State laws aim to buttress role of medical boards

Physicians in North Carolina previously faced extremes when the medical board considered disciplining them: Either nothing would happen, or their licenses would be revoked or suspended.

"There wasn't much in between," said David Henderson, executive director of the North Carolina Medical Board. State legislators changed that in July by passing a measure that gives the board more disciplinary options, including probation, public reprimands and treatment programs. The changes to the state's medical practice act strengthened the board's authority to regulate physicians in North Carolina.

The measure was one of several that state legislators around the country passed to bolster how medical boards operate, improve regulation of physicians and increase patient safety. Some changes were the result of legislation, but others were measures the boards instituted themselves.

The theme was "strengthening the role of medical boards," said James Thompson, MD, president and CEO of the Federation of State Medical Boards. "The legislation is a response to the need of state medical boards to have additional resources and authority to take action when necessary in the disciplinary process."

In addition to more disciplinary options, North Carolina's law lets the state medical board deny a license to an applicant who has been out of practice for more than two years or impose conditions to re-enter medical practice. The law also allows a committee of three or more board members to conduct a detailed disciplinary hearing, with recommendations reported to the full board. Previously, the full board conducted license denial and disciplinary hearings, limiting the number of cases the board could handle, officials said. The changes are set to take effect Oct. 1.

Regulating expert witnesses

South Carolina overhauled its medical practice act in June, authorizing the state Board of Medical Examiners to conduct national criminal background checks on new medical license applicants. The board also can do a criminal history check for existing licensees during a board investigation or disciplinary proceeding.

In addition, the new law requires out-of-state physicians to obtain a special license before they can act as an expert witness in South Carolina. The revisions were the culmination of several years of work by the board, said Richard P. Wilson, deputy general counsel for the board.

The Mississippi State Board of Medical Licensure also addressed expert witness testimony by adopting standards to regulate physicians who testify as experts. Under the regulations that took effect July 1, physician medical experts must comply with medical ethics principles, including those of the American Medical Association. Experts cannot make or use any false, fraudulent or forged statement or document.

Violators could lose their Mississippi medical licenses or pay up to $10,000 to cover the board's investigative costs. Physicians from other states who give false testimony could be prohibited from giving further testimony or have their state boards notified.

"The plaintiff lawyers will tell you we're out to put a chilling effect on experts. That's not what these regulations are about. These are about policing physicians," said Philip Merideth, MD, board vice president.

Some states addressed scope of practice, such as Kentucky legislation that created an acupuncture advisory council under that state's medical board. Next year, some states are expected to address licensing of out-of-state physicians during emergencies.

"In times of emergency, we seem to attract people who have lost their license or who have been disciplined who think volunteering will help restore their license," Dr. Thompson said.