Who can file a complaint?
The complaint process is open to any individual or organization interested in filing a complaint against a licensee of the NC Medical 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.
What kinds of issues can the Medical Board address through the complaint process?
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.
What are some examples of issues the Medical Board cannot address through the complaint process?
The Board cannot help a patient sue a provider for money, settle fee disputes, resolve issues about disability ratings and compensation or mediate personality conflicts among patients, doctors, and office staff.
What is the Medical Practice Act?
The Medical Practice Act (MPA) is chapter 90 of the NC General Statute on medicine and allied health occupations. Chapter 90 is the law that governs the practice of medicine in the state of North Carolina. It grants the Board the authority to license and regulate physicians, physician assistants and certain other medical professionals. The MPA clearly outlines the Board’s disciplinary responsibilities and gives specific examples of the types of conduct that may result in discipline. The Board may only take action when conduct is found to violate the MPA.
You can read more about the Medical Practice Act here.
How do I file a complaint?
There are two ways to file a complaint with the NC Medical 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. Please download a complaint form here. You may also call the Board (800-253-9653) to request that a complaint form be mailed to you.
Does NCMB accept anonymous complaints?
Yes. Individuals who choose to file anonymously are asked to submit all the information NCMB needs to open an investigation but are allowed to withhold their name and contact information. You can learn more about filing an anonymous complaint here.
What information must be submitted with an anonymous complaint?
At minimum, NCMB needs the correct spelling of the licensee’s full name (first and last) and the date or dates of service, or upon which alleged misconduct occurred. In addition, complainants should provide a brief explanation of the alleged problems with conduct or medical care.
What happens if an anonymous complaint does not provide at least the minimum information needed to open a case?
Generally, NCMB is not able to open an investigation, since the individual providing the complaint cannot be contacted.
Can NCMB guarantee that the physician, PA or other medical professional who is the subject of the complaint will not learn who reported them?
No. NCMB does not reveal any identifying information about a complainant, but the licensee may be able to guess the identity from the details he or she is asked to respond to. For example, if the person filing the complaint is the patient involved in the reported issue, it will not be possible to be anonymous because a patient name must be provided to the licensee in order for them to respond.
If I file an anonymous complaint, how will I know if action is taken against the licensee I reported?
If a complaint results in public action, it will be posted to the licensee’s public information page on NCMB’s website. Otherwise, anonymous complainants are not notified.
Complainants who do not request anonymity receive a “closure letter” that notifies them of the resolution of the case, whatever the outcome.
What about cases that do not involve patient care (such as sexual misconduct, licensee alcohol or substance use or criminal activity)? Can NCMB guarantee anonymity then?
Again, no. The details reported in a complaint are often so specific the licensee under investigation may be able to guess who reported the matter. If the misconduct reported has occurred multiple times over a period of several months or years, it may be more difficult for a licensee to determine who complained.
Once I file my complaint, what happens?
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.
Will my complaint be taken seriously?
Each complaint is thoroughly evaluated to determine if a violation of Board policy or state law has occurred. NCMB may take public action only in matters where it is determined that a violation of Board policy or state law occurred.
What are the possible outcomes of a complaint?
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.
Will filing a complaint resolve the problem I have with my provider?
Most likely, no. The Board does not intervene on behalf of individual patients. Rather, it acts for the people of North Carolina at large. When the Board takes action against a provider, that action is aimed at preventing future problems and protecting future patients. Your complaint, therefore, can play a significant part in protecting the people of North Carolina from incompetent, unqualified, or unethical practitioners.
Will my provider dismiss me as a patient if I file a complaint?
The Board has found that some licensees choose to dismiss patients who file complaints. Provided they follow all appropriate laws and guidelines, this is within the provider’s rights.
What are examples of conduct that may lead to discipline by the Board?
The Board is authorized to take action against a licensee only when it determines that a violation of the Medical Practice Act has taken place. Section 90-14 of the Act lists specific acts and reasons that may result in disciplinary action. They include:
- Immoral or dishonorable conduct
- Failure to maintain acceptable standards of care; lack of professional competence
- Inappropriate prescribing
- Making false statements/representations to the Board
- Being unable to practice medicine with reasonable skill and safety to patients due to alcohol or substance abuse, dependence and/or addiction
- Certain criminal convictions; conviction of a felony
- Falsely advertising or representing professional credentials, training or education
- Promotion or sale of drugs, devices, appliances, goods or services to patients in an inappropriate, exploitative manner
What types of punishment do publicly disciplined providers receive?
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.
How often does a complaint result in the Board taking formal disciplinary action against a provider?
About six to eight percent of cases investigated by the Board result in public action being taken against the provider’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 providers over time and detect patterns of behavior that might warrant future intervention.
I am having difficulty obtaining medical records from my doctor’s office. What can I do?
If the licensee/medical practice that has the records fails to respond to a request to provide copies of patient medical records in a timely manner (e.g. within 30 days) the patient requesting records may submit a complaint with the Medical Board. The complaint form can be found here.