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Alabama Board of Medical Examiners | 2025 Annual Report

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Alabama State Board of Medical Examiners

2025 ANNUAL REPORT


PG 2 | ALBME

EXECUTIVE DIRECTOR’S REPORT

One of the Alabama Board

At the Annual Meeting of the Federation of State Medical

of Medical Examiners’

Boards in Seattle, Washington, two Commission members

most significant

received national appointments and honors. The Board

accomplishments in 2025

proudly congratulates Dr. Jorge Alsip and Dr. Craig

was the publication of

Christopher for exemplifying the agency’s commitment

updated Office-Based

to fairness, empathy, and justice in fulfilling its duty to

Surgery regulations. These

protect the health and safety of Alabama patients.

updates reflect the first

William M. Perkins Executive Director

updates to these regulations in twenty years. The Board began the process to

update the regulations in 2022. Throughout this process, the Board invited, welcomed, and engaged in a robust dialogue with Alabama physicians. At its January 2026 meeting, the Board voted to finalize the proposed rules.

In response to trends and concerns surrounding emerging ketamine and testosterone therapies, the Board convened two physician-led work groups to conduct a comprehensive review of these treatments. As a result, the Board issued guidance to support Alabama physicians in delivering safe, evidence-based, high-quality care.

The Board believes that the current draft, as certified, best

The Alabama Opioid Overdose and Addiction Council’s

strikes the balance between protecting the public and

Prescribers and Dispensers Standing Committee,

avoiding unnecessary regulatory burdens on physicians.

established in 2017, marked a significant milestone

The Board, along with the Medical Licensure Commission, modernized medical licensure applications by refining how mental health questions are addressed. In recognition of this effort, the Board and Commission were named a 2025 Wellbeing First Champion by ALL IN: Wellbeing First for Healthcare, a national coalition dedicated to advancing clinician wellbeing.

this year. For the first time since its inception, Alabama experienced a 30 percent reduction in substancerelated overdose deaths between April 2024 and April 2025. The Board remains proud of its ongoing participation in the Council’s work, which focuses on equipping controlled substance prescribers with appropriate education and training through ALAHOPE.

Alabama Board of Medical Examiners bme@albme.gov

|

albme.gov


2025 ANNUAL REPORT | PG 3

Certificates of Qualification Issued 2024

2025 2

Retired Senior Volunteer

56

57

Limited DO

2

INCREASE IN NUMBER OF LICENSES ISSUED VIA IMLCC The Interstate Medical Licensure Compact Commission (IMLCC) released their Year Eight Data Study. Compared to Year Four, the number

Limited MD

246

260

of licenses issued by the Alabama Medical Licensure Commission in Year Eight increased 1 2

0 0

251

229

Temporary Military DO Temporary Military MD Prior Temporary Military MD/DO - 1 Converted To Full License - 2 Expired Full DO Full MD/DO Applicants Accepting Non-Disciplinary Citation With Administrative Charge

75

76

by approximately 126%. Alabama was among the top 4 states issuing the most licenses. The IMLCC is a multi-state agreement that streamlines the medical licensure process for qualified physicians who want to practice across state lines. Alabama was among the first states to join the

1,189

1,069

Interstate Medical Licensure Compact in 2017

Full MD

and remains committed to expanding access to high-quality medical care by making it easier for qualified physicians to practice here. “This growth is more than a statistic, it’s a step forward to ensuring patients across our state have better access to 1,761 total

qualified physicians,” said Dr. Max

1,603 total

Rogers, Chair of the Alabama Board of Medical Examiners. “Through the

Certificate of Qualification Renewals 2024

2025

Compact, we’re making it easier for physicians to practice in Alabama, serve patients and uphold the high standards our Board is committed to maintaining.”

Interstate Medical Licensure Compact 537

515

233

Letters of Qualification Issued to Other States

13

Letters of Qualification Denied/Withdrawn

14

State of Principal Licensure Redesignation

8 6 Limited COQ Renewal Retired Senior Volunteer COQ Renewal


PG 4 | ALBME

CONTROLLED SUBSTANCES/PAIN MANAGEMENT REGISTRATIONS ISSUED IN 2025 Pain Management Services Registrations Alabama Controlled Substances Certificates 2024

2025

1,463

1,458

398

333

2024

2025

582 554 447

472 13,526

Initial Location Additional Locations

13,281 110 Expired Reissued

New Issued Expired Reissued Renewed

Renewed

Initial Location Additional Locations

14 60

13 1 46 14

107

6 42

6 0 34 8

New Issued

Initial Location Additional Locations

BOARD ISSUES NEW GUIDANCE In 2025, the Board, with the help of two work

The guidelines for the off-label use of ketamine

groups consisting of practicing physicians, issued

detail who should prescribe, patient selection,

guidance for the off-label use of ketamine for the

recommended medical screenings, location

treatment of treatment-resistant depression in

requirements, dosing, and safety precautions.

outpatient settings and testosterone replacement therapy in males and females.

The Board’s guidelines for the use of testosterone replacement therapy in males and females provides

On behalf of the Board, the groups reviewed current

detailed recommendations for physicians on when

trends and concerns in the use of these treatments

and how to evaluate, prescribe, and monitor

and developed recommendations to help

testosterone therapy.

physicians deliver the highest quality care to patients in Alabama.


2025 ANNUAL REPORT | PG 5

OUTREACH & EDUCATION HIGHLIGHTS

ADVANCED PRACTICE PROVIDER PROTOCOL UPDATES

LICENSING SUMMIT

In March 2025, the Board approved protocols for the

As part of the Board’s ongoing efforts to strengthen

injection of cosmetic botulinum toxin by Physician

collaboration with stakeholders and provide more

Assistants in certain practice settings. Shortly after,

streamlined services to both them and its licensees, the

the Board approved the same protocols for Certified

Board’s Credentialing Department hosted its inaugural

Registered Nurse Practitioners. The approved

Licensing Summit. Attendees included medical staff

protocols detail the requirements for the performance

professionals and postgraduate training program

of the procedure.

coordinators who play a vital role in assisting healthcare practitioners with licensing and registration.

In August 2025, the Board approved updated protocols for the Qualified Alabama Controlled Substances

CONTROLLED SUBSTANCES PRESCRIBING

Certificate (QACSC) and the Limited Purpose Schedule

The Board also began offering two hours of free Continuing

II Permit (LPSP). The updates were designed to

Medical Education on controlled substance prescribing at

support safe prescribing practices and include the

events sponsored by various organizations. In 2025, a total

use of new quarterly quality assurance (QA) forms.

of 224 free CME credits were provided through this program.

The Board also approved updates to

LICENSING EDUCATION

the following specialty protocols:

In addition to prescribing related education, staff of the

• Botox Injections for Hyperhidrosis

Advanced Practice Providers Department provided

• Botox Injections for Chronic Migraine

instruction on license and registration requirements

• Critical Care

to future graduates of all Physician Assistant and

• Dermatology

Anesthesiologist Assistant programs in the state.

• Fluoroscopy

PROFESSIONAL BOUNDARIES

• Tunneled Central Venous Line Insertion

As part of the continuing effort to protect the health and safety of patients and educate licensees, free, required professional boundary education was implemented for all physicians, physician assistants, and anesthesiologist assistants licensed in Alabama. At the 2025 Federation of State Medical Boards meeting in April, Effie Hawthorne, Associate General Counsel of the Board, co-presented a poster series on the Board’s ongoing professional boundaries education initiative. More than 20,000 Alabama physicians have completed the free course.

(Left to Right) Amanda Olaogun and Kasey Cleary with PBI Education, along with Effie Hawthorne, Associate General Counsel of the Board, co-presenting at FSMB in Seattle, Washington.


PG 6 | ALBME

ENFORCEMENT ISSUES Enforcement Issues 2024

2025

15

Pending Review Referred For Other Resolution Issues Referred to Other Agencies, Outside Board Jurisdiction, or Withdrawn

6

14

42

45

183

UPDATED OFFICE-BASED SURGERY REGULATIONS In 2022, the Board began the process of updating its Office-Based Surgery regulations, which first became effective in November 2003. These regulations remained essentially unchanged for twenty years; however, office-based surgery has changed dramatically in this time period with physicians utilizing their offices for more intensive and invasive procedures as technologies advance.

Referred For Formal Investigation/ Pending

102

184

In October 2023, the Board began soliciting comments from stakeholders and adopting revisions based on this feedback. In December 2024, the rules were officially noticed for public comment. Due to the amount of constructive feedback, the

Referred For Formal Investigation/ Resolved

Board terminated the publication period in April 2025 to allow time for a thorough review and incorporation of stakeholder comments. In July 2025, the Board published a substantially

Resolved Without Formal Investigation Prescribing Related

115

122

84

67 16

Board received public comments to this rule draft, and

18 614 total

365 total

revised ruleset in response to the public comments. The in November 2025, the Board republished the draft after making material changes based on these comments.

ANESTHESIOLOGIST ASSISTANT LICENSES/ REGISTRATIONS Anesthesiologist Assistants ISSUED IN (AA) 2025 2024 1

9

considered the comments at its January 2026 meeting and voted to finalize the proposed rules after making non-material editorial changes based on the comments received.

2025

At all times, the Board’s primary concern when deciding to make a

10

change or not was whether the public’s health, safety, and welfare would be protected. The Board believes that the current draft, as

45

44

Following the end of this comment period, the Board

certified, best strikes the balance between protecting the public

18

15

46

50

and avoiding unnecessary regulatory burdens on physicians. Throughout this process, the Board has invited, welcomed, and engaged in a robust dialogue with Alabama physicians. The Board is committed to maintaining the level of

Licenses Issued Expired Licenses Reissued (None Issued 2025) Licenses Renewed Registered To Physicians (New) Total Registrations

responsiveness to physician input that it has shown in the rulemaking process going forward. Medicine is evolving, and the Board expects its regulations to evolve with it.


2025 ANNUAL REPORT | PG 7

ADVANCED PRACTICE NURSES (CRNP/CNM) AND COLLABORATIVE PHARMACY PRACTICES IN 2025

PA LICENSES/ REGISTRATIONS ISSUED IN 2025

Advanced Practice Nurses (CRNP/CNM)

25

Collaborative and Supervisory Practice Education Opportunities 3 Educational Site Visits 12 Practice Compliance Seminars

2024

2025

16 88

15 293

868

863

Limited Purpose Schedule II Permits Renewed

204

Expired Limited Purpose Schedule II Permits Reissued

256

12

45

403

1,325 25

367

Qualified Alabama Controlled Substances Certificates Renewed Expired Qualified Alabama Controlled Substances Certificates Reissued

1,534

1,688

2 8

500

535

1,616

19

Qualified Alabama Controlled Substances Certificates Issued

4,251

Number Of Physicians In Collaboration

6

48

220 3,455

Collaborative Practice Registrations Issued

8

1,675

269 1

2025 97

2

238

Qualified AL Controlled Substances Certificates Issued Expired Reissued Renewed

Collaborative Pharmacy Practice 2024

2025

2

2

0

2

1

0

Collaboration Registrations Issued Collaboration Registrations Renewed Collaboration Registrations Reissued 6 Physicians in Collaboration in 2025

11

Total Registrations Registered to Physicians (New) Temporary Licenses Converted to Full Licenses Renewed Temporary Military Licenses Issued Temporary Military Licenses Converted to Full New Licenses Issued Expired Licenses Reissued Physician Assistants Granted Temporary License

2024

3,499

29 12

1 228

3,981

2025

Collaborative And Supervisory Practice Audits

Limited Purpose Schedule II Permits Issued

1,325

2024

Limited Purpose Schedule II Permits 2 35 67 1 169

170


PG 8 | ALBME

BOARD DISCIPLINARY/CONFIDENTIAL ACTIONS Disciplinary

Voluntary Restriction On Certificate Of Qualification

ACSC

2

Entered

Temporary Suspension

1

ABME Physician Monitoring Program

Surrender

1

– Licensees Currently Monitored

239

Restrictions And/Or Limitations Modified Or Terminated

2

– Licensees Monitored Since 1990

1,975

Consent Order/Settlement Agreement

2

QACSC 1

Temporary Suspension

1

Revocation

1

Settlement Agreement Certificate Of Qualification Denied

1

Certificate Of Qualification And/Or Medical License Surrendered

6

Physician Assistant Licenses Disciplined/Restricted

3

Confidential Voluntary Agreements

22

Prescribing Related

8

Agreements Amended

5

Agreements Terminated

8

29

Non-Disciplinary Board Orders

23

Continuing Medical Education Prescribing Related

10 6

Evaluation Interviews Conducted

38

Letters Of Concern

65

Prescribing Related

11

Formal Filings With The Medical Licensure Commission Administrative Complaints Filed

14

Administrative Complaints With Petition For Summary Suspension Of Medical License

4

Surrender

1

Revocation

3

Notice Of Intent To Contest Reinstatement Filed

1

Administrative Fines Assessed (ABME – 4 And MLC – 13)

17

Administrative Costs Assessed (ABME – 0 And MLC – 4)

4


2025 ANNUAL REPORT | PG 9

ALABAMA OPIOID OVERDOSE AND ADDICTION COUNCIL The Board is proud to continue to be a part of the Governor’s

experienced a 30 percent decrease in substance-related

Opioid Overdose and Addiction Council’s Prescribers and

overdose deaths from April 2024–April 2025. According to

Dispensers standing committee and its current focus on

the 2025 annual report of the Alabama Opioid Overdose

equipping controlled substances prescribers with training

and Addiction Council, ALAHOPE recorded a completion

through ALAHOPE, an online Alabama-specific education

rate of 3,370 for 2025. This number represents the medical

program for health professionals.

professionals seeking training in substance use and

The Council was established by Governor Ivey in 2017

alternatives for pain management.

and for the first time since its establishment, Alabama

ALABAMA SWEEPS SEATTLE At the 2025 Annual Meeting of the Federation of State Medical Boards in Seattle, Washington, Medical Licensure Commission member Jorge A. Alsip, MD, was elected to the FSMB Board of Directors for a three-year term. This position follows over 20 combined years of leadership on both the Alabama Board of Medical Examiners and the Medical Licensure Commission. Dr. Alsip practiced emergency medicine in Baldwin County, Alabama, followed by both national and local consulting and teaching positions. At the same meeting, the Federation of State Medical Boards honored Medical Licensure Commission member Craig H. Christopher, MD, with the FSMB Leadership Award. Dr. Christopher, who has also been a leader on both the Alabama Board of Medical Examiners and the Medical Licensure Commission for more than 20 combined years, practiced for over 30 years as a highly respected OBGYN in Birmingham.

(above) Dr. Jorge Alsip is congratulated by Board member Dr. Jay Suggs. (right) Dr. Craig H. Christopher


PG 10 | ALBME

LEGISLATIVE UPDATE With the endorsement of the Board and Medical

provision was a barrier for some doctors who wished

Association of the State of Alabama, a bill sponsored

to volunteer their services under the RSV program but

by Representative Paul Lee of Dothan and passed by

were unable to commit to that number of hours. With

the Alabama Legislature removed the requirement for

this requirement removed, more retired doctors may

Retired Senior Volunteer (RSV) licensees to perform the

now offer their services at free medical clinics, helping

annual minimum of 100 hours of volunteer service. This

fill gaps in underserved communities across Alabama.

ALBME & MLC NAMED 2025 WELLBEING FIRST CHAMPION

The Alabama Board of Medical Examiners

unrelated to a doctor’s current ability to practice

(ALBME) and Medical Licensure Commission

safely. The revised forms now focus only on

(MLC) were named a 2025 Wellbeing First

conditions that may currently impair safe practice.

Champion for removing mental health questions from medical license applications that might inhibit someone from answering questions truthfully. ALL IN: Wellbeing First for Healthcare, a national coalition of healthcare organizations awarded the honor to the ALBME and MLC. The change encourages physicians to seek care without fear of professional consequences, strengthening the healthcare workforce and improving patient outcomes. Previously, applications asked about past mental health or substance use treatment, even when

The changes came as a recommendation from the Dr. Lorna Breen Heroes’ Foundation. According to the foundation, as of September 19, 2025, five dental licensure boards, 40 medical licensure boards, six nursing licensure boards, and nine pharmacy licensure boards verified their licensing applications do not include intrusive mental health questions. The ALBME & MLC are proud to receive the honor of being a Wellbeing First Champion.


2025 ANNUAL REPORT | PG 11

2025 BOARD AND COMMISSION MEMBERS

Alabama Board of Medical Examiners

State of Alabama Medical Licensure Commission

Charles M. A. Rogers, IV, M.D.

Jorge A. Alsip, M.D.

Chairman, Bay Minette

Chairman, Daphne

Hernando D. Carter, M.D.

Kenneth W. Aldridge, M.D.

Vice-Chairman, Birmingham

Vice-Chairman, Tuscaloosa

William E. Admire Jr., D.O., Mobile

Craig H. Christopher, M.D., Birmingham

Aruna T. Arora, M.D., Huntsville

Howard J. Falgout, M.D., Tuscaloosa

Gregory W. Ayers, M.D., Hoover

Paul M. Nagrodzki, M.D., Birmingham

Tonya E. Bradley, M.D., Auburn

Nina P. Nelson-Garrett, M.D., Montgomery

Nina S. Ford-Johnson, M.D., Mobile

James R. Seale, Esq., Montgomery

Adam C. Harrison, D.O., Cullman

Pamela D. Varner, M.D., Birmingham

Marquisha M. Jarmon, M.D., Birmingham Beverly F. Jordan, M.D., Enterprise Mark H. LeQuire, M.D., Montgomery William J. Schneider, M.D., Huntsville William J. Suggs, M.D., Decatur David R. Thrasher, M.D., Montgomery Jane A. Weida, M.D., Tuscaloosa Amanda J. Williams, M.D., Montgomery


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