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Policy Discussions Archive

Draft position statement: Physician Practice Drift

Discussion Ended on 10/25/2019

NCMB’s Policy Committee recently reviewed and revised its position statement entitled “Physician scope of practice”, which include changing the title to “Physician practice drift”. The Board will accept comments on the proposed revision through close of business on Friday, Oct. 25.

The policy retains the expectation that, regardless of what area a licensee trained in, he or she will be held to the current accepted standards of care in their chosen area of practice. That is, there is no acceptable lower standard of care for licensees who choose to practice in an area in which they have not completed formal training.



To me, “Physician Drift” carries a negative connotation, which I don’t think is correct.  Who came up with the idea to change this terminology?  Widening a physician’s scope of practice is done for many reasons as the position statement refers to.  I completely agree with NCMB that those who decide to pursue complimentary areas of medicine to their primary specialty, should be competent to treat patients and any of their potential complications. Being competent is not necessarily determined by a set organization.

By Harrill Coley on Oct 24th, 2019 at 4:53pm

The revision seems appropriate and adequately describes criteria physicians should meet prior to performing acts outside what is considered “scope of practice.” There are guidelines in place by the state for safety in regards to procedures performed in office settings; it is the physicians duty to ensure safety measures are taken to meet these criteria.  There are plenty of physicians who “drift” from his or her primary specialty and have excellent results with procedures regardless of ABMS specialty or certain board certification.  It takes more than just having an ABMS certification to deem a physician qualified to perform procedures. As long as the physician has the training and knowledge, they should be able to practice free will.

By Amber Allen on Oct 24th, 2019 at 1:30pm

Physicians who “drift” from their area of formal training should have hospital privileges to perform any and all procedures that they are performing in an outpatient (office) setting.  Any physician performing procedures must be competent in the treatment of any complications that arise from such treatment.  These practitioners must disclose their ABMS board certification so as NOT to mislead the public on their qualifications.

By Gregory Swank on Oct 24th, 2019 at 8:14am

These guidelines seem appropriate and important for those physicians who do ultimately practice in an area outside of their initial training.

I am concerned about NCMB’s lack of response to the growing issue with scope of practice from NPs. I feel both NCMB, and the BON should have a stronger response about what is scope of practice for NPs (including CRNAs), in addition to firmer supervision requirements for NPs (and CRNAs). The BON does not seem to take appropriate action for the NPs managed by their Board, and it falls on NCMB to take a stance to ensure that all citizens of NC are receiving care from adequately trained professionals.

By rebecca taylor on Oct 22nd, 2019 at 4:45pm