2009-2010: The NCMB’s ‘Year of Transparency’Categories: President’s Message Comments: 0 comments
When I was appointed in 2005, I had a preconceived notion of what the Board was like. To be blunt, I assumed I would be working with a bunch of arrogant, know-it-all physicians, each with a personal agenda. Instead, I’ve had the good fortune to work with a group of caring, thoughtful doctors who, to a person, are deeply committed to the people of North Carolina, as well as to their physician colleagues. My non-physician colleagues on the Board have been equally dedicated.
At the same time, the Board is no monolith. Its members are often divided, at least initially, which I think brings credibility to the Board. Cases and policy issues are usually decided after vigorous debate, and decisions are never made lightly.
I often wish that more licensees could see the Board in action, so they could witness how diligent, thoughtful and compassionate this Board is in its treatment of sensitive matters that, we are all too aware, affect people’s lives and livelihoods. But most licensees will never see Board proceedings firsthand, either as observers or as the subjects of disciplinary cases. I suspect many licensees have their own preconceived notions of the Board.
The Board was reminded of this last year when an effort mounted by licensees, professional groups and others resulted in a new law that requires the NCMB to provide additional rights to licensees under investigation.
To me, the most surprising thing about this effort was not the suggestion that the NCMB should improve its investigative and disciplinary policies and procedures (what organization can’t do better?) It was the obvious perception among those advocating for change that the NCMB hid its way of doing things from the regulated, perhaps even deliberately. I, and my colleagues on the Board, knew this perception to be false.
Well, in my view, if you disagree with the way outsiders perceive your organization the best remedy is to shine a bright light on your proceedings and let your actions speak for themselves.
That’s what I’ve tried to do as Board president during the past year, which I hope will be remembered as a year of transparency. I believe everyone—patients, the profession—should be involved when the Board sets up rules, adopts position statements or sets policy of any kind. (Incidentally, this belief is central to my personal management style. I often begin meetings by reminding participants to interrupt me if I leave anything out or fail to recognize someone who wants to speak.)
Of course, the NCMB has followed an open, multi-step process before making any significant change since long before I was on the Board. Many Board committee meetings where proposed policy changes are discussed (the Policy Committee, for example) are open to the public. Draft position statements are published, both on the Board’s website and in this newsletter, for licensee review and comment. Similarly, changes to administrative rules are published for comment and, in most cases, subject to formal public hearings before they can take effect.
But, as I noted earlier in this article, few licensees, or members of the public for that matter, participate in the official, public process. So what we’ve done over the past year is create even more opportunities for stakeholders outside the Board to have input into its work. The most visible way we’ve done this is by creating more special committees and task forces, whose memberships have included representation from interested parties outside the Board, to tackle specific issues. Over the past year, the work of these types of groups has helped to determine whether the Board should create a new license type for those practicing administrative medicine (decision:
No); to develop clear standards for physicians who wish to advertise board certifications and, most recently; to explore the subject of “practice drift."
Another way we have deepened the Board’s commitment to transparency is through the administrative rulemaking process. Over the past 12 months, the Board has overhauled its licensing rules to clarify requirements and processes, and to create an expedited path to licensure for experienced physicians. In addition to the new statutory requirements that afford more protections to licensees under investigation by this Board, the NCMB thinks it can improve its investigative and disciplinary processes further still by setting down much of its internal processes as rule. Once these rules, which are still under development, are in effect, we believe licensees will have all the information they need to understand the disciplinary processes.
I think the Board has improved every year, and we are always looking for new opportunities to do better.
If you think the Board can do still more, by all means, think about getting involved. I’d encourage any physician who’s willing and able to put in the hours to seek a seat on the Board. At least two seats will come open next year.
I think most licensees would be as impressed as I have been with the way the NCMB conducts itself.