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The Meeting Summary provides brief descriptions of selected actions taken by the NC Medical Board during its most recent meeting or hearing. Actions are listed by committee, where applicable.
For a full account of the Board’s proceedings please check the meeting minutes, which are posted approximately two months after the meeting date. You can subscribe to our Meeting Minutes RSS feed to be notified when the minutes are posted.
Last year, the Board signalled its intention to begin prosecuting licensees who are out of compliance with the Board?s CME requirements and fail to correct the deficiencies in a timely manner. The Board voted last fall to pursue an administrative rule that would authorize the Board to automatically fine licensees whose CME deficiency cases meet certain criteria.
Upon further review and consideration, the Board has determined that automatic fines are not an essential part of its plans to address the small but growing number of CME deficiency cases it handles each year. Therefore, the Board voted in January to set aside plans to make the issuance of fines a matter of rule. Instead, the Board will continue to consider CME deficiency cases on a case-by-case basis and make a determination of whether a fine is appropriate based on the unique circumstances of each case.
Eight out of 12 members of the NC Medical Board are nominated for possible appointment by the Governor by an independent Review Panel established by statute. Under NC law, this independent nominating body must include one public member of the NC Medical Board. Currently, Judge John B. Lewis, Jr., a public member now serving his second term on the NCMB, occupies the public member seat on the Review Panel.
The Board voted to reappoint Judge Lewis to serve on the Review Panel.
In addition, the Board elected Board Member Thomas R. Hill, MD, to serve as Secretary/ Treasurer of the NCMB.
The Board has considered whether it should continue to issue non-disciplinary letters of advice to new licensees who meet certain criteria. For example, physician assistant licensees who also hold MD degrees might be cautioned in a letter of advice to ensure that they only use the title physician assistant or PA, and not the title physician or medical doctor. The Board has decided that the intent of letters of concern might be misunderstood or misinterpreted by licensees and others.
At the January meeting, the Board voted to discontinue the use of non-disciplinary letters of advice. Alternatively, it voted to expand the list of circumstances under which the staff of the Board is authorized to issue pre-approve Private Letters of Concern (PLOC) to include situations that, previously, had typically resulted in a letter of advice. The new pre-approved PLOC categories are listed below.
Pre-approved PLOCs approved at the January Board Meeting
Please note: The application/reactivation must be otherwise "pristine". In each instance below, there can be no question that the circumstances that led to the error are inadvertent and unintentional. Only one of the following may be present in a given application to proceed with a pre-approved PLOC:
1. Send letter clarifying that PA can only use the title of physician assistant and not the title of physician or medical doctor, to mid-level licensees who also have MD degrees.
2. Send letter including the Board's Position Statement for applicants who plan to practice telemedicine.
3. Send letter to all applicants who report a minor or inconsequential misdemeanor arrest or conviction from the beginning of their professional career (i.e. medical school, dental school etc.)
Last year, the NCMB began a scheduled review of its position statement entitled, "Self-treatment and treatment of family members and others with whom significant emotional relationships exist." To assist with its work, the Board established a task force made up of members of the Board as well as several representatives of professional groups and organizations representing other interested parties. In addition, the Board gathered feedback directly from licensees via a Web-based survey that garnered more than 1,000 responses.
In January, the Board gave preliminary approval to a proposed revision of the position on self-treatment. Before voting to give it final approval, the Board will circulate the proposed revision to all members of the task force for review. In addition, the proposed revision will be published in the Spring 2012 issue of the Forum, which publishes in April.
The proposed text also appears below:
Self-treatment and treatment of family members
It is the Board's position that it is not appropriate for licensees to write prescriptions for controlled substances or to perform procedures on themselves or their family members. In addition, licensees should not treat their own chronic conditions or those of their immediate family members or others with whom the licensee has a significant emotional relationship. In such situations, professional objectivity may be compromised, and the licensee's personal feelings may unduly influence his or her professional judgment, thereby interfering with care. There are, however, certain limited situations in which it may be appropriate for licensees to treat themselves, their family members or others with whom the licensee has a significant emotional relationship.
1. Emergency Conditions. In an emergency situation, when no other qualified licensee is available, it is acceptable for licensees to treat themselves or their family members until another licensee becomes available.
2. Urgent Situations. There may be instances when licensees or family members do not have their prescribed medications or easy physician access. It may be appropriate for licensees to call in short term prescriptions.
3. Acute Minor Illnesses Within Clinical Competence. While licensees should not serve as primary or regular care providers for themselves or their family members, there are certain situations in which care may be acceptable. Examples would be treatment of a simple urinary tract infection or prescribing ear drops for a family member with external otitis. It is the expectation of the Board that licensees will not treat recurrent acute problems.
4. Over the Counter Medication. This position statement is not intended to prevent licensees from suggesting over the counter medications or other non-prescriptive modalities for themselves or family members, as a lay person might.
Licensees who act in accord with this position statement will be held to the same standard of care applicable to licensees providing treatment for patients who are unrelated to them. Thus, licensees should not treat problems beyond their expertise or training and should be sure to maintain an appropriate medical record documenting any care that is given.
Licensees who inappropriately treat themselves, their family members or others with whom they have a significant emotional relationship should be aware that they may be subject to disciplinary action by the Board.
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