Amicus Brief Re; § NCGS Chapter 90 NC Medical Board NC Medical Society & § 90-14 NC Physicians Health Program
The following is a brief commentary and summary of issues that have occurred during 2014, most of which occurred after the release of the NC Office of the State Auditor (NCOSA) audit of the NC Physicians Health Program (NCPHP).
The relationship of the NC Medical Society (NCMS) & NCMB to the NCPHP cannot be overlooked. Both entities are fully enmeshed and intertwined.
I am writing this brief in good faith. I fear the NCMB & NCPHP however. I respectfully request that regarding these agencies, the anonymity of those referenced and my own anonymity be respected.
Suggestion of Racketeering/RICO Activities within the NCMB Legal Department;
There is every appearance of impropriety and a strong appearance of the NCMB attorneys running their own extortion ring, whether it is with or without the knowledge of the NCMB Board Members.
The basis for this claim is that;
1. The wide range of punitive actions taken against those victimized by the NCMB. This has been illustrated in the past and will be again illustrated in selected actions of 2014.
2. The very large variance between what is written on the “Consent Orders” by the NCMB attorneys and the stories told by the providers who have been victimized—there is very little common ground in the two versions of the events.
3. These providers are strongly encouraged by defense attorneys (which is also my experience) to sign the fictitious “Consent Orders” which will then be “rubber-stamped” by the NCMB President on the belief that the Board will be much more harsh than the deal that is being offered in the consent order.
4. Upon signing the consent order, there is often a known “return to practice date” which may not be offered in the initial draft of a consent order, but if the provider bargains/negotiates/holds out long enough, will often be included as an extra incentive—an incentive that will improve the longer the provider holds out (an experience of my own and many providers I’ve contacted—the NCMB files would need to be examined to prove this).
5. Numerous victimized providers have related stories (which I share) of large amounts of money required to be paid “up front” by the “defense” attorneys in order to undertake a formal hearing. Jim Wilson required $100K to defend me in front of the NCMB in a formal hearing “with no guarantee of success”. I did not accept that offer.
a. These defense attorneys frequented with the NCMB all appear to be quite familiar with each other and give strong recommendations to the provider that they continue with their chosen attorney.
b. Defense attorneys that I have caught in such dishonesty include Michael Weddington of the firm Smith-Law in Raleigh, James A. Wilson in Durham & Alan Schneider in Charlotte.
c. Unfortunately, I lack the ability to research their financial records. I believe it would be fruitful for an investigator that could do so.
6. The fact that the NCMB actually refers providers who have come to their attention to specific attorneys “that we work with on a regular basis”.
7. Not surprisingly, these “defense” attorneys (I have been subjected to two of them) boast “good, strong working relationships with the NCMB attorneys”, giving the hope that there will be a reasonable, expeditious outcome.
a. The two attorneys I have been subjected to both stated to my wife and I that “there are no rules that govern what the NCMB does, they answer to nobody” (NC General Statues Chapter 90 contains >100 pages of regulations pertaining to the NCMB).
b. Jim Wilson Esq. went so far as to explain how State Medical Boards are widely perceived as being overly lenient and are ranked by the Federation of State Medical Boards; it is advantageous to them to discipline providers for as long as possible, as harshly as possible and as often as possible to change their rankings and the perception among the public that they are a “more effective” Board.
8. There are several attorneys practicing within the NCMB. Mike Weddington, Esq. answered my request that we appear for a change to a different attorney at the NCMB that “it wouldn’t make any difference”. This indicates to me that it is a systemic issue endemic to the entire NCMB and either occurs with the blessing (and possible cooperation) of Thomas Mansfield Esq., Director of the Legal Department and R. David Henderson Esq. Executive Director of the NCMB or that these two supervisory attorneys are so totally inept that the extortion ring operates without their awareness (which is unlikely).
High-Liability NCMB Legal Staff;
The NCMB attorneys tend to be overly aggressive. Marcus Jimison can be singled out among their attorneys as having caused an inordinate amount of problems for the licenses for which I’ve corresponded who have been victimized by the NCMB. His “Consent Orders” are the ones that are the most likely to be the farthest from factual and the most damning to the practitioner involved.
Logan Graddy MD of the NCPHP admitted to my wife and I @ 1330 7/30/13 that;
R; My attorney does not think that Jimison has been dishonest with or about me, doesn’t believe he’s said anything bad about me. He spoke to Mr. Weddington; I get the sense that Mr. Jimison and Mr. Weddington are very tight. I just wanted Cheryl to hear this as well.
G; All of these guys are all friends, and they all, you know, are on both sides, so one of the reasons, you know why your attorney is so good is because he worked for the board for a number of years and that also makes him very effective. I’ve done some forensic legal work; my Dad’s an attorney too. You know these guys a little bit I think. He’s just doing his job, you know, I don’t think it’s personal, I think.
R; He did go after me!
G; I thought you did well, I thought you did very well…
R; But my recollection is that Mr. Jimison made me look like a liar.
G; That’s his job.
C; Even if it’s a lie?
G; I mean, they, for whatever reason, I mean he took an aggressive tack, I mean, I don’t know…
A copy of the audio of this is available. At the prior appointment I had with Dr. Graddy (unfortunately it was not recorded) Dr. Graddy told me that there was “nothing I can do at this point, Mr. Jimison told me he doesn’t want to hear anything else I have to say”. This happened after I had signed an NCPHP contract and was thus supposed to receive advocacy per the terms of that contract. Dr. Graddy basically told me that I would not receive advocacy while making it clear to me that I would still be held to my part of the contract.
Mr. Jimison is a huge liability to the NCMB. There is no way that Thomas Mansfield and R. David Henderson can be unaware of his tactics.
Further Professional Misconduct of NCPHP Physicians;
At the very least, the NCPHP physicians are guilty of gross professional misconduct by failing to fulfill their professional obligations to provide advocacy to their fellow physicians and mid-level providers; “just do what the NCMB tells you to do” is NOT advocacy!
Warren Pendergast MD, director of the NCPHP is the 2013 President of the Federation of State Physicians Health Programs http://www.fsphp.org/Board_of_Directors.html. The standard PHP is a “one size fits all” model of addiction therapy—that has been proven to not work for everybody. Furthermore, the mentality of these programs and the way they deal with their allegedly impaired colleagues is far more punitive than geared toward compassion & rehabilitation http://disruptedphysician.com/2014/08/12/three-shells-and-a-pea-asam-fsphp-and-lmd-2/ . Many of these PHP Medical Directors have their own “colorful” (some would say sordid) histories http://disruptedphysician.com/2014/08/12/three-shells-and-a-pea-asam-fsphp-and-lmd-2/ .
Until 2014, there was not a mental health specialist empaneled on the NCMB. Debra A. Bolick MD is a geriatric psychiatrist. She does not however; appear to have any role in critically reviewing the decision by individual treatment centers on specific providers (the NCPHP’s responsibility). This leaves the NCMB in the untenable position of practicing outside of the scope of their training—the very thing that they are charged to enforce! How does the NCMB reconcile this inconsistency?
Furthermore, there are state and federal confidentiality statements that are routinely violated by the NCMB with the apparent full consent and approval of the NCPHP;
State Confidentiality Statement;
Summary Information Concerning State Law and Program Policy on the Subject of Confidentiality of Alcohol and Drug Abuse Patient Records
The North Carolina Physicians Health Program (NCPHP) is required by State law to report detailed information to the North Carolina Medical Board (NCMB) about any medical professional licensed by NCMB if:
1. The medical professional constitutes an imminent danger to the public or himself;
2. The medical professional refuses to cooperate with the program, refuses to submit to treatment, or is still impaired after treatment and exhibits professional incompetence; or
3. It reasonably appears that there are other grounds for disciplinary action.
Federal Confidentiality Statement;
Summary Information Concerning Federal Law on the Subject of Confidentiality of Alcohol and Drug Abuse Patient Records
The confidentiality of alcohol and drug abuse patient records maintained by this program (NC Physicians Health Program) is protected by Federal law and regulations. Generally, the program may not say to a person outside the program that a patient attends the program, or disclose any information identifying a patient as an alcohol or drug abuser unless:
1. The patient consents in writing; (coerced/under duress Re; NCPHP)
2. The disclosure is allowed by a court order; or
3. The disclosure is made to medical personnel in a medical emergency or to qualified personnel for research, audit, or program evaluation.
It should be noted that when a physician or mid-level provider is referred to the NCPHP, they are required, coerced under duress to sign the NCPHP “contract” or forfeit their livelihood. This aspect has not been adequately addressed at any point by any agency.
Once disclosure is made to the NCPHP, it is published on the public website of the NCMB—which is NOT HIPAA protected.
Furthermore The Diagnostic and Statistical Manual Version V notes that substance abuse as a mental health disorder http://www.dsm5.org/Documents/Substance%20Use%20Disorder%20Fact%20Sheet.pdf. This, then, speaks to yet another HIPAA violation on every posting of the NCMB regarding substance abuse on a providers public profile.
Nowhere does § 90 mandate forfeiture of basic civil rights including HIPAA protection and privacy. Indeed, the HIPAA statutes are quite clearly elucidated;
http://www.hhs.gov/ocr/privacy/hipaa/news/2002/combinedregtext02.pdf appears to mandate a separate authorization for mental health conditions.
Penalties for HIPAA Violation;
HIPAA violations to $50,000/violations with an annual maximum of $1.5 million per http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/hipaahealth-insurance-portability-accountability-act/hipaa-violations-enforcement.page?
In April 2014, the NCOSA released an audit of the NCPHP. This is due to be repeated in 18 months, around October 2015.
Is it prudent to postpone this audit for another year? Can the state of North Carolina afford the liability exposure placed on them by the actions of the NCMB & NCPHP?
Can NC afford more physician suicides due to the lack of restraint of the NCMB/NCMS/NCPHP triad?
Lack of Advocacy by the NCPHP to it’s clients;
Another inconvenient fact is that after a provider signs an NCPHP contract, they expect to receive treatment in an appropriate facility and that the recommendations of that facility will be followed. The “advocacy” provided by the NCPHP (if the NCMB even bothers to refer the provider to the NCPHP) is generally “just do what the NCMB tells you to do! Acceptance is the key to sobriety!” This is criminal neglect and professional misconduct by the NCPHP and its physicians.
Professionals who go into fields related to the treatment of addiction are often addicts themselves—hopefully recovering addicts. One of the key pathologic characteristics of addiction is referred to as the “isms” (I, self, me)—narcissistic characteristics that can be characterized as “me first, all about me”. This is clearly evident in the manner in which the physicians of the NCPHP deal with their charges—it’s not “about” those in their care!
§ 90-5.1. Powers and duties of the Board.
(a) The Board shall:
(1) Administer this Article.
(2) Issue interpretations of this Article.
(3) Adopt, amend, or repeal rules as may be necessary to carry out and enforce the provisions of this Article.
(4) Require an applicant or licensee to submit to the Board evidence of the applicant's or licensee's continuing competence in the practice of medicine.
(5) Regulate the retention and disposition of medical records, whether in the possession of a licensee or nonlicensee. In the case of the death of a licensee, the rules may provide for the disposition of the medical records by the estate of the licensee. This subsection shall not apply to records created or maintained by persons licensed under other Articles of this Chapter or to medical records maintained in the normal course of business by licensed health care institutions.
(6) Appoint a temporary or permanent custodian for medical records abandoned by a licensee.
(7) Develop educational programs to facilitate licensee awareness of provisions contained in this Article and public awareness of the role and function of the Board.
(8) Develop and implement methods to identify dyscompetent physicians and physicians who fail to meet acceptable standards of care.
(9) Develop and implement methods to assess and improve physician practice.
(10) Develop and implement methods to ensure the ongoing competence of licensees.
(b) Nothing in subsection (a) of this section shall restrict or otherwise limit powers and duties conferred on the Board in other sections of this Article. (2007-346, s. 5.)
NCMS Role, Failure & History of Impropriety vs. Corruption;
At this time, § 90 mandates that the NC Medical Society shall play a role in monitoring the actions of the NCMB & NCPHP.
Clearly, they are not up to the task. This legislation needs to be rewritten and changed drastically. Only 34% of practitioners licensed in NC are members of the NCMS. This is due to a variety of factors, especially decreasing compensation for practitioners and decreasing effectiveness of medical organizations and societies in general during this age of heavy managed care and the new Accountable Care Act’s effect on professional autonomy.
Perhaps it’s time for the state to recognize this evolvement and effect further changes reflecting the current situation—“to get with times”.
Furthermore, there is a well-documented history of the improper relationship between the NCMS & NCMB; http://www.starnewsonline.com/assets/pdf/wm8798228.pdf documents litigation in 2007 relating to the improper dealings with the NCMS members receiving preferential treatment by the NCMB. After this litigation, there was a period in which active NCMS members were not put on the NCMB. Preferential treatment continued however http://www.amednews.com/article/20070903/profession/309039958/7 and appears to continue to this day.
This document clearly portrays that the NCMS has not been able to impartially fulfill it’s duties regarding the NCMB & NCPHP.
On every occasion that I have appeared before any committee of the NCMB among the first questions asked of me is whether or not I am a member of the NCMS. What would the relevance of such a question be other than to perhaps temper anticipated punishment?
Review of violations of confidentiality by NCPHP & NCMB;
§ 90-21.22. Peer review agreements
(c) … The purpose of the programs shall be to identify, review, and evaluate the ability of those physicians and physician assistants to function in their professional capacity and to provide programs for treatment and rehabilitation. The Board may provide funds for the administration of impaired physician and impaired physician assistant programs, and shall adopt rules with provisions for definitions of impairment; guidelines for program elements; procedures for receipt and use of information of suspected impairment; procedures for interventions and referral; monitoring treatment, rehabilitation, post-treatment support and performance; reports of individual cases to the Board; periodic reporting of statistical information; assurance of confidentiality of nonpublic information and the review process.
(d) Upon investigation and review of a physician licensed by the Board, or a physician assistant approved by the Board, or upon receipt of a complaint or other information, a society which enters a peer review agreement with the Board, or the Academy if it has a peer review agreement with the Board, as appropriate, shall report immediately to the Board detailed information about any physician or physician assistant licensed or approved by the Board if:
1. The physician or physician assistant constitutes an imminent danger to the public or to himself;
2. The physician or physicians assistant refuses to cooperate with the program, refuses to submit to treatment or is still impaired after treatment and exhibits professional incompetence ; or
3. It reasonably appears that there are other grounds for disciplinary action…
(e) Any confidential patient information and other nonpublic information acquired, created, or used in good faith by the Academy or a society pursuant to this section shall remain confidential and shall not be subject to discover or subpoena in a civil case. No person participating in good faith in the peer review or impaired physician or impaired physician assistant program of this section shall be required in a civil case to disclose any information acquired or opinions, recommendations, or evaluations acquired or developed soley in the course of participating in any agreements pursuant to this section.
(f) 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.)
Lack of Patient Harm by Accused Practitioners;
This lack of harm is perhaps the most important concept of this amicus brief: Regarding physicians practicing with impairments; “They’re often described as the best workers in the hospital,” according to says Dr. Marv Seppala, M.D., Chief Medical Officer at Hazelden. “They’ll sign up for extra call and show up for rounds they don’t have to do.”
How does the NCPHP in particular or any state PHP reconcile this? Of the cases that we have reviewed, disciplinary actions by the NCMB such as keeping a physician out of practice, often for years, due to a DUI when not on duty certainly does not meet the litmus test of “in good faith”! In our review of the NCMB’s own records, records that are highly slanted to the point of grossly dishonest consent orders (which providers are coerced to sign under duress), it is very rare to see a substance abuse or boundary violation provider who has harmed a patient. Although I am not arguing that these providers should not receive evaluation and indicated treatment, I do believe that lack of harm to a patient is a mitigating factor that should be considered before taking a provider out of practice after being cleared by the treating facility.
Differences in Addiction therapy between Practitioners and the General Public;
A further consideration should include the way in which providers suffering from addiction are treated. They are isolated in treatment centers for 3 months, away from their support systems http://www.idealmedicalcare.org/blog/physician-suicide-101-secrets-lies-solutions/ . Most of us go into medicine because we crave and thrive on patient contact. Why send an excellent doctor hundreds of miles away from his support to attend inpatient treatment for addiction? Most addicts are treated initially in “IOP; Intensive Outpatient Therapy”. Such treatment is generally available close enough to a physician’s location that he could be treated in this manner while being allowed the support of his family, practice, coworkers, colleagues, and yes, even patients. Practicing medicine involves supporting patients. This support is often a 2-way street, especially when long-term relationships are established with patients. Mental health professionals may be quick to call “boundary violation” over issues such as going out to eat at a local restaurant owned by a patient, shopping in stores where patients work, patronizing the businesses of patients, etc. These behaviors do NOT characterize psychopathology or sociopathology!
Expert witness use and Non-Standard of Care by the NCMB;
Along the lines of addiction, it is pertinent to talk about the NCMB use of “expert witnesses”. I discuss this in the framework of addiction because I believe it demonstrates an important issue within the NCMB and it’s policy regarding “expert witnesses”. The journal Family Practice Management of the American Academy of Family Physicians published an article http://www.aafp.org/fpm/2014/1100/p6.html in their Nov-Dec 2014 edition discussing how patients on Opiates for Chronic Pain should be monitored. It’s a pretty typical article that covers the national standard of care for the practice. The NCMB published it’s position paper http://www.ncmedboard.org/images/uploads/other_pdfs/Policy_for_the_Use_of_Opiates_for_the_Treatment_of_Pain_June_4_2014.pdf ; a 58 page PDF that I used to revamp the controlled medication contract/consent that I’ve used for at least the past decade of my practice career. The re-writing of my document took it from 2 pages to 9 pages in length. Clearly anybody practicing opiate prescribing for chronic pain who is following the national standard of care will be 7 pages short on the documentation required for this one area of practice alone. It’s no wonder that expert witnesses that review for the NCMB do not find that physicians are practicing according to the standard of care!
My personal history with the NCMB has been documented in a letter written to Gov. Pat McCrory 10/2/13 http://www.tequestafamilypractice.com/A/index.htm
Irregularities during my Formal Board Hearing;
6/20-21/14 the NCMB held a hearing regarding me that was rife with procedural errors despite numerous objections at every stage from my attorney. The fact that my attorney & I refused to allow telephonic testimony, which would not provide me the opportunity to face my witnesses is under appeal in Wake County Superior Court. There were other issues with this hearing including;
1. The hearing panel was non-representative including 5 female board members and only two males.
2. One of the hearing members is currently employed by the practice where complaints against me arose. We objected that this would have an influence on her looking to protect and uphold her employer. This was to no avail.
3. Testimony was obtained from witnesses on cases that had been closed by the NCMB “in order to establish a pattern of behavior” whose etiology conflicted with the sexualized target of Mr. Jimison during the hearing. In one of these cases there was a letter from the witness of the prior event from 2010 attesting to the fact that it was a false charge—the behavior had never occurred.
4. There was no segregation of witnesses. My wife took a photograph of all of the witnesses who had complained against me congregated at the front door of the NCMB smoking cigarettes and (presumably) exchanging stories as they conversed, laughed, etc.
5. Acumen Associates, whom the NCMB referred me to, recommended my immediate return to practice with supervision of the psychologist I had begun seeing related to communication issues I recognized prior to coming to the attention of the NCMB. I spent >$20K there with the expectation of having their recommendations followed by the NCMB & advocacy by the NCPHP. This was not part of the plan of the power-players in the equation however.
6. An “expert witness” was brought in from Acumen Associates, where I had spent several weeks in “therapy sessions” to testify regarding me. This was not the therapist who handled my case and therapy while I was there, he was unable to answer specific questions by the panel against me and gave vague and at times misleading testimony.
7. Logan Graddy MD testified on behalf of the NCPHP that I was not in compliance with my NCPHP contract. Specifically the issues in which he alleged that I was noncompliant entailed;
a. I had not been paying my monthly service fee to the NCPHP—I had communicated with them that as long as I was out of work I had no money to pay them!
b. I had not gone back to Acumen for the follow sessions that were designed to track my progression once I had returned to the exam room and review how issues with patients were going—how could I do this when I hadn’t been returned to practice?
c. I had missed several sessions with Dr. Dickinson in the prior months. These sessions were designed to review my performance in the exam rom and patient communication issues. Again, how could I do these things if I was not allowed to practice?
8. On a subsequent phone call AFTER the hearing he admitted he was incorrect, that I probably should have been considered in compliance.
9. Telephonic testimony against our objections was allowed during the hearing. This testimony clearly prejudiced the panel. After the hearing during closing arguments and the “sentencing” portion of the hearing, the judicial officer admonished the panel that they must disregard that testimony. The damage had already been done however! False and misleading testimony, once spoken, cannot be undone and is prejudicial.
10. During closing arguments, Mr. Jimison again distorted and mis-represented the facts, portraying me as a dangerous, brain-damaged psychopath despite testimony from the two prior expert witnesses that I have Asperger’s disorder. This disorder easily explained the behaviors in question which were never sexual, but merely miscommunication and failed attempts at humor. There was never and has never been any charge of boundary issues such as sexual contact with patients etc.
11. On conclusion of the hearing, my wife had been sitting in the car outside of the NCMB offices (she was not allowed in any aspect of the hearing due to the risk of protected HIPAA information about a patient being revealed). She noticed that a videographer with camera and reporter from the television studio next door came into a side-entrance of the NCMB. As luck would have it, my attorney and I were in conference in a small isolated room. The reporter and videographer left the building during the NCMB Panel’s deliberation regarding sentencing. It’s a fair assumption that I would otherwise have been on the news that night.
12. Other aspects of my case that entail the legalities of the NCMB’s actions prior to the panel hearing and the numerous statutes that were broken can be found at; http://www.tequestafamilypractice.com/A/index.htm.
13. Among the egregious actions of the NCMB’s postings are my personal mental health issue (Asperger’s) and the implication that I also suffer from sexual/boundary pathology—which has never been an issue and has been ruled out by their own consultants! These are clear violations of my HIPAA rights!
Another Typical Example of Abuse of an Impaired Practitioner;
Another story of which the author has clear first-hand knowledge involves Enrico Guy Jones MD, who was a stable, long-term recovering alcoholic. He required knee surgery, had a brief relapse on opiates that he was taking to manage his knee pain peri-operatively. He self-reported to the NCPHP which turned him over to the NCMB. He voluntarily entered treatment at Fellowship Hall in Greensboro, continued attendance at the Greensboro Caduceus meetings and was advised after completion of treatment that he was not cleared to return to his practice. Where is the advocacy of the NCPHP? He was treated and cleared to return to practice after his 90 days there. Why did he not receive advocacy from the NCPHP and return immediately to practice? He was simply advised by the NCPHP that he had to practice “acceptance” and “not make waves”. This despite the criminal negligence of the NCPHP to FAIL to provide ADVOCACY for him and return him to practice as was recommended by Fellowship Hall, the treatment facility that the NCPHP & NCMB mandated him to! He is currently “indefinitely suspended”
Harsh Over-reach of the NCMB on a variety of areas;
Why is it necessary for the NCMB to involve itself with dual-license providers who have had difficulties in another state? Why is it necessary for a practitioner who has voluntarily surrendered his license to then receive an indefinite suspension? What is the rationale for such behavior other than to garner “more disciplinary actions, harsher disciplinary actions, against more providers for longer durations of time” as if to “pad” the ranking that may or may not be taking place by other entities such as the Federation of State Medical Boards or Ralph Nader’s Citizen Watch www.citizen.org/
Telemedicine is a growing area. Several providers have gotten into trouble for the “negligence” of not documenting a full physical exam (while others have gotten into trouble by having nursing or office staff “scribe” for them)—something impossible to do with telemedicine. Perhaps it’s time for the NCMB to modernize their means and methods.
1. Clearly the NCOSA study on the NCPHP released 4/2014 has not had a desired effect on the NCPHP much less any impact on the NCMB/NCMS.
2. The 8/2014 NCOSA report on all 57 licensing and professional boards within the state also show that there is a large amount of work to be done.
3. I would propose that there is ample evidence of criminal activity—that meets the major RICO criteria, to enlist the services of the FBI regarding the interactions of NCMB attorneys, defense attorneys and the physicians of the NCPHP. Without access to financial data and the ability to look for “gifts in kind” such as airline tickets for vacations and other non-cash “incentives” spread between defense attorneys, NCMB attorneys and NCPHP staff, it’s hard to prove or disprove illegal activities. Investigation is overdue.
4. This may be an area in which the NC Institute of Medicine could expand into and replace the NC Medical Society which has an unenviable history in this regard.
5. Perhaps a trial of academic and or/retired with current CME physician overseers who reviewed the briefs prepared by the NCMB attorneys prior to their submission to the NCMB Members/disciplinary panel would be a better alternative than the current malfunctioning system.
6. Consideration to using a set pool of expert witnesses who are Board-Certified in their specialties but to REPLACE the current pool as well as replacing most of the current staff and administration of the NCMB in an attempt to replace their misbegotten “corporate culture”.
7. Have a group of recently disciplined physicians who have successfully been through whatever reasonable correction (CME, addiction treatment, etc.) actions be part of #5 above.
There is a comprehensive link http://woundedhealersnc.net/#Reviewofdisciplinaryactions to most of the de-identified NCMB victims of the last decade.