In November, I had the honor of being sworn in as the North Carolina Medical Board’s 119th President. A little over five years ago, when I was a new Board Member, it would have been hard to believe I’d find myself in the top leadership position. Like many physicians, aside from the direct experience renewing my license each year, I had very little understanding of NCMB’s role in the practice of medicine. I became interested in learning more through my work as a partner in a large emergency medicine practice in Charlotte, where I am responsible for responding to the occasional complaints we receive from patients. We are usually able to resolve concerns without further escalation but, from time to time, I’d receive a letter from NCMB directing me to respond to a complaint a patient seen by a provider in my group had submitted.

I’ll admit to feeling somewhat affronted by having to answer to the medical board. I happen to believe that my practice, and the larger community of physicians and other medical professionals, hospitals and others involved in the delivery of medical care in Charlotte, do an excellent job of holding one another accountable, when necessary. In an emergency department, we practice in a fishbowl and everyone knows what everyone else is doing. When someone is not practicing up to standard, everyone knows and that behavior won’t be tolerated for long. What additional value, I wondered, could the medical board possibly provide?

Serving on the Board – and specifically, reviewing disciplinary cases – quickly taught me that the level of transparency and accountability I take for granted isn’t necessarily in place in every practice environment. There are a lot of areas in NC where the licensee practices in his or her own bubble and no one is watching. Who holds that physician or PA responsible if patient care is substandard? Who intervenes if the licensee exploits patients sexually or financially? Who will ensure that he or she gets assistance with substance use or mental health problems, if needed?

In many cases that come to the Board’s attention, NCMB is the patient’s only means of holding medical providers accountable, and the only agency with the authority and imperative to act. I should also say that inadequate oversight is not limited to rural or less populous parts of North Carolina. No part of the state or practice environment is perfect at identifying and addressing problems with professional misconduct or medical care.

When NCMB acts to address serious problems with licensee conduct or care, we protect both the people of North Carolina and the integrity of the medical profession. Allowing misconduct or substandard care to continue unchecked impugns the reputations of all honorable and competent medical professionals. In situations where impairment has eroded a physician or PA’s professional and personal life, the Board’s involvement is often the start of a process that literally saves that licensee’s practice, not to mention life.

NCMB’s mission truly is to regulate medicine and surgery for “the benefit and protection of the people of North Carolina” – a group I have come to realize includes the medical professionals it regulates.

Be well,

Timothy E. Lietz, MD
Board President