Board of Medical Licensure and Discipline

The primary objectives of the Delaware Board of Medical Licensure and Discipline are to promote public health, safety and welfare and to protect the public from the unprofessional, improper, unauthorized, or unqualified practice of medicine and certain other healthcare professions. To meet these objectives, the Board:

• develops standards for professional competency,

• promulgates rules and regulations,

• adjudicates complaints against professionals and, when necessary, imposes disciplinary sanctions.

The Board issues physician (M.D. and D.O.) licenses and physician training licenses to residents, interns, fellows and house physicians (see figures 1-3).

Figure 1.

Active Medical Board Licenses by Type*, N=9,895 records across licenses

Figure 2.

Active Medical Board Licenses by Gender, select license types (when reported)

Figure 3.

Active Physician Licenses by Birth Year

The Board also issues for licenses these additional healthcare professions: physician assistants, respiratory care practitioners, acupuncture practitioners, acupuncture detoxification specialists, eastern medicine practitioners, genetic counselors, polysomnographers, midwifery practitioners and administrative medical. A Council for each of these healthcare professions advises and assists the Board on licensure and regulatory matters pertaining to its profession.

The Board also issues certifications to and has other responsibilities in regard to emergency medical technicians/paramedics in collaboration with the Office of Emergency Medical Services.

The Board’s statutory authority is in 24 Del. C., Chapter 17. Additional statutory provisions on the Board’s responsibilities in connection with emergency medical technicians/paramedics are in 16 Del. C., Chapter 97 and Chapter 98.

* an active license does not guarantee an individual is actively seeing patients.

* According to the Social Security Administration “Full retirement age is the age when you can start receiving your full retirement benefit amount. The full retirement age is 66 if you were born from 1943 to 1954. The full retirement age increases gradually if you were born from 1955 to 1960, until it reaches 67. For anyone born 1960 or later, full retirement benefits are payable at age 67.”

Physician

Physicians and surgeons diagnose and treat injuries or illnesses and address health maintenance.

Physicians and surgeons work in both clinical and nonclinical settings. Clinical settings include physicians’ offices and hospitals; nonclinical settings include government agencies, nonprofit organizations, and insurance companies.¹

There are two terminal degrees for physicians, Doctor of Osteopathic Medicine (D.O.) and Doctor of Medicine (M.D.) from the Latin Medicinae Doctor.

MDs are allopathic doctors. That means they treat and diagnose conditions using conventional medical tools like x-rays, prescription drugs, and surgery. Allopathic medicine is also called conventional or mainstream medicine see figure 4-5).

Figure 4.

Numerical Distribution of Active Physician - MD by ZIP code

Figure 5.

Visual Distribution of Active Physician - MD by ZIP code

Figure 5 shows most, but not all, ZIP codes due to scaling limitations. Hot spots are employed to bring perspective to viewing the overall map and distribution of healthcare professionals and should not be interpreted has valuing value without referring to the numbers listed in the chart above.

MDs can choose to be broad practitioners and work as family medicine or primary care doctors (see figures 6 & 7). They can also specialize in several different areas requiring further education (see figure 8) including:

Figure 6.

Numerical Distribution of Active Family Medicine Physicians by ZIP Code

Figure 7.

Visual Distribution of Active Family Medicine Physicians by ZIP code

Figure 8.

Physician Licenses by AAMC Specialty*

• Surgery,

• Organ System Specific Specialty,

• Psychiatry,

• Geriatric Medicine, and

• Pediatrics

Figure 7 shows most, but not all, ZIP codes due to scaling limitations. Hot spots are employed to bring perspective to viewing the overall map and distribution of healthcare professionals and should not be interpreted has valuing value without referring to the numbers listed in the chart above.

*At the time of data extraction, the DELPROS licensing system allowed for natural language submissions in the field “Specialty.” In over 1,600 instances no specialty was selected and those entries were researched. In the remaining records that did not have a listing which conformed to AAMC (Association of American Medical College) taxonomy, staff employed best reasoning possible in selecting an accurate category. This operation was overseen by a physician. Please see the following pages for the AAMC taxonomy detail with subspecialty information.

Future reports, pending adoption of a picklist system in DELPROS, will result in a more accurate number per specialty, and essential exercise to relate physician specialists to disease prevention and treatment.

DO stands for doctor of osteopathic medicine. They use the same conventional medical techniques as MDs but with a few other methods. DOs tend to focus more on holistic health and prevention. In holistic health, all parts of a person, including their mind, body, and emotions, are considered during the treatment. They also use a system of physical manipulations and adjustments to diagnose and treat people (see figures 9 & 10).

Figure 9.

Numerical Distribution of Active Physician - DO by ZIP code

Figure 10.

Visual Distribution of Active Physician - DO by ZIP code

Figure 10 shows most, but not all, ZIP codes due to scaling limitations. Hot spots are employed to bring perspective to viewing the overall map and distribution of healthcare professionals and should not be interpreted has valuing value without referring to the numbers listed in the chart above.

Over half of DOs choose to work in primary care, but they can also choose to specialize in another area, just like MDs. DOs have all the same responsibilities and rights as MDs, including the abilities to perform surgery with proper training and prescribe medicine.

How Are MDs and DOs Similar?

MDs and DOs follow similar educational routes. They must first earn a four-year undergraduate degree, and most will take pre-medicine courses during this time. After getting an undergraduate degree, they will attend either medical school or a college of osteopathic medicine.

After finishing four years of medical education, MDs and DOs must complete an internship and a residency. A residency is on-the-job training under the supervision of more experienced doctors. Some MDs and DOs will also go on to do fellowships to learn more about a specialty.

MDs and DOs often train side by side in residencies and internships, despite going to different types of schools.​

Both MDs and DOs must also take a licensing exam in order to practice medicine professionally.²

ACGME Training License - Physician Training Licensure (Residents, Interns, Fellows, House Physicians)

An ACGME training license is required for that part of the education which all physicians, regardless of degree type (D.O. or M.D.), go through after medical school to prepare them for fully independent practice. Another section of this report examines these types of trainings and the Delaware institutions at which they are offered (see figures 11 & 12).

Figure 11.

Numerical Distribution of Active ACGME Physicians by ZIP code

Figure 12.

Visual Distribution of Active ACGME Physicians by ZIP code

Figure 12 shows most, but not all, ZIP codes due to scaling limitations. Hot spots are employed to bring perspective to viewing the overall map and distribution of healthcare professionals and should not be interpreted has valuing value without referring to the numbers listed in the chart above.

Physicians are employed in an ACGME-approved institution located in Delaware and are:

• a Resident, Intern or Fellow registered in a training program outside of Delaware who will rotate through a program in Delaware for over one month, or

• employed as a House Physician.

For more information about Training licensure, see Section 4.0 of the Board’s Rules and Regulations.

Physician Assistant

Physician assistants practice medicine on teams with physicians, surgeons, and other healthcare workers (see figures 13 & 14). Physician assistants work in physicians’ offices, hospitals, outpatient clinics, and other healthcare settings. Most work full time.³

Figure 13.

Numerical Distribution of Active Physician Assistants by ZIP code

Figure 14.

Visual Distribution of Active Physician Assistants by ZIP code

Figure 14 shows most, but not all, ZIP codes due to scaling limitations. Hot spots are employed to bring perspective to viewing the overall map and distribution of healthcare professionals and should not be interpreted has valuing value without referring to the numbers listed in the chart above.

Administrative Medical

An Administrative Medical license allows physicians to use their medical and clinical knowledge, skill, and judgment only in an administrative capacity. These licensed cover physicians practicing administrative medicine and who do not provide any of the following medical or clinical services:

• examine, care for or treat patients;

• prescribe medications including controlled substances; or

• delegate medical acts or prescriptive authority to others

Respiratory Care Practitioner

Respiratory therapists care for patients who have trouble breathing—for example, because of a chronic condition such as asthma.

Most respiratory therapists work full time. Because they may work in medical facilities that are always open, such as hospitals, they may have shifts that include nights, weekends, or holidays.⁴

Acupuncture or Eastern Medicine Practitioner

• Acupuncture Practitioners have earned a Diplomate in Acupuncture from the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) or an equivalent organization.

• Eastern Medicine Practitioners have earned a Diplomate in Oriental Medicine from the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) or an equivalent organization. The Acupuncture Advisory Council may waive this Diplomate requirement under specific circumstances as outlined in 24 Del. C. §1798 (c).

Acupuncture/Oriental medicine (AOM) is an ancient and empirical system of medicine based on the concept of qi (pronounced “chee”), which is usually translated as energy.

AOM treatments identify a pattern of energetic imbalance within a patient and redress that disharmony through a variety of therapies that may include acupuncture needling, cupping, acupressure, exercises such as tai ji and qi gong and Chinese herbal preparations.

AOM is virtually free of the side effects that accompany many modern medical procedures. As a relatively inexpensive form of treatment, it is especially appropriate for reducing healthcare costs. The success of acupuncture today is due to its efficacy, remarkable safety record, cost-effectiveness and significant public demand.⁵

Acupuncture Detoxification Specialist

Individuals that have a current license or certificate, are in good standing in a healthcare related profession, are approved by the Acupuncture Advisory Council and the Medical Board are eligible for this additional level of specialization.⁶

The National Acupuncture Detoxification Association (NADA) protocol is a unique form of acupuncture. It specifically targets behavioral health, including addictions and co-occurring disorders. The protocol involves the bilateral insertion of 1Y5 needles into predetermined points on each ear (auricle).⁷

Genetic Counselor

Genetic counselors assess individual or family risk for a variety of inherited conditions, such as genetic disorders and birth defects.

Genetic counselors work in university medical centers, private and public hospitals, diagnostic laboratories, and physicians’ offices. They work with families, patients, and other medical professionals. Most genetic counselors work full time.

Genetic counseling requires an original or provisional license from the American Board of Genetic Counselors or the American Board of Medical Genetics and Genomics. Genetic counselors typically need a master’s degree in genetic counseling or genetics, along with board certification.⁸

Polysomnographer

A Polysomnographer is an allied health professional who performs overnight sleep assessments used to diagnose various sleep disorders. In the evening the patient will arrive at a sleep laboratory in a hospital, medical facility, or hotel. Increasingly, physicians are prescribing at-home sleep tests to ensure the patient’s comfort and to reduce cost. The polysomnographer will attach various electrodes used to record the patient’s brain activity and will then monitor the patient throughout the night.

Work environments include:⁹

• Hospitals

• Medical facilities

• Hotels

• Patients’ homes

Midwifery Practitioner

Midwifery encompasses the independent provision of care during pregnancy, childbirth, and the postpartum period; sexual and reproductive health; gynecologic health; and family planning services, including preconception care. ¹⁰

• Certified Professional Midwifes (CPM) receive certification by the North American Registry of Midwives (NARM) or its equivalent or successor.

• Certified Midwifes (CM) receive certification by the American Midwifery Certification Board (AMCB) or its equivalent or successor.