I was pleasantly surprised with the many positive comments I received in response to my first President’s Message, in which I described the lifestyle changes I have made to prevent professional burnout. A few readers were moved to point out the apparent contradiction of the Board President expressing concerns about burnout even as NCMB prepares to implement a new continuing medical education (CME) requirement for controlled substances prescribers. More than one individual who commented opined that medical boards and the rules and requirements they impose are one of the reasons so many physicians are burned out.

This is a reasonable point and not one that is lost on the Board, although I must disagree that the new controlled substances CME (CS CME) requirement is an example of oppressive overregulation. We are all aware of the grave public health threat the overabundance of opioids poses to patients, as evidenced by the steady rise in overdose deaths in NC in recent years. In nearly half of opioid overdose deaths in the U.S., the medications implicated were prescribed by a licensed medical professional (though often not directly to the decedent). NCMB has a responsibility to educate prescribers about the problem and to encourage them to get the education and training they need to provide appropriate care. That is why the Board embraced a 2015-2016 state budget provision that called on all boards that license controlled substances prescribers to adopt CME requirements related to the abuse of controlled substances. NCMB’s approach to the new requirement, which will be in effect as of July 1, shows its commitment to being thoughtful when it imposes new mandates.

First, NCMB decided to make the new CME hours required for controlled substances prescribers part of the total CME requirements for physicians and PAs, not in addition to the total number of hours required. That is, physicians who prescribe controlled substances do not need to earn hours over and above the 60 total hours required during each three year CME cycle – they simply need to ensure that three of their 60 hours cover topics related to controlled substances. Similarly, PAs need only ensure that two of the 50 total CME hours required during each two year cycle cover the requisite topics.

Second, NCMB is allowing physicians and PAs the freedom to decide for themselves which CME courses they complete in order to satisfy the new requirement,
not dictating that they complete a specific program. It’s pretty simple – if a CME course covers one or more of the required education topics AND is AMA PRA Category 1 certified, it can be counted. NCMB hopes that this flexibility will enable licensees who may already have completed relevant CME courses to avoid duplicating their efforts. Also, NCMB recognizes that some prescribers hold licenses in other states that already have a CS CME requirement. These licensees may claim credit for courses completed for other states, as long as the CME covered the required topics and was completed during the current NC CME cycle. As is the case with all other CME, NCMB licensees are not required to submit CME certificates to the Board. NCMB recommends that physicians and PAs keep documentation for six years in case they are selected for a CME compliance check.

Finally, NCMB supported the new CME requirement by partnering with Wake AHEC to develop controlled substances CME that was provided at no cost to licensees. The CME included a webinar and a related series of four 2-hour live panel discussions that were held in rural areas of the Triangle region in April and May. Completion of the webinar (still available online) and attendance at one panel discussion equals three total hours of controlled substances CME – enough to meet the new requirement. The collaboration, which was supported by a grant from NC AHEC, was so successful that NCMB and Wake AHEC requested additional funding to offer more panel discussions across the state. This grant was recently approved.

The vast majority of licensees who have contacted the Board with questions or comments about the new requirement have been more than ready to do what they need to do to comply – Your professionalism is much appreciated. NCMB understands how busy its licensees are and has tried to make meeting this new requirement easy. If you still have questions about how the new CME requirement may apply to you, I hope you’ll take advantage of the resources available at www.ncmedboard.org/prescribingcme, or pick up the phone to call the Board’s staff.

Be well,

Elanor E. Greene, MD, MPH
Board President

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Panelists needed for CS CME

NCMB and Wake AHEC recently received a grant to support many more controlled substances CME panel discussions across North Carolina. If you have expertise in this area and are interested in serving as a panelist, please email NCMB at PrescribingCME@ncmedboard.org Clinicians with relevant experience in the following areas are needed:

Primary care
Psychiatry
Addiction medicine
Pain management