2023 Laws of Puerto Rico › TITLE TWENTY - Examining Boards and Professional Colleges (§§ 1 — 6033) › Chapter 6 - Medical Discipline and Licensure Board Act (§§ 131 — 135j) › Subchapter IV - Discipline (§§ 134 — 134d) › § 134d - Incompetent physicians

The Board may restrict, suspend, revoke, or deny a medical license to any physician whom the Board has determined to be incompetent as the result of repetitive conduct of medical malpractice. These provisions shall be implemented or consistent with the following:
(a) Definitions.— The following terms shall have the meaning stated below:
(1) Competence.— Means to meet requirements as to ability and qualities (cognitive, non-cognitive and communicational) to effectively engage in the professional practice of medicine within its bounds, abiding by the ethical standards of the profession.
(2) Incompetence.— Means to fail to meet requirements as to ability and qualities (cognitive, non-cognitive and communicational) to effectively engage in the professional practice of medicine within its bounds.
(3) Evaluation program.— Means a formal system to evaluate the competence of physicians within the bounds of the professional practice of medicine.
(4) Remediation.— Means the process whereby the deficiencies as to the performance of a physician are defined and such deficiencies are identified and corrected by means of an evaluation program, to render the level of competence of a physician acceptable.
(b) The Board shall have the authority to develop and implement methods to identify incompetent physicians and physicians who fail to provide quality care. The Board shall start an investigation against any physician due to incompetence whenever it is notified of three (3) unfavorable judgments against such physician or of any combination of five (5) or more unfavorable judgments and settlements within a period of five (5) years due to medical malpractice against a licensed physician. The Board shall not consider a judgment or settlement as conclusive evidence of the professional competence or conduct of the physician. The Board shall also have authority to develop and implement methods to evaluate and improve the medical practice.
(c) The Board shall have access to an evaluation program approved by the entity and be under the obligation to evaluate the clinical competence of physicians.
(d) The Board shall have authority to require, in its discretion, that licensees and applicants for a license pass an evaluation of their medical competence conducted by an independent evaluating entity designated by the Board. [The] results of the evaluation shall be admissible in hearings before the Board, regardless of any counter-privilege lawsuit, rule or statute. Any person who receives a license or who applies for a license to practice medicine shall provide authorization to submit to any mental and physical examination or chemical dependency test and waive any objection to the admissibility of the results in any hearing before the Board. If a licensee or an applicant for a license to practice medicine fails to undergo the test when so instructed by the Board, unless failure to do so is due to reasons beyond his/her control, the Board is hereby allowed to enter a final order by means of proper notice, hearing and proof to contest, for the physician to submit to such examination.
(e) If the Board should find, after evaluation of the program, that a licensee or an applicant for a license is impeded from practicing medicine competently, the Board shall have authority to take one of the following measures:
(1) To suspend, revoke, or deny the medical license of the physician;
(2) to restrict or limit the practice of medicine only to those areas of competence, and/or
(3) to direct the licensee to complete a remediation program.
(f) Any licensee or applicant for a license who has been prohibited from practicing medicine under this chapter may, at reasonable intervals, have the opportunity to prove to the satisfaction of the Board that he/she is able to resume or begin the practice of medicine safely and with reasonable skill. A license shall not be reinstated, in any case, without paying the applicable fees and meeting all requirements, as if the applicant had not been previously prohibited from practicing.
(g) The Board shall have the authority to require the evaluation program established a written report of the results of the [evaluation] with recommendations to remedy or identify deficiencies.
(h) The Board shall have access to remedial medical education programs in order to refer physicians who need remediation. This program shall be approved by the Board and incorporated, and meet the standards established by the Board. During remediation, the program shall provide, at intervals to be determined by the Board, written reports on the progress of the physician. Upon completion of the remediation program, he/she shall render a written report to the Board retaking the remediation of areas previously identified as deficient. The Board shall order physicians to pass a post-remediation evaluation with the purpose of identifying the continually deficient areas. All expenses incurred as part of the evaluation and remediation shall be the sole responsibility of the physician.
History —Aug. 1, 2008, No. 139, § 30, eff. Jan 1, 2009; Apr. 8, 2011, No. 57, § 4.