, you opt to knowingly withhold the fact that your license was previously
suspended over 15 years ago. Are your actions justified?
A. Yes. Because your suspension was so long ago, it is likely the hospital will never find out about it.
B. Yes. Ever since you got your license back, you have been a model physician and you have obeyed all laws.
C. No. The hospital will eventually find out and report you to the Board, resulting in more trouble.
D. No. It is never okay to make a false statement when applying for hospital privileges.
Answer: D. No. It is never okay to make a false statement when applying for hospital privileges.
A.R.S. 32-1401(27)(t) states that it is unprofessional conduct to knowingly make any false or fraudulent statement, written or oral, in connection with the
practice of medicine or if applying for privileges or renewing an application for privileges at a health care institution.
5. Financial Interest
Scenario: You are a pain specialist and many of the patients you see benefit from a combination of pain medication and other forms of therapy, such as
physical therapy. In addition to your pain clinic, you are also part owner of an outpatient physical therapy clinic. If you prescribe physical therapy at the clinic
where you are part owner, should you inform the patients that you have a direct financial interest in the clinic?
A. No. Your patients will receive good care at the physical therapy clinic and do not need to know.
B. No. The amount of money you receive from your ownership interest in the clinic is not enough to require you to inform your patients.
C. Yes. You should inform patients of your financial interest and let them know they can receive therapy elsewhere.
D. Yes. You should inform patients of your financial interest, but stress that they will receive the best therapy at your clinic.
Answer: C. Yes. You should inform patients of your financial interest and let them know they can receive therapy elsewhere.
A.R.S. 32-1401(27)(ff) states that it is unprofessional conduct to knowingly fail to disclose to a patient on a form that is prescribed by the board and that is
dated and signed by the patient or guardian acknowledging that the patient or guardian has read and understands that the doctor has a direct financial
interest in a separate diagnostic or treatment agency or in non-routine goods or services that the patient is being prescribed and if the prescribed treatment,
goods or services are available on a competitive basis. This subdivision does not apply to a referral by one doctor of medicine to another doctor of medicine
within a group of doctors of medicine practicing together. A "Notice To Patients" form can be downloaded off the Board's website.