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Apr 26 2011

New position statement closes out Board task force’s work on “drift”

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The NC Medical Board voted in March to adopt a new position statement on physician scope of practice.

The position statement is the product of the NCMB’s Special Task Force on Practice Drift, which brought specialists, primary care doctors, insurance industry representatives and others together with members of the Board for a public meeting in October 2010.

That group affirmed the idea that all licensees have a professional obligation to provide care that meets accepted and prevailing standards, even if the licensee did not complete formal training in the area of practice in which treatment has been rendered. The task force also discussed the NCMB’s obligation to act whenever it determines that any licensee has provided substandard care, regardless of specialty area or the licensee’s level of training.

The Board has no interest in stalling the natural evolution of medical practice; nor does it seek to prevent licensees from pursuing areas of practice that are of interest to them for a variety of reasons. The Board hopes simply to make clear its expectation that any licensee who moves into a new area of practice is able to meet accepted standards of care.

The full text of the position statement appears below. It is also published online.

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PHYSICIAN SCOPE OF PRACTICE
This Position Statement is intended to guide physicians who undertake to perform new procedures, use new technologies, or migrate into areas of practice for which they have not receiv ed formal graduate medical education. The Board recognizes that medicine is a dynamic field that, along with individual practices, continues to evolve. Economic pressures, business opportunities, lifestyle considerations, and access to care are all reasons that physicians move into new areas of practice. However, patient harm can occur when physicians practicing outside areas in which they were trained are unable to meet accepted and prevailing standards of care in the new practice area.

The informed, prudent care of patients begins with adequate training and the selection of appropriate patients. Follow up care and the ability to address complications is paramount. Physicians intending to expand their practice to an area outside of their graduate medical education should ensure that they have acquired the appropriate level of education and training.

It is the Board’s position that all physicians, irrespective of their training, will be held to the standard of acceptable and prevailing medical practice as set forth in N.C. Gen. Stat. § 90-14(a)(6).* It also may be prudent for physicians to confirm that their liability insurance provides coverage for the procedures they intend to perform.

*In some instances, the Board may have provided relevant guidance to particular practice areas. See for example the Board’s position statements on Laser Surgery, Office-Based Procedures, Care of the Patient Undergoing Surgery or Other Invasive Procedure, and Advertising and Publicity

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