NCMS Board Welcomes Visitor, Considers Policy Proposal

The North Carolina Medical Society (NCMS) Board of Directors held its regularly scheduled Board meeting during the M3 Conference last week

in Greensboro. The Board welcomed Joseph Guarino, MD, an occupational medicine specialist from Reidsville to the meeting.

“I want to express my concerns that we really ought to be advocating for physicians in private practice who can practice medicine the way he or she wants to,” Dr. Guarino told the Board. “The state medical society is responding to issues with resiliency programs. It would be helpful to get to the root causes [of physician burnout], and oppose some of the things happening with consolidation, electronic health records, value-based payments and ACOs.”

When asked, Dr. Guarino didn’t propose any specific solutions other than to say that “if the state wants to save money on Medicaid they could curtail the services offered, cut back on optional services and by reducing eligibility. Medicaid for the pediatric population is really a middle-class entitlement,” he said.

Board members described the approach to complex issues that is generally used in the NC legislature. Medicaid reform and scope of practice issues, for example, require the medical community to participate in problem solving discussions that involve opposing interests. Those opposing interests come from many sources, sometimes from within the medical profession.

“We don’t hold all the cards in our hands,” Immediate Past President Robert Schaaf, MD, told Dr. Guarino. “We understand the points you’re making, and you can be sure we are committed to addressing the difficult challenges faced by practicing physicians.”

Dr. Guarino, who was attending the M3 conference, thanked the Board members who in turn expressed their appreciation for him sharing his views.

The Board also considered a request submitted by John Dykers, MD, of Siler City to change the law regarding the physician’s role in issuing concealed carry permits. Currently, the law is different in each county. Generally, the Sheriff makes an evaluation of whether an applicant is allowed to have permit. This can involve a request for medical information. Dr. Dykers’ proposal would require the Sheriff to ask the doctor whether a person is not fit to carry a firearm.

Board members voted to refer this matter to the Legislative Cabinet to report back to the Board with a recommendation.


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