Little Health Law Blog
Our healthcare and business law firm advises physicians and other licensed healthcare providers on professional licensing matters, including medical board investigations. If you are a North Carolina licensee who has received notice that the North Carolina Medical Board (“NCMB” or “the Board”) has received a complaint or other information about you, understanding what comes next—and what the Board expects from you—is an important first step. This post walks through the Board’s investigative process, from initial notice through final Board review. A separate post will discuss the potential outcomes of an investigation. If you would like to discuss a medical board matter or would like to discuss this blog post, you may contact our healthcare and business law firm at (404) 685-1662 (Atlanta) or (706) 722-7886 (Augusta), or by email, info@littlehealthlaw.com. You may also learn more about our law firm by visiting www.littlehealthlaw.com.
(1) Why the Board Investigates
The NCMB was established to protect the public, and one of its primary tools for doing so is its authority to investigate and discipline licensees whose professional conduct or ability to practice medicine may fall below accepted standards. That authority is granted by the Medical Practice Act (N.C.G.S. Chapter 90).
Complaints and other information come to the Board from a wide range of sources, including patients and their families, other licensees and healthcare professionals, law enforcement, hospitals and other healthcare institutions (which are required to report changes in staff privileges), malpractice insurance carriers (which report professional liability payments), federal and state agencies, and the National Practitioner Data Bank. The Board also accepts and may investigate anonymous complaints and tips. Receiving a notice from the Board does not mean that a violation has been found or that disciplinary action is forthcoming—it means the Board has received information it is required to evaluate.
(2) Initial Notice and Your Response
In most cases, when the Board opens an investigation, it provides the licensee with written notice that an investigation has begun. There are limited circumstances in which notice is withheld—generally where providing it would jeopardize the investigation itself.
After notice is issued, the Board contacts the licensee to obtain a response. Depending on the matter, this may involve receiving a copy of the complaint and being asked to respond in writing, or being interviewed by a Board investigator. The licensee is required to respond within the time permitted under 21 NCAC 32N .0107. In many cases, the written response is the licensee’s most significant opportunity to present their perspective, provide context, and bring any mitigating factors to the Board’s attention. A clear and thorough response, supported by relevant medical records or documentation, frequently provides the Board with everything it needs to complete its review. Whether and how to respond—and what to include—are questions worth discussing carefully with counsel before submitting anything.
(3) Staff Review and Medical Director Evaluation
Once the licensee’s response is received, Board staff begins a thorough evaluation of the case. Any matter that involves quality of care is forwarded to the Board’s Office of the Medical Director (OMD), which is staffed by physicians and a physician assistant. Depending on the specialty area involved, the OMD may assess the case directly or forward it to an independent reviewer who practices in the same specialty as the licensee under investigation. The OMD then makes recommendations for Board action in each case. Board attorneys review each case as well and make recommendations for Board action.
(4) Senior Staff Review Committee and Board-Level Review
After staff-level review, each case is examined by the Senior Staff Review Committee (SSRC), a committee made up of the chiefs and managers of the Complaints, Investigations, and Legal departments, as well as the OMD. The SSRC reviews the case and reaches a recommendation for Board action. The SSRC does not have to, but may, follow the recommendations by OMD or Board attorneys.
For cases where some type of Board action is recommended—whether public or private—the case proceeds to the Board’s Disciplinary Committee for a further round of review. The committee examines and discusses each assigned case and makes final recommendations, which again may or may not align with what the SSRC recommended.
The final step in the process is review by the full Board. The Board may accept the committee recommendation, or it may determine that additional information is needed before reaching a decision. In those situations, the Board may request that the licensee attend a confidential interview with a panel of Board members, or that the licensee obtain a specific type of assessment—neurologic, substance abuse, clinical competence, or otherwise. The Board makes its final determination only when it is satisfied it has the information it needs. The entire process—from initial contact through final Board action—may take six months or more.
If you are a North Carolina licensee who has received notice of an NCMB investigation, or if you have questions about how the Board’s process may apply to your situation, we would be glad to discuss your matter with you. You may contact our healthcare and business law firm at (404) 685-1662 (Atlanta) or (706) 722-7886 (Augusta), or by email, info@littlehealthlaw.com. You may also learn more about our law firm by visiting www.littlehealthlaw.com.