The North Carolina Medical Board has asked the NCMS to share this announcement with our members in hopes of recruiting physician mentors for re-entry programs:

“Physicians or physician assistants who have not actively practiced for the two-year period immediately preceding the filing of an application for initial license or license reinstatement are required to develop, and successfully complete, a reentry program approved by the Board as a condition of licensure.

Reentry programs typically involve a 3 step progressive program of patient care and responsibility generally lasting approximately 6-8 months. Occasionally other forms of comprehensive assessment may also be used in lieu of, or as a part of, the reentry plan. Once a reentry program is accepted by the Board reentry physicians or PAs are issued a license with a non-disciplinary consent order (“Reentry agreement”).  One provision of the reentry program is that, “An applicant shall identify a mentoring physician acceptable to the Board”. This requirement is often the greatest obstacle encountered by reentry applicants.

Mentoring physicians should be currently ABMS or AOA board certified in the applicable area of practice and have no recent public Medical Board actions.  Mentoring physicians provide oversight and direct supervision as outlined in the reentry agreement and periodic reports to the Board on the progress of the reentry licensee.

Mentors are considered “agents of the Board” and thus have certain legal protections from civil liability connected with their role as mentoring physicians. These legal protections are formalized in the reentry agreement. Financial arrangements, including possible compensation for mentoring responsibilities, can be arranged independently between the reentry applicant and the mentoring physician.”

If you have an interest in providing mentoring for physicians or physician assistants reentering clinical practice and would like additional information please contact:

Michael Sheppa, MD or Scott Kirby, MD
North Carolina Medical Board
1203 Front St
Raleigh, NC 27609
(919) 326-1100

The North Carolina Medical Board has posted notice that the physician seat on the NC Board of Electrolysis Examiners is vacant.

The Medical Board has the statutory responsibility for nomination of a physician to fill the position.

Below is a copy of the notice that curently appears on the Medical Board’s website.  The notice can also be accessed online at:  http://www.ncmedboard.org/notices/detail/board_of_electrolysis_examiners_seeks_physician_member/.

Interested candidates should submit their curriculum vitae to Nancy Hemphill at the Medical Board by January 17^th via email, nancy.hemphill@ncmedboard.org.

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North Carolina Medical Board  -  January 10, 2011 

Board of Electrolysis Examiners seeks physician member

The North Carolina Board of Electrolysis Examiners (NCBOEE) is seeking a NC-licensed physician to fill a vacant position. Under NCGS 88A-5 (see below), candidate(s) are nominated to the Governor by the the NC Medical Board for appointment to the NCBOEE. The physician candidate need not be in current practice.

The NCBOEE typically holds meetings in Greensboro four to five times per year. Meetings generally last a few hours, and members receive no reimbursement.  An ideal candidate would be a dermatologist, cosmetic or plastic surgeon or other physician who possesses working knowledge of Class IV laser technology.

Anyone interested in being nominated should send a letter of interest and CV by January 17, 2011. 

……………………………………………………………………………………….

§ 88A 5.  Creation and membership of Board.

(a) The North Carolina Board of Electrolysis Examiners is created. The Board shall consist of five members as follows:

(1) Three electrologists who have engaged in the practice of electrolysis for at least five years, one of whom shall be appointed by the General Assembly upon the recommendation of the Speaker of the House of Representatives, one of whom shall be appointed by the General Assembly upon the recommendation of the President Pro Tempore of the Senate, and one of whom shall be appointed by the Governor.

(2) A physician licensed under Chapter 90 of the General Statutes, who shall be nominated by the North Carolina Medical Board and appointed by the Governor.

3) A public member, appointed by the Governor, who has not practiced electrolysis, who is not in training to become an electrologist, and who is not related to anyone who would be prohibited by this subdivision from serving on the Board as a public member.

(b) Legislative appointments shall be made in accordance with G.S. 120 121. A vacancy in a legislative appointment shall be filled in accordance with G.S. 120 122.

(c) Each member shall be appointed for a term of three years and shall serve until a successor is appointed. Of the members initially appointed, one of the electrologist members shall serve a term of one year. The public member and the second electrologist member shall serve a term of two years. The physician member and the third electrologist member shall serve a term of three years. The terms of all initial appointments shall commence within 30 days of the effective date of this act. No member may serve more than two consecutive full terms.

(d) Vacancies shall be filled by the appropriate appointing authority within 30 days after the position is vacated. Appointees shall serve the remainder of the unexpired term and until their successors have been appointed and qualified.

(e) The Board may remove any of its members for gross neglect of duty, incompetence, or unprofessional conduct. A member subject to disciplinary proceedings shall be disqualified from all Board business until the charges are resolved. The Governor may also remove any member of the Board which he appoints.

(f) Each member of the Board shall receive per diem compensation and reimbursement for travel and subsistence in the amounts the Board votes upon and records in its minutes, provided the amounts do not exceed the amounts specified in G.S. 93B 5.

(g) The Board shall elect a Chairman, a Vice Chairman, a Treasurer, and such other officers as are deemed necessary by the Board. All officers shall be elected annually by the Board for one year terms and shall serve until their successors are elected and qualified.

(h) The Board shall hold at least two meetings each year to conduct its business, and shall adopt rules governing the calling, holding, and conducting of regular and special meetings. A majority of the members shall constitute a quorum. (1989 (Reg. Sess., 1990), c. 1033, s. 1; 1995, c. 94, s. 6.)

The North Carolina Medical Board has filed proposed rules related to re-entry into practice by physicians and physician assistants. These rules were published in the November 15^th edition of the N.C. Register and can be viewed at this link: http://www.ncoah.com/rules/register/Volume25Issue10November152010.pdf.

If approved, the rules will become effective on March 1, 2011. A public hearing to solicit stakeholder feedback is scheduled for Jan. 14, 2011 at the Medical Board’s offices in Raleigh.

In addition to new re-entry procedures, the filed rules propose to:

• Require a Federation Credential Verification Service (FCVS) profile for all international medical graduates.

• Require applicants to provide proof of U.S. citizenship.

• Bring nurse practitioner prescribing authority in line with physician assistant rules, meaning NPs cannot prescribe drugs that their supervising physician cannot also prescribe.

• Change current rules to prevent the Medical Board from publishing alcohol and drug related misdemeanors that occur prior to an applicant’s entrance into medical school.

The North Carolina Medical Board voted on November 19, 2010 to approve a Position Statement on Advertising and Publicity. This Position Statement was adopted in lieu of new rules that the Medical Board intended to approve earlier this year after convening a special work group on the issue. 

The Position Statement explains that advertising or publicity that is deceptive, false or misleading constitutes unprofessional conduct under the Medical Practice Act and provides examples of advertising to include oral, written and other types of communication disseminated by or at the direction of the licensee for the purpose of encouraging or soliciting the use of the licensee’s services.  Business letterhead, envelopes and cards are all considered advertising under this Position Statement.

Board Certification should only be advertised when a physician holds current certification by the American Board of Medical Specialties (ABMS), the Bureau of Osteopathic Specialists of the AOA, the Royal College of Physicians and Surgeons of Canada (RCPSC), or a board that meets a list of seven criteria outlined by the Position Statement.  Among these criteria are requirements that the organization requires satisfactory completion of a training program with training, documentation, and clinical requirements similar in scope and complexity to ACGME or AOA approved programs in the specialty or sub-specialty field of medicine in which the physician seeks certification.

The Medical Board also recommends that any advertisement of board certification should disclose in the advertisement the name of the board by which the physician was certified.

For more information and to view the entire Position Statement, click here.

The North Carolina Medical Board reviews Position Statements at least once every four years and is currently in the process of reviewing its existing Position Statement regarding Office-Based Procedures.  You can view the existing language on the Medical Board’s website at the following link: http://www.ncmedboard.org/position_statements/detail/office-based_procedures/

The Policy Committee of the Medical Board will be discussing any recommended changes to the Position Statement at their next meeting in January 2011 and has asked for feedback from NCMS members.  Should you or your colleagues have suggested amendments or comments to the Position Statement please direct them to the North Carolina Medical Board as soon as possible.  Comments can be mailed to P.O. Box 20007, Raleigh, NC 27619 or faxed to 919-326-1130.

Governor Bev Perdue has appointed Eleanor E. Greene, MD, of High Point as the newest member of the North Carolina Medical Board. Dr. Greene fills the vacancy of George L. Saunders, MD, past-president of the Board. 

Dr. Greene received her MD from the University of North Carolina, Chapel Hill and completed her training in obstetrics and gynecology at Ohio State University.  She currently practices at Triad Women’s Center in High Point.

The North Carolina Medical Board held a meeting in Raleigh on Wednesday night to discuss the development of a new position statement on what is being referred to as practice “drift.” You can read more about these efforts in the Summer 2010 issue of the Forum.

Practice drift is a term that describes the outflow of physicians from areas in which they were trained into new areas of practice. The Board has noted a small but increasing number of physicians “drifting” outside their formal areas of training, and recognizes that the evolution of physician practice is not necessarily negative but may be cause for developing guidelines.

A variety of stakeholders participated in this week’s meeting, including representatives from professional liability insurance companies and a balanced representation of  both primary care and specialty physicians.

The Committee’s aim is to produce a draft Position Statement on Practice Drift for consideration by the full Board. Thomas Hill, MD is chairing the effort and encourages stakeholder feedback. The deadline to submit comments to the Medical Boardis Monday, November 1, 2010. The Board is hopeful to have a draft available for comment at their January 2011 meeting.

The North Carolina Medical Board has approved a final draft rule on Advertising of Specialty and Board Certification which can be viewed here. However, it is not yet known when the current language will be filed for publication and final adoption.  You can also view the Medical Board’s Advertising Task Force Report, which was used to develop the final policy, by clicking here.  As written, the rule applies only to advertising standards and does not impact licensure requirements or physician credentialing.

In last week’s Bulletin, NCMS provided information regarding the Medical Board’s proposed revisions to question ten of the application for physician licensure. The Medical Board later approved revisions to that question with an additional change.

Question ten on the application will now read: 

10.          Have you ever been suspended, placed on scholastic or disciplinary probation, expelled or requested to resign from any medical school, residency or fellowship program?   While at any professional school, or training program, have you ever:

• Been suspended, placed on scholastic or disciplinary probation, expelled or requested to resign, or
• Withdrawn or gone on leave of absence while under investigation or threat of investigation or disciplinary action?

The North Carolina Medical Board met this week and discussed a number of issues of interest to the physician community.  The NCMS encourages members to provide feedback on these issues and let us know if you have any questions or concerns about the many proposed policy and rule changes that the Board is currently considering. 

Advertising of Specialty and Board Certification Rules

Almost one year ago, the Medical Board published a proposed rule to set standards for physician licensees who wish to advertise themselves as Board Certified or to say that they specialize in a certain area of practice.  Following a public hearing in November of 2009 and the receipt of many written comments from licensees and board certifying entities, the Medical Board convened a task force to address the issue and make recommendations.

Since the task force’s last meeting several changes to the originally proposed rule were made. Many of these changes appear to be driven by comments received from the American Board of Physician Specialists (ABPS) who were not specifically recognized in the Medical Board’s original recommendation. The final draft of the recommended rule can be viewed here.

Items that are underlined are additions to the original proposal; those struck through were a part of the original proposal but removed by the task force. Items that are both underlined and highlighted are the newest changes which were approved by the Medical Board’s Policy Committee on Wednesday afternoon.

In addition to having several members sit on the Medical Board’s task force, the NCMS convened its own work group to develop feedback regarding the proposed rule. Our comments to the Board can be viewed here.

Following approval by the full Medical Board, this proposed rule change should be re-published and a second public hearing held due to the substantial changes that have been made since 2009.

Proposed Changes to the Statutory Requirement for Postgraduate Training

On Wednesday, the Licensing Committee of the Medical Board approved a recommendation allowing staff to pursue a legislative change to NCGS 90-9.1 (a)(2) to require completion of 2 years of postgraduate education prior to receiving full licensure. Current statute only requires 1 year of postgraduate education for full licensure.  The Committee also recommended parity for internationally trained medical graduates, which would reduce the current requirement of 3 years postgraduate training to two years before becoming eligible for full licensure.

Proposed Re-Entry Rules

The Licensing Committee also discussed proposed rules for re-entry into practice after a licensee’s absence from practice for two or more years.  These rules have not yet been published; however the current draft is available here.

Updates to Licensing Application

The Licensing Committee recommends that question number ten on the licensee application form be re-written to reflect the following.

Federal Credentials Verification Service Requirement for International Medical Graduates

Rules may soon be filed to require applicants for licensure to submit a FCVS profile if the applicant is a graduate of a medical school approved by LCME, CACMS or COCA, and the applicant has previously completed a FCVS or if the applicant is a graduate of a medical school other than those approved by the LCME, COCA or CACMS. A copy of the proposed rule change can be viewed here.

On Friday, July 23, 2010 the North Carolina Medical Board met and gave final passage to a Board policy on Telemedicine. The final policy should appear on the Medical Board’s website soon; in the meantime, you can read the language approved by the NCMB Policy Committee here. After receiving feedback from the NC Medical Society and the NC Chapter of the American College of Radiology, NCMB staff removed language regarding informed consent and also omitted the fees section of the policy.

The NCMS was invited to an in-house meeting with staff of the NC Medical Board last Friday to discuss proposed rules regarding the re-entry of licensees following two years of absence.  This proposed rule will appear on the Medical Board’s agenda in September. In the meantime, NCMS members are encouraged to offer their feedback on this proposed rule and can do so via rules@ncmedboard.org. The Medical Board asks that all comments be received by August 20, 2010.  The draft rule can be viewed here.

The North Carolina Medical Board will have new licensing rules effective August 1, 2010. The new rules will conform the Board’s licensing regulations to current practice and language and incorporate policy changes approved by the Board.

Some key changes are:

• Reviewing license applicants’ immigration and work status (using a Homeland Security entity to check the status of international medical graduates);            
• Adopting an expedited application process for experienced physicians from other states (for those with at least 5 years of practice, clean applications, and current specialty board certification);
• Limiting license applicants to only three attempts on each step of the USMLE to get at least a score of 75;
• Clarifying CME requirements;
• Clarifying the “Ten Year Rule”;
• Tightening up the special purpose license for visiting instructors;
• Adopting a limited physician license for disasters and emergencies;
• Allowing the Board to waive renewal requirements, CME, fees, and other conditions of licensure for licensees on active military duty.

The final rules are not yet posted on the Office of Administrative Hearings website, however you can view the draft rules that were approved here.

The NCMS has sent a letter to the NC Medical Board (NCMB) regarding the Board’s proposed rule about advertising of specialty and board certification. Before preparing the letter, the NCMS held two meetings of a multi-specialty work group that addressed which certifying entities should be recognized by the NCMB and the advertising standards for board certification and specialization. The NCMS supports requiring minimum levels of accreditation or education when medical providers publicize their qualifications or skills. Read the letter sent by NCMS President Douglas D. Sheets, MD, to NCMB President Donald E. Jablonski, DO.

The Policy Committee of the North Carolina Medical Board is currently reviewing a draft policy on Telemedicine.  As a result of public comment received at the committee’s last meeting, the Board has updated its proposed draft to eliminate language requiring informed consent.  A copy of the updated draft can be viewed here.

The Policy Committee will review these changes at their next meeting in July.  Should the committee report favorably on this draft, the full Medical Board may also approve this policy during the July meeting.