Below are some of the most frequently asked questions surrounding the complaint process. Click the arrow next to each question to expand and see FAQ answer.
The complaint process is open to any individual or organization interested in filing a complaint against a licensee of the North Carolina Medical Board (“Board”). Complaint forms are accepted from patients, family members and other members of the public, as well as from medical professionals and health care organizations such as hospitals, pharmacies, insurance companies, health care agencies or other entities.
The Board is authorized to act only on complaints that may involve a violation of the Medical Practice Act, a state law that covers a wide range of misconduct. Three types of cases account for more than half of the Board’s public actions against providers: quality of care, prescribing (either self-prescribing or improperly prescribing to others) and cases where a provider is impaired due to alcohol or substance abuse. Many other disciplinary cases fall under the broad category of “unprofessional or unethical conduct”, such as violating patient confidentiality, misrepresenting professional credentials, or practicing without an active medical license. Problems with medical recordkeeping and sexual misconduct or other boundary violations account for many cases as well. See our brochure outlining the complaint process for more information.
There are two ways to file a complaint with the Board.
1. Online: Most complaints are submitted online. NOTE: Attachments submitted with a complaint may not exceed 20 MB. Complaints submitted with attachments that exceed 20 MB will not reach the Board.
2. Regular mail: If paper records and other documents must be submitted to the Board along with your complaint, send the complaint via regular mail. You may call the Board (800-253-9653) to request that a complaint form be mailed to you.
Our online complaint form has several data fields that require information in order to successfully file a complaint with the Board. You can find a checklist here. Please note: It is a good idea to collect all of this information prior to filing your complaint.
Here is a brief description of the complaint review process:
Complaints will be acknowledged via e-mail or USPS once the review process begins.
All complaints are initially reviewed to determine if there is a possible violation of the Medical Practice Act that rises to the level of further inquiry.
If the conduct that prompted the complaint is not found to be a violation of the Medical Practice Act, you are informed of this in your initial letter and the case is closed. However, the licensee is informed of your complaint and the information is kept on file.
If a possible violation has occurred and further inquiry is warranted through the Administrative Investigations Department, a copy of your complaint is sent to the licensee for review and response to the Board; medical records are obtained as necessary.
Typically your written complaint serves as your full statement and you will not be contacted by the Board unless clarification or additional information is needed.
Case reviews are done by medical and non-medical persons once all information is obtained to determine level of discipline, if any.
The complaint review process can take up to six (6) months or more.
The Board will only reconsider its decision on a case if a complainant provides new or additional information that was not available or reviewed during the initial investigation. The new or additional information must be relevant to the original allegations and have the potential to affect the case outcome. If the new or additional information meets this criteria, the case will be re-opened, and the new or additional information will be considered by the Board. Complainants should submit their information and request to .(JavaScript must be enabled to view this email address) and reference their original case number. Please note: This reconsideration process is not a guarantee that the original decision of the case will be changed.
Complaints are most often resolved in one of three ways.
No formal action. Typically, this is the result when no violation of the Medical Practice Act has occurred. However, the provider is notified and the information is kept on file. This allows the Board to spot recurrent issues or a pattern of behavior that may cause the Board to intervene in future.
Private action is taken. There may be no violation of the Medical Practice Act that warrants public action, but the Board is nonetheless concerned about some aspect of the provider’s conduct or performance. In such cases, the Board takes private action, such as a confidential letter of concern to the provider that cautions against repeating similar conduct. Alternatively, licensees may be brought before the Board for a private interview. The contents of the letter or interview are confidential.
Public action is taken. In these cases, the Board determines there was a violation of the Medical Practice Act and takes formal public action. For example, this may be in the form of a public letter of concern, an order imposing conditions or restrictions on the license, a suspension of the licensee’s authority to practice or some other type of action. Public actions are posted indefinitely on the Board’s website.
Public disciplinary actions include public letters of concern, reprimands, monetary fines, limitations or conditions on practice, or license suspensions or revocations. Public actions are posted indefinitely on the Board’s website.
About six to eight percent of cases investigated by the Board result in public action being taken against the clinician’s license. In another 20-25 percent of cases, the case leads to private discipline, such as a confidential letter expressing the Board’s concern and cautioning against similar conduct in future. Often when no action is taken, it is because no violation of the Medical Practice Act has occurred and the matter is therefore not actionable. When no formal action is taken, the Board keeps a copy of the complaint in its permanent file. This file is an important resource that helps the Board track clinicians over time and detect patterns of behavior that might warrant future intervention.
