# Title 43 — Occupations and Professions

## Chapter 43-17 — Physicians, Resident Physicians, and Physician Assistants

### § 43-17-01. Definitions.

As used in this chapter, unless the context or subject matter otherwise requires:
1. "Board" means the North Dakota board of medicine.
2. "Licensee" means a physician, resident physician, or physician assistant licensed to
practice in this state or a physician assistant privileged to practice in this state under
chapter 43-17.5.
3. "Physician" includes physician and surgeon (M.D.) and osteopathic physician and
surgeon (D.O.).
4. "Physician assistant" means an individual issued a physician assistant license under
this chapter or privileged to practice in this state under chapter 43-17.5.
5. "Practice of medicine" includes the practice of medicine, surgery, and obstetrics. The
following persons are regarded as practicing medicine:
a. A person that holds out to the public as being engaged within this state in the
diagnosis or treatment of diseases or injuries of human beings.
b. A person that suggests, recommends, or prescribes any form of treatment for the
intended relief or cure of any physical or mental ailment of any individual, with the
intention of receiving, directly or indirectly, any fee, gift, or compensation.
c. A person that maintains an office for the examination or treatment of individuals
afflicted with disease or injury of the body or mind.
d. A person that attaches the title M.D., surgeon, doctor, D.O., osteopathic physician
and surgeon, or any other similar word or words or abbreviation to the person's
name, indicating that the person is engaged in the treatment or diagnosis of the
diseases or injuries of human beings shall be held to be engaged in the practice
of medicine.
6. "Resident physician" means an individual issued a postgraduate training license under
this chapter.
7. "Telemedicine" means the practice of medicine using electronic communication,
information technologies, or other means between a licensee in one location and a
patient in another location, with or without an intervening health care provider.
"Telemedicine" includes direct interactive patient encounters, asynchronous
store-and-forward technologies, and remote monitoring.
### § 43-17-02. Persons exempt from the provisions of chapter.

The provisions of this chapter do not apply to the following:
1. The domestic administration of family remedies.
2. Dentists practicing their profession when properly licensed.
3. Optometrists practicing their profession when properly licensed.
4. The practice of christian science or other religious tenets or religious rules or
ceremonies as a form of religious worship, devotion, or healing, if the person
administering, making use of, assisting in, or prescribing, such religious worship,
devotion, or healing does not prescribe or administer drugs or medicines and does not
perform surgical or physical operations, and if the person does not hold out to be a
physician or surgeon.
5. Commissioned medical officers of the armed forces of the United States, the United
States public health service, and medical officers of the veterans administration of the
United States, in the discharge of their official duties, and licensed physicians from
other states or territories if called in consultation with a person licensed to practice
medicine in this state.
6. Doctors of chiropractic duly licensed to practice in this state pursuant to the statutes
regulating such profession.
7. Podiatrists practicing their profession when properly licensed.
8. A nurse practicing the nurse's profession when properly licensed by the North Dakota
board of nursing.

9. A naturopath duly licensed to practice in this state pursuant to the statutes regulating
such profession.
10. An individual duly licensed to practice medical imaging or radiation therapy in this state
under chapter 43-62.
11. An acupuncturist duly licensed to practice in this state pursuant to the statutes
regulating such profession.
### § 43-17-02.1. Physician assistant - Scope of practice.

1. An individual providing the services of a physician assistant under this chapter to a
patient located in this state shall possess an active North Dakota license for physician
assistant practice or be privileged to practice in this state under chapter 43-17.5. The
board shall adopt rules governing the conduct, licensure, fees for licensure and
privilege, qualifications, and discipline of physician assistants. Physician assistants are
not authorized to perform any services that must be performed by individuals licensed
under chapters 43-12.1, 43-13, 43-15, and 43-28 or services otherwise regulated by
licensing laws, notwithstanding medical doctors are not required to be licensed
specifically to perform the services contemplated under such chapters or licensing
laws.
2. A physician assistant may:
a. Provide a legal medical service for which a physician assistant is prepared by
education, training, and experience and is competent to perform, including:
(1) Obtaining and performing a comprehensive health history and physical
examination;
(2) Evaluating, diagnosing, managing, and providing medical treatment;
(3) Ordering and evaluating a diagnostic study and therapeutic procedure;
(4) Performing a diagnostic study or therapeutic procedure not involving the use
of medical imaging as defined in section 43-62-01 or radiation therapy as
defined in section 43-62-01;
(5) Performing limited sonography on a focused imaging target to assess
specific and limited information about a patient's medical condition or to
provide real-time visual guidance for another procedure;
(6) Educating a patient on health promotion and disease prevention;
(7) Providing consultation upon request; and
(8) Writing a medical order;
b. Obtain informed consent;
c. Supervise, delegate, and assign therapeutic and diagnostic measures not
involving the use of medical imaging as defined in section 43-62-01 or radiation
therapy as defined in section 43-62-01 to licensed or unlicensed personnel;
d. Certify the health or disability of a patient as required by any local, state, or
federal program;
e. Authenticate any document with the signature, certification, stamp, verification,
affidavit, or endorsement of the physician assistant if the document may be
authenticated by the signature, certification, stamp, verification, affidavit, or
endorsement of a physician; and
f. Pronounce death.
3. A physician assistant shall collaborate with, consult with, or refer to the appropriate
member of the health care team as indicated by the condition of the patient, the
education, experience, and competence of the physician assistant, and the standard of
care. The degree of collaboration must be determined at the practice which may
include decisions made by the employer, group, hospital service, and the credentialing
and privileging systems of a licensed facility. A physician assistant is responsible for
the care provided by that physician assistant and a written agreement relating to the
items in this chapter is not required.
4. A physician assistant:
a. May prescribe, dispense, administer, and procure drugs and medical devices;

b. May plan and initiate a therapeutic regimen that includes ordering and prescribing
nonpharmacological interventions, including durable medical equipment, nutrition,
blood and blood products, and diagnostic support services, including home health
care, hospice, and physical and occupational therapy;
c. May prescribe and dispense schedule II through V substances as designated by
the federal drug enforcement agency and all legend drugs;
d. May not dispense a drug, unless pharmacy services are not reasonably available,
dispensing is in the best interest of the patient, or an emergency exists;
e. May request, receive, and sign for a professional sample, and may distribute a
professional sample to a patient; and
f. If prescribing or dispensing a controlled substance, shall register with the federal
drug enforcement administration and shall comply with appropriate state and
federal laws.
5. A physician assistant shall practice at a licensed health care facility, facility with a
credentialing and privileging system, physician-owned facility or practice, or facility or
practice approved by the board.
6. Notwithstanding subsections 3 and 5, a physician assistant with less than four
thousand hours of practice approved by the board under subsection 5 shall execute a
written collaborative agreement that:
a. Is between a physician and a physician assistant with less than four thousand
hours practice;
b. Describes how collaboration required under subsection 3 must occur; and
c. Is available to the board on request.
7. A physician assistant shall comply with any privileging and credentialing systems at
the facility at which the physician assistant practices.
### § 43-17-02.2. Use of certain words or initials prohibited.

1. An individual may not use the title of "doctor of medicine", "medical doctor", "doctor of
osteopathic medicine", "osteopathic physician", "physician", "M.D.", or "D.O." unless
the individual is licensed as a physician or resident physician under this chapter.
2. An individual may not use the title of "physician assistant" or "P.A." unless the
individual is licensed as a physician assistant under this chapter or is privileged to
practice in this state under chapter 43-17.5.
3. This section may not be construed to prohibit a licensed health care professional from
using a title incorporating any of the words specified in subsection 1 or 2, or from using
a title or designation that is not specifically protected by subsection 1 or 2, if the title or
designation used is permitted under the health care professional's practice act.
4. Notwithstanding subsections 1 and 2, an individual who does not hold an active
physician, resident physician, or physician assistant license may still use the title
conferred by a qualified educational degree recognized under this chapter, but may not
practice unless licensed under this chapter or privileged to practice in this state under
chapter 43-17.5.
### § 43-17-02.3. Practice of medicine or osteopathy by holder of permanent, unrestricted

license - Exceptions.
The practice of medicine is deemed to occur in the state the patient is located. A practitioner
providing medical care to a patient located in this state is subject to the licensing and
disciplinary laws of this state and shall possess an active North Dakota license for the
practitioner's profession. Notwithstanding anything in this chapter to the contrary, any physician
who is the holder of a permanent, unrestricted license to practice medicine or osteopathy in any
state or territory of the United States, the District of Columbia, or a province of Canada may
practice medicine or osteopathy in this state without first obtaining a license from the North
Dakota board of medicine under one or more of the following circumstances:
1. As a member of an organ harvest team;
2. On board an air ambulance and as a part of its treatment team;

3. To provide one-time consultation on a diagnosis for a patient to a physician licensed in
the state, or teaching assistance for a period of not more than seven days;
4. To provide consultation or teaching assistance previously approved by the board for
charitable organizations; or
5. Under rules adopted by the board.
### § 43-17-02.4. Licensure exemption for certain physicians.

1. A physician licensed in good standing to practice in another state is exempt from the
licensure requirements of this chapter if the physician:
a. Has a written or oral agreement with a sports team to provide care to team
members and coaching staff traveling with the team for a specific sporting event
in this state; or
b. Has been invited by a national sport governing body to provide services to team
members and coaching staff at a national sport training center in this state or to
provide services at an event or competition in this state which is sanctioned by
the national sport governing body if:
(1) The physician's practice in this state is limited to the practice required by the
national sport governing body; and
(2) The services provided by the physician are within the physician's scope of
practice.
2. A physician exempt under this section may not:
a. Provide care or consultation to an individual residing in this state, other than an
individual specified in subsection 1; or
b. Practice at a licensed health care facility in this state.
3. An exemption under subdivision a of subsection 1 is valid while the physician is
traveling with the sports team. This exemption may not exceed ten days for each
sporting event. A physician may apply to the board to receive an exemption of twenty
additional days per sporting event.
4. The board may enter an agreement with a medical and osteopathic licensing board of
another state to implement this section. An agreement may include a procedure for
reporting a potential medical license violation.
5. The board may adopt rules to implement this section.
### § 43-17-02.5. Licensure for resident physicians.

Resident physicians of medicine or osteopathy who are continuing their training and
performing the duties of a resident in a hospital or institution maintained and operated by the
state, an agency of the federal government, or a residency program accredited by the
accreditation council on graduate medical education will be required to possess an active North
Dakota residency license. The board shall adopt rules relating to the licensure, fees,
qualifications, activities, scope of practice, and discipline of such individuals.
### § 43-17-03. North Dakota board of medicine - How appointed - Qualifications.

1. The governor shall appoint a North Dakota board of medicine consisting of fifteen
members; ten physicians, nine of whom are doctors of medicine and one of whom is a
doctor of osteopathy; two physician assistants; one naturopath; and two public
members. If no osteopathic physician is qualified and willing to serve, any qualified
physician may be appointed in place of the osteopathic physician.
2. Each physician member must:
a. Be a practicing physician of integrity and ability.
b. Be a resident of and duly licensed to practice medicine in this state.
c. Be a graduate of a medical or osteopathic school of high educational
requirements and standing.
d. Have been engaged in the active practice of the physician's profession within this
state for a period of at least five years.
3. Each public member of the board must:

a. Be a resident of this state.
b. Be at least twenty-one years of age.
c. Not be affiliated with any group or profession that provides or regulates health
care in any form.
4. Each physician assistant member of the board must:
a. Be a practicing physician assistant of integrity and ability.
b. Be a resident of and be duly licensed to practice as a physician assistant in this
state.
c. Have been engaged in the active practice as a physician assistant within this
state for a period of at least five years.
5. The naturopath member must:
a. Be a practicing naturopath of integrity and ability.
b. Be a resident of and duly licensed to practice as a naturopath in this state.
c. Have been engaged in the active practice as a naturopath within this state for a
period of at least five years.
6. An individual appointed to the board shall qualify by taking the oath required of civil
officers.
### § 43-17-04. Term of office.

The term of office of each member of the board is four years and until a successor is
appointed and qualified. The terms must be so arranged that no more than four terms expire on
the thirty-first of July of each year. The governor shall fill all vacancies by appointment but in
case of a vacancy before the expiration of a term, the appointment must be for the residue of
the term only. The board, at least six months in advance of filling an expired term, shall
communicate with the governor's office regarding specialty areas to be filled on the board. The
governor's office shall take this information into consideration when filling vacancies. No
member of the board may serve thereon for more than two full terms.
### § 43-17-05. Removal of members of North Dakota board of medicine - Re-election.

1. The governor for good cause shown and upon the recommendation of three-fourths of
the members of the North Dakota board of medicine may remove any member of such
board for misconduct, incapacity, or neglect of duty.
2. If a member of the board is consistently absent from board or committee meetings, the
board may declare a vacancy. Vacancies on the board must be filled by appointment
by the governor.
### § 43-17-06. Officers of the board and executive director.

The board shall elect a president and vice president from its own number and employ an
executive director to provide administrative services to the board.
### § 43-17-07. Meetings of the board.

The board shall hold at least three meetings in each calendar year and may call such
special meetings as may be necessary. The meetings must be held at such places as the board
may designate.
### § 43-17-07.1. Powers of the board of medicine.

In addition to any other powers, the board may:
1. Employ or contract with one or more organizations or agencies known to provide
acceptable examinations for the preparation and scoring of required examinations
relating to physician licensure, and employ or contract with one or more organizations
or agencies known to provide acceptable examination services for the administration
of the required examination.
2. Prescribe the time, place, method, manner, scope, and subject of examination.
3. Impose sanctions, deny licensure, levy fines, or seek appropriate civil or criminal
penalties against anyone who violates or attempts to violate examination security,

anyone who obtains or attempts to obtain licensure by fraud or deception, and anyone
who knowingly assists in that type of activity.
4. Require information on an applicant's or licensee's fitness, qualifications, and previous
professional record and performance from recognized data sources, including the
federation of state medical boards action data bank, other data repositories, licensing
and disciplinary authorities of other jurisdictions, professional education and training
institutions, liability insurers, health care institutions, and law enforcement agencies be
reported to the board. The board or its investigative panels may require an applicant
for licensure or a licensee who is the subject of a disciplinary investigation to submit to
a statewide and nationwide criminal history record check. The nationwide criminal
history record check must be conducted in the manner provided by section 12-60-24.
All costs associated with the criminal history record check are the responsibility of the
licensee or applicant.
5. Require the self-reporting by an applicant or a licensee of any information the board
determines may indicate possible deficiencies in practice, performance, fitness, or
qualifications.
6. Establish a mechanism for dealing with a licensee who abuses or is dependent upon
or addicted to alcohol or other addictive chemical substances, to enter an agreement,
at its discretion, with a professional organization whose relevant procedures and
techniques it has evaluated and approved for the organization's cooperation or
participation.
7. Issue a cease and desist order, obtain a court order, or an injunction to halt unlicensed
practice, a violation of this chapter, or a violation of the rules of the board.
8. Issue a conditional, restricted, or otherwise circumscribed license as it determines
necessary.
9. Utilize board funds and resources for promotion, education, and outreach services for
the professions and students of the professions licensed under this chapter.
10. Adopt rules to implement this chapter.
### § 43-17-07.2. Conflict of interest.

A member of the board, acting in that capacity or as a member of any committee of the
board, may not participate in the making of any decision or the taking of any action affecting that
member's personal, professional, or pecuniary interest, or that of a known relative or business
or professional associate.
### § 43-17-08. Power of board to administer oaths - Summon witnesses - Take testimony.

Repealed by S.L. 1987, ch. 525, § 13.
### § 43-17-09. Subpoena - How to issue - Fees - Service.

Repealed by S.L. 1987, ch. 525, § 13.
### § 43-17-10. Failure to appear or testify - Penalty.

Repealed by S.L. 1987, ch. 525, § 13.
### § 43-17-11. Records of board - License applications - Preservation.

The board shall keep a record of all of its proceedings and applications for license. Failure
of an applicant to submit a completed application within one year is grounds to discontinue
processing the application, and records will be disposed of unless otherwise approved by the
chairman and executive director for good cause.
### § 43-17-12. Biennial report.

The board may submit a biennial report to the governor and the secretary of state in
accordance with section 54-06-04.

### § 43-17-13. Board to adopt rules and regulations.

Repealed by S.L. 1987, ch. 525, § 13.
### § 43-17-14. Compensation - Expenses of board and the members thereof.

1. A member of the board shall receive for each day during which the member actually is
engaged in the performance of the duties of the member's office such per diem as
must be fixed by the board and as provided in sections 44-08-04 and 54-06-09.
2. The executive director of the board shall receive such salary or other compensation,
and such allowance for clerical and other expenses of the board as the board shall
determine.
3. The board may employ staff to carry out the duties under this chapter.
### § 43-17-15. Fees deposited with state treasurer - Separate fund - Vouchers.

Repealed by S.L. 1971, ch. 510, § 15.
### § 43-17-16. License required.

Repealed by S.L. 1987, ch. 525, § 13.
### § 43-17-17. Application for license.

In order to obtain a license to practice medicine in this state, an application must be made
to the board through the executive director. The application must be upon the form adopted by
the board and must be made in the manner prescribed by it.
### § 43-17-18. Physician license requirements.

1. General. Every applicant for licensure shall file a written application, on forms provided
by the board, showing to the board's satisfaction that the applicant satisfies all of the
requirements of this chapter including:
a. Successful completion of a medical licensure examination satisfactory to the
board;
b. Physical, mental, and professional capability for the practice of medicine in a
manner acceptable to the board; and
c. A history free of any finding by the board, any other state medical licensure
board, or any court of competent jurisdiction, of the commission of any act that
would constitute grounds for disciplinary action under this chapter; the board may
modify this restriction for cause.
2. Graduates of United States and Canadian schools.
a. An applicant who is a graduate of an approved medical or osteopathic school
located in the United States, its possessions, territories, or Canada, shall present
evidence, satisfactory to the board, that the applicant has been awarded a degree
of doctor of medicine or doctor of osteopathy from a medical school located in the
United States, its possessions, territories, or Canada, approved by the board or
by an accrediting body approved by the board at the time the degree was
conferred.
b. An applicant who is a graduate of an approved medical or osteopathic school
located in the United States, its possessions, territories, or Canada, must present
evidence, satisfactory to the board, that the applicant has successfully completed
one year of postgraduate training in the United States or Canada in a program
approved by the board or by an accrediting body approved by the board.
3. Graduates of international schools.
a. An applicant who is a graduate of a medical school not located in the United
States, its possessions, territories, or Canada, shall present evidence,
satisfactory to the board, that the applicant possesses the degree of doctor of
medicine or a board-approved equivalent based on satisfactory completion of
educational programs acceptable to the board. Graduates of osteopathic schools
located outside the United States are not eligible for licensure.

b. An applicant who has graduated from a medical school not located in the United
States, its possessions, territories, or Canada, must present evidence,
satisfactory to the board, that the applicant has successfully completed twenty-
four months of postgraduate training in a program located in the United States, its
possessions, territories, or Canada, and accredited by a national accrediting
organization approved by the board or other graduate training approved in
advance by the board as meeting standards similar to those of a national
accrediting organization. However, if such an applicant has not completed thirty
months of postgraduate training in a program approved by the board or by an
accrediting body approved by the board, but has met all other licensing
requirements and has successfully completed one year of postgraduate training
in the United States or Canada in a program approved by the board, and if the
board finds that the applicant has other professional experience and training that
is substantially equivalent to the last eighteen months of postgraduate training,
then the applicant may be deemed eligible for licensure. The board is granted
broad discretion in determining whether to apply this exception to the normal
licensing requirements. An applicant seeking licensure under this exception must
present evidence satisfactory to the board that:
(1) The applicant is certified by a specialty board recognized by the American
board of medical specialties or by a specialty board recognized by the royal
college of physicians and surgeons of Canada; or
(2) The applicant has passed the special purpose examination developed by
the federation of state medical boards of the United States.
c. The applicant shall present evidence satisfactory to the board that the applicant
has been awarded a certificate by the educational council for foreign medical
graduates. The board may adopt rules establishing specific exceptions to this
requirement.
d. The applicant has a working ability in the English language sufficient to
communicate with patients and physicians and to engage in the practice of
medicine.
4. Uniquely qualified license. The board may issue a medical license to an applicant who
does not meet all the technical eligibility requirements if the board determines the
applicant is uniquely qualified through training or experience or will make a unique or
special contribution to the practice of medicine not readily available to the citizens of
the state. The board shall adopt rules for qualifications and factors to be considered
under this subsection.
5. An applicant may require an interview before the board for such examination into the
applicant's qualifications. The board may adopt rules to issue provisional and
temporary licenses to be in effect in the interval between board meetings.
### § 43-17-19. License granted without examination upon qualification of applicant.

Repealed by S.L. 1957, ch. 302, § 16.
### § 43-17-20. Examinations - How conducted - Subjects.

Repealed by S.L. 1987, ch. 525, § 13.
### § 43-17-21. License granted without examination to persons licensed in other states.

Repealed by S.L. 2023, ch. 382, § 34.
### § 43-17-22. License - Fees.

Repealed by S.L. 1987, ch. 525, § 13.
### § 43-17-23. Licenses to be recorded.

Repealed by S.L. 1983, ch. 479, § 3.

### § 43-17-24. Physicians licensure with the board.

1. An applicant shall file with the executive director of the board a completed application
and shall pay to the executive director the application fee. No person may engage in
the practice of medicine in this state without a current license issued by the board.
2. Each licensee shall maintain a permanent electronic mail or mailing address with the
board to which all communications from the board to the licensee will be sent. A
licensee who changes the individual's electronic mail or mailing address shall notify
the board in writing of the new contact information within sixty days.
3. If a licensee fails to notify the board in writing of the changes as required by this
section after sixty days, the board may impose upon the licensee a fee not to exceed
one hundred dollars and may initiate disciplinary action against the licensee.
### § 43-17-25. Application fee.

The fee for any individual seeking licensure or renewal in the state must be fixed by
regulation of the board. All fees must be paid to and held by the executive director of the board
and are subject to disbursement by the board in performing its duties.
### § 43-17-26. Annual license issued - License posted.

Repealed by S.L. 1987, ch. 525, § 13.
### § 43-17-26.1. Physician license renewals - Late fees.

A physician seeking to renew the physician's license who has failed to complete the renewal
application within the time specified by the board must be assessed a fee up to three times the
normal licensure fee, in addition to such other penalties as are authorized by law, if that
physician is found to have been practicing medicine in this state after the physician's license
expired. A physician who is not found to have been practicing medicine in this state may renew
a license upon payment of the arrearage and meeting the other requirements of the board.
However, a physician whose license lapsed more than three years before that physician
petitioned the board for reinstatement must submit a new application for licensure, whether or
not that physician has practiced medicine in this state since the physician's license was last
current.
### § 43-17-27. Board to make rules and regulations as to registration statement - Keep

record of persons paying fee.
Repealed by S.L. 1987, ch. 525, § 13.
### § 43-17-27.1. Physician continuing education requirements.

1. The board shall promote a high degree of competence in the practice of medicine by
establishing rules requiring every physician licensed in the state to fulfill continuing
education requirements. Compliance with these rules must be documented at such
times and in such manner as is required by the board. Physicians failing to comply
with continuing education requirements in the time and manner specified by rule of the
board will be assessed a fee up to three times the licensure fee, in addition to such
other penalties as are authorized by law.
2. The board shall require physicians to complete a minimum of one hour of continuing
education on nutrition and metabolic health each renewal cycle.
3. Before a license may be renewed, the physician shall submit evidence to the board
establishing that all continuing education requirements prescribed by the rules adopted
by the board have been met.
4. The board may accept current certification, maintenance of certification, or
recertification by a member of the American board of medical specialties, the American
osteopathic association, or the royal college of physician and surgeons of Canada in
lieu of compliance with continuing education requirements.
5. The board may exempt a physician from the requirements of this section in
accordance with rules adopted by the board.

6. Notwithstanding subsection 1, if an individual fails to file a timely response, the board
may determine whether the individual's failure to file a timely response to an audit
constitutes an admission of noncompliance with this section and whether the
individual's license should be subject to action by the board. If the board determines
that the individual's failure to file a timely response is an admission of noncompliance
and that the individual's license should be subject to action by the board, the board
shall hold a hearing in accordance with chapter 28-32 to take any appropriate action.
7. The board shall provide access on the board's website to an instructional course on
chapters 12.1-19.1, 14-02.1, and 14-02.6 as the chapters relate to the practice of
medicine. The instructional course must be developed by contract through the office of
management and budget, in consultation with and with final approval from the attorney
general. This section does not create a right of action against the board by a physician
acting upon reliance of the instructional course. The instructional course must be
updated periodically to accurately reflect state law.
### § 43-17-27.2. Record retention requirements.

1. A licensee shall retain all medical records, unless otherwise appropriately transferred
to another licensee or entity, for at least seven years from the last date of service for
each patient, except as otherwise required by law.
2. The board may adopt rules to implement record retention and requirements for
transfer of medical records for situations in which the licensee sells the licensee's
medical practice, departs from the medical practice, or upon licensee death,
incapacity, or retirement.
### § 43-17-28. When fee remitted to licensee.

Repealed by S.L. 1987, ch. 525, § 13.
### § 43-17-29. Practitioners not registered prohibited from practicing - Revocation of

license.
Repealed by S.L. 1987, ch. 525, § 13.
### § 43-17-30. Payment of delinquent registration fee - Reinstatement.

Repealed by S.L. 2023, ch. 382, § 34.
### § 43-17-30.1. Disciplinary action.

The board is authorized to take disciplinary action against a licensed physician by any one
or more of the following means, as it may find appropriate:
1. Revocation of license.
2. Suspension of license.
3. Probation.
4. Imposition of stipulations, limitations, or conditions relating to the practice of medicine.
5. Letter of censure.
6. Require the licensee to provide free public or charitable service for a defined period.
7. Impose fines, not to exceed five thousand dollars for any single disciplinary action. Any
fines collected by the North Dakota board of medicine must be deposited in the state
general fund.
### § 43-17-31. Grounds for disciplinary action.

1. Disciplinary action may be imposed against a physician upon any of the following
grounds:
a. The use of any false, fraudulent, or forged statement or document, or the use of
any fraudulent, deceitful, dishonest, or immoral practice, in connection with any of
the licensing requirements.
b. The making of false or misleading statements about the physician's skill or the
efficacy of any medicine, treatment, or remedy.

c. The conviction of any misdemeanor determined by the board to have a direct
bearing upon a person's ability to serve the public as a practitioner of medicine or
any felony. A license may not be withheld contrary to the provisions of
chapter 12.1-33.
d. Use of alcohol or drugs to such a degree as to interfere with the licensee's ability
to safely practice medicine.
e. Physical or mental disability materially affecting the ability to perform the duties of
a physician in a competent manner.
f. The performance of any dishonorable, unethical, or unprofessional conduct likely
to deceive, defraud, or harm the public.
g. Obtaining any fee by fraud, deceit, or misrepresentation.
h. Aiding or abetting the practice of medicine by an unlicensed, incompetent, or
impaired person.
i. The violation of any provision of a medical practice act or the rules and
regulations of the board, or any action, stipulation, condition, or agreement
imposed by the board or its investigative panels.
j. The practice of medicine under a false or assumed name.
k. The advertising for the practice of medicine in an untrue or deceptive manner.
l. The representation to a patient that a manifestly incurable condition, sickness,
disease, or injury can be cured.
m. The willful or negligent violation of the confidentiality between physician and
patient, except as required by law.
n. The failure of a doctor of osteopathy to designate that person's school of practice
in the professional use of that person's name by such terms as "osteopathic
physician and surgeon", "doctor of osteopathy", "D.O.", or similar terms.
o. Gross negligence in the practice of medicine.
p. Sexual abuse, misconduct, or exploitation related to the licensee's practice of
medicine.
q. The prescription, sale, administration, distribution, or gift of any drug legally
classified as a controlled substance or as an addictive or dangerous drug for
other than medically accepted therapeutic purposes.
r. The payment or receipt, directly or indirectly, of any fee, commission, rebate, or
other compensation for medical services not actually or personally rendered, or
for patient referrals; this prohibition does not affect the lawful distributions of
professional partnerships, corporations, limited liability companies, or
associations.
s. The failure to comply with the reporting requirements of section 43-17.1-05.1.
t. The failure to transfer medical records to another physician or to supply copies of
those records to the patient or to the patient's representative when requested to
do so by the patient or the patient's designated representative, except if the
disclosure is otherwise limited or prohibited by law. A reasonable charge for
record copies may be assessed.
u. A continued pattern of inappropriate care as a physician, including unnecessary
surgery.
v. The use of any false, fraudulent, or deceptive statement in any document
connected with the practice of medicine.
w. The prescribing, selling, administering, distributing, or giving to oneself or to one's
spouse or child any drug legally classified as a controlled substance or
recognized as an addictive or dangerous drug.
x. The violation of any state or federal statute or regulation relating to controlled
substances.
y. The imposition by another state or jurisdiction of disciplinary action against a
license or other authorization to practice medicine based upon acts or conduct by
the physician that would constitute grounds for disciplinary action as set forth in
this section. A certified copy of the record of the action taken by the other state or
jurisdiction is conclusive evidence of that action.

z. The lack of appropriate documentation in medical records for diagnosis, testing,
and treatment of patients.
aa. The failure to furnish the board or the investigative panel, their investigators, or
representatives information legally requested by the board or the investigative
panel.
bb. Noncompliance with the physician health program established under chapter
43-17.3.
2. The board shall keep a record of all of its proceedings in the matter of suspending,
revoking, or refusing licenses together with the evidence offered.
### § 43-17-31.1. Costs of prosecution - Disciplinary proceedings.

In any order or decision issued by the board in resolution of a disciplinary proceeding in
which disciplinary action is imposed against a physician or physician assistant, the board may
direct any physician or physician assistant to pay the board a sum not to exceed the reasonable
and actual costs, including reasonable attorney's fees, incurred by the board and investigative
panels of the board in the investigation and prosecution of the case. If applicable, the
physician's or physician assistant's license may be suspended until the costs are paid to the
board. A physician or physician assistant may challenge the reasonableness of any cost item in
a hearing under chapter 28-32 before an administrative law judge. The administrative law judge
may approve, deny, or modify any cost item, and the determination of the judge is final. The
hearing must occur before the physician's license or physician assistant's license may be
suspended for nonpayment.
### § 43-17-31.2. Limitations on disciplinary actions.

The board may not take disciplinary action against a licensee based solely on the licensee
prescribing or dispensing ivermectin for the off-label treatment or prevention of severe acute
respiratory syndrome coronavirus 2 identified as SARS-CoV-2, or any mutation or viral
fragments of SARS-CoV-2. This section does not limit the board from taking a disciplinary action
on another basis, such as unlicensed practice, inappropriate documentation, or substandard
care, or any basis that would in the board's determination harm the patient.
### § 43-17-32. Appeal from decision of board refusing, suspending, or revoking a license.

Repealed by S.L. 1987, ch. 525, § 13.
### § 43-17-32.1. Temporary suspension - Appeal.

1. When, based on verified evidence, the board determines by a clear and convincing
standard that the evidence presented to the board indicates that the continued practice
by the licensee would create a significant risk of serious and ongoing harm to the
public while a disciplinary proceeding is pending, and that immediate suspension of
the license is required to reasonably protect the public from that risk of harm, the
board may order a temporary suspension ex parte. For purposes of this section,
"verified evidence" means testimony taken under oath and based on personal
knowledge. The board shall give prompt written notice of the suspension to the
licensee, which must include a copy of the order and complaint, the date set for a full
hearing, and a specific description of the nature of the evidence, including a list of all
known witnesses and a description of any documents relied upon by the board in
ordering the temporary suspension which, upon request, must be made available to
the licensee.
2. An ex parte temporary suspension remains in effect until a final order is issued after a
full hearing or appeal under this section or until the suspension is otherwise terminated
by the board.
3. The board shall conduct a hearing on the merits of the allegations to determine what
disciplinary action, if any, shall be taken against the licensee who is the subject of the
ex parte suspension. That hearing must be held not later than thirty days from the
issuance of the ex parte temporary suspension order. The licensee is entitled to a

continuance of the thirty-day period upon request for a period determined by the
hearing officer.
4. The licensee may appeal the ex parte temporary suspension order prior to the full
hearing. For purposes of appeal, the district court shall decide whether the board
acted reasonably or arbitrarily. The court shall give priority to the appeal for prompt
disposition thereof.
5. Any medical record of a patient, or other document containing personal information
about a patient, which is obtained by the board is a confidential record as defined in
section 44-04-17.1.
### § 43-17-33. Use of fraudulent device in obtaining a license - Fraudulent impersonation

of physician - Penalty.
Repealed by S.L. 1987, ch. 525, § 13.
### § 43-17-34. Practicing without a license - Violation of chapter - Penalty.

Any person who practices medicine in this state without complying with the provisions of
this chapter, and any person who violates any of the provisions of this chapter for which another
penalty is not specified is guilty of a class B misdemeanor. In addition to the criminal penalties
provided, the civil remedy of injunction is available to restrain and enjoin violations of any
provisions of this chapter without proof of actual damages sustained by any person.
### § 43-17-35. Enforcement of chapter - Duty of secretary-treasurer.

Repealed by S.L. 1987, ch. 525, § 13.
### § 43-17-36. Physician practicing medicine while intoxicated.

Repealed by S.L. 1987, ch. 525, § 13.
### § 43-17-37. Emergency treatment by resident licensee.

Any individual licensed under the provisions of this chapter who in good faith renders in this
state emergency care at the scene of the emergency is expected to render only such
emergency care as in the individual's judgment is at the time indicated.
### § 43-17-38. Emergency treatment by nonresident licensee.

Any individual duly licensed to practice in another state of the United States who renders in
this state emergency care at the scene of the emergency may only be held to the degree of care
as specified in section 43-17-37, and may not be deemed to be practicing medicine within this
state as contemplated by this chapter.
### § 43-17-39. Qualified doctors of osteopathy may be licensed.

Repealed by S.L. 1987, ch. 525, § 13.
### § 43-17-40. Limitation of liability - Legislative intent.

No physician, surgeon, hospital, blood bank, tissue bank, or other person or entity who
donates, obtains, prepares, transplants, injects, transfuses, or otherwise transfers, or who
assists or participates in obtaining, preparing, transplanting, injecting, transfusing, or transferring
any tissue, organ, blood, or component thereof from one or more human beings, living or dead,
to another human being, may be liable as the result of any such activity, save and except that
each such person or entity remains liable for the person's or entity's own negligence or willful
misconduct only.
The availability of scientific knowledge, skills, and materials for the transplantation, injection,
transfusion, or transfer of human tissue, organs, blood, and components thereof is important to
the health and welfare of the people of this state. The imposition of legal liability without fault
upon the persons and organizations engaged in such scientific procedures inhibits the exercise
of sound medical judgment and restricts the availability of important scientific knowledge, skills,
and materials. It is therefore the public policy of this state to promote the health and welfare of

the people by limiting the legal liability arising out of such scientific procedures to instances of
negligence or willful misconduct.
### § 43-17-41. Duty of physicians and others to report injury - Penalty.

1. Any physician, physician assistant, naturopath licensed under chapter 43-58,
acupuncturist licensed under chapter 43-61, or any individual licensed under
chapter 43-12.1 who performs any diagnosis or treatment for any individual suffering
from any wound, injury, or other physical trauma:
a. Inflicted by the individual's own act or by the act of another by means of a knife,
gun, or pistol shall as soon as practicable report the wound, injury, or trauma to a
law enforcement agency in the county in which the care was rendered; or
b. Which the individual performing diagnosis or treatment has reasonable cause to
suspect was inflicted in violation of any criminal law of this state, shall as soon as
practicable report the wound, injury, or trauma to a law enforcement agency in the
county in which the care was rendered.
2. The report under subsection 1 must state the name of the injured individual and the
character and extent of the individual's injuries, except when the individual's physical
injury is the result of a sexual offense, as defined in chapter 12.1-20, in which case the
individual's name, address, and any identifying information may not be included in the
report without the individual's written release.
3. When a report of domestic violence, as defined in section 14-07.1-01, or a report of
physical injury resulting from a sexual offense, as defined in chapter 12.1-20, is made
to a law enforcement agency as required by this section, the injured individual must be
provided with information regarding a domestic violence sexual assault organization as
defined in section 14-07.1-01 or other victims' assistance program by the physician,
physician assistant, naturopath, acupuncturist licensed under chapter 43-61, or any
individual licensed under chapter 43-12.1, unless it is known that the information has
previously been provided to the injured individual.
4. The reports mandated by this section must be made as soon as practicable and may
be either oral or in writing. Oral reports must be followed by written reports within
forty-eight hours if so requested by the sheriff or state's attorney to whom the oral
report is originally made.
5. Any individual required to report as provided by this section who willfully fails to do so
is guilty of an infraction.
6. Any individual making or not making a report in good faith pursuant to this section is
immune from liability for making or not making a report.
7. Reports made under this section are exempt records as defined by section 44-04-17.1.
### § 43-17-42. Employment of physicians by hospitals, nonprofit entities, and charitable

trusts.
Notwithstanding any other provision of law, a hospital licensed under chapter 23-16,
nonprofit entity, or charitable trust may employ directly or indirectly a physician if the
employment relationship between the physician and hospital, nonprofit entity, or charitable trust
is evidenced by a written contract. The written contract must contain language to the effect the
employment relationship with the physician may not affect the exercise of the physician's
independent judgment in the practice of medicine, and the physician's independent judgment in
the practice of medicine is in fact unaffected by the physician's employment relationship with the
hospital, nonprofit entity, or charitable trust. Under this section the hospital, nonprofit entity, or
charitable trust is not engaged in the practice of medicine.
### § 43-17-43. Topical fluoride varnish.

A licensee may apply topical fluoride varnish to an individual in accordance with rules
adopted by the board.

### § 43-17-44. Standard of care and professional ethics.

A licensee is held to the same standard of care and same ethical standards, whether
practicing traditional in-person medicine or telemedicine. The following apply in the context of
telemedicine:
1. Professional ethical standards require a practitioner to practice only in areas in which
the practitioner has demonstrated competence, based on the practitioner's training,
ability, and experience. In assessing a licensee's compliance with this ethical
requirement, the board shall give consideration to board certifications and specialty
groups' telemedicine standards.
2. A licensee practicing telemedicine shall establish a bona fide relationship with the
patient before the diagnosis or treatment of a patient. A licensee practicing
telemedicine shall verify the identity of the patient seeking care and shall disclose, and
ensure the patient has the ability to verify, the identity and licensure status of any
licensee providing medical services to the patient.
3. Before initially diagnosing or treating a patient for a specific illness or condition, an
examination or evaluation must be performed. An examination or evaluation may be
performed entirely through telemedicine, if the examination or evaluation is equivalent
to an in-person examination.
a. An examination utilizing secure videoconferencing or store-and-forward
technology for appropriate diagnostic testing and use of peripherals that would be
deemed necessary in a like in-person examination or evaluation meets this
standard, as does an examination conducted with an appropriately licensed
intervening health care provider, practicing within the scope of the provider's
profession, providing necessary physical findings to the licensee. An examination
or evaluation consisting only of a static online questionnaire or an audio
conversation does not meet the standard of care.
b. Once a licensee conducts an acceptable examination or evaluation, whether
in-person or by telemedicine, and establishes a patient-licensee relationship,
subsequent followup care may be provided as deemed appropriate by the
licensee, or by a provider designated by the licensee to act temporarily in the
licensee's absence. In certain types of telemedicine utilizing asynchronous
store-and-forward technology or electronic monitoring, such as teleradiology or
intensive care unit monitoring, it is not medically necessary for an independent
examination of the patient to be performed.
4. A licensee practicing telemedicine is subject to all North Dakota laws governing the
adequacy of medical records and the provision of medical records to the patient and
other medical providers treating the patient.
5. A licensee must have the ability to make appropriate referrals of patients not amenable
to diagnosis or complete treatment through a telemedicine encounter, including a
patient in need of emergent care or complementary in-person care.
### § 43-17-45. Prescribing - Controlled substances.

1. A licensee who has performed a telemedicine examination or evaluation meeting the
requirements of this chapter may prescribe medications according to the licensee's
professional discretion and judgment. Opioids may only be prescribed through
telemedicine if prescribed as a federal food and drug administration approved
medication assisted treatment for opioid use disorder or to a patient in a hospital or
long-term care facility. Opioids may not be prescribed through a telemedicine
encounter for any other purpose.
2. A licensee who, pursuant to this chapter, prescribes a controlled substance, as defined
by North Dakota law, shall comply with all state and federal laws regarding the
prescribing of a controlled substance, and shall participate in the North Dakota
prescription drug monitoring program.

### § 43-17-46. Payment of fees under the interstate medical licensure compact and the

physician assistant licensure compact.
1. Fees levied under subsection 1 of article XIII of the interstate medical licensure
compact by the interstate medical licensure compact commission to this state must be
paid by the board through the board's funding mechanism, and the board may not
request funds deposited in the general fund for the fee. A physician granted licensure
through the interstate medical licensure compact who fails to complete the addendum
questions within the time specified by rule of the board must be assessed a fee up to
three times the normal licensure fee, in addition to other penalties as authorized by
law.
2. Fees levied under section 43-17.5-07 of the physician assistant licensure compact by
the physician assistant licensure compact commission to this state must be paid by the
board through the board's funding mechanism, and the board may not request funds
deposited in the general fund for the fee. A physician assistant granted licensure or
privilege to practice in this state through the physician assistant licensure compact
who fails to complete the addendum questions within the time specified by rule of the
board must be assessed a fee up to three times the normal licensure fee for a
physician assistant licensed in this state, in addition to other penalties as authorized by
law.
3. Notwithstanding subsections 1 and 2, if an individual fails to timely submit the
addendum questionnaire required by rule of the board, the board may determine
whether the individual's failure to file a timely response constitutes an admission of
noncompliance with this section and whether the license should be subject to action by
the board. If the board determines the individual's failure to file a timely response is an
admission of noncompliance and the individual's license or privilege to practice should
be subject to action by the board, the board shall hold a hearing in accordance with
chapter 28-32 to take any appropriate action.
