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8.1.1: Physician Practice Drift

When physicians are granted a license by the Board, they are generally given the privilege of practicing the full breadth of medicine and are not limited to a particular specialty. This general medical license allows physicians a certain degree of discretion to expand or shift their practice areas. The Board recognizes that medicine is a dynamic field that, along with individual practices, continues to evolve. Business and financial opportunities, personal lifestyle considerations, and access to care are all reasons that physicians modify their practice.

When considering changes to one’s area of practice, physicians have a professional and ethical duty to put their patients’ interests first and only offer medical care that the physician is competent to provide. Patient harm can occur when physicians practice outside of areas in which they have been adequately trained.

Physicians intending to expand their practice to a new area should ensure that they have acquired the appropriate level of education and training. This may involve seeking additional training by attending appropriate educational programs. Physicians should be prepared to provide information about their qualifications and any additional training that has prepared them to provide medical care in this modified or new area of practice. It may also be prudent for physicians to confirm that their liability insurance provides coverage for the new or modified practice.

It is the Board’s position that all physicians, irrespective of their area of training, will be held to the standard of acceptable and prevailing medical practice in the specialty area that the care was rendered as set forth in N.C. Gen. Stat. § 90-14(a)(6).

The Board also refers licensees to the Board’s Position Statement entitled “Physician Supervision of Other Licensed Health Care Professionals” and Board Rules 21 NCAC 32S .0213 (addressing physician supervision of physician assistants) and 21 NCAC 32M .0102 (addressing the scope of practice of nurse practitioners).

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