Relationships among the “Big 3” of the NCMB, NCMS, & NCPHP:
The very first action of the NCMB was to create the §90-1 North Carolina Medical Society.
They also used the NCMS as a basis for the selection of NCMB members by means of referral to the governor recommending 5 of the 12 seats on the NCMB. Remember that §NCGS90 also mandates that there be 12 members of the NCMB; 7 licensed physicians (5 recommended by the NCMS), a physician who is either;
1. An Osteopathic physician.
2. An Integrative medicine physician.
3. A member of the Old North State Medical Society (precursor of the NCMS, in essence allowing 6 of the 12 seats recommended by the NCMS, however shall not be subjected to the Review Panel (can seek a seat on the NCMB independent of the NCMS). One member will be a mid-level provider such as a Physicians Assistant or Nurse Practitioner and three shall be non-medical people appointed by the governor.
The section in the NCMS website “About” & “History” contain no information on their role in working with the NCMB on issues such as peer review, the decisions on who to install in the NCMB or other issues. “Promote physician wellness” is as close as they come to any relationship with the NCPHP per their website.
"Peer Review" is another area in which the NCMB & NCMS work together.
§90-21.22. Peer review agreements. (b) Peer review agreements shall include provisions for the society and for the Academy to receive relevant information from the Board and other sources, conduct the investigation and review in an expeditious manner, provide assurance of confidentiality of nonpublic information and of the review process, make reports of investigations and evaluations to the Board, and to do other related activities for promoting a coordinated and effective peer review process. Peer review agreements shall include provisions assuring due process.
NC General Statutes §150B-2. 8a defines “rule” as requiring the
basic requirements of the 5th Constitutional Amendment in terms of
Specifically there are certain requirements for "Peer Review";
1) A statement that a professional review action has been proposed 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.
Thus, the NCPHP was created by § 90-21.22.c. §90-21.22.(d) specifies the duties and limitations of the NCPHP with stipulations for the protection of the NCPHP; Peer review activities conducted in good faith pursuant to any agreement under this section shall not be grounds for civil action under the laws of this State and are deemed to be State directed and sanctioned and shall constitute State action for the purposes of application of antitrust laws. (1987, c. 859, s. 15; 1993, c. 176, s. 1; 1995, c. 94, s. 23; 2006-144, s. 8.).
Unfortunately, the new standard of PHP care in North Carolina consists of deceit, extortion & kickbacks from their “referral centers”. Nationally, PHP’s serve themselves, not those in need, but at great expense to those in need.
The North Carolina Physicians Health Program originated as a physicians health committee of the North Carolina Medical Society. Established as a formal program by the Medical Society in 1988 and administered by its Foundation, the program subsequently evolved into a not-for-profit 501(c)3 corporation.
NCPHP’s first Medical Director was Robert C. Vanderberry, MD who served until his retirement in 1998, when Michael W. Wilkerson, MD took over the position. Dr. Wilkerson added an Associate Medical Director to the staff as referrals continued to climb. Dr. Vanderberry is legendary in the good works that he did for so many wounded healers in this state. His is a star that still shines on in the lives of those whom he saved from the ravages of addiction and other impairments, for those who he restored to practice without unnecessary delays, whose lives and families he restored. He provided a very strong foundation for the NCPHP to grow and build upon.
Change however, is inevitable. There is incredible power in the ability to “make or break” a professional. As the founders of the US know and took great care to prevent in our constitution, checks and balances were set in place to forestall and hopefully prevent corruption. The NCPHP fell victim to this corruption and lack of foresight. Warren Pendergast assumed control of the NCPHP after the departure of Dr. Wilkerson. He is the current CEO & Medical Director of the NCPHP. Despite this lofty position, he’s not even certified by the American Board of Addiction Medicine.
There is confusion and concern about how the NCPHP operates. During its evaluations of potentially impaired physicians its job is to assess/diagnose problems and then refer/provide treatment for any existing impairment/pathology. Unfortunately, the NCPHP’s status as a 501(c)3 corporation filed with the NC Secretary of State does not license it to diagnose and treat. When notified of this, CEO Pendergast claimed that the organization engages in peer review. Despite this, the NCPHP does not follow the requirements for peer review enumerated above.
Unfortunately for these entities, the phrase; “in good faith” appears routinely throughout §90 North Carolina General Statutes Chapter 90.
Unfortunately for the licensees of North Carolina, the “Big 3” do not function “in good faith”.
In April 2014, Beth Wood, the NC State Auditor released a performance audit on the NCPHP (which unfortunately ignored the NCMB & NCMS). The audit was very lenient on the actions of the NCPHP. A follow-up audit by the NCOSA is due to be repeated in October 2015
There were important key findings;
1. Boards operate with ineffective oversight from state-level entities.
2. Twenty-one of 57 Boards (37%) did not comply with reporting deadlines set by NC General Statutes.
3. Six of 57 Boards (11%) did not comply with Board member training requirements.
4. Analysis of Board operational and financial information identified items for further review. These items include complaint resolution, inspection efforts, and financial position.
Key recommendations were made by the NCOSA;
1. The General Assembly should clarify which state-level entities have oversight authority and specific responsibility for monitoring Board activities.
2. Boards should comply with reporting and training requirements.
3. A master list of occupational licensing boards should be maintained and shared among state-level entities.
4. Responsible state-level entities should work with legislators and Boards to develop meaningful financial and performance measures.
5. State-level entities should regularly monitor and follow-up on non-compliance and unusual measures as necessary.
North Carolina has been negligent in their oversight of all 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.
Importantly, the Supreme Court of the United States of America ruled against the NC Dental Board. SCOTUS ruled that State licensing boards composed of market participants do not enjoy automatic immunity from antitrust laws.
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.
Back to the PHP…
Since the NCHP audit of April 2014, other developments have occurred on the US Physicians Health Program front. There are three websites that physicians use a lot to communicate among themselves, sharing ideas, thoughts, problems and emotional aspects of their jobs.
http://www.medscape.com was the first site to write articles related to the behavior of national PHP’s. It was soon joined by
What is fascinating about these sites is the number of comments generated; well over a thousand comments were generated, ranging from negative to absolutely terrifying and awful. To be fair, there were a handful of positive comments—that came from PHP directors and staff members (some of whom tried to disguise themselves).
The NCPHP routinely commits medical malpractice as an institutional policy. As bizarre as this sounds, just as the NCMB uses “Consent Orders” that truly contain “Findings of Fiction” (not “Findings of Fact”) in order to justify their harsh punishments and threats, the NCPHP has a similar strategy. The NCPHP uses erroneous diagnoses on their contractees to justify referral to their “diagnostic and treatment facilities of choice”. This issue was one of the key findings of the April 2014 Performance Audit done by the NCOSA on the NCPHP. The auditor identified the problem but did not delve deeply into it.
An Email was sent to the NCOSA about this prior to their follow up NCPHP audit report being released. Links to the articles and comments were enclosed in the above-mentioned Email to Auditor Wood. These are all unsolicited comments, mostly from folks who have “been through the system” in various states. Interestingly, it’s North Carolina that was singled out the most frequently as having the worst PHP in the union. The Email was sent to Ms. Wood to allow her to review the commentaries about the NCPHP from other sources, another perspective—those who had “been through the system”. We are striving to improve “the system”, any way that we can!
One of the key points of the April 2014 NCPHP Performance Audit was the need to establish a formal means to appeal actions of the NCPHP. We attempted to get information regarding this process via an Email dialogue. As the link will show, the NCPHP was typically well less than forthcoming in the details. The exchange began 9/2/15 and didn’t conclude until 10/5/15 and only then on threat of exposing them further to various agencies.
In November 2014 an Amicus Brief was filed with the NCOSA & FBI among others, regarding NCMB/NCMS & NCPHP activities of 2014. This brief was a follow-up of an initial October 2013 appeal to Governor McCrory by another wounded healer within the state. We contacted this abused practitioner, who, after lengthy discussion, allowed us to reproduce and use the document.
The NCMB has broad disciplinary authority with virtually no recourse due to the difficulties associated with the mandates of §NCGS90. An appeal to the Wake County Superior Court is another great expense to one who has been out of work for a prolonged period, having exhausted their savings without a means to replenish their accounts.
The Board Members themselves seem blissfully unaware that they are in violation of the disciplinary ethics section of NCGS90 in terms of “unprofessional conduct”, often lead there by the NCPHP itself with the implicit permission of the NCMS. This is in keeping with the NCOSA audit of August 2014.
Despite the codification spelled out by §90-14. Disciplinary Authority (b) “The Board shall refer to the North Carolina Physicians Health Program all licensees whose health and effectiveness have been significantly impaired by alcohol, drug addiction or mental illness. Sexual misconduct shall not constitute mental illness for purposes of this subsection.”
This is not done as often as it should be.
There are numerous cases of their licensee victims who should have been referred to the NCPHP but were disciplined without the involvement of the NCPHP.
Disciplinary actions in such cases by the NCMB is frequently done with the use of a “Consent Order”; essentially a confession produced under duress, written up the NCMB attorney who then coerces the involved licensee into signing a document containing a “Findings of Fact” section that would be more accurately deemed “Findings of Fiction” .
Consent Orders are written in such a manner as to justify the disciplinary actions dealt by the legal staff of the NCMB without the necessity of having any semblance to factual occurrences.
The NCMB clearly prefers persecution to investigation!
The NCMS prefers a “blind eye” as it stocks the NCMB with it’s chosen few, despite the fact that they represent less than a third of the providers in NC.
The NCPHP remains as dishonest and disingenuous as it’s partners in the “Big 3”.
The NCMS continues to look the other way.
The NCMB continues its collusion with the NCPHP as it continues to destroy lives.
long will this continue?
How many more lives must be ruined or lost?
Who will stop the insanity? When? How?