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May 8 2009

The NC Medical Board: 150 years of service to patients and medical professionals

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Image for The NC Medical Board: 150 years of service to patients and medical professionals The North Carolina Medical Board marked its 150th anniversary with a reception at the North Carolina Museum of History in Raleigh in March. The celebration brought together about 200 guests, including current and past Board members, legislators, medical society and regulatory board members, public advocacy groups and others. Established on April 15, 1859, the Board is one of the oldest medical regulatory boards in the country.

Several exhibits gave guests a look at medicine as it was 150 years ago. Artifacts on display included medical equipment and supplies from the late 1800s to mid-1900s. Costumed history enthusiasts representing a North Carolina Confederate surgeon and a 19th century apothecary were on hand. The Museum of History also provided the Board's guests access to a permanent exhibit that recreates a 1920s-era drugstore.

The Board displayed original minute books from its first meetings dating back to 1859 and presented a short video highlighting the first Board, first female licensee, first African American licensee and major advancements in medicine from 1859 to the present. Finally, the Board showed off a historical highway marker it commissioned in honor of the anniversary. In April, the marker was installed two blocks from the Board's original meeting place, the Old State Capitol in Raleigh.

Why does the anniversary matter?
The Board's founders--who as you may know included the early leaders of the NC Medical Society--understood that establishing and enforcing high standards for medical education, training and practice not only protected patients from unqualified practitioners but raised the status and credibility of the profession. The modern Medical Board is very different from the one founded 150 years ago. But the essential mission--and value to the profession--remains the same.

Below, we offer a few thoughts on some important ways the Board enhances the quality of medicine in North Carolina and the dignity of the medical profession.

Screening out unqualified practitioners
A medical license is privilege not lightly granted by the Board. The Board's founders considered licensing to be a critical public service that would help patients tell qualified physicians from "ignorant pretenders". However, by modern standards the original criteria for licensure were spare. Under the 1859 Medical Practice Act, a candidate for licensure had only to be 21 years old, of good moral character and able to pass the exam. It wasn't until 1921 that the law was amended to require that all applicants prove they are graduates of a four-year medical school. Over the years additional requirements have been added so that, today, North Carolina is widely recognized to have one of the nation's most rigorous licensing processes. Keeping standards for physician licensure high enhances the value of the license hanging on every licensee's office wall.

Punishing misconduct and remediating deficient providers
The Board's founders implicitly understood that both medical professionals and their patients are best served when the Board is effective at identifying and suppressing unqualified or immoral practitioners. Initially, however, the Board did not have the authority to discipline its licensees. That power did not come until 1915, when the General Assembly granted the Board the authority to prosecute violations of the Medical Practice Act. Lawmakers strengthened the Board's disciplinary authority again in 1921, when it clearly defined the practice of medicine for the first time and created a list of specific acts of wrongdoing for which the Board could take action against a physician's license. That list included drug abuse, abortion, grossly immoral conduct, false advertising and unprofessional or dishonorable conduct. That list still forms the basis for most disciplinary cases brought by the Board today.

Acting as a resource for professionals, as well as the public The Board believes that the vast majority of licensees are caring, competent professionals who want to act in the best interests of their patients. As such, the Board sees educating its licensees about its policies and applicable laws and rules as an important strategy for preventing misconduct, intentional or not. This is a relatively modern notion, however. The original Board consisted of seven physician members who met no more than once or twice a year. Their time was consumed with reviewing applications, conducting examinations and interviews and granting licenses. There was little or no outreach to licensees. In fact, the Board operated without support staff until the early 1950s. It wasn't until the 1990s that the Board substantially boosted its outreach to the profession and public. Since that time, the Board has drafted position statements to articulate its views on applicable rules and laws. These statements provide guidance to licensees who wish to avoid disciplinary action. In 1995 the Board hired a full time senior level staff person to establish a department of Public Affairs. The following year it began publishing the Forum with the objective of informing licensees about Board policy, applicable laws and rules, clinical guidelines and other matters. Shortly after introducing the Forum, the Board also launched a public Web site with information and news for professionals and patients. The current Web site includes all of the position statements of the Board and a complete archive of the Forum, as well as information about laws, rules and Board policy.
Preserving confidence in the Board and its licensees

An effective regulatory authority is essential to preserving patients' faith and trust in the medical profession. The North Carolina Medical Board strives each day to honor its mandate and mission -- a commitment that benefits both the public and the profession.

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