On being appointed to NCMB, I had only the most basic understanding of the Board's work. I knew that licenses were authorized and renewed, and I had some sense that NCMB imposed disciplinary actions for egregious behavior. But that was a very limited view.
Having served on the Board for nearly six years, I now fully appreciate the words in NCMB’s founding statute, which state that NCMB exists “for the benefit and protection of the people of North Carolina”. This is the foundation of literally everything we do.
In licensing, NCMB ensures that applicants have appropriate qualifications and character to practice medicine safely and well. In its disciplinary role, the Board doesn’t just mete out punishment – whenever possible and appropriate it uses a variety of corrective interventions designed to help the physician or PA address the issue and resume productive careers. Whether the remedy is counseling for burnout, treatment for substance use or targeted CME to address identified knowledge deficits, NCMB’s goal is not to “shut down” the licensee but to preserve the precious resource our licensees represent to the state and its people.
It’s been especially exciting during my tenure on the Board to see NCMB stretching and growing to enhance its value to our state. Last year under the leadership of Immediate Past President Tim Lietz, MD, the Board developed a vision statement that captures what we are aiming for:
NCMB will be a proactive and progressive leader that addresses emerging challenges in medicine. I want to highlight two areas of particular import that show the strides NCMB has taken toward that goal:
The opioids crisis
There has been so much activity in this area it’s difficult to summarize, but I will try:
• With the Safe Opioid Prescribing Initiative, the investigative program established in 2016, NCMB is proactively identifying potentially unsafe prescribing. We continue to refine this program to ensure NCMB is using all the data and tools available to it to identify problem prescribers.
• NCMB collaborated with Wake AHEC on a free statewide training initiative to educate prescribers across the state in safe opioid prescribing practices and licensees with obtaining CME credit to satisfy the requirement for NC controlled substances prescribers.
• We are working on our own and with others to encourage licensees to incorporate medication assisted treatment (MAT) for opioid use disorder into their practices. For example, the last issue of the electronic Forum focused on MAT.
• We are finalizing the details of a partnership with MAHEC that will provide one-on-one coaching to identified prescribers of concern, an intervention called “academic detailing”. NCMB is excited to be able to offer this type of intensive intervention to licensees.
Professional sexual misconduct
I’m very proud to say that NCMB has, and will continue to be, a leader in the ongoing discussion about medical board handling of sexual misconduct cases. This troubling topic has been a frequent topic of discussion nationally in the wake of national media coverage of shocking cases such as that of Dr. Larry Nasser, the former USA Gymnastics national team doctor who abused young gymnasts for decades. Some of NCMB’s actions in this area include:
• Establishing a Victim Services Program that provides support and help connecting to needed services to victims of sexual assault. This program is staffed by an NCMB paralegal and offers help to victims regardless of whether the Board pursues regulatory action against the licensee involved. The program was featured in a poster session at the FSMB Annual Meeting in April 2019.
• Participating in national meetings and trainings. NCMB’s Deputy General Counsel served on a general session panel discussion on professional sexual misconduct at the 2019 FSMB Annual Meeting and also presented on the topic at a recent national training for Medical Board Investigators.
• Trained Board Members, legal and investigative staff in the effects of trauma on the brain, to develop a better understanding of responses and behaviors of victims of sexual assault and other trauma.
• Dr. Venkata Jonnalagadda, NCMB’s current Secretary/Treasurer, served on the FSMB’s Workgroup on Physician Sexual Misconduct, which is charged with updating FSMB’s policy on sexual boundaries and developing best practices for cooperating with law enforcement.
• Successfully advocated for changes to state law that allow NCMB to revoke the license of any licensee who is convicted of felony sexual assault and establishes a new legal obligation for licensees to report medical professionals they believe have engaged in sexual misconduct to the Board, so it can investigate.
These are just two broad areas where NCMB is working to fulfill its pledge to be a “proactive and progressive leader that addresses emerging challenges in medicine”. Mind, all of this has been achieved in addition to NCMB’s core work of licensing and regulation. I feel proud to have served and led as this work has been accomplished.
My charge to you as a licensee of the Board is to consider serving as a member of the North Carolina Medical Board yourself one day. It is an unbelievably gratifying and rewarding experience that affords the opportunity to be part of one of the most progressive boards in the country.
Thank you to all for an amazing and fulfilling six years!
