Legal Issues:

 

Formal hearings by the NCMB do not follow state law for legal proceedings. 

Generally, defense attorney objections are overruled while Board attorney objections are sustained. 

Witnesses for the Board are not segregated away from each other, allowing them to compare stories. 

The same cannot be said of defense witnesses. 

The hearing panel does not include the entire Board; only certain members are empaneled. 

The NCMB legal department, theoretically choosing panelists who can be partial to the NCMB legal departments arguments, can set up the empanelment.  Their legal department Òstacks the deckÓ against the licensee by their choice of board members on the panel.

Impartiality is not to be expected. 

Legal requirements, including the most basic tenet of US law that the accuser must testify in front of the accused are disregarded despite objection from the defense. 

The administrative law judge (retired) that sits on the panel allows all of these violations of legal courtroom procedure.

Every bit of evidence against the accused is presented in a distorted and inflammatory manner regardless of the facts of the case.

Any legal representation must be encouraged to submit as much evidence as possible; plan on losing in front of the NCMB panel, appeal to the Wake County Superior Court provides the only impartial review available—but they wonÕt look at additional evidence.  Any and all defense evidence must be presented in front of the NCMB Formal Hearing Panel in order to be admitted for consideration by the Wake Superior Court!

 

Legally, a Medical License is deemed to be property; specifically the property of the practitioner, not of the Board of Medicine.   Disciplined North Carolina licenseeÕs can and do get licensed in other states.  We have discovered several NC-disciplined providers who have been able to get licensed in other states with little difficulty.  One can go on with their career and life.  ItÕs should also be possible to go back before the NCMB with the release of the state audit to remove the effects of misdeeds of the NCMB.  

Tennessee & South Carolina seem to have more reasonable medical boards.  Providers who have lost their NC license have been known to get licensed in these states.

Texas and Maryland are to be avoided.

 

Another option to be considered is a complaint to the US Office of Civil Rights (OCR).  Typically, these complaints must be made within 6 months of any violation, but this rule is not cast in stone.  Explanations by the violated licensee of the fact that an attorney or numerous attorneys were contacted, state authorities were contacted (if applicable) without anybody from whom assistance on the matters recommended contacting the OCR or how to do so.  The web based complaint system is simple to complete.

 

What would constitute a civil rights violation? 

 

Any mention in a consent order or any other posting by the Board about an accused licensee that mentions any form of potential mental health disorder including various addictions for which there is a DSM, ICD9 or ICD10 code is a HIPAA violation of Protected Health Information (PHI). 

 

HIPAA violations are routinely committed by the NCMB & allowed by the NCPHP; technically the NCMS is also implicated as the three agencies are all intertwined.  

 

HIPAA violations of HIV status or mental health disorders, including addiction/substance abuse posted in consent orders or records of a hearing or complaint are violations of the licensees civil rights.   These require a second-level release for this PHI.

 

Failure to accommodate any form of disability and use of punitive measures are another form of violation.

Licensees with disabilities have been known to be punished instead of accommodated in violation of the Americans with Disabilities Act (ADA)

 

In theory, mention that a physician was intoxicated on occasion in a complaint wouldnÕt be a violation.  Any notation that the licensee Òis unable to practice medicine due to substance abuseÓ would be a violation.

 

Typical Mental Health Diagnosis (DSM-V) are listed with their corresponding ICD-9 and ICD-10 Codes.  Unfortunately Òboundary issuesÓ are not listed as a diagnosis and thus cannot be used as a defense against these allegations.

 

HIIPAA violations carry a penalty of $100/violation with an annual maximum of $25,000 for repeat violations as a minimum penalty with a maximum of $1.500,000 as an annual maximum.  Note that this is an annual maximum.  The NCMB has been engaging in this as a routine policy for years!

 

In Kansas, there is no way for the public to see specifically what violations allegedly occurred, only that there was an issue.  The only access to the Kansas site is for licensees of that states medical board.

 

WHEN ARE DRUG USERS COVERED UNDER THE ADA?

The ADA provides that any employee or job applicant who is Òcurrently engagingÓ in the illegal use of drugs is not a Òqualified individual with a disability.Ó[6]Therefore, an employee who illegally uses drugs—whether the employee is a casual user or an addict—is not protected by the ADA if the employer acts on the basis of the illegal drug use.[7] As a result, an employer does not violate the ADA by uniformly enforcing its rules prohibiting employees from illegally using drugs.[8] However, Òqualified individualsÓ under the ADA include those individuals:

A former drug addict may be protected under the ADA because the addiction may be considered a substantially limiting impairment.[12] 

The Legal Action Center is a non-profit advocacy group whose sole mission is to fight discrimination against people with histories of addiction, HIV/AIDS or criminal records and to advocate for sound public policies in these areas.  The organization was formed in the 1970Õs.  They have successfully aided hundred of thousands of people with employment and other problems in their lives.

The legal profession has been very proactive in their dealings with disabled attorneys, it's a shame that physicians organizations are well behind that profession!

 

Re; NC Medical BoardÕs pervasive corruption implies extortion on massive RICO scale

 

Four major criteria have been met which qualify an investigation into the NCMB per Racketeer Influenced and Corrupt Organizations Act the (RICO Criteria)

 

Clearly there are a large number of victims of the NCMB with the above-mentioned actions.  Their illegal and unethical activity needs to stop.  It cries out for an independent review. A great many physicians have been harmed by the capricious actions of the NCMB.

 

Unfortunately, being caught with a trivial, unintentional error in the application process can be quite rewarding for the Board.  The NCMB generates thousands of dollars monthly from providers who unintentionally make mistakes in filling out the misleading application form, as a review of the minutes from these meetings will attest. 

 

This has been a long-ongoing process as noted by the length of time period that these fines and punishments have spanned.  There appear to be no plans to clarify the form and kill the golden goose of this extra income.  These errors are also annuities of a sort for the Board; licensees are generally rewarded with a ÒPublic Letter of ConcernÓ to accompany their initial fine for having a ÒwrongÓ answer (arbitrarily in the mind of any Board member) on their application.  This letter of concern will be publicly displayed on the BoardÕs website so that if the practitioner should ever inadvertently offend a future patient, thereÕs a much greater chance of that patient writing future complaints to the Board about that ÒbadÓ doctor!  This increases the opportunity for the NCMB to call such a ÒbadÓ provider in front of an investigative committee for further actions as we have demonstrated on this site.  In one authorÕs experience, an admonition was given that the directions on the form should have been ignored in a certain area, since they were followed, a public letter was placed in that practitioners file.  Other providers are faulted for not following every direction to the letter-including ambiguous directions.

 

Once an unfortunate practitioner falls under the scrutiny of the Board, the adventure drastically intensifies!

 

Unlike the story given by multiple ÒdefenseÓ attorneys specializing in dealing with the Board, practitioners actually DO have legislative protection!  The Board illegally ignores the North Carolina General Statutes set in place to govern it.  One of the defense attorneys actually commented to a witness and an author regarding when representation by an attorney was needed would be in situations in which:  ÒThose circumstances might include when the physician is being threatened with being taken out of practice, rather than a two year, then return to practice.Ó  In other words, if the NCMB plans to permanently revoke the medical license, get an attorney; otherwise itÕs probably unnecessary and unlikely to be helpful. 

 

Truth be told, one authorÕs experience has been that attorneys who regularly deal with the Board often act as covert agents of the Board.  Interviews with various practitioners have revealed that some of them were advised BY THE BOARD which attorneys to use.  One of these defense attorneys demanded an up-front retainer of $75,000 before he would do any work to represent to represent a client before the Board!  There is a lot of money to be made by those playing on the BoardÕs field.  The Board regularly refers its licenseeÕs who have come to their attention to a select group of attorneys that it regularly works with; attorneys who have been shown to cooperate well with the board, to not have their accused clients best interests at heart.

 

The term ÒConsent OrderÓ is basically the licenseeÕs agreement to accept a disciplinary action proposed by the NCMB Legal Department.  The attorneys for the Board typically greatly exaggerate the outcome of not accepting a proposed consent order by threatening the licensee that if the offer is refused, the Board will be much more harsh than what is being offered.  A review of hundreds of actions by the Board Members themselves, reveals that they are MUCH more lenient than the attorneys of the NCMB Legal Staff who routinely bully the licensees.  Negligence actions are treated much more leniently than other actions; a patientÕs death due to practitioner negligence generally merits a ÒPublic Letter of ConcernÓ, getting clean and sober after self-referral to the NCPHP has generally resulted in years spent out of practice despite recommendations of the treating facilities.  The NCPHP only refers licensees to the facilities of the NCPHPÕs choice; practitioners rarely have any say regarding where they go for treatment.  The most harshly treated providers are uniformly in the 40-65 year age range—the highest income-producing period of a physicianÕs life.

Review of ÒConsent OrdersÓ by the NCMB demonstrates major components;

1.     Findings of Fact*

2.     Statements of Law

3.     Final Order

*Rarely are the ÒFindings of FactÓ factual, more often than not, they are grossly distorted ÒFindings of FictionÓ worded in a manner to defame licensees while attempting to validate the action taken by NCMB attorneys.

 

Typically, the Consent Order is ÒgivenÓ to the practitioner with serious warnings from both the Board attorneys and the ÒdefenseÓ attorneys that the order is the practitionerÕs best option to avoid drastically more dire consequences (which is absolutely NOT borne out by the historical record). 

 

There are dire consequences, usually not appreciated by those that sign "Consent Orders".

 

It is generally a VERY bad idea to sign a consent order.  Would you rather have your future decided by one Board attorney, possibly somebody Òwith an attitudeÓ, or a group of your peers?  A careful review of a decadeÕs worth of Board Actions reveals that Consent Orders, while often able to return the physician to practice at an earlier date, are MUCH more harsh than going to a formal hearing by the Board. The attorneys who work with the Board on a regular basis often prefer and encourage their clients to accept such a consent order. 

 

If you feel that your attorney is not representing your best interests, you are entitled to his records regarding your case (Section "D" of this link)

Due process is entirely absent from these proceedings; there cannot be due process while coercion and duress are employed, a regular occurrence with the BoardÕs legal department.

 

If a formal hearing is chosen, licensees have the right to mandate that any witness that testifies must be physically present in the hearing room.  The attorneys for the NCMB will object to this, but precedent has been set.  It is often difficult for witnesses to travel to Raleigh, often for an 8:00 AM hearing.  This strategy can be helpful for cases involving allegations over trumped-up or minor events.

 

US Constitutional Rights guaranteed by at least the 5th (prevents Òdouble jeopardyÓ, being tried more than once for a given offense and compelling a person to be a witness against themselves),  6th (speedy trial) and 14th (due process) amendment among others are routinely violated.  A former member of the NCPHP Board of Directors recently volunteered that the reason for routine use of documents specifying suspensions of licensure that are immediately stayed is that Òthis prevents any wiggle room for the offender in the futureÓ.  The rough translation of this is that itÕs a systemic and systematic violation of the rights guaranteed by ¤NC General Statutes.  It also demonstrates the close cooperation and collusion between the NCMB & NCPHP.  The NCPHP should strongly object to this strategy that they openly condone!

 

The subject of the Òindex caseÓ regarding abuse by the NCMB & NCPHP sent documentation of that index case to Governor McCroryÕs office.  Todd Batchelor, Aide for Community & Consumer Affairs, forwarded it to the NC Attorney General Roy Cooper.  The attorney generalÕs duties include defending state agencies in the event of litigation; Mr. Batchelor essentially handed the plaintiffÕs evidence to the defense attorney!  It was thoroughly ignored, no acknowledgement of its receipt was ever provided to the complainant.  A meeting was held with an assistant district attorney for Wake County, where all NCMB appeals are to be handled.  It was rejected on the grounds that the case involved civil law; the DA only deals with criminal issues.  Finally, it was submitted to John Watters of the NC State Bureau of Investigation who also declined to address the issues raised in the complaint.

 

Accordingly, parties including the index case researched the problem, documenting the past decade of abuse by the NCMB.  The information was provided to the NC Office of the State Auditor initially.  According to Tim Hoegemeyer, their chief legal counsel, the material was ignored because the NCOSA had been charged to investigate the NCPHP.  He refused to comment on the wrongdoing of the NCMB during a telephone conversation with one of our investigators.  The detailed analysis presented on this website has been received yet again by the Wake County DA, Mr. Watters of the NC SBI and the Charlotte Field Office of the Federal Bureau of Investigation (FBI) as documented by the return receipts of the certified letters sent to the agencies.   

 

To date, the NCMB has been able to hide behind their claim of Sovereign Immunity, claiming protection from facing charges of negligence and willful wrongdoing.  Luckily the phrase used throughout North Carolina General Statute Chapter¤90 contains the clause "in good faith" which limits their ability to hide behind this claim.  The NC Medical Board has waived its sovereign immunity for tort claims against the state to the extent provided by the Tort Claims Act

 

In Williams v. Pasquotank County,1 EricÕs estate sued the county and the department for the young manÕs wrongful death, alleging that the Òswimming holeÓ was unsafe.  ItÕs conclusion;

ÒThe North Carolina Court of AppealsÕ decision in Williams was undoubtedly a significant one for the Williams family and Pasquotank County. But if the decision attains greater long-term significance, it will be found in the guidance the opinion provides to future courts and the clarity the court attempted to bring to an important but confused area of the law. Whether it will ever achieve that significance is—for now—up to the North Carolina Supreme Court. A petition for discretionary review is pending.Ó

The NC Supreme Court upheld in Bynum v. Wilson City [367 N.C. 355 (2014) on pp. 361-362 that if fees are collected by a state agency did not categorically render the County immune from plaintiffsÕ tort claims.  While this ruling applied to the Wilson County, it could be generalized to include other state agencies as the County is essentially a state agency charged with governing the affairs of Wilson County.

 

 

Many law firms have concerns that the state of NC will claim Òsovereign immunityÓ if pressed by a plaintiff on the actions of the unregulated, unsupervised NC Boards.  Precedent is important in legal issues; it has clearly been set in this regard.  Essentially, the NCMB is a business because it collects fees and has no adequate state-level oversight.  

 

An argument may be made that the NCMB enjoys the lack of competition, as itÕs the only licensing agency in the state for physicians and mid-level healthcare providers.  Consider the situation in this era of ÒtelemedicineÓ however.  If a physician on another continent is using telemedicine to review imaging studies or perform another procedure or provide opinions etc., duly licensed by the locale in which they practice, but donÕt have a full NC license, are they not practicing in NC without a NC license?  This would remove the lack of competition and further remove the sovereign immunity enjoyed.

 

Furthermore, State licensing boards composed of market participants do not enjoy automatic immunity from antitrust laws, the Supreme Court ruled.  The FTC sued the NC Dental Board because it prohibited teeth whitening services from operating independently in shopping malls.  The SCOTUS ruling was heavily influenced by the lack of appropriate oversight of the NCDB by the NC State authorities.  The state has been negligent in their oversight of their professional Boards.  This was noted by the NC Office of the State Auditor in their repot of August 2014 regarding ALL professional and licensing boards in the state failing to meet their requirements by the state regarding filing required reports on time and other issues.  Any criminal act by state employees can remove their claim to sovereign immunity as noted in the case of Sanon v. City of Pella (Iowa).

 

There are numerous types of legal specialties as noted by www.lawyers.comMany of these specialties would be appropriate to bring action against the NCMB, NCMS & NCPHP.  The NCMS is clearly legally entwined in the pattern of corruption of the NCMB & NCPHP as noted by the requirements of NC General Statutes Chapter 90 which governs the NCMB.

 

All illegal actions are not criminal; One proposed definition is that a crime or offence (or criminal offence) is an act harmful not only to some individual or individuals but also to a community, society or the state ("a public wrong"). Such acts are forbidden and punishable by law.[1][4].  Clearly the actions of the NCMB ARE CRIMINAL!

 

Public corruption is the top priority among FBI criminal investigations—and for good reason.  Corruption of public officials, either elected or appointed drastically affects the entire populace.  That is why ItÕs their #1 Criminal Priority according to their website.  Since the NC State Bureau of Investigation, Attorney General, Auditor, & GovernorÕs office refuse to get involved in the issues regarding the NCMB & NCPHP, the authors of this site suggest that those who have been subjected to illegal activity at the hands of the agencies contact;

 

Charlotte FBI Field Office

Special Agent John A. Strong

7915 Microsoft Way

Charlotte NC 28273

Phone: (704) 672-6100
Fax: (704) 672-6595
E-mail: Charlotte.public@ic.fbi.gov

 

The FBI does not accept appointments, phone & Email does not seem effective.  The best approach is to visit the facility with copies of pertinent paperwork; electronic devices including cell phones are not allowed into their huge and highly secure facility.

 

Complaints can also be filed with the Office of the Inspector General of the US; https://www.oig.doc.gov/Pages/online-hotline-complaint-form.aspx

 

Contacting the members of the Joint Legislative Program evaluation Oversight Committee to express concern is also recommended

 

 

Pre-Signed Prescriptions;

A review of the current NCMB website was unable to locate any information that formally addressed this concern.  Most licensees have at one time or another in their career pre-signed or even pre-written RxÕs for their patients. A pre-signed Rx may be left in the office for emergency use when the physician is unavailable, generally locked up where only the office manager would have a key and must clear use of it with the signing practitioner.   An archive of the NC Medical Society from 1996 addressed this issue, that the NCMB would not tolerate such actions.  The winter issue of the 2012 Bulletin addressed this topic on page 8.   A review of the search box on the reveals 139 citations, the vast majority of which chronicle their prosecution of physicians who have engaged in the activity, which is not listed in any of their position papers/statements.  It only appeared in the Winter 2012 Bulletin and prior publications.

 

Use of Chart ÒReviewersÓ by the NCMB;

The NCMB uses reviewers that will give them the report that they want to see about a given practitioner.  The reviewers are paid well for the simple task of reviewing charts from what the Board deems to be a ÒquestionableÓ or ÒsubstandardÓ clinician.  ItÕs widely recognized that anybody can play ÒMonday morning quarterbackÓ, easily criticizing actions of another.  Professionals and others will also realize that the ÒpracticeÓ of medicine requires science, and art; the ÒsenseÓ of the patientÕs perception of their own needs, this is a big part of the art of medicine.  Rarely do two practitioners practice medicine in exactly the same way every time.   Members of the group responsible for this site have felt this effect first-hand.  The use and abuse of chart reviewers is not limited only to the Board however; this has been a contentious issue in the medical malpractice arena for decades.

 

Licensees of the NCMB have a legal responsibility to report unprofessional behavior and can lose their license for failure to do so!

The NCMB provides a sense of Continuous Quality Improvement (CQI), which has been a big buzzword in medicine and many other sectors of the economy.  Basically, it refers to how to continually improve performance.  Inadequate practitioners are Òselected outÓ and given the opportunity to improve to meet the current standards.   ThatÕs the theory.  Sometimes, the overseers can be inadequate; then what happens?

Violations of Ethical Guidelines are by definition unprofessional conduct.  Licensees of the NCMB are required by the NCMB to report such violations according to ¤ 90-5.2.  Board to collect and publish certain data (d) Failure to provide information as required by this section and in accordance with Board rules or knowingly providing false information may be considered unprofessional conduct as defined in G.S. 90-14(a)(6).  (2007-346, s. 6; 2009-217, s. 2; 2013-152, s. 5.)

 

Failure to report unprofessional behavior among other physicians, including NCMB members is itself an example of unprofessional conduct.  The NCMB can discipline licensees who fail to report another professional discipline and sanction for such a failure to report.  When the NCMB itself is suspected of engaging in unprofessional conduct, the report is best made to the NC Attorney General and Justice Department, the NC State Bureau of Investigation, and The Wake County District Attorney; per statutes, any legal issues involving the NCMB that require an appeal go through the Wake County Superior Court District 10

 

When reporting unprofessional conduct by the NCMB and/or unjust treatment, itÕs best to provide full documentation including any consent orders and an explanation of the inaccuracies, errors and fraudulent representations in the consent order. Additionally, special attention to ¤North Carolina General Statutes Chapter 90: http://www.ncga.state.nc.us/gascripts/statutes/statutelookup.pl?statute=90 violations should also be clearly explained. 

Violations of US Constitutional Rights should also be clearly spelled out as well as any HIPAA violations including listings of alleged illnesses (which could include addiction issues—especially those which have been successfully treated) and any disabilities, which are covered under the ADA.    

 

Fact or Fiction (What Actually Happened vs. the NCMBÕs Perspective:

What the ÒConsent OrderÓ on the NCMB Public Website contains is often quite different from what really happened from the providers perspective.

 

Effects of North Carolina Medical Society Membership:

The North Carolina Medical Board has a long history of improper dealings with the North Carolina Medical Society (NCMS) as detailed in the 2007 lawsuit with itÕs complaint that statutorily, the NCMS solely nominated physicians to the NCMB.  Further, the complaint demonstrated numerous cases in which members of the NCMS were preferentially treated by the NCMB despite wanton and egregious unprofessional conduct that dealt severe penalties to practitioners who were not members of the NCMS.  Members of the NCMS who had committed gross negligence completely escaped disciplinary measures by the NCMB. 

 

The 2007 lawsuit appeared to have changed the relationship between the NCMB & the NCMS.  In 2013 there are no members of the NCMS on the NCMB, which is unusual, considering that the NCMS currently has a membership of 12,200 of the 36,011 physicians currently licensed in North Carolina.  The NCMS represents a third of the physicians in the state, yet NONE were members of the NCMS.  With the 2007 lawsuit, it became evident that any open relationship between the NCMS & NCMB could be worrisome.  The NCMB had a reputation at the time of protecting members of the NCMS.  In 2014 that changed when Timothy Lietz, MD and Debra Bolick, MD were appointed to the NCMB.  Luckily, for the members of the NCMS the protective effect of membership from the NCMB appears alive and well.  When undergoing disciplinary evaluations and actions, members of the NCMS have enjoyed a far easier ride than non-members.  The fact could be that very few of the physicians who belong to the NCMS commit misdeeds (statistically speaking however, with a sample size of 12K+ members, itÕs far more likely that the population is not selective, that it represents practitioners as a whole).

 

The NCMB also is noted for itÕs long institutional and vengeful memory.  The physician who initiated the 2007 lawsuit was later excessively punished in 2013 when a patient he had by all evidence from the NCMB website treated appropriately, died unexpectedly after therapy.  Everybody dies.  Death is not automatic evidence of wrongdoing or malpractice.  There was no evidence of either in the case of the physician who blew the whistle in 2007 based on the report of the NCMB disciplinary action on their website!   This practitioner gave permission to relay the story of his public documents during a private phone call.

 

It should be noted that few of the actions of the NCMB are public; some actions involve dismissing unwarranted cases against physicians.  The Board also has the ability to issue private sanctions.  The only material available to these authors for review is what has been listed on the public website for the NCMB.  Decisions about whether disciplinary actions was excessively harsh, reasonable or overly lenient were made by these authors after reviewing hundreds of public Board Actions in North Carolina and thirty other Medical Boards

 

The purpose of this site is to educate practitioners regarding the rights that NCMB licensees have in their dealings with the NCMB & the NCPHP.   The other purpose of this site is to review the arbitrary and extremely variable nature with which the NCMB disciplines its licensees for real and perceived transgressions.

 

¤North Carolina General Statutes Chapter 90: http://www.ncga.state.nc.us/gascripts/statutes/statutelookup.pl?statute=90

Governs what the NCMB can and cannot do to its licensees.

 

Legal protection is also provided to NCMB licensees by Chapter 150B of the NC Administrative Procedure Act; http://www.ncga.state.nc.us/enactedlegislation/statutes/html/bychapter/chapter_150b.html

 

In many cases, the attorneys of the NCMB and even the ÒdefenseÓ attorneys routinely violate the statutes above.  The NC State Bar Association has a strict NC State Bar Association Professional Code of Ethics.  Any practitioner that believes that either the attorneys of the NCMB or the defense attorneys have violated statues of legal codes of ethics, please review ¤NC General Statutes Chapter 90 (link above) and the BarÕs Code of Ethics.  If there have been violations of either of the above, then filing a Grievance with the Bar is the next step;

Joe Commisso

NC Bar Director of Investigations

NC State Bar

PO Box 25908

Raleigh NC 27611

jcommisso@ncbar.gov

 

Anybody choosing to file a grievance against NCMB attorneys should please be sure to include R. David Henderson Esq. Executive Director of the NCMB & Thomas Mansfield Esq, the NCMB Legal Department Director.  Include the statutes/ethical codes violated in the complaint (often ethical codes in Section 8; Maintaining the Integrity of the Profession are violated).

 

If there is any future intent to go after those involved for damages, having the Bar sanction an attorney before any lawsuit is filed will speed the process along!

 

The Federation of State Medical Boards has a formal policy on Impaired Providers: http://www.fsmb.org/pdf/grpol_policy-on-physician-impairment.pdf .  Many states also have formal policies.  North Carolina currently is not among those states.

 

A Review of Other State Medical Board Disciplinary Actions was undertaken:

The most recent information obtainable was from Citizens Watch www.citizenswatch.org which has data from 2008-2010

From their report, Louisiana had the most discipline given to their physicians with 5.98 actions/1000 physicians, Alaska was in second place with 5.47 actions/1000 practitioners, Ohio had 5.36/1000.   In 2013, North Carolina had 6.6 actions/1000 practitioners, well over and above the rates any other state has had.

 

North Carolina Statute 90-21.22 gives the NCMB authority to enter into an agreement with the NCPHP for the NCPHP to evaluate physicians and complaints against physicians.  Specifically, the referenced Statute addresses "investigation" of complaints, among other issues including the provision of due process. 

 

Unfortunately, the NCPHP does not investigate the veracity or integrity of any complaint against a physician, but instead proceeds as if the complaint--even an anonymous complaint--is correct and true.  This leads to investigation with the presumption of guilt until proven otherwise, in violation of NCGS 90-21.22, without the mandated provision of due process.

 

Effectiveness of the North Carolina Physicians Health Program a Physician Advocacy Group for Impaired Practitioners:

The NCPHP was established by the NCMS in 1988 as a formal program to assist and advocate for practitioners who are impaired by a variety of ailments.  This organization is charged to advocate for practitioners contracted to it before the Medical Board and other groups such as Hospitals regarding staff privileges and insurance companies that would otherwise reject a physician from being able to participate in the care of that managed care organizations panel of patients.  It was established as a non-disciplinary agency charged to help return impaired practitioners back to productive practice.  Although it has a role in those with physical and mental illnesses, the most common use of this agency is for practitioners impaired by substance abuse and behavior issues.  Warren Pendergast MD, a general psychiatrist without certification in any subspecialty areas chairs the NCPHP.   Despite this, he refuses to accept diagnostic assessments from at least one addiction-certified specialist.  Notably, Dr. Pendergast also chaired the Federation of State Impaired Physician Programs in 2013 despite his lack of additional credentials in related fields.

Logan Graddy MD is another psychiatrist who joined the NCPHP in 2013.  Joseph Jordan PhD is a psychologist with the group.   

 

Dr. Pendergast has historically mandated that practitioners have diagnostic evaluations done only at the facilities among the set group that the NCPHP Òapproves ofÓ.  Despite the fact that a given facility is licensed to do diagnostic evaluations, assessments by ÒNCPHP-unapprovedÓ facilities have been deemed ÒunacceptableÓ.   As with the NCMB, they appear to do this after theyÕve decided the fate of a given practitioner.  This appears to be similar to the NCMBÕs use of ÒReviewersÓ to evaluate physician competency.  The NCPHP uses the same group of facilities located outside of the state of North Carolina.  In a state with five medical schools and twenty-five post-graduate degree mental health programs, there is not a single facility within this state capable of evaluating NCPHP-referred practitioners as demonstrated by their referral patterns.

 

It causes one to wonder what other ÒarrangementsÓ are in effect.

 

At least one practitioner has successfully challenged (and prevailed) in this type of bias by the NCPHP & NCMB.

 

More than one member of the group responsible for this website has been told by the professionals of the NCPHP that; Òjust because you are here, in front of the Board, there is a presumption of guilt; you must be willing to assume some degree of punishment because of that factÉÓ.  This statement being made after review by the parties involved and with the involved defense attorney stating to the professional of the NCPHP that the Board agrees that there is no evidence, that an investigation has not been completed regarding allegations made against the provider involved.

Advocacy; noun, plural adávoácaácies. the act of pleading for, supporting, or recommending; active espousal: He was known for his advocacy of states' rights.

 

This is the level of support & advocacy given to those charged to the care of the NCPHP; Òjust because you are here, in front of the Board, there is a presumption of guilt; you must be willing to assume some degree of punishment because of that factÉÓ  Evidently, the NCPHP forms the opinion that practitioners who have signed contracts provided by the NCPHP for their protection and advocacy do not even deserve the presumption of Òinnocent until proven guiltyÓ that is a cornerstone of US law.

 

The NCPHP is allegedly an ÒadvocacyÓ group.  Participants in the program sign a contract given to them by the program.  In many cases the level of ÒadvocacyÓ is advice to Òsign the consent order that the NCMB has given youÓ.  That is NOT advocacy!  One or the other parties can cancel contracts at any time for failure to perform, to meet the terms of the contract.  This has been done with practitioners under contract to the NCPHP as well, practitioners CAN and SHOULD cancel their contracts if the NCPHP has failed to advocate per the terms of the contract!  Consideration can be given to a new contract with different terms if desired and appropriate.  There are sites with more information on dealing with agencies such as the NCPHP such as www.ncpag.org.

 

Administered by the NCMS Foundation, the program subsequently evolved into a not-for-profit 501(c)3 corporation.

 

Others have argued that the organization conducts diagnostic evaluations of those providers referred to it, arguing that it is not properly accredited as an agency that has the proper certifications and licenses to diagnose and treat anybody. 

The response of the NCPHP to this claim is that it does not diagnose or provide therapy, it merely performs "peer review"; noun evaluation of a person's work or performance by a group of people in the same occupation, profession, or industry.

 

Peer Review Requirements:

NCMB licensees have certain rights whether they are considered patients or being subjected to peer review by the NCPHP.  The NCPHP has maintained that they are not treating NCMB licensees as ÒpatientsÓ but are actually performing Òpeer reviewÓ. The Health Care Quality Improvement Act of 1986 makes it clear that any physician who is to be subjected to peer reviewed must receive a written notice at least thirty days in advance of any peer review hearing.  That notice must include:

1) A statement that a professional review action has been proposed to be taken against the physician

2) The reason for the action

3) An indication that the physician may request a hearing and any applicable time limits for making the request

4) A summary of the physician's rights in the hearing, to include:

            a) Representation by an attorney or any other person of the physician's choice

            b) Ability to call, examine and cross-examine witnesses

            c) Ability to present evidence

            d) Submit a written statement at the conclusion of the hearing

            e) Have a record made of the proceedings

            f) The physician is entitled to have a copy of the hearing including the findings and recommendations at the conclusion of the hearing.

 

The NCPHP is not in compliance with any aspect of The Health Care Quality Improvement Act, and the NCPHP does not afford the accused physician any of the mandated due process rights or protection of any kind as is required by this act.

 

Any practitioner who has concerns regarding their treatment by the NCPHP should contact info@woundedhealersnc.net .  Unfortunately, the Federation of Impaired Physician Programs will not assist practitioners in this dilemma.  This is likely a reflection of the relationship of Dr. Pendergast to that group.  However other options are available:

Licensees also enjoy the most basic protections provided by the US Constitution including its amendments and by HIPAA.

 

If you are a practitioner who has been harmed by the NCPHP, there are resources available for your protection.  A summary of the APA Code of Ethics is in order, as well as what can be done with that information.

 

Another option is to file a complaint with the North Carolina Board of Licensed Professional Counselors.  Joseph Jordan PhD is the Clinical Director, as a PhD he is not governed by the Medical Board, this is his board.  Unlike DrÕs Pendergast & Graddy, he wonÕt be protected by the NCMB.  A good start to filing a complaint would be to request a complete copy of the file that the NCPHP would have on you as a licensee who has been contracted to them.  The NCPHP wonÕt release the complete file, in violation of state and federal statutes.  This is a good basis for a complaint by itself.  It should also be included in the Civil Rights complaint.  Additionally review of the NCBLPC Code of Ethics carefully cross-referenced to your experience will also be helpful in formulating an accurate and thorough case against the NCPHP and itÕs Clinical Director.

 

 

Medical Malpractice Issues:

Once a practitioner is sanctioned in any way by a state medical board, medical malpractice coverage issues arise.  Medical Malpractice carriers consider such providers to be at higher risk of future problems, expenditures to their company.  Premiums for coverage may increase by at least 40%, remaining elevated for several years after Board action against the involved practitioner.  An independent insurance broker can often help practitioners in this dilemma.  Such brokers often represent several companies; they can provide the program/deal that best meets the needs of the involved. 

 

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