Professional Documents
Culture Documents
Presidential Remarks
Dr. Jablonski commenced the meeting by reading from the State Government Ethics Act,
“ethics awareness and conflict of interest reminder.” No conflicts were reported.
Dr. Jablonski explained the process to the Board members regarding the NCMB Officers and
Executive Committee recommendations.
Dr. Jablonski had Ms. Blizzard give a brief overview from the ”CPEP Learning Summit” she
attended.
Minute Approval
Motion: A motion passed that the May 19, 2010 Board Minutes and the June 17, 2010
Hearing minutes are approved as presented.
Mr. Henderson updated the Board members regarding Dr. Scott Kirby becoming the new NCMB
Medical Director. It was also noted that Dr. Sheppa would remain at the NCMB but on a part-
time basis.
Ms. Judie Clark, Director of Complaints, recognized Amy Ingram on her 5 year anniversary at
the NCMB.
Mr. Henderson noted that the NCPHP Compliance & BOD meeting would be held today at the
Renaissance Hotel starting at 3:00pm.
Mr. Curt Ellis, Director of Investigations, presented David Hedgecock, NCMB Investigator, for
completion of the Certified Medical Board Investigator Certificate.
Mr. Henderson noted that Ms. Jean Fisher-Brinkley, Director of Public Affairs, would be doing a
Bi-annual program update for the Board on Friday morning.
The Executive Committee of the North Carolina Medical Board met beginning at 10:40 am,
Wednesday July 21, 2010 at the offices of the Board. Committee members present were:
Donald E. Jablonski, DO, Chair; Janice E. Huff, MD; George L. Saunders, MD; William A.
Walker, MD; and John B. Lewis, Jr. Also present were Ralph C. Loomis, MD, R. David
Henderson (Executive Director), Hari Gupta (Director of Operations) and Peter T. Celentano,
CPA (Comptroller).
Financial Statements
Monthly Accounting May 2010: Mr. Celentano, CPA, presented the May 2010 compiled
financial statements. May is the seventh month of fiscal year 2010. The Committee
recommends the Board accept the financial statements as reported.
Old Business
Fines: N.C. General Statute 90-14(a) permits the Board to fine a licensee who has
violated the Medical Practice Act. The Board previously approved the use of fines in cases
where there is other disciplinary action. Senior staff continues to work on the manner in which
fines, without accompanying discipline or other public action, should be published or reported.
This issue will be discussed further at the September meeting.
Change in Staff Privileges: N.C. General Statute Section 90-14.13 states that the chief
administrative officer of every licensed hospital shall report to the Board actions involving a
physician’s privileges to practice in that institution including any resignation from practice or
voluntary reduction of privileges. However, the Board’s online Change in Staff Privileges form
only requires hospitals to report “for cause” resignations or reductions in privileges.
The Committee believes the current law may be too broad and recommends the Board
seek a change to N.C. General Statute Section 90-14-13 to provide that changes in staff
privileges are reportable pursuant to rules to be adopted by the Board.
New Business
2012 Meeting and Hearing Calendars: The Committee reviewed the proposed 2012
Board Meeting and Hearing schedule and recommends adoption.
Committee Members: Dr. Loomis, Dr. Walker, Judge Lewis, and Dr. Camnitz
Staff: Todd Brosius, Christina Apperson, and Wanda Long
NEW BUSINESS:
LAST
SCHEDULED REVISED/
FOR REVIEWED/ REVISED/ REVISED/ REVISED/ REVISED/
POSITION STATEMENT ADOPTED REVIEW ADOPTED REVIEWED REVIEWED REVIEWED REVIEWED
Professional Obligation to
Report Incompetence,
Impairment, and
Unethical Conduct Nov-98 March 2010 Nov-98
Medical, Nursing,
Pharmacy Boards: Joint
Statement on Pain
Management in End-of-
Life Care Oct-99 May 2010 Oct-99
What Are the Position
Statements of the Board
and To Whom Do They
Apply? Nov-99 May 2010 Nov-99
Contact With Patients
Before Prescribing Nov-99 July 2010 Feb-01
Guidelines for Avoiding
Misunderstandings
During Physical
Examinations May-91 July 2010 Oct-02 Feb-01 Jan-01 May-96 May-93
Office-Based Procedures Sep-00 Jan-03
Access to Physician
Records Nov-93 Aug-03 Mar-02 Sep-97 May-96
Medical Supervisor-
Trainee Relationship Apr-04 Apr-04
The Treatment of Obesity Oct-87 Jan-05 Mar-96
HIV/HBV Infected Health
Care Workers Nov-92 Jan-05 May-96
Writing of Prescriptions May-91 Mar-05 Jul-02 Mar-02 May-96 Sep-92
Laser Surgery Jul-99 Jul-05 Aug-02 Mar-02 Jan-00
Self- Treatment and
Treatment of Family
Members and Others
With Whom Significant
Emotional Relationships
Exist May-91 Sep-05 Mar-02 May-00 May-96
Advertising and Publicity Nov-99 Sep-05 Mar-01
It is the position of the North Carolina Medical Board that prescribing drugs to an individual the
prescriber has not personally examined is inappropriate except as noted in the paragraphs
below. Before prescribing a drug, a licensee should make an informed medical judgment based
on the circumstances of the situation and on his or her training and experience. Ordinarily, this
will require that the licensee personally perform an appropriate history and physical
examination, make a diagnosis, and formulate a therapeutic plan, a part of which might be a
prescription. This process must be documented appropriately.
Prescribing for an individual whom the licensee has not met or personally examined may also
be suitable when that individual is the partner of a patient whom the licensee is treating for
gonorrhea or chlamydia. Partner management of patients with gonorrhea or chlamydia should
include the following items:
It is the position of the Board that prescribing drugs to individuals the licensee has never met
based solely on answers to a set of questions, as is common in Internet or toll-free telephone
prescribing, is inappropriate and unprofessional.
It is the position of the North Carolina Medical Board that proper care and sensitivity are
needed during physical examinations to avoid misunderstandings that could lead to charges
of sexual misconduct against physicians licensees. In order to prevent such
misunderstandings, the Board offers the following guidelines.
1) Sensitivity to patient dignity should be considered by the physician licensee when
undertaking a physical examination. The patient should be assured of adequate
auditory and visual privacy and should never be asked to disrobe in the presence of
the physician licensee. Examining rooms should be safe, clean, and well
maintained, and should be equipped with appropriate furniture for examination and
treatment. Gowns, sheets and/or other appropriate apparel should be made
available to protect patient dignity and decrease embarrassment to the patient while
a thorough and professional examination is conducted.
(Adopted May 1991) (Amended May 1993, May 1996, January 2001, February 2001, October
2002)
OLD BUSINESS:
Issue: In November 2009, the Board approved the Policy Committee’s recommendation
to review Position Statements at least once every four years. A review schedule has
been formulated for the Committee’s consideration.
TELEMEDICINE
Issue: The Board to consider recent adoptions of telemedicine policies and statements by the
Federation, Blue Cross Blue Shield and the AMA.
5/2009 COMMITTEE DISCUSSION: Dr. Rhyne reported that the Federation recently adopted a
statement regarding telemedicine. It was also reported that BCBS would be implementing a new
e-medicine policy.
5/2009 BOARD ACTION: Mr. Brosius to use information from AMA, Federation, Medical Society
and BCBS, to begin working on a comprehensive policy. This policy should include the
telepsychiatry issue the Committee addressed last year.
9/2009 COMMITTEE DISCUSSION: Mr. Brosius presented the following proposed Position
Statement. Comments were solicited from DHHS and their recommendations were considered
and incorporated where the Policy Committee deemed appropriate.
9/2009 BOARD ACTION: Have proposed Position Statement published in Forum for comments
before final adoption by Board.
11/2009 BOARD ACTION: Continue to collect comments. Position Statement and comments
will be considered at the January 2010 meeting.
1/2010 COMMITTEE DISCUSSION: Comments received are on file and were provided for the
Committee’s review. The Committee discussed the need for informed consent. It was the
consensus of the Committee that the proposed Position Statement should not be changed.
1/2010 BOARD ACTION: After a full Board discussion, the Board voted to table this issue until
the staff could obtain additional information regarding informed consent.
3/2010 COMMITTEE DISCUSSION: The Committee received comments from Dr. Wu and Mr.
Bode regarding current standards in telemedicine as it related to radiology. Additional
comments were made from public guests, indicating their interest in monitoring the Board’s
activity on this issue.
3/2010 COMMITTEE RECOMMENDATION: Mr. Brosius is to prepare new language for the
informed consent section of the proposed Position Statement. The proposal will be presented
to the Policy Committee at the May meeting for further consideration.
5/2010 COMMITTEE DISCUSSION: The Committee heard from Dr. Brian S. Kuszyk, MD, Past
President, NC Chapter of the American College of Radiology. Dr. Kuszyk explained that the
nature of radiology is such that all or nearly all of radiology is teleradiology. He also indicated
that the specialty of radiology is not one that relies upon informed consent. The Board
discussed the fact that perhaps the section on informed consent is aimed at such a narrow
category of cases that it is in fact more distracting than helpful.
7/2010 COMMITTEE RECOMMENDATION: Allow full Board to review letter from NCIMS.
Approve proposed changes to Telemedicine position statement, which include deleting the
informed consent and fee sections.
Telemedicine
The Board cautions, however, that licensees practicing via telemedicine will be held to the same
standard of care as licensees employing more traditional in-person medical care. A failure to
conform to the appropriate standard of care, whether that care is rendered in-person or via
telemedicine, may subject the licensee to potential discipline by this Board.
The Board provides the following considerations to its licensees as guidance in providing
medical services via telemedicine:
Training of Staff -- Staff involved in the telemedicine visit should be trained in the use of the
telemedicine equipment and competent in its operation.
Other examinations may also be considered appropriate if the licensee is at a distance from the
patient, but a licensed health care professional is able to provide various physical findings that
the licensee needs to complete an adequate assessment. On the other hand, a simple
questionnaire without an appropriate examination may be a violation of law and/or subject the
licensee to discipline by the Board.1
Licensee-Patient Relationship – The licensee using telemedicine should have some means of
verifying that the person seeking treatment is in fact who he or she claims to be. A diagnosis
should be established through the use of accepted medical practices, i.e., a patient history,
mental status examination, physical examination and appropriate diagnostic and laboratory
testing. Licensees using telemedicine should also ensure the availability for appropriate follow-
1
See also the Board’s Position Statement entitled “Contact with Patients before Prescribing.”
July 21-23, 2010
up care and maintain a complete medical record that is available to the patient and other
treating health care providers.
Medical Records -- The licensee treating a patient via telemedicine must maintain a complete
record of the telemedicine patient’s care according to prevailing medical record standards. The
medical record serves to document the analysis and plan of an episode of care for future
reference. It must reflect an appropriate evaluation of the patient's presenting symptoms, and
relevant components of the electronic professional interaction must be documented as with any
other encounter.
The licensee must maintain the record’s confidentiality and disclose the records to the patient
consistent with state and federal law. If the patient has a primary care provider and a
telemedicine provider for the same ailment, then the primary care provider’s medical record and
the telemedicine provider’s record constitute one complete patient record.
Licensure -- The practice of medicine is deemed to occur in the state in which the patient is
located. Therefore, any licensee using telemedicine to regularly provide medical services to
patients located in North Carolina should be licensed to practice medicine in North Carolina.2
Licensees need not reside in North Carolina, as long as they have a valid, current North
Carolina license.
North Carolina licensees intending to practice medicine via telemedicine technology to treat or
diagnose patients outside of North Carolina should check with other state licensing boards.
Most states require physicians to be licensed, and some have enacted limitations to
telemedicine practice or require or offer a special registration. A directory of all U.S. medical
boards may be accessed at the Federation of State Medical Boards Web site:
http://www.fsmb.org/directory_smb.html.
Fees – The Board’s licensees should be aware that third-party payors may have differing
requirements and definitions of telemedicine for the purpose of reimbursement.
Medical, Nursing, Pharmacy Boards: Joint Statement on Pain Management in End-of-Life Care
2
N.C. Gen. Stat. § 90-18(c)(11) exempts from the requirement for licensure: “The practice of medicine or
surgery by any nonregistered reputable physician or surgeon who comes into this State, either in person
or by use of any electronic or other mediums, on an irregular basis, to consult with a resident registered
physician or to consult with personnel at a medical school about educational or medical training. This
proviso shall not apply to physicians resident in a neighboring state and regularly practicing in this State.”
The Board also notes that the North Carolina General Statutes define the practice of medicine as
including, “The performance of any act, within or without this State, described in this subdivision by use of
any electronic or other means, including the Internet or telephone.” N.C. Gen. Stat. § 90-1.1(5)f.
July 21-23, 2010
7/2010 COMMITTEE RECOMMENDATION: Mr. Brosius to contact the Pharmacy Board
and the Nursing Board to determine if they object to the proposed changes and if they
will join in those changes.
Through dialogue with members of the healthcare community and consumers, a number of
perceived regulatory barriers to adequate pain management in end-of-life care have been
expressed to the Boards of Medicine, Nursing, and Pharmacy. The following statement
attempts to address these misperceptions by outlining practice expectations for physicians and
other health care professionals authorized to prescribe medications, as well as nurses and
pharmacists involved in this aspect of end-of-life care. The statement is based on:
the legal scope of practice for each of these licensed health professionals;
professional collaboration and communication among health professionals providing
palliative care; and
a standard of care that assures on-going pain assessment, a therapeutic plan for pain
management interventions; and evidence of adequate symptom management for the
dying patient.
It is the position of all three Boards that patients and their families should be assured of
competent, comprehensive palliative care at the end of their lives. Physicians, nurses and
pharmacists should be knowledgeable regarding effective and compassionate pain relief, and
patients and their families should be assured such relief will be provided.
Because of the overwhelming concern of patients about pain relief, the physician needs to give
special attention to the effective assessment of pain. It is particularly important that the
physician frankly but sensitively discuss with the patient and the family their concerns and
choices at the end of life. As part of this discussion, the physician should make clear that, in
some end of life care situations, there are inherent risks associated with effective pain relief.
The Medical Board will assume opioid use in such patients is appropriate if the responsible
physician is familiar with and abides by acceptable medical guidelines regarding such use, is
knowledgeable about effective and compassionate pain relief, and maintains an appropriate
medical record that details a pain management plan. Because the Board is aware of the
inherent risks associated with effective pain relief in such situations, it will not interpret their
occurrence as subject to discipline by the Board.
With regard to pharmacy practice, North Carolina has no quantity restrictions on dispensing
controlled substances including those in Schedule II. This is significant when utilizing the
federal rule that allows the partial filling of Schedule II prescriptions for up to 60 days. In these
situations it would minimize expenses and unnecessary waste of drugs if the prescriber would
note on the prescription that the patient is terminally ill and specify the largest anticipated
quantity that could be needed for the next two months. The pharmacist could then dispense
smaller quantities of the prescription to meet the patient’s needs up to the total quantity
authorized. Government-approved labeling for dosage level and frequency can be useful as
guidance for patient care. Health professionals may, on occasion, determine that higher levels
are justified in specific cases. However, these occasions would be exceptions to general
practice and would need to be properly documented to establish informed consent of the patient
and family.
Federal and state rules also allow the fax transmittal of an original prescription for Schedule II
drugs for hospice patients. If the prescriber notes the hospice status of the patient on the faxed
July 21-23, 2010
document, it serves as the original. Pharmacy rules also allow the emergency refilling of
prescriptions in Schedules III, IV, and V. While this does not apply to Schedule II drugs, it can
be useful in situations where the patient is using drugs such as Vicodin for pain or Xanax for
anxiety.
The nurse is often the health professional most involved in on-going pain assessment,
implementing the prescribed pain management plan, evaluating the patient’s response to such
interventions and adjusting medication levels based on patient status. In order to achieve
adequate pain management, the prescription must provide dosage ranges and frequency
parameters within which the nurse may adjust (titrate) medication in order to achieve adequate
pain control. Consistent with the licensee’s scope of practice, the RN or LPN is accountable for
implementing the pain management plan utilizing his/her knowledge base and documented
assessment of the patient’s needs. The nurse has the authority to adjust medication levels
within the dosage and frequency ranges stipulated by the prescriber and according to the
agency’s established protocols. However, the nurse does not have the authority to change the
medical pain management plan. When adequate pain management is not achieved under the
currently prescribed treatment plan, the nurse is responsible for reporting such findings to the
prescriber and documenting this communication. Only the physician or other health professional
with authority to prescribe may change the medical pain management plan.
Communication and collaboration between members of the healthcare team, and the patient
and family are essential in achieving adequate pain management in end-of-life care. Within this
interdisciplinary framework for end of life care, effective pain management should include:
It is important to remind health professionals that licensing boards hold each licensee
accountable for providing safe, effective care. Exercising this standard of care requires the
application of knowledge, skills, as well as ethical principles focused on optimum patient care
while taking all appropriate measures to relieve suffering. The healthcare team should give
primary importance to the expressed desires of the patient tempered by the judgment and legal
responsibilities of each licensed health professional as to what is in the patient’s best interest.
(October 1999)
OLD BUSINESS:
9/2009 COMMITTEE DISCUSSION: It was reported that the following rule has been
submitted to the Office of Administrative Hearings to be published in the NC Register.
A public hearing for the purpose of collecting any comments will be held at the
Board’s office on November 30, 2009 at 11:00 am. The proposed rule will be
submitted to the Board at its December meeting for adoption.
July 21-23, 2010
9/2009 BOARD ACTION: Accept as information.
11/2009 COMMITTEE DISCUSSION: It was reported that the following rule has been
submitted to the Office of Administrative Hearings and was published in the NC
Register. A public hearing for the purpose of collecting any comments will be held at
the Board’s office on November 30, 2009 at 11:00 am. The Board continues to
receive comments. The proposed rule and comments collected will be presented to
the Board at its January 2010 meeting for consideration.
5/2010 COMMITTEE DISCUSSION: The taskforce has been created and its first
meeting is scheduled for May 18th, 2010.
5/2010 COMMITTEE DISCUSSION: The taskforce has been created and held its
first meeting on May 18, 2010. The taskforce invited additional comments on the
issue to those present and will table this matter until sufficient time has transpired to
allow for additional comment.
(a) No physician shall advertise or otherwise hold himself or herself out to the public as being
“Board Certified” without proof of current certification by a specialty board approved by (1) the
American Board of Medical Specialties; (2) the Bureau of Osteopathic Specialists of American
Osteopathic Association; (3) the Royal College of Physicians and Surgeons of Canada; (4) a
board or association with an Accreditation Council for Graduate Medical Education approved
postgraduate training program that provides complete training in that specialty or subspecialty;
or (5) a board or association with equivalent requirements approved by the North Carolina
Medical Board.
(b) Any physicians advertising or otherwise holding himself or herself out to the public as “Board
Certified” as contemplated in paragraph (a) shall disclose in the advertisement the specialty
board by which the physician was certified.
(c) Physicians shall not list their names under a specific specialty in advertisements, including
but not limited to, classified telephone directories and other directories unless: (1) they are
board certified as defined in paragraph (a); or (2) they have successfully completed a training
program in the advertised specialty that is accredited by the Accreditation Council for Graduate
Medical Education or approved by the Council on Postdoctoral Training of the American
Osteopathic Association.
A motion passed to close the session pursuant to Section 143-318.11(a) of the North Carolina
General Statutes to prevent the disclosure of information that is confidential pursuant to
Sections 90-8, 90-14, 90-16, 90-21.22 of the North Carolina General Statutes and not
considered a public record within the meaning of Chapter 132 of the General Statutes and/or to
preserve attorney/client privilege.
Eleven licensure interviews were considered. A written report was presented for the Board’s
review. The Board adopted the Committee’s recommendation to approve the written report.
The specifics of this report are not included because these actions are not public
information.
July 21-23, 2010
A motion passed to return to open session.
OPEN SESSION
OLD BUSINESS:
Issue: At the March 2009 meeting a motion was passed for staff to investigate the feasibility of
changing NCGS 90-9.1(a)(2)a to require completion of more than 1 year of postgraduate
education for graduates of a medical college approved by the Liaison Commission on Medical
Education, an osteopathic college approved by the American Osteopathic Association or The
Committee for the Accreditation of Canadian Medical Schools after graduation from medical
school. 11/09 Board Action: Have legal provide an update at the January 2010 meeting.
Tasked to legal 12/9/09
01/2010 Board Action: Recommend special project assignment to contact stake holders and
research the repercussions it will have on the medical community.
05/2010 Board Action: Thom Mansfield to continue to get input from stakeholders.
Update: Mr. Mansfield has not undertaken any additional meetings as of yet because it became
clear that the input process would be lengthy and that this session of the legislature was going
to end quickly without any realistic possibility of getting a bill considered this year.
Committee Recommendation: Dr. Kirby and Mr. Mansfield to pursue meetings with
stakeholders regarding the impact of changing the statue will have on the GME programs,
starting with Dr. Gerancher.
Board Action: Dr. Kirby and Mr. Mansfield to pursue meetings with stakeholders regarding the
impact of changing the statue will have on the GME programs, starting with Dr. Gerancher.
Staff continues to investigate the most practical way to verify that an applicant is a legal resident
of the US. 11/09 Board Action: Move forward with staff’s proposal. Legal and Licensing
Staff have submitted an application to participate in the SAVE program and are awaiting a
response to the request.
1/2010 Board Action: Accept as information – Staff to provide update at March meeting.
3/2010 Board Action: Department of Homeland Security has backlog. Legal to provide update
at May 2010 meeting.
05/20 10 Board Action: Staff will continue to request status updates from the Department of
Homeland Security every 2 months. Legal will provide updates at next committee meeting.
Update: No news from Save Program. Mr. Balestrieri will continue to check in with them
periodically and report at the September meeting.
NEW BUSINESS
Issue: Dr. Sheppa requests clarification for consistency – see his 4/9 email to Dr. Huff. The
committee discussed setting the criteria for PLOCs.
Issue: The following amendment to 32B .1303(b) (4) was approved during the June hearings
and submitted to Rules Review as a part of the licensing rules rewrite:
Issue (4) within the past three years, received a practice-relevant, three-year AMA Physician's
Recognition Award or AOA equivalent CME. years completed CME as required by 21 NCAC
32R .0101(a), .0101(b), and .0102
Issue: Currently, otherwise clean applications which use the AMA/PRA certificate to satisfy the
ten-year rule are routed to Board members for review to make sure the CME is practice
relevant. Staff believes this can be handled by the OMD and Board members consulted on an
as needed basis.
Board Action: For clean applications in which AMA/PRA certificate is submitted to satisfy the
ten-year rule: OMD will review underlying CME to make sure it is practice relevant. If so, staff
will issue license. If not, or if there is any question, staff will send out for Board member review.
Board Action: Accept as information. Send Amy Whitted at NCMS a copy of the new license
application and relative forms.
Issue: There was a discussion on whether staff should put prior out of state actions on the
licensee information page or allow the licensee to update.
A motion passed to close the session pursuant to Section 143-318.11(a) of the North Carolina
General Statutes to prevent the disclosure of information that is confidential pursuant to
Sections 90-8, 90-14, 90-16, 90-21.22 of the North Carolina General Statutes and not
considered a public record within the meaning of Chapter 132 of the General Statutes and/or to
preserve attorney/client privilege.
Ten licensure interviews were conducted. A written report was presented for the Board’s
review. The Board adopted the Committee’s recommendation to approve the written report.
The specifics of this report are not included because these actions are not public
information.
Reinstatement
Anthony, Robert Ray
Barber, Alfred Joseph
Bermudez, Jennifer Jane
Boliek, William Gary
Fisher, David Andrew
Fuller, Lance Robert
Hill, Becki Sue
Hines, Chesley
Huneycutt, Benjamin Stuart
July 21-23, 2010
May, Monique Danielle
Mirmow, Dwight Paul
Oliver, Lanta Christine
Orkubi, Ghada Abdullah
Samuel, Colleen Rochelle
Taylor, Richard Stephen
Ungerleider, Ross Michael
Uniat, Reuben Wayne
Reactivation
Clanton, Pamela Anne
PA-Cs
Name
PA-Cs Reactivations/Reinstatements/Re-Entries
PA-Cs
PA-Cs
Present: Thomas Hill, MD, Chairperson, Peggy Robinson PA-C, George Saunders, MD, Lori
King, CPCS, Quanta Williams, Jane Paige, Marcus Jimison, Nancy Hemphill, Katharine Kovacs,
Audrey Tuttle
21 NCAC 32S.0219. Limited Physician Assistant License For Disasters and Emergencies
During the May 2010 Board Meeting, the Board heard comments from PAs at the PA Advisory
Committee and the Allied Health Committee about concerns they had that the rule regarding PA
licensure during a disaster would prevent a PA from being paid even if responding to the
disaster was a requirement of his or her employment. Originally, the Board drafted the attached
rule to prevent gouging and exploitation of patients during a disaster. However, the Board did
not intend PA responders to forego their usual compensation if responding to a disaster was
part of their employment. Marcus Jimison, Nancy Hemphill and the Committee discussed.
Immigration Status – Addition to PA Licensure Rule. Nancy Hemphill, Marcus Jimison and the
Committee discussed.
A motion passed to close the session pursuant to Section 143-318.11(a) of the North Carolina
General Statutes to prevent the disclosure of information that is confidential pursuant to
Sections 90-8, 90-14, 90-16, 90-21.22 of the North Carolina General Statutes and not
considered a public record within the meaning of Chapter 132 of the General Statutes and/or to
preserve attorney/client privilege.
The Committee reported on one cases. A written report was presented for the Board’s
review. The Board adopted the Committee’s recommendation to approve the written report.
The specifics of this report are not included because these actions are not public.
Summary: In May, the Board approved a new process for approving protocols. They decided to
wait until after the CPP Joint Subcommittee meeting on July 20 to implement the process.
Board Action: Accept the policy change and begin using the new procedure with applications
received on and after August 1, 2010. Mr. Jimison will draft a letter and send it to Dr. Loomis for
approval. The letter, which will explain the statutory scope for a CPP, that the CPP is
encouraged to keep his or her protocols current, and that practicing outside of the scope of the
CPP’s written agreement will subject the CPP to discipline, will be mailed out with CPP
approvals.
BOARD ACTION: Preemptive approval of proposed addition to Rule 21 NCAC 32V.0103. The
PAC will review and discuss this at its August meeting.
A motion passed to close the session pursuant to Section 143-318.11(a) of the North Carolina
General Statutes to prevent the disclosure of information that is confidential pursuant to
Sections 90-8, 90-14, 90-16, 90-21.22 of the North Carolina General Statutes and not
considered a public record within the meaning of Chapter 132 of the General Statutes and/or to
preserve attorney/client privilege.
The Committee reported on one case. A written report was presented for the Board’s
review. The Board adopted the Committee’s recommendation to approve the written report.
The specifics of this report are not included because these actions are not public.
PERFUSIONISTS
ANESTHESIOLOGIST ASSISTANTS
Staff Present: Jay Campbell, David Henderson, Marcus Jimison, and Quanta Williams
Dr. Loomis opened the meeting with introductions and thanked everyone for coming.
Election of Chair
Dr. Loomis asked for motions for a new chair. Since there were none, Dr. Loomis will continue
on as Chair of the Committee.
Approval of Minutes
Dr. Hill gave a brief summary of the appearance of and types of protocols that have been
received since 2001 when CPP approval began. He also discussed the current process for
approving CPP protocols and the logic behind changing the approval process. The Board no
July 21-23, 2010
longer reviews the protocols for PAs and NPs. This seems to be a natural evolution for the
CPPs as well.
CPP applicants will no longer be required to submit the written agreements between themselves
and their supervising physicians (or protocols) with their applications for review and approval by
the two boards. If an application is approved, a letter will be sent out to each CPP that will
explain the statutory scope of practice for a CPP, that the CPP is encouraged to keep his or her
protocols current, and that practicing outside of the scope of the CPP’s written agreement will
subject the CPP to discipline. CPPs will no longer have to submit Change of Status forms
requesting additional protocols.
There will be a compliance program similar to the one used by the Nurse Practitioner Joint
Subcommittee for compliance reviews of CPP protocols. An investigator from each Board will
work together to conduct compliance reviews of about 5 CPPs per year.
This program is not approved by the North Carolina Center for Pharmaceutical Care (NCCPC)
or the American Council on Pharmaceutical Education (ACPE). Therefore, it does not meet the
requirements stated in the rules for CPP approval. This information will be communicated to the
pharmacist that inquired about this program. The pharmacist may direct her inquiry to the two
credentialing bodies for information about the process by which a program may be approved by
the credentialing body.
Future Meetings
A motion passed that all future agendas be dictated by Dr. Loomis and that Mr. Henderson and
Mr. Campbell will let the Chair know when sufficient need arises for a meeting.
Miscellaneous
Dr. Saunders thanked the Board of Pharmacy for its spirit of collegial cooperation with the
Medical Board.
A motion passed to close the session pursuant to Section 143-318.11(a) of the North Carolina
General Statutes to prevent the disclosure of information that is confidential pursuant to
Sections 90-8, 90-14, 90-16, 90-21.22 of the North Carolina General Statutes and not
considered a public record within the meaning of Chapter 132 of the General Statutes and/or to
preserve attorney/client privilege.
The Committee reported on one case. A written report was presented for the Board’s
review. The Board adopted the Committee’s recommendation to approve the written report.
The specifics of this report are not included because these actions are not public.
A motion passed to close the session pursuant to Section 143-318.11(a) of the North Carolina
General Statutes to prevent the disclosure of information that is confidential pursuant to
Sections 90-8, 90-14, 90-16, 90-21.22 of the North Carolina General Statutes and not
considered a public record within the meaning of Chapter 132 of the General Statutes and/or to
preserve attorney/client privilege.
July 21-23, 2010
The Review (Complaint) Committee reported on forty two complaint cases. A written report
was presented for the Board’s review. The Board adopted the Committee’s
recommendation to approve the written report. The specifics of this report are not included
because these actions are not public.
A motion passed to close the session pursuant to Section 143-318.11(a) of the North Carolina
General Statutes to prevent the disclosure of information that is confidential pursuant to
Sections 90-8, 90-14, 90-16, 90-21.22 of the North Carolina General Statutes and not
considered a public record within the meaning of Chapter 132 of the General Statutes and/or to
preserve attorney/client privilege.
The Disciplinary (Complaints) Committee reported on ten complaint cases. A written report
was presented for the Board’s review. The Board adopted the Committee’s
recommendation to approve the written report. The specifics of this report are not included
because these actions are not public.
A motion passed to close the session pursuant to Section 143-318.11(a) of the North Carolina
General Statutes to prevent the disclosure of information that is confidential pursuant to
Sections 90-8, 90-14, 90-16, 90-21.22 of the North Carolina General Statutes and not
considered a public record within the meaning of Chapter 132 of the General Statutes and/or to
preserve attorney/client privilege.
A motion passed to close the session pursuant to Section 143-318.11(a) of the North Carolina
General Statutes to prevent the disclosure of information that is confidential pursuant to
Sections 90-8, 90-14, 90-16, 90-21.22 of the North Carolina General Statutes and not
considered a public record within the meaning of Chapter 132 of the General Statutes and/or to
preserve attorney/client privilege.
Thirteen informal interviews were conducted. A written report was presented for the Board’s
review. The Board adopted the recommendations and approved the written report. The
specifics of this report are not included because these actions are not public information.
A motion passed to close the session pursuant to Section 143-318.11(a) of the North Carolina
General Statutes to prevent the disclosure of information that is confidential pursuant to
Sections 90-8, 90-14, 90-16, 90-21.22 of the North Carolina General Statutes and not
considered a public record within the meaning of Chapter 132 of the General Statutes and/or to
preserve attorney/client privilege.
A motion passed to close the session pursuant to Section 143-318.11(a) of the North Carolina
General Statutes to prevent the disclosure of information that is confidential pursuant to
Sections 90-8, 90-14, 90-16, 90-21.22 of the North Carolina General Statutes and not
considered a public record within the meaning of Chapter 132 of the General Statutes and/or to
preserve attorney/client privilege.
A motion passed to close the session pursuant to Section 143-318.11(a) of the North Carolina
General Statutes to prevent the disclosure of information that is confidential pursuant to
Sections 90-8, 90-14, 90-16, 90-21.22 of the North Carolina General Statutes and not
considered a public record within the meaning of Chapter 132 of the General Statutes and/or to
preserve attorney/client privilege.
Dr. Reece was charged with unprofessional conduct for allegedly practicing below the
standard of care with regard to his treatment of eight patients, lack of professional
competence to practice medicine with a reasonable degree of skill and safety based on
a comprehensive evaluation by CPEP, and failing to provide adequate coverage for his
patients at times when he planned to be unavailable.
Members of the Panel were: Dr. Jablonski, Dr. Camnitz and Ms. Blizzard. Thomas
Moffitt served as Independent Counsel.
PANEL FINDINGS: The Panel found that Dr. Reece’s care of patients A through H
departed from or failed to conform to the standards of acceptable and prevailing medical
practice within the meaning of NC Gen. Stat. § 90-14(a)(6). The Panel also found that
Dr. Reece’s lack of medical knowledge and clinical reasoning constituted a lack of
professional competence to practice medicine with a reasonable degree of skill and
safety to patients and failure to maintain acceptable standards of one or more areas of
professional physician practice with the meaning of NC Gen. Stat. § 90-14(a)(11).
Additionally, the Panel found that by failing to provide adequate coverage for his patients
in times that he planned to be unavailable, Dr. Reece engaged in unprofessional conduct
within the meaning of NC Gen. Stat. § 90-14(a)(6).
A Motion by the Respondent to reopen the case to allow further evidence was heard on
July 22, 2010, by Dr. Jablonski and Ms. Blizzard.
Members of the Quorum were: Dr. Huff, Dr. Saunders, Dr. Loomis, Dr. Walker, Dr. Hill,
Ms. Lennon, Dr. Gerancher, Judge Lewis, and Ms. Robinson.
BOARD ACTION: To allow 30 days for Dr. Reece to close his practice, his medical
license will be indefinitely suspended effective August 26, 2010. Dr. Reece may not
reapply for a medical license for one year.
ADJOURNMENT
This meeting was adjourned at 1:00 p.m., July 23, 2010.
_____________________________________________________
William A. Walker, MD
Secretary/Treasurer