North Carolina changes medical board nomination process

The North Carolina Medical Society will have less input in recommending physicians to serve on the state's medical board under a new law adopted last month.

The society now nominates seven of the 12 board members to the governor, who usually appoints the nominees. But a lawsuit over the process prompted the state Legislature to seek changes. Starting Jan. 1, 2008, a nine-member review panel, which will include six physicians, will recommend potential board members to the governor.

"We supported the bill and pushed for it in the [state] General Assembly, and we believe it's a sound approach," said Stephen Keene, the medical society's deputy executive vice president and general counsel.

On Feb. 28, a physician and three patients sued the North Carolina Medical Board, Gov. Michael Easley, the state and the medical society, claiming that the medical society had too much power over the medical board. The lawsuit, which family physician John Faulkner, MD, and the patients filed in Wake County Superior Court, asks that the process that requires the society to nominate physicians for board appointment be declared unconstitutional.

The complaint claims that the board failed to investigate and discipline physicians who endanger patients "because of the control exercised" by the medical society. The society denied the accusation. The society and medical board said the selection process was fair.

The three patient plaintiffs said they or family members were harmed by poor physician care. Dr. Faulkner, who does not belong to the medical society, said his wife was injured in a preventable operating room fire.

Burton Craige, the Raleigh, N.C., attorney for the plaintiffs, said he wanted state legislators to change how board members are nominated. Lawmakers introduced the bill in March. At the time, Craige said he would drop the lawsuit if lawmakers changed the process. Now that the measure has passed, Craige said he has not decided if he will drop the lawsuit. "We're considering it now," he said. "I'm certain that this wouldn't have happened without the lawsuit. It's a step in the right direction."

New criteria for nominees

The law does not change the board's makeup, just how members are nominated. The board consists of eight physicians, one physician assistant or nurse practitioner, and three public members. Members serve a three-year term and can serve for two terms.

One of the eight physicians must be an osteopath, a faculty member of a medical school who uses integrative medicine in practice or a member of the Old North State Medical Society, an association of black physicians. The governor will appoint a person to that position, and the person will not be subject to the review panel.

The governor also will appoint three public members without input from the panel.

Panel members will make recommendations on the seven other physician slots and the physician assistant or nurse practitioner position.

The nine-member panel will consist of four people from the state medical society, one person from the Old North State Medical Society, one from the North Carolina Osteopathic Medical Assn., one from the North Carolina Academy of Physician Assistants, one from the North Carolina Nurses Assn. Council of Nurse Practitioners, and one public member currently on the medical board.

"You've got a broad representation of parties serving on this panel," said David Henderson, medical board executive director.

Applicants for the eight board positions under review must have:

• An active North Carolina license.
• An active clinical or teaching practice.
• Five consecutive years of practicing in the state.
• Intentions to keep an active practice while on the medical board.
• Three letters of recommendation.
• No public discipline in the state in the past 10 years.
• No felony convictions, and no misdemeanor convictions related to medical practice.
• An understanding of the board's role to protect the public.

The panel will recommend at least two nominees per opening, and the governor will make the final decision. The board now has three physician openings that need to be filled this year. Because the new law will not yet be in effect, the existing nomination system will be used, Henderson said.

The new panel will be used for a physician opening next year, he said.