BEFORE THE GEORGIA COMPOSITE MEDICAL BOARD STATE OF GEORGIA 6E6,th amp?;er MEDICAL BOARD IN THE MATTER OF: MAY 2 0 2014 JACOB WARD, M.D., OCKET NUMBER License No. 32075, 1 Respondent. I 0 0 0 0 AMENDMENT TO PUBLIC CONSENT ORDER WHEREAS, on or about July 12, 2012, JACOB WARD, M.D. ("Respondent") entered into a Public Consent Order ("Order") with the Georgia Composite Medical Board (?Board?), Docket Number 10120006. The Order placed Respondent's license on a period of probation with terms and conditions. One of the terms restricted Respondent?s use of midlevel practitioners and provided that Respondent could petition to lift the restriction no sooner than three (3) months from the effective date of the Order; WHEREAS, on or about April 16, 2014, Respondent petitioned the Board to lift the restriction and allow him to supervise, delegate to, and/or have a collaborative practice with midlevel practitioners. The Board received letters supporting Respondent?s petition from his supervising and monitoring physicians; and NOW THEREFORE, the Board hereby amends the Public Consent Order as follows: 1. The restriction set forth in the Order, page 6, paragraph entitled "Use of Physician Assistant or Nurse Practitioner", shall be lifted. Page 1 of 2 2. Except as provided herein, Respondent?s license shall remain on a period of probation and subject to all of the remaining terms and conditions as set forth in the Public Consent Order of July 12, 2012. A violation of this Amendment to Public Consent Order shall be considered a violation of a lawful order of the Board as if it were a violation of the July 12, 2012 Public Consent Order. 3. This Amendment to Public Consent Order shall become effective upon its acceptance by the Georgia Composite Medical Board and its docketing by the Executive Director of the Georgia Composite Medical Board. Accepted this 20 day of A 3 2014. GEORGIA COMPOSITE MEDICAL BOARD BY: 4' RICHARD WEIL, M.D. Chairperson GHBS ut ve Director ATTEST: (BOARD SEAL) Page 2 of 2 BEFORE THE GEORGIA COMPOSITE MEDICAL BOARD GEORGIA COMPOSITE: STATE OF GEORGIA IN THE MATTER OF: JUL 1 2 22 JACOB WARD, M.D., - . . License No. 32075, Respondent. lg PUBLIC CONSENT ORDER - in By agreement of the Georgia Composite Medical Board (?Board?) and Jacob Ward, MD. (?Respondent?), the following disposition of the matter is entered into pursuant to the provisions of O.C.G.A. 50?13-13 (4), as amended. FINDINGS OF FACT Respondent is licensed to practice medicine in the State of Georgia and 1avas so licensed at all times relevant to the matters stated herein. 2+ In February 2007, two (2) female patients filed statements with the Woodstock Police Department alleging inappropriate touching during medical examinations Without a chaperone present. A Board agent met with Respondent concerning these allegations and advised Respondent of the requirement for a chaperone to be present during examinations of the breast and genitalia of patients. 3. In July 201 1, the Board required Respondent to obtain a mentall?physical examination at a Board approved facility based on allegations by a female patient that Respondent examined her without a chaperone present and touched her inappropriately. The examination results revealed concerns about Respondent?s behavior during examinations, and recommended professional sexual misconduct-specific treatment. 4. Respondent participated in Intensive Outpatient Treatment Program from March 12, 2012 to May 4, 2012. After treatment, several recommendations were made concerning Respondent?s practice, including that he abstain from performing anvbreast or pelvic exams and that he obtain a professional mentor in his same specialty with whom he can discuss problematic patients andfor his interactions with of?ce staff on a regular basis. Enrollment in an ongoing maintenance program was also recommended; Respondent has enrolled in Professional Sexual Misconduct Maintenance Treatment Program. 5. Respondent admits the above findings of fact and waives any further ?ndings of fact with respect to the above-styled matter. CONCLUSIONS OF LAW Respondent?s conduct constitute suf?cient grounds for the Board to exercise its disciplinary authority and impose sanctions upon ReSpondent?s license to practice medicine in the State of Georgia pursuant to O.C.G.A. Chs. 1 and 34, T. 43, _a_s amended. Respondent hereby waives any further conclusions of law with respect to the above?styled matter. mm The Georgia Composite Medical Board, having considered the particular facts and circumstances of the case, hereby orders, and Respondent hereby agrees, as follows: 1. Beginning on the effective date of this Order, Respondent?s license shall be placed on probation-until terminated by a written order of the Board, subject to the following terms and conditions: Maintenance Program. Respondent shall continue to participate in BMI's Professional Sexual Misconduct Maintenance Treatment Program or an equivalent maintenance pro gram approved by the Board, which shall include polygraph examinations every six (6) months. Respondent shall provide the Board with a copy of his maintenance contract upon execution- Respondent shall abide by all BMI guidelines. Failure of Respondent to comply with the maintenance program shall subject Respondent's license to summary suspension, pending further proceedings, or further disciplinary action. Participation in Support Group. On a weekly basis, Respondent shall attend meetings of a support group such as Caduceus Club or 12 Step group meetings for sexually compulsive behavior or similar support group acceptable to the Board and keep a record of his attendance. Upon request from the Board, Respondent shall provide his record of attendance to the Board. Supervision and Monitoring. Respondent shall designate an acceptable supervising (?supervising?) physician to supervise his work and with whom he can discuss problematic patients and! or his interactions with of?ce staff on a regular basis. Respondent shall also designate an acceptable treating (?monitoring?) physician with whom he will continue therapeutic care and who will monitor any medications prescribed to Respondent. ReSpondent shall provide a copy of this Order to both the supervising and the monitoring physicians. Within ten (10) days of the effective date of this Order Respondent shall submit or cause to be submitted written statements from his supervising and monitoring physicians to the Board stating he! she has read this Order and agrees to act as Respondent's supervising] monitoring physician. By executing this Consent Order, Respondent specifically consents to his supervising and monitoring physicians reporting upon Respondent?s condition or behavior, notwithstanding any privilege provided by state or federal law. Respondent shall obtain prio_r Board approval through the Medical Director for any change in supervising and monitoring physicians. Quarterly Reports. Respondent shall submit or cause to be submitted quarterly reports from his supervising and monitoring physicians by March 31, June 30, September . 30 and December 31 of each calendar year, beginning with the ?rst reporting period following the effective date of this Consent Order. Failure to submit or have such reports submitted in a timely manner shall be considered a violation of this Consent Order. It is expected that said supervising and monitoring physicians will communicate with each other and will immediately report to the Board any change in Respondent?s condition or behavior which would render Respondent unable to practice with reasonable skill and safety to patients. By executing this Consent Order, Respondent speci?cally consents to his supervising and monitoring physicians reporting upon Respondent?s condition or behavior, i notwithstanding any privilege provided by state or federal law. Work Restrictions. Chaperone. Respondent shall have a female chaperone present for the entire visit ot?ali female patients that he sees for consultation andfoerhysical examinations, whether the . patient is examined or not. Respondent shall provide a docketed copy of this Consent Order to the chaperone and shall submit or cause to be submitted a written statement from the chapercne to the Board stating she has read this Order in its entirety. Reapondent shall ensure that the chaperone signs the office note in the medical record in the lower right hand corner for each of?ce visit, indicating the chaperone was present for the entire visit. Any questions regarding Respondent?s compliance with this requirement should be directed to the Medical Director for the Board. (2) Practice Limitation. Respondent shall not perform any breast or pelvic examinations on female patients. Respondent shall refer such patients to their gynecologist or other appropriate medical provider. (3) Work Hours. Respondent shall work no more than forty (40) hours per calendar week including call. Respondent may petition the Board to lift this requirement after one (1) year from the effective date of this Order. Respondents petition shall contain letters of advocacy from his supervising and monitoring physicians. Any decision to further modify or lift this provision shall be in the discretion of the Board. Employee Af?davits. If deemed necessary by the Board or ReSpondent?s supervising andr'or monitoring physicians, the Board or the monitoring physician may facilitate the submission of employee affidavits concerning ReSpondent?s compliance with the terms of this Order andfor Respondent?s observed behavior with female patients. Staff Surveillance Forms. Respondent shall submit Staff Surveillance Forms concerning Respondent?s compliance with the terms of this Order andfor Respondent?s observed behavior with female patients at a frequency to be determined by Respondent's treating physician. Continuing Medical Education. In addition to the mandated continuing medical education required of ail Georgia physicians, Respondent shall obtain an additional 10 hours of continuing medical education each year of probation in the area of medical ethics. Respondent must obtain the additional 10 hours on an annual basis and shall submit prooT of completion of said additional hours to the board by December 31 of each year of the probation. Prior to obtaining the CME, Respondent shall submit the title of the course(s) he plans to attend and information concerning the course(s) to the Board. Use of Physician Assistant or Nurse Practitioner. During the probationary period, Respondent shall not employ, supervise, delegate to, or have a collaborative practice with any Physician Assistants or Nurse Praetitioners and respectively), including those associated with covering physicians. No sooner than three (3) months from the effective date of this Order, Respondent may petition the Board to lift this requirement. Respondent's petition shall contain letters of advocacy from his supervising and monitoring physicians. Any decision to further modify or lift this provision shall-be in the discretion of the Board. 0) Periods of Residency Outside Georgia and Periods When Not Actively Practicing Medicine. In the event Respondent should leave Georgia to reside or practice outside of Georgia for periods longer than thirty (30) consecutive days, Respondent shall notify the Board in writing of the dates of departure and return. Periods of residency or practice outside of Georgia as well as periods when Respondent is not actively engaged in practicing as a physician will not apply to the reduction of Respondent?s probationary period, except as authorized by the Board. Abide By Lavvs. Rules and Terms. Respondent shall abide by all State and Federal laws regulating his practice as a physician or relating to drugs, the Rules and Regulations of the Georgia Composite Medical Board and the terms of the Consent Order, outpatient treatment, and probation. If Respondent shall fail to abide by such laws, rules or i terms, or if it should appear from reports submitted to the Board that Respondent is otherwise unable to practice with reasonable skill and safety to patients, or should Respondent violate the criminal laws of the state, including any term of probation, if any, Respondent?s license shall be subject to further discipline, including revocation, upon substantiation thereof after notice and hearing, and if revoked, the Board in its discretion may determine that the license should be permanently revoked and not subject to reinstatement. Respondent further agrees that any violation of this Consent Order or the receipt by the Board of any complaint of sexual misconduct or boundary violations shall be deemed to be suf?cient to authorize the Board to order summary suspension of Respondent?s license, pending further proceedings, pursuant to the provisions of the Georgia Administrative Procedure Act, O.C.G.A. 50-13- or any other statute authorizing emergency action, but Respondent understands that Respondent shall be entitled to an espedited hearing to substantiate such violation(s), if the Board exercises such right. (1) Further Evaluation. At any time during the period of probation, the Board shall also have the authority to order Respondent to undergo a physical or mental evaluation by physicians designated by the Board. Respondent shall execute such releases as may be required for the Board to obtain the results of such evaluations. Employmentt Residency. Respondent shall advise the Board of any change in address of record or employment status within ten (10) days of making the change. Disclosure. In addition to other disclosures required by the Oonsent Order, Respondent shall supply a copy of the Consent Order, once approved and docketed, and within ten (10) days from-receipt of the docketed copy by Respondent, to each hospital or other institution in Georgia where Respondent maintains staff privileges of any kind, and to any physician with whom Respondent is associated in practice or to any person or entity for whom Respondent is employed as a physician in the State of Georgia. Respondent shall also be required to disclose the existence of and provide a copy of the Consent Order to such individuals or entities in connection with any future application for institutional appointment, associated practice, utilization of a physician assistant, or employment as a physician in the State of Georgia while the Consent Order is in effect. By executing the Consent Order, Respondent specifically consents to any such individuals or entities reporting to the Board information which would affect Respondent?s ability to practice medicine with reasonable skill and safety to patients, notwithstanding any privilege provided by state or federal law. Respondent shall document compliance with the condition of disclosure by submitting or causing to be submitted a statement from each individual or entity within 30 days of the effective date of this Order that hefshe has been provided with a copy of this Order. Termination of Probation. Respondent shall not be eligible to petition for termination of probation until five (5) years from the effective date of this Consent-Order. At such time, Respondent may petition for termination by certifying under oath before a notary public that he has complied with all conditions of probation and by providing documentation supporting discharge from probation, including, but not limited to, a written statement from Respondent?s supervising and monitoring physicians that hefshe agrees with terminating the probation period. The Georgia Composite'Medical Board shall review and evaluate the practice of Respondent prior to lifting the probation. At such time, the Board shall be authorized, but is not required, to terminate the probation period. If the Board denies the Respondent?s petition for termination of probation, Respondent may petition for termination of probation on an annual basis thereafter. In any event, the Consent Order shall remain in effect pending a ?nal determination by the Board and noti?cation that the probation period has terminated. 2. This Consent Order shall constitute a public reprimand of the Board of Respondent's conduct and may be disseminated by the Board as a public disciplinary action. 3. Approval of this Consent Order by the Georgia Composite Medical Board shall in no way be construed as condoning Respondent's conduct and shall not be construed as a waiver of any of the lawful rights possessed by the Board. The Board Specifically reserves the right to initiate and! or take further disciplinary action against Respondent's license if there is any subsequent criminal conviction concerning Respondent. In addition, the Board Speci?cally reserves the right to initiate andi?or take further disciplinary action for any other matters, pending investigation or otherwise, that do not involve the three (3) patients referenced in the ?ndings of fact in this Order. 4. Respondent understands that pursuant to O.C.G.A. Title 43, Chapter 34A, the contents of this order shall be placed on Respondent?s Physician Profile. Furthermore, by executing this Consent Order, Respondent hereby agrees to permit the Board to update the Physician?s Pro?le re?ecting this Consent Order. 5. Respondent acknowledges that he is represented by counsel and that he has read this Consent Order and understands its contents. Respondent understands that he has a right to a hearing, and freely, knowingly, and voluntarily waives that right. Respondent understands that the Consent Order will not become effective until approved and docketed by the Georgia Composite Medical Board. Respondent further understands and agrees that a representative of the Department of Law may be present during the presentation of the Consent Order to the Board and that the Board shall have the authority to review the investigative ?le and all relevant evidence in considering the Consent Order. Respondent further understands that the Consent Order, once approved, shall constitute a public record that may be disseminated. However, if the Consent Order is not approved, it shall not constitute an admission against interest in the proceeding, or prejudice the right of the Board to adjudicate the matter. ReSpondent consents to the terms and conditions contained herein. Approved, this day of( ,2012. GEORGIA COMPOSITE MEDICAL BOARD {3 BY: a I WILLIAM NEITHER, MD. Chai erson ?Kg .. if"? 2) ATTEST: 60C k?x C9 (EARN, HUGHES ?3 xe tive Director CONSENTED . Ht 10 ATTACHMENT A DISCLOSURE STATEMENT 1 have been provided with a copy of the Private Consent Order between JACOB WARD, MD. and the Georgia Composite Medical Board. My relationship to Dr. Ward is that of a Signature Print Name: Address: Telephone License Sworn to and subscribed before me The day of 20 NOTARY PUBLIC My commission expires: ll