FROM THE PRESIDENT
Reflections on my six-year sojourn
on the NC Medical Board
IN THIS ISSUE
3 The ‘Six Core Competencies’:
Evaluating licensee performance
4 Developing a practice website
8 Understanding the disciplinary
case review process
10 Policy Committee offers new posi-tion
statement on telemedicine
11 Changes to disciplinary, investi-gative
processes in efect
12 Quarterly Disciplinary Report
NCMB President George Saun-ders,
MD, says “medicine in
North Carolina is better for the
Board’s efforts.”
In July of 2003, I reported for duty to my first North Caro-lina
Medical Board meeting. I was there to replace John
Dees, MD, a family physician from eastern North Carolina
who had served as president of the Board until his death
earlier that year. Life has come full circle and now, I too
leave the Board as president (though thankfully under more
fortunate circumstances than Dr. Dees.)
I do not pretend that I was the best candidate for my seat
on the Board. I know of others more qualified than me. I was,
quite frankly, surprised that my name was put forward as a
nominee by the North Carolina Medical Society, and that I
was chosen by then-Governor Easley.
I had much to learn. In this, my final President’s Mes-sage,
I would like to share with you some of the things I have
learned in my years at 1203 Front Street, and reflect on some
of the Board’s achievements.
The North Carolina Medical Board is truly one of the best—
if not the best—in this nation. Your Board serves the citizens
of this great state with kindness and care and its licensees
with fairness and justice.
Sometimes when so much is going on, the spectacular seems mundane. Make no mistake
—what the Board does here routinely is spectacular.
Let me take you through a few of the changes that have gone forward during my time on
the Board.
The Board adopted the first position statement in the nation to sanction discipline of
teachers of medicine who abuse their students. The Board has yet to prosecute anyone un-der
this rule, but I have no doubt that the Board’s stance on this issue has worked to deter
some of the more extreme forms of student mistreatment.
We were nudged, somewhat reluctantly, to provide greater information to the citizens of
this great state. This winter, with the public launch of expanded licensee information pages
on the Board’s website, North Carolina joins the ever-growing number of state medical
regulatory bodies that provide a broad range of information about their licensees.
When the very heart of medicine—the preservation of life and alleviation of suffering
—was assaulted by state policies that contemplate active physician participation in the
death penalty, your Board opposed that position clearly and forcefully. I sat, beaming
with pride, as the Board’s attorneys took our case to the State’s highest court. Our Legal
Department was able to convince three of seven justices that doctors should be healers, not
harbingers of death. We lost that battle, but I am proud to this day that we fought for the
dignity and caring that is the heart of the profession of medicine.
Pg. 16 – There’s still time: Update
your Licensee Info page
Board officers
President
George L. Saunders, III, MD | Oak Island
President Elect
Donald E. Jablonski, DO | Etowah
Secretary/Treasurer
Janice E. Huff, MD | Charlotte
Immediate Past President
Janelle A. Rhyne, MD | Wilmington
Board members
Pamela Blizzard | Raleigh
Paul S. Camnitz, MD | Greenville
William W. Foster, MD | Raleigh
Thomas R. Hill, MD | Hickory
Thelma Lennon | Raleigh
John B. Lewis, Jr, LLB | Farmville
Peggy R. Robinson, PA-C | Durham
William A. Walker, MD | Charlotte
Forum staf
Executive Director
R. David Henderson
Editor
Jean Fisher Brinkley
Associate Editor
Dena M. Konkel
Editor Emeritus
Dale G Breaden
Contact Us
Street Address
1203 Front Street
Raleigh, NC 27609
Mailing Address
PO Box 20007
Raleigh, NC 27619
Telephone / Fax
(800) 253-9653
Fax (919) 326-0036
Website:
www.ncmedboard.org
E-Mail:
info@ncmedboard.org
Have something for the editor?
forum@ncmedboard.org
The Forum of the North Carolina Medical Board is published four times a year. Articles appearing in the Forum,
including letters and reviews, represent the opinions of the authors and do not necessarily reflect the views of the
North Carolina Medical Board, its members or staff, or the institutions or organizations with which the authors are
affiliated. Official statements, policies, positions, or reports of the Board are clearly identified.
We welcome letters to the editor addressing topics covered in the Forum. They will be published in edited form
depending on available space. A letter should include the writer’s full name, address, and telephone number.
North Carolina Medical Board Forum Credits Volume XIV | Fall 2009
Primum Non Nocere
PRESIDENT’S MESSAGE
Your Board has stood at the forefront of medical regula-tion,
just as doctors in North Carolina have stood in the lead-ership
of medicine and research throughout this country.
Twice during my time on the Board, the Federation
of State Medical Boards (the umbrella organization that
guides state medical regulators) has selected North Carolina
Medical Board members to serve on its Board of Directors.
Numerous Board members serve on the many committees
of the FSMB, helping to influence policy and scholarship in
medical regulation nationally.
Your Board has taken proactive steps to help licensees
improve interactions with patients and prevent complaints
by recognizing that effective communication is the key to the
relationship between doctors and patients. Over the past 12
months, your Board identified homegrown, affordable, con-venient
courses where physicians who lost, or perhaps never
had, good communication skills can learn effective com-munication.
It is my hope and aspiration that these courses
will reach beyond the troubled physicians we see here and be
used by all physicians who strive to become skilled commu-nicators.
Your Board has done all this, and more, with quiet yet
bold leadership. And it has done it all with a modest-sized
staff and operating budget that strains under ever-increasing
obligations.
Numerous challenges remain before the Board.
The Board needs to streamline its licensing process while
maintaining the integrity and high standards of the evalua-tions.
The Board must strive to build a workforce within the
Board which looks like the workforce outside the Board. It
must find a way of performing clinical evaluations of li-censees
in their own clinical settings, which would be more
relevant and useful than the costly and inefficient practice of
sending a physician under review off to some distant place
that does not resemble the conditions in which he or she
practices.
I know that some of these changes will take members of
the staff and Board outside of their comfort zones. Newness
is not always a bad thing.
Finally, I personally owe a great deal to the Board’s staff
and to my colleagues on the Medical Board. The people of
this great state, including the Board’s licensees, owe them
much more. They are the centurions of care and the guard-ians
of good medical practice.
Medicine in North Carolina is better for the Board’s ef-forts.
It has been my privilege to be part of those efforts for
the past six years.
Send feedback to forum@ncmedboard.org.
BE a BETTER CoMMUNICaToR
In the last issue of the Forum, Dr. Saunders wrote about
a Board initiative aimed at improving licensees’ com-munication
skills. He wrote of the Board’s intention to
publicize more information about the specific vendors
providing communications training when it was avail-able.
The Board is pleased to recommend the programs
listed below. Courses are typically scheduled on Satur-days
and take a full day.
Course: Interpersonal and Communication Skills Semi-nar
for Physicians
Offered by: SEAHEC, Charlotte AHEC and MAHEC
Locations: Wilmington, Charlotte, Asheville
Cost: $400-$450
CME Credits: 7 Category 1 Credits
Information/registration: www.seahec.net
Course: Strategies for Effective Medical Communication
Offered by: Wake AHEC
Locations: Chapel Hill
Cost: $550
CME Credits: 6.5 Category 1 Credits
Information/registration: www.wakeahec.org, 919-
350-8547
FORUM | Fall 2009 3
ANNOUNCEMENTS
The ‘Six Core Competencies’: Evaluating
Licensee Performance and Conduct
The North Carolina Medical Board has a duty to address
misconduct and substandard care. However, its mem-bers
also consider taking proactive steps to help prevent
such problems to be a priority.
To that end, this issue of the Forum begins a series
of short features on an important tool the Board uses to
evaluate possible misconduct: the ACGME’s six core com-petencies.
A decade ago, the Accreditation Council for Graduate
Medical Education (ACGME) endorsed six core compe-tencies
it expects all medical residents to demonstrate
proficiency in. Since then, the core competencies have
gained acceptance among numerous healthcare organiza-tions
as a useful means of gauging clinical aptitude. For
example, the American Board of Medical Specialties uses
the six core competencies as part of its Maintenance of
Certification programs. Just last year, the Joint Commis-sion
began requiring all accredited hospitals to capture
physician-specific data that indicate proficiency in the six
core competencies.
The Board has used the core competencies as a frame-work
for discussing disciplinary cases for some time. It
has observed that licensees under review usually exhibit
shortcomings in one or more competency.
This February, during a Board retreat, Board members
hit on the idea of educating licensees about the core com-petencies
as a means of preventing problems. In general,
the Board believes that a licensee who demonstrates
proficiency in the core competencies can reduce his or her
chances of patient complaints or disciplinary action.
Licensees who work with resident training programs or
who are active members of an accredited hospital staff are
likely at least generally familiar with the competencies.
However, the Board recognizes that many licensees prac-tice
in settings that do not bring them in regular contact
with the competencies and may be unfamiliar with them.
Over the next few issues of the Forum, the Board will
highlight two competencies per issue in detail, and publish
a complete list of all six competencies. Detailed definitions
for each competency are taken from the ACGME.
In this issue: Patient Care and Medical Knowledge
Read the detailed definitions for information on what
behaviors and skills demonstrate proficiency within a par-ticular
competency.
Patient Care: “What you do”
Practitioners must be able to provide patient care that is
compassionate, appropriate, and effective for the treat-ment
of health problems and the promotion of health.
Practitioners are expected to:
• Communicate effectively and demonstrate caring and
respectful behaviors when interacting with patients
and their families.
• Gather essential and accurate information about their
patients.
• Make informed decisions about diagnostic and thera-peutic
interventions based on patient information and
preferences, up-to-date scientific evidence and clinical
judgment.
• Develop and carry out patient management plans.
• Counsel and educate patients and their families.
• Use information technology to support patient care
decisions and patient education.
• Perform competently all medical and invasive proce-dures
considered essential for the area of practice.
• Provide health care services aimed at preventing
health problems or maintaining health.
• Work with health care professionals, including those
from other disciplines, to provide patient-focused care.
Medical Knowledge: “What you know”
Practitioners must demonstrate knowledge about estab-lished
and evolving biomedical, clinical, and cognate (e.g.
epidemiological and social-behavioral) sciences and the
application of this knowledge to patient care. Practitioners
are expected to:
• Demonstrate an investigatory and analytic thinking
approach to clinical situations.
• Know and apply the basic and clinically supportive sci-ences
which are appropriate to their discipline.
WHaT aRE THE SIX CoRE
CoMPETENCIES?
A complete list of the six competencies
appears below.
• Patient Care
• Medical Knowledge
• Practice-based Learning and
Improvement
• Interpersonal and Communication Skills
• Professionalism
• Systems-based Practice
SPECIAL FEATURE
Developing a website for your practice
Marjorie A. Satinsky, MBA
Think of the number of times you, your family and
friends access the Internet. You use the Web to make
travel arrangements, make purchases, download music,
share information with friends and relatives and find infor-mation
on topics that interest you.
Yet many medical practices have yet to establish a pres-ence
on the Web. If your patients are online, why aren’t
you?
Neil Baum, MD, author of Marketing Your Clinical
Practice, writes, “Your website might be the first impres-sion
your patient has of your practice, the way you treat
patients, and your attention to detail. If you have built a
user-friendly, interactive website, this becomes a way to
build trust and enhance the patient-physician relationship.”
The purpose of this article is to remove the mystery from
website development. It addresses the following topics:
types of practice websites, setting goals, selecting a vendor,
developing content material, tips for getting noticed and
methods for monitoring site traffic.
Practice website basics
Many medical practices regard their websites as a second
door to their offices that also offers improvements in effi-ciency,
cost savings, increased visibility and improvements
in revenue cycle management.
Depending on the capabilities you choose to offer
through a website, you can provide basic informa-tion
to all users and also give current
patients the ability to use the website
for both administrative and clinical
functions. This interactive feature,
called a patient portal, allows patients
electronically or bring them to
their next appointment. They
may pay bills online, receive
email reminders about appoint-ments
and preventive care, and
access health information. Now that payers such as Blue
Cross Blue Shield of North Carolina are reimbursing physi-cians
for electronic or “e-visits,” physicians may be paid for
providing online advice to existing patients, subject to plan-specific
requirements.
Prospective patients can use your website to learn about
the services that you provide and about your practitioners
and administrative staff. Patient testimonials can tell them
how other patients perceive your practice. Referring physi-cians
can see what care you provide and what insurance
you accept.
Setting up and maintaining a website takes time and
money. The cost, however, may be less expensive than
advertising in the Yellow Pages, which, let’s face it, doesn’t
produce the results it once did now that people have the In-ternet.
These days, patients’ fingers are more likely to walk
across the computer keyboard than through a cumbersome
paper phone book.
Set your goals
If you’re interested in establishing a practice website,
start by setting goals. Look at the sites of other practices
in your specialty and in your community. Some provide
information only. Other websites function as interactive
patient portals, but are significantly more costly to estab-lish.
Decide what’s right for your practice before you make
decisions about budget, vendors and site content.
If you are happy with your existing practice logo and
printed brochures, they may be a good jumping off point
for your website’s look and feel.
When I opened Satinsky Consulting in 2002, I started
with my logo and print materials and created a website that
was consistent with them. I wanted to reinforce a clear and
simple message with repetition. Three different people col-laborated
on the design, content editing and programming
of my corporate website.
Some experts argue that the Web is
a totally different medium and recom-mend
starting fresh with the help of an
experienced Web developer. “Some of the
advantages of starting with Web design in-clude
selecting colors that reproduce well
both on the Web and in print,” said Alice
Saunders of Finishing Software.
“The implications of vertical and
horizontal logos and taglines on
the masthead of a website differ
from print material, since space
may be more limited.” Informa-tion
that has been specifically written and organized for the
Web sometimes produces better copy for print material as
well, Saunders said.
Who will build the site?
Some practices may have the in-house expertise to create
and maintain a website, but most medical practices prefer
to outsource the job to one or more vendors with proven
to request appointments and prescrip-tion
refills and view lab and other test
results. They may download forms and
either return them to the practice
col
laborated recom
mend in
clude A ‘patient portal’ that lets patients request appointments, see lab test results and take care of other business can improve patient sat-isfaction
and reduce overhead.
IMPaCT oRTHoPaEDICS
Dr. Rob Jones opened Impact Orthopae-dics
in Raleigh in mid-2008. His website,
www.impactorthopaedics.com, contains
comprehensive information about the
services that he provides and about the
background and experience of both clini-cal
and administrative staff. Right now,
patients can download financial policies,
a Notice of Privacy Practices and forms
to fill out prior to their appointments.
The patient portal aspect of the site gives
Dr. Jones the flexibility to add additional
interactive features at a later date should
he decide to do so.
NC DERMaToLogy aSSoCIaTES
Dr. Vikas Patel opened his new dermatol-ogy
practice in March 2009. His website,
www.ncdaskin.com, offers basic informa-tion
and downloads. Dr. Patel plans to
add a patient portal that will integrate into
his EHR system. With the portal, patients
will be able to pre-register prior to their
visit, thus eliminating paper registration.
Dr. Patel used a freelance Web designer to
help with design. Two features are built
into Dr. Patel’s site. One is Search Engine
Optimization (defined in RFP box Pg. 6)
and the second is a Web analytic tool that
provides information to help the practice
understand user behavior.
aVaNCE CaRE
Avance Care is a paperless primary care
practice with one site in Morrisville and
plans to expand to two other locations.
Information technology has been a priority
since day one. Patients can go to www.
avancecare.com and click on quick links
that take them to new patient registration
and appointment requests, established
patient appointments and an online patient
satisfaction survey. Other sections of the
home page offer health information and a
live (i.e. on-line) chat with the receptionist
to discuss appointments, walk-in policies
and waiting time. The results of the patient
satisfaction survey, which are very positive,
are posted right on the site. Avance Care
believes the features on its website help the
practice keep its overhead low and manage
more efficiently.
BLUE RIDgE FaMILy PHySICIaNS
Blue Ridge Family Physicians in Raleigh
had a dilemma. Patients were calling on
the phone and waiting on hold for as long
HaRNESSINg THE PoWER oF THE WEB: WHaT oTHERS HaVE DoNE
as thirty minutes to make appointments,
request prescription refills and take care
of other administrative matters. With
ten providers, the practice struggled with
an inefficient front office and with billing
and clinical processes that had a negative
impact on patient communication. Patient
complaints skyrocketed, and the practice
realized it needed to address all of these
problems.
The practice was already well on its way to
becoming a paperless practice. In 2002,
it had implemented an electronic medical
record system (EHR), and it had a prac-tice
website that was up and running. It
sought a solution that would blend well
with its other investments. Working with
Medfusion in Raleigh, the practice added a
patient portal to its existing website. Once
patients had the ability to request appoint-ments,
pay bills, pre-register, submit health
forms and renew and refill prescriptions,
the telephone problem abated. The prac-tice
saved money on postage, paper and
printing. Patients and staff love the new
features. In fact, the practice involved both
groups in contests to come up with ideas to
market the new website to patients.
FORUM | Fall 2009 5
If your patients are
online, why
aren’t you?
“ “
SPECIAL FEATURE
skills and track records of developing attractive, functional
sites for their clients.
If your practice uses a marketing consultant, he or she
can likely recommend a Web developer and help you with
decisions about how to proceed. If you want to go directly
to Web vendors, go with the knowledge of what you need
and communicate your requirements clearly.
Whatever your preference, you need website design, con-tent
editing and programming – three different skills. Some
Web design companies do everything, but others do not. In
such cases you will need a team of people with complemen-tary
skills. Vendors who do not provide the full range of
services you require should be able to recommend addition-al
expertise to get the job done. Experienced vendors likely
will have established partners who work with them.
Selecting a vendor
Before you select outside help, look at other websites.
What look do you like? Do you want videos, case studies,
a before/after photo gallery or other enhancements? Try
navigating around websites you like to see how informa-
SPECIAL FEATURE
tion is organized and displayed. In some cases you can find
the name of the Web developer on the bottom of the home
page. Contact colleagues and professional associations
whose sites you admire and ask for their suggestions.
In my experience, there are good reasons to select a ven-dor
that specializes in creating websites for medical prac-tices.
Examples are Medfusion, Early Design Group and
Mednet Technologies . These companies know the medical
practice industry and the unique requirements of certain
specialties. Partnership arrangements often give them the
capability to integrate their patient portal right into other
products such as practice management systems (PMS) or
electronic health records (EHR).
An effective way to get comparable bids is to develop a
concise but thorough Request for Proposal (RFP). Please
see the accompanying box (below) for a list of the areas that
a good RFP should cover.
Developing content material
Presumably you have looked at other websites before you
began your own project and have some idea of the topics that
you want to cover on your own site. At the very least, you
will want visitors to your website to learn:
• Who you are (name, mission, goals)
• How to contact your office (phone, fax, email)
• How to find your office (driving directions, map, parking)
• Hours when your office is open
• Availability of appointments and walk-ins
• Who provides clinical and administrative services (pic-tures
and biographical information on physicians, other
clinical staff, key administrative staff)
• What services you provide (names and brief descriptions)
• What insurance plans you accept
• Information on medical conditions that you frequently
treat
• Link to your practice newsletter if you have one
• Current news on you and your practice
• How you comply with HIPAA (download Notice of Pri-vacy
Practices)
Tips for getting noticed
Setting up your website is only half the challenge. Once
it’s up and running, you want to make sure that people ac-cess
it. Here are suggestions for maximizing Web traffic:
A thorough Request for Proposal can help a practice
clearly state its goals for a website and help select a vendor
capable of delivering the results you want. Thanks to the
Foundation of the Lucy Daniels Center for Early Childhood
in Cary, which shared the basic framework it used for its
RFP.
• Project summary
• Proposal Guidelines and Requirements (e.g. open
and competitive process, deadline for receipt, fixed
price, willingness to incorporate elements of Proposal
into final agreement)
• Length of the Contract Term
• Purpose, Description, and Objectives (what you
want to accomplish)
• Description of website that you want (e.g. flexibil-ity,
informative, easy to maintain, safe and secure, quick
loading)
• Internet Objective (e.g. create brand identity)
• Specific Strategies and Required Functional-ity
(e.g. focus on existing and/or potential patients,
resource for referring physicians, provision of down-loadable
administrative tools/forms, encourage patient
communication with practice)
• Maintenance Strategy Will you or the vendor pro-vide
updates and how extensive and frequent do you
expect them to be?
• Miscellaneous Related Services How will you
acquire a domain name and who will be responsible for
this task? How does the vendor handle Web hosting and
is the hosting service HIPAA compliant? How will email
be sent through the site? Who will provide technical
support? What Search Engine Optimization* or Search
Engine Marketing** strategy does the vendor propose?
• Design Preferences (e.g. look and feel, additional
features such as photography or video)
• Technical Specifications What software or program-ming
language will the vendor use to create the site?
How will site traffic be tracked and analyzed***? Who
will host the site ****and who will provide technical
support if the site crashes?
• Timeline for completion
• Pricing Terms Ask the vendor to itemize pricing for
various services. (e.g. acquiring domain name, hosting,
design, customization, video and other special features,
content management if you are not doing it yourself,
monthly maintenance, price per click for some items,
etc.) If the vendor offers different levels of service, re-quest
a pricing range and recommendation for the level
appropriate for your organization.
• Payment Terms How much money is due up front?
How is billing done once the project is underway
(weekly or monthly, based on completion of project
Finding the right Web vendor(s): a good RFP can help
There are good reasons to select a vendor that
specializes in creating websites for medical practices “ “
• Include your website address on all correspondence,
including but not limited to letters, postcards and bills.
• Post signs in your office encouraging patients to use your
website.
• Put a computer with access to your website (but not
Internet shopping) in your waiting room so patients can
explore your website while they are waiting to be seen.
• Involve your patients in website promotion by asking for
suggestions and offering prizes for ideas that you select.
• Create and customize listings in online directories and
phone books. For example, the Google Maps local busi-ness
listings appear in Google searches, making them
very valuable.
• All links back to your website will improve your search
rank, so create listings for your website wherever people
look for services online. For example, maintain listings
with Yahoo, Superpages, Merchant Circle, HealthGrades
and Vitals.
• Encourage patients to write reviews in Google Maps list-ings
and other directories.
• Update your site regularly. Google can determine the last
time you updated your site. If your site is “stale,” your
search ranking will suffer.
Conclusion
So what’s the right type of website for your practice?
Do you even need one at all? How will you accomplish the
FORUM | Summer 2009 7
SPECIAL FEATURE
milestones)? If the vendor will provide ongoing mainte-nance,
how will you be billed once the project is done?
• Asset Ownership Who owns the assets, such as logos
and images, at the initial project completion? In what
format will the vendor need these assets? What, if any,
proprietary tools and techniques are being used and are
essential for further development and maintenance of
the site? What are the license fees for these tools and
techniques and who is responsible for paying them go-ing
forward?
• Evaluation Criteria How you will measure the ven-dor’s
responsiveness to your needs
Cheat sheet for Web development lingo
*Search Engine Optimization (SEO) is a means of ensuring that the content of your site gets optimal visibility on the Web. For example, if
you were a general surgeon practicing in Hickory, you would want to make sure that your practice name comes to the top of the list when
people type in Hickory surgeon on Google, Yahoo and other search engines. SEO can make that happen, so ask vendors for examples of
ongoing or previous SEO projects so you know how they work.
**Search Engine Marketing (SEM) is related to SEO but extends into the realm of paid advertising in the search engines. Advertising is one
way to ensure that your listing appears above others, but it can be costly if there is a lot of competition in your community.
***Tracking and analytics refers to systems that allow you to get as much information as possible about your website users. For example,
Google Analytics lets you measure Web traffic, path analysis, visitor trends, page views, entry pages, top pages, exit pages, length of stay per
page and what browsers and platforms visitors use. These metrics can help you make changes in both design and content.
****Web hosting is a service that lets individuals and organizations make a website accessible via the World Wide Web. If your vendor pro-vides
this service, ask how frequently the server is backed up and how frequently you can expect your site to be down or disrupted because
of maintenance. Who will provide technical support and security? Health care practices will want to know if the hosting vendor/company is
HIPAA compliant.
Ms Satinsky is president of Satin-sky
Consulting, LLC, in Durham, NC.
She is a frequent contributor to the
Forum. Ms. Satinsky may be reached
at (919) 383-5998 or Margie@satin-skyconsulting.
com
project? The decision is up to you!
The author wishes to thank: Robert G. Jones, MD, Im-pact
Orthopaedics; Lynette Mutter, Business Development,
Talon for Healthcare; Manish Patel, Avance Care; Vikas
Patel, MD, North Carolina Dermatology Associates; Rich-ard
Pedersen, Medfusion; Don Rosenblitt, MD, The Lucy
Daniels Center for Early Childhood; and Alice Saunders,
Finishing Software.
Send feedback to forum@ncmedboard.org.
References
Baum, N. and Kenkel, G. (2004). Marketing Your Medical Prac-tice.
Sudbury, MA, Jones and Bartlett Publishers.
Brown, P.A. (2008) “ Website as Online Patient Service Center –
and Strategic Investment.” Group Practice Journal, October,
pages 44-48.
Fall 2009 Understanding the NCMB’s disciplinary
case review process
In the last issue of the Forum I reviewed the actions the
North Carolina Medical Board takes in response to the
complaint, malpractice, medical examiner and investigative
case information that comes to its attention. In 2008, the
Board took public action in approximately 10 percent of cases
closed that year, private action 30 percent of the time and no
action (internally referred to as ‘Accept as Information’) 60
percent of the time. In this commen-tary
I will discuss the process used
by the Board and its staff to evalu-ate
each case and explain how that
process ultimately results in the final
actions taken by the Board.
Initial staf review
The Board opens cases involving
its licensees in response to informa-tion
provided by patients and other
private citizens, Board licensees and
other health care workers, the North
Carolina Medical Examiner’s Of-fice,
hospitals and other health care
institutions, malpractice and other
insurance companies, the National Practitioner Data Bank,
other regulatory bodies and, occasionally, the media.
The first review of such cases is always conducted by Board
staff (as you may know, the majority of Board members are
working professionals who meet approximately every two
months to do official Board business.) Once the staff reviews
the initial information, the first step is to identify the licensee
or licensees who appear most involved and ask them to
respond. The licensee may be sent information received by
the Board and asked to provide a written response, or he or
she may be interviewed by a Board investigator. The Board
expects licensees to provide a timely, complete and accurate
account of their involvement in a case under review. The li-censee’s
response should include pertinent information from
the medical record or from other sources that help clarify and
support their explanation of the conduct or care at issue.
The licensee response is an important opportunity for the
licensee to explain his or her perspective, and to bring any
mitigating factors that may have bearing on the case to the
Board’s attention. After reviewing the licensee’s response,
Board staff may request additional information, including
office and hospital medical records, photographs, North
Carolina Controlled Substance Reporting System reports,
pharmacy records, information from others associated with
the case, copies of advertisements and brochures, evidence
of licensee certification and continuing education, billing
and coding records and police and court reports. In some
instances, a Board investigator may visit a licensee’s office, a
hospital, laboratory or other site in order to obtain whatever
other information is necessary to adequately evaluate the
circumstances of a particular case.
ofice of Medical Director review
Once a licensee response is received by the Board, all com-plaints,
malpractice and medical examiner information, and
those investigations that deal with quality of care issues, are
forwarded to me or my colleague, Dr. Scott Kirby, the Board’s
assistant medical director. If we believe additional informa-tion
is needed, it is requested. If it is impossible to obtain
information needed to adequately assess a particular case,
it is noted. When Dr. Kirby or I do not have the expertise to
assess a quality of care issue, an opinion from an indepen-dent
reviewer is requested. (The independent reviewer is a
practitioner whose area of practice is similar to that of the
licensee whose conduct or care is the subject of the case.)
Once we have all the information we need to form an opinion,
Dr. Kirby or I then summarize each case and make an initial
recommendation for Board action. All the case information,
along with the Office of the Medical Director summary and
recommendation, is then sent to a panel of senior Board staff
for further discussion and review.
Legal Department review
For investigations that do not involve a quality of care is-sue
(such as boundary violations, substance abuse, felony or
misdemeanor arrests and convictions, etc.) case information,
including licensee responses, are reviewed by a Board staff
attorney. The staff attorney makes an initial recommenda-tion
for Board action and forwards the case to the senior staff
panel.
Occasionally, quality of care cases may also involve po-tential
violations of law. When this occurs, cases are jointly
reviewed by the Office of the Medical Director and the Legal
Department, which work together to reach a recommenda-tion
for Board action.
Senior Staf Review Committee
Each case and its accompanying preliminary recom-mendation
for Board action is then evaluated by the Board’s
Senior Staff Review Committee. This committee includes Dr.
Kirby and me; a Board staff attorney and Thomas Mansfield,
From the ofice of
the Medical Director
Michael
Sheppa, MD
BOARD NEWS
the director of the Board’s Legal Department; Curt Ellis, the
director of the Investigative Department; and Judie Clark, the
director of the Complaint Department. As a group, this com-mittee
revisits each case and comes up with its own recom-mendation
for Board action. The committee’s discussion and
recommendation for action take place in the context of the six
core competencies. (If you are unfamiliar with the ACGME’s
core competencies, see the article on Pg. 3 of this issue of the
Forum. ) Consideration is also given to the licensee’s past
Board history and to any mitigating factors that may have
influenced a licensee’s behavior. In cases involving a quality of
care issue, attention is focused on whether accepted stan-dards
of care have been met. The committee looks at patient
outcome, the licensee’s level of experience, the presence or
absence of patterns of poor performance or behavior, and any
previously failed attempts to remediate the licensee. Gross
negligence, failure on the part of the licensee to address a
fundamental component of good medical practice, a licensee’s
unwillingness to accept responsibility for clearly substandard
care, a dishonest or misleading licensee response, or failure to
cooperate with the Board inquiry all influence the committee’s
recommendation
The Senior Staff Review Committee’s recommendation
for Board action is one of consensus agreement. It may or
may not differ from the initial recommendation of the Office
of the Medical Director or Legal Department. If senior staff
cannot reach a consensus recommendation, an explanation is
provided to the Board.
Board committee review and Board action
Each case and corresponding senior staff recommenda-tion
is then sent to either the Board’s Disciplinary or Review
committee, depending upon what Board action has been
recommended by senior staff (In general, the Disciplinary
Committee reviews cases of a more serious nature and the
Review Committee looks at cases that involve misconduct of
a lesser degree.) There are two exceptions: in complaint and
investigative cases where the Senior Staff Review Commit-tee’s
recommendation is for no Board action, the complaint
or investigative case is closed and retained in the licensee’s
confidential permanent file.
Cases sent to the Board’s Disciplinary or Review committee
are assigned to individual Board members who serve on that
committee. The Board member is responsible for familiarizing
him- or herself with the facts of the assigned cases and with
the accompanying Board staff recommendations. The Review
and Disciplinary committees have the opportunity to review
and discuss each case assigned to their committee members.
The committee will either agree with the senior staff recom-mendation
for Board action or offer an explanation for alter-native
action. When a Board committee reaches a recommen-dation
for action, the case and recommendation are then sent
to the full Board for review and discussion.
During the full Board discussion, the staff recommendation
or suggested alternative action may be discussed at length.
Following the discussion, the full Board may vote to take
action, or it may defer action until more information can be
obtained. For example, the full Board may order a licensee to
undergo a physical or mental health examination, a substance
abuse evaluation, a competency assessment or ask the staff
to gather additional information. At times, the Board may
obtain additional information directly from a licensee by
requesting that the licensee attend a confidential interview
with members of the Board. The Board votes to take disciplin-ary
action only when Board members are satisfied they have
received all the information needed to thoroughly evaluate a
case.
Conclusion
At each step in the review process, opportunity exists to
further clarify or amplify the information and recommenda-tions
associated with a particular case. The entire review pro-cess
receives input from numerous individuals and involves
checks and balances.
The full Board’s final action reflects the collective wisdom,
expertise and experience of the Board’s 12 individual mem-bers,
as well as that of the staff. This rigorous process helps
the Board regulate medicine and surgery for the benefit and
protection of the people of North Carolina, as mandated by
state law. It also helps the Board avoid taking inappropriate
action against licensees who, despite the circumstances that
may have brought them to Board attention, practice medicine
safely and professionally.
Send feedback to forum@ncmedboard.org
NCMB SEEKS PHySICIaN aSSISTaNT
FoR NEW FULL-TIME STaFF PoSITIoN
The North Carolina Medical Board is expanding its Of-fice
of the Medical Director (OMD) to include a full-time
physician assistant. The OMD, which currently employs two
full-time physicians, helps review quality of care issues as-sociated
with the complaint, investigative and licensing work
of the Board.
The Board seeks employment applications from physician
assistants who hold an active North Carolina license and
have no history of disciplinary actions. Candidates for the
position must be certified and have at least 15 years of expe-rience
in broad-based areas of practice including in-hospital
and outpatient clinical work. The position also requires
excellent written and oral communication skills.
Interested applicants should send curriculum vitae, the
names of three professional references and contact informa-tion
for each and a 250 word statement of interest to: HR
Director, NCMB, PO Box 20007, Raleigh, NC, 27619.
BOARD NEWS
FORUM | Fall 2009 9
Policy Committee ofers new position
statement on telemedicine
The Policy Committee of the North Carolina Medical Board has drafted a proposed position statement on telemedicine for
consideration and possible adoption by the full Board. The Policy Committee discusses position statements in public ses-sions
during regularly scheduled Board meetings. In addition, proposed statements are published on the Board’s website and
in the Forum before they are considered by the full Board. This allows licensees and other interested parties the opportunity to
provide written comments that may influence the final version presented for Board action.
The full text of the proposed position statement on telemedicine appears below. Comments may be submitted to the Policy
Committee via email at info@ncmedboard.org or post (PO Box 20007, Raleigh, NC 27619).
Telemedicine
“Telemedicine” is the practice of medicine using electronic communication, information technology or other means between
a physician in one location and a patient in another location with or without an intervening health care provider.
The Board recognizes that technological advances have made it possible for physicians to provide medical care to patients
who are separated by some geographical distance. As a result, telemedicine is a potentially useful tool that, if employed ap-propriately,
can provide important benefits to patients, including: increased access to health care, expanded utilization of
specialty expertise, rapid availability of patient records, and the reduced cost of patient care.
The Board cautions, however, that physicians practicing via telemedicine will be held to the same standard of care as physi-cians
employing more traditional in-person medical care. A failure to conform to the appropriate standard of care, whether
that care is rendered in-person or via telemedicine, may subject the physician to potential discipline by this Board.
The Board provides the following considerations to its licensees as guidance in providing medical services via telemedicine:
Training of Staff— Staff involved in the telemedicine visit should be trained in the use of the telemedicine equipment and
competent in its operation.
Examinations — Physicians using telemedicine technologies to provide care to patients located in North Carolina must
provide an appropriate examination prior to diagnosing and/or treating the patient. However, this examination need not be
in-person if the technology is sufficient to provide the same information to the physician as if the exam had been performed
face-to-face.
Other examinations may also be considered appropriate if the physician is at a distance from the patient, but a licensed
health care professional is able to provide various physical findings that the physician needs to complete an adequate assess-ment.
On the other hand, a simple questionnaire without an appropriate examination may be a violation of law and/or subject
the physician to discipline by the Board.
Informed Consent — The physician using telemedicine should obtain the patient’s informed consent before providing
care via telemedicine services. In addition to information relative to treatment, the patient should be informed of the risks
and benefits of being treated via telemedicine, including how to receive follow-up care or assistance in the event of an adverse
reaction to the treatment or in the event of an inability to communicate as a result of a technological or equipment failure. The
patient retains the right to withdraw his or her consent at any time.
Physician-Patient Relationship — The physician using telemedicine should have some means of verifying that the person
seeking treatment is in fact who he or she claims to be. A diagnosis should be established through the use of accepted medical
practices, i.e., a patient history, mental status examination, physical examination and appropriate diagnostic and laboratory
testing. Physicians using telemedicine should also ensure the availability for appropriate follow-up care and maintain a com-plete
medical record that is available to the patient and other treating health care providers.
Medical Records — The physician treating a patient via telemedicine must maintain a complete record of the telemedicine
patient’s care according to prevailing medical record standards. The medical record serves to document the analysis and plan
of an episode of care for future reference. It must reflect an appropriate evaluation of the patient's presenting symptoms, and
relevant components of the electronic professional interaction must be documented as with any other encounter.
The physician must maintain the record’s confidentiality and disclose the records to the patient consistent with state and
federal law. If the patient has a primary physician and a telemedicine physician for the same ailment, then the primary physi-cian’s
medical record and the telemedicine physician’s record constitute one complete patient record.
BOARD NEWS
FORUM | Fall 2009 11
Licensure — The practice of medicine is deemed to occur in the state in which the patient is located. Therefore, any phy-sician
using telemedicine to regularly provide medical services to patients located in North Carolina should be licensed to
practice medicine in North Carolina. Physicians need not reside in North Carolina, as long as they have a valid, current North
Carolina license.
North Carolina physicians intending to practice medicine via telemedicine technology to treat or diagnose patients outside
of North Carolina should check with other state licensing boards. Most states require physicians to be licensed, and some have
enacted limitations to telemedicine practice or require or offer a special registration. A directory of all U.S. medical boards may
be accessed at the Federation of State Medical Boards website: www.fsmb.org/directory_smb.html.
Fees — The Board’s licensees should be aware that third-party payors may have differing requirements and definitions of
telemedicine for the purpose of reimbursement.
1See also the Board’s Position Statement entitled “Contact with Patients before Prescribing.”
2N.C. Gen. Stat. § 90-18(c)(11) exempts from the requirement for licensure: “The practice of medicine or surgery by any nonregistered repu-table
physician or surgeon who comes into this State, either in person or by use of any electronic or other mediums, on an irregular basis,
to consult with a resident registered physician or to consult with personnel at a medical school about educational or medical training. This
proviso shall not apply to physicians resident in a neighboring state and regularly practicing in this State.”
The Board also notes that the North Carolina General Statutes define the practice of medicine as including, “The performance of any act,
within or without this State, described in this subdivision by use of any electronic or other means, including the Internet or telephone.” N.C.
Gen. Stat. § 90-1.1(5)f.
A new law that modifies the North Carolina Medical
Board’s investigative and disciplinary processes took
effect October 1. Many of the provisions codify existing poli-cy
or interpretation of the Medical Practice Act, while other
provisions create entirely new practices.
The brief article below summarizes two significant
changes that affect licensees who are under investigation
by the Board or who face an imminent public charge of
misconduct by the Board.
Written notice of rights, responsibilities
Historically, when the Board received a complaint
against a licensee, it provided the licensee with a copy and
gave oral answers to any questions about the Board’s review
process. For investigations initiated on or after October 1,
the Board will now mail or deliver in person written notices
to licensees under investigation. The notices address the
licensee’s duty to cooperate with the Board, how the Board
will communicate with the licensee and any legal counsel,
NCMB implements changes to investigative
and disciplinary processes
the amount of time the investigation is expected to take and
the licensee’s rights should the Board vote to take public
disciplinary action.
Pre-charge conference for licensees pending charges
Traditionally, the Board conducted informal confer-ences
with some licensees prior to voting to initiate a public
disciplinary proceeding. The new law requires the Board to
provide, upon request, the licensee with the opportunity to
meet with a designated Board member. Such meetings would
occur after the Board votes to charge but before charges are
issued and a hearing is scheduled. If a meeting is requested,
it will be scheduled soon after the decision to take public
action. Prior to the meeting, which may be telephonic or in
person, the Board will provide the licensee and/or his or her
legal counsel, with information gathered in the investigation.
The purpose of the meeting will be to inform the licensee of
the basis for the Board’s decision to charge and explain the
process going forward.
REaD MoRE oNLINE
The law covers numerous other aspects of the Board’s investigative and disciplinary procedures. To read the full text
of the new law, visit: www.ncga.state.nc.us/Sessions/2009/Bills/Senate/PDF/S958v6.pdf
BOARD NEWS
DISCIPLINARY REPORT
North Carolina Medical Board
Quarterly Disciplinary Report | May – July 2009
Board actions are now published in an abbreviated format. The re port no longer includes non-prejudicial actions such as reentry
agreements and non-disciplinary consent orders. If you prefer the previous method of reporting Board actions, you may access
an expanded disciplinary report by visiting the Board’s website at www.ncmedboard.org Readers who prefer the more comprehen-sive
version may sign up on the website to be notifi ed when a new report is posted. Go to “Professional Resources” and select “Sub -
scriptions” to sign up for an RSS Feed to be notifi ed. Be sure to select the feed for “Bimonthly Disciplinary Report. ”
Name/license#/location Date of action Cause of action Board action
REVoCaTIoNS
ANDERSON, Eric Andres, PA-C
(000102798) Charlotte, NC
07/17/2009 Felony conviction for Medicaid fraud
and obtaining controlled substance
by fraud.
Notice of revocation
HAQUE, Ehteshamul, MD
(009500929) Norfolk, VA
05/20/2009 Felony conviction for trading a con-trolled
substance for sex with patient
Notice of revocation
SMALL, Fairleigh David, MD
(000024710) Abingdon, VA
06/04/2009 Felony conviction for malicious
wounding
Notice of revocation
SUSPENSIoNS
GREENWOOD, Denise Rochelle, MD
(000039149) Huntington, WV
05/29/2009 History of alcohol/substance abuse;
multiple disciplinary actions in Ark.
Indefinite suspension of NC medical
license
HARRIS-CHIN, Cheryl Jacqueline, MD
(200200914) Charlotte, NC
06/18/2009 Disciplinary action by Maryland State
Board of Physicians
Indefinite suspension of medical
license
(See also Consent Orders)
SUMMaRy SUSPENSIoNS
HENSON, Joseph Bascom, MD
(000007500) Greensboro, NC
06/17/2009 Physical and mental impairment Summary suspension of medical
license
CoNSENT oRDERS
ANDERSON, Jeffery Stuart, MD
(000039759) Morehead City, NC
07/17/2009 Billing and records issues; prescribing
w/o keeping proper records of exams,
treatment and prescribing
Reprimand
DACOSTA, Gaston Fitzgerald, MD
(200900761) Carthage, NY
05/06/2009 Disciplined by New York medical
regulatory authority
Reprimand
DOBYNS, Perrin Thomas, MD
(200701865) Fayetteville, NC
07/30/2009 Substance abuse; multiple positive drug
screens while under NCPHP contract.
Indefinite suspension of NC medical
license
EARLA, Janaki Ram Prasad, MD
(200701202) Fayetteville, NC
07/06/2009 Prescribed controlled substances for
coworkers and others without first
establishing an appropriate physician-patient
relationship.
Indefinite suspension of NC medical
license
FABER, Steven Mark, MD
(000035892) Elizabeth City, NC
05/22/2009. Concerns about quality of care Reprimand; NC license placed on
probation for one year
GOOCH, Joel Robert, MD
(009300706) Lenoir City, TN
06/11/2009 Entered into a consent order with
Tennessee Board of Medical Exam-iners
regarding misuse of the drug
Ultram
Reprimand; must comply with Ten-nessee
order
GOODSTEIN, Richard Stuart, DO
(200800359) Marshall, MI
05/07/2009 Entered into consent order with Michi-gan
medical regulatory authority after
problems intubating a patient
Must comply with Michigan consent
order
GREGORY, Ginger Dobbins, PA-C
(000101410) Fuquay-Varina, NC
06/19/2009 Substance abuse Indefinite suspension of PA license
HENSON, Joseph Bascom, Jr., MD
(000007500) Greensboro, NC
07/30/2009 Mental and physical impairment;
License summarily suspended on
06/17/2009; Voluntarily surrendered
license on 06/17/2009.
Board accepts surrender of license as
resolution of case.
INTINI, Ronald Samuel, MD
(200100706) Wendell, NC
07/21/2009 Did not treat a patient with diffuse
skin lesions as aggressively as he
should have.
Reprimand; Must complete CME and
comply with other conditions.
DISCIPLINARY REPORT
FORUM | Fall 2009 13
Name/license#/location Date of action Cause of action Board action
JACKSON, Richard Thomas, MD
(200500510) Radford, VA
06/12/2009 History of alcohol abuse Reprimand; must comply with
NCPHP contract
LONG, James Randall, MD
(000033456) Lexington, NC
05/29/2009 Pleaded guilty to misdemeanor
charges stemming from illegal decod-ing
of satellite TV signals.
Reprimand; NC license placed on
probation for one year
MARDER, Curtis Charles, MD
(200901252) Marquette, MI
07/01/2009 Failed to disclose three payments
made on his behalf in connection with
allegations of negligence with regard
to the care of three patients.
NC medical license issued, with a
reprimand.
MCINTOSH, John Clark, MD
(000036570) Asheville, NC
05/22/2009 Inappropriate prescribing of controlled
substances; Continued to prescribe
when warned by law enforcement that
patients diverted drugs
Indefinite suspension of NC license
MENDOZA, Dominador Manguera, MD
(000022149) Danbury, NC
06/15/2009 Concerns about quality of care provided
to patients treated for chronic pain
License on probation for two years;
Must not treat chronic pain
MESA, Gregory Robert, PA-C
(000103090) Hendersonville, NC
07/17/2009 Pleaded guilty to misdemeanor
larceny for embezzling funds; Cor-porate
structure of practice resulted
in unintentional fee-splitting and
unintentional aiding and abetting of
the unlicensed practice of medicine.
NC PA license suspended for a period
of six months beginning Sept. 15,
2009. Beginning on October 30,
2009, the suspension shall be stayed.
Must comply with conditions.
MESSNER, Keith Harold, MD
(200600748) Fayetteville, NC
06/03/2009 History of alcohol abuse; Has com-pleted
residential treatment
Issued dated license to expire
9/30/2009; Must comply with condi-tions.
NICHOLAS, Theodore William, MD
(200200059) Kill Devil Hills, NC
07/17/2009 Concerns about quality of neurodiagnos-tic
studies performed; billing concerns.
Reprimand; Medical license placed
on probation for two years.
NIEMEYER, Meindert Albert, MD
(000030440) Elon, NC
07/17/2009 Concerns about prescribing of con-trolled
substances; prior disciplinary
history with Board. License summar-ily
suspended 03/25/2009.
License suspended for three years. Sus-pension
stayed, except for a period of
eight months beginning on 03/25/09,
and ending on 11/25/09. May not pre-scribe
controlled substances Schedules
I, II, IIN, III and IIIN.
NGUYEN, Mai Trang Le, MD
(200901281) Greensboro, NC
07/13/2009 Prior boundary violation in MA that led
to surrender of MA license in 2005.
NC medical license issued via consent
order; Must complete a plan of reentry.
O’DELL, Kevin Bruce, MD
(000039312) Gastonia, NC
07/06/2009 MD had reaction to Lexapro after
consuming alcohol that led to erratic
behavior and resulted in his being
charged with a number of crimes.
License surrendered 07/27/2007.
Board shall issue a dated medical
license; Must comply with conditions.
PAUL, Robert Allen, Jr., PA-C
(000102781) Greensboro, NC
07/21/2009 History of alcohol abuse; Diverted
Vicodin for personal use; NCPHP
advises he is safe to return to practice.
Issued temporary PA license to expire
11/30/2009; Must comply with
conditions.
PERILSTEIN, Roger Sadhaka D., MD
(000027837) Chapel Hill, NC
05/07/2009 Concerns about patient evaluations,
documentation and assessments;
Independent clinical assessment recom-mended
several remedial steps
Must complete recommendations of
clinical assessment
PIZARRO, Glenn, Sr., MD
(009601772) Amsterdam, NY
06/23/2009 Entered a 9/04/2008 consent order
with the medical licensing authority
in New York.
NC license placed on probation for
two years, to run concurrent with NY
order; may not practice emergency
medicine and meet other conditions.
TOMPKINS, Kenneth James, MD
(009701625) Kitty Hawk, NC
07/21/2009 History of alcohol abuse; NCPHP ad-vised
MD is safe to return to practice.
MD shall be issued a temporary
license for a period of four months;
Must comply with conditions.
WEBSTER, Laurence Seaton, MD
(009500269) High Point, NC
06/24/2009 Boundary violations; inappropriate
self-diagnosis and treatment
Indefinite suspension of medical
license
WHITE, Anne Litton, MD
(000029552) Winston-Salem, NC
05/22/2009 MD ran inaccurate, misleading adver-tisements
about her practice
Reprimand
WOODYEAR, John Montgomery, Jr.,
MD (009500278) Troy, NC
05/15/2009 MD advertised “free” evaluation that
necessitated a patient have scans that
cost more than $1,500
Reprimand; MD shall not perform
neuro-scans and shall not treat pa-tients
with the Accu Spinea machine
Name/license#/location Date of action Cause of action Board action
MISCELLaNEoUS aCTIoNS
CRAWFORD, Edward Coleman, MD
(200600164) Saint Simmons Island, GA
06/18/2009 Entered a 08/08/2009 order with the
GA board that placed license on pro-bation,
imposed several conditions.
NC license placed on probation, to
run concurrent with Georgia order
DENIaLS oF LICENSE/aPPRoVaL
DENIS, Guy Joseph, MD
(000026649) Orchard Park, NY
07/30/2009 Disciplined in NY for multiple allega-tions
of negligence/misconduct.
Application for reinstatement of NC
medical license denied
GECKLER, Thomas Alan, PA
(NA) Dahlonega, GA
07/31/2009 Failed to disclose a 1971 arrest for
possession of heroin with intent to
sell; Subsequent explanation to the
Board was inadequate.
Application for NC PA license denied
LOWE, James Edward, Jr., MD
(000037887) Fayetteville, NC
05/05/2009 Prior disciplinary history in NC; license
revoked by medical regulator in NY
Application for reinstatement of NC
license denied; Hearing set 08/19/09
MASSI, Daniel Spong, MD
(NA) Chicago, IL
06/19/2009 False statements and misrepresenta-tions
made on NC license application
Application for NC medical license
denied
OKSANEN, Owen David, MD
(NA) Port St. Joe, FL
06/15/2009 Failed to disclose information, including
suspension of hospital privileges for
inappropriate treatment, on application.
Application for NC medical license
denied
TADKOD, Altaf Husain, MD
(NA) Duluth, GA
05/14/2009 Concerns about professional compe-tence
Application for NC medical license
denied; Hearing set for August 19,
2009
SURRENDERS
ALFORD, Todd Michael, MD
(200701869) Kings Mountain, NC
05/26/2009 Voluntary surrender of NC medical
license
BOOK, Roy Dewayne, MD
(009701700) Greensboro, NC
05/01/2009 Voluntary surrender of NC medical
license
HALL, Charles Daniel, MD
(009401205) Supply, NC
05/08/2009 Voluntary surrender of NC medical
license
HENSON, Joseph Bascom, Jr., MD
(000007500) Greensboro, NC
06/17/2009 See previous entry for Summary
Suspension.
Voluntary surrender of NC medical
license.
MCANALLEN, Terry Joseph, DO
(200301013) Boone, NC
06/22/2009 Voluntary surrender of NC medical
license.
MCALISTER, Linda Theresa, MD
(000028667) Fayetteville, NC
06/12/2009 Voluntary surrender of NC medical
license.
NOWLAN, Ashley, PA-C
(001001770) High Point, NC
07/21/2009 Voluntary surrender of NC PA license.
SIEGEL, Drew Kevin, MD
(000039999) Burlington, NC
06/16/2009 Voluntary surrender of NC medical
license.
THOMPSON, Robert Bruce, MD
(000040006) Charlotte, NC
06/04/2009 Voluntary surrender of NC medical
license.
WEBSTER, Laurence Seaton, MD
(009500269) High Point, NC
05/18/2009 Voluntary surrender of NC medical
license.
PUBLIC LETTER oF CoNCERN
BAIRD, Charlotte Leak, PA
(000102027) Cary, NC
06/25/2009 Failure to renew PA license; practic-ing
without a valid license.
Public letter of concern issued
BERMAN, Lorraine Mayer-Wolpert, MD
(200901449) Richmond, VA
07/31/2009 Concerns about allegations regarding
MD’s care of two patients ; MD urged
to maintain the level of skill needed to
avoid future problems.
Public letter of concern issued
BERTRAND, Susan True, MD
(200900836) Anchorage, AK
05/12/2009 Concerns about multiple allegations of
medical negligence that came to light
during Board’s review of application.
NC license issued, with a public letter
of concern
BRODSKY, Hal Marc, MD
(000033347) Pembroke Pines, FL
05/28/2009 Concerns about a quality of care issue
that led to a settlement agreement
with the medical board in Florida
Public letter of concern issued
COUCH, Gordon Thames, MD
(200900976) Pensacola, FL
06/02/2009 Disciplined by medical board in
Florida
Public letter of concern issued
DISCIPLINARY REPORT
FORUM | Fall 2009 15
DISCIPLINARY REPORT
Name/license#/location Date of action Cause of action Board action
DAVIS, John Blevins, MD
(000029252) Winston-Salem, NC
07/02/2009 Felony conviction for obtaining
controlled substances by misrepre-sentation/
fraud; Conduct that led to
the conviction led to a 2006 consent
order with the Board.
Public letter of concern issued
FINGER, Frederick Eli, MD
(000029567) Charlotte, NC
06/31/2009 Implanted artificial lumbar disc at the
incorrect level.
Public letter of concern issued
FRIEDMAN, Kenneth Stan, MD
(200100535) Clayton, NC
05/11/2009 Concerns about MD’s guilty plea sur-rounding
use of an escort service
Public letter of concern issued
GUARINO, Clinton Toms Andrews, MD
(009900062) Hickory, NC
06/02/2009 Concerns about quality of patient care,
supervision of mid-level providers
Public letter of concern issued
HADAR, Eldad Joseph, MD
(200100542) Chapel Hill, NC
05/06/2009 Performed lumbar decompression at
incorrect level
Public letter of concern issued
HARRISON, William Henry, III, MD
(000024913) Advance, NC
05/20/2009 Prescribed to family in a manner
inconsistent with the Board’s position
statement on care of self/family
Public letter of concern issued
ILUNGA, Christine Kabunga, MD
(009800069) Goldsboro, NC
07/22/2009 MD failed to adequately inform pa-tients
of decision to close her practice.
Public letter of concern issued
JEFFERSON, Henry Dawson, MD
(000026015) Cary, NC
05/04/2009 Concerns about adequacy of supervi-sion
of mid-level practitioners
Public letter of concern issued
JONES, Vickie Denese, MD
(200900936) Lithonia, GA
05/28/2009 Provided inaccurate or incomplete
information on NC license application
NC license issued, with a public letter
of concern
MEDLIN, Laura Ann, PA-C
(000102545) Rocky Mount, NC
07/01/2009 Concerns about prescribing of con-trolled
substances.
Public letter of concern issued
RAYNOR, Eileen Margolies, MD
(200900984) Durham, NC
06/05/2009 Provided incorrect or incomplete in-formation
on NC license application.
Public letter of concern issued
ROCA, Margo Hirshman, MD
(200901239) Port Charlotte, FL
06/29/2009 Provided incorrect or incomplete in-formation
on NC license application.
Public letter of concern issued
SHROPSHIRE-ATKINS, Wendy Yvonne, PA
(001000036) Wilmington, NC
05/29/2009 Practiced without valid PA license after
failing to timely renew with the Board
Public letter of concern issued
TEMPoRaRy/DaTED LICENSES: ISSUED, EXTEND-ED,
EXPIRED, oR REPLaCED By FULL LICENSES
AUGUSTINE, Santhosh, MD
(009600445) Lumberton, NC
05/21/2009 Full medical license issued
BLISS, Laura Katherine, MD
(009500018) Efland, NC
05/21/2009 Dated medical license issued to expire
05/31/2010
HENSLER, Rachel Hurst, PA
(001000107) Wilmington, NC
07/16/2009 Full PA license issued
HUMBLE, Scott David, MD
(200700897) Salisbury, NC
05/21/2009 Full medical license issued
KELLER, Philip Arthur, PA
(000102305) Currituck, NC
07/16/2009 Full PA license issued
MORALES, Sergio Eli, MD
(200900131) Greenville, NC
07/16/2009 Dated medical license issued to expire
11/30/2009
ROGERS, Bruce William, MD
(000032563) Greensboro, NC
05/21/2009 Full medical license issued
ROSNER, Michael John, MD
(000026865) Hendersonville, NC
05/01/2009 Dated medical license issued to expire
09/30/2009
STROTHER, Eric Furman, MD
(009901620) Raleigh, NC
05/21/2009 Dated medical license issued to expire
11/30/2009
WARD, Amy Elizabeth, MD
(009600833) Pfafftown, NC
05/21/2009 Dated medical license issued to expire
11/30/2009
YOUNG, Jordon Terrell, MD
(200701009) Goldsboro, NC
05/21/2009 Dated medical license issued to expire
11/30/2009
DISMISSaLS
MCKINNEY, Gisele, MD
(200401273) Williamston, NC
05/11/2009 Dismissal without prejudice; Notice of
Charges & Allegations dated 03/16/09
North Carolina Medical Board
1203 Front Street
Raleigh, NC 27609
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EXAMINATIONS
Residents Please Note USMLE Information
United States Medical Licensing Examination
Computer-based testing for Step 3 is available on a daily basis. Applications are available on the
Federation of State Medical Board’s website at www.fsmb.org.
Special Purpose Examination (SPEX)
The Special Purpose Examination (or SPEX) of the Federation of State Medical Boards of the
United States is available year-round. For additional information, contact the Federation of
State Medical Boards at PO Box 619850, Dallas, TX 75261-9850, or telephone (817) 868-4000.
BOARD MEETING DATES
November 18-20, 2009 (Full Board)
December 17, 2009 (Conference Call)
January 20-22, 2010 (Full Board)
Meeting agendas, minutes and a
full list of meeting dates can be
found on the Board’s website
ncmedboard.org
Visit the Board’s website at www.ncmedboard.org to change your address online. The Board requests all licensees maintain a current
address on file with the Board office. Changes of address should be submitted to the Board within 30 days of a move.
Update your Licensee Information: There’s still time!
In September, the Board mailed notices asking its more than 35,000 physician and physician assistant licensees to
update and expand their public information pages on the Board’s website. This process is separate from the annual
renewal, so it is necessary to update your information even if you have already renewed your license this year.
Expanded licensee information pages are expected to go live on the Board’s website in December. The Board anticipates
the launch will be widely covered by the mainstream press. That could send unprecedented numbers of patients and oth-ers
to the Board’s site for information about North Carolina medical practitioners.
Viewing and updating your information now is the only way to ensure your page is accurate and complete before the
pages go live. The Board has added a number of optional categories of information that allow licensees to highlight their
unique skills and training. Don’t miss out on this opportunity to market yourself and your practice!
As of mid-October, more than half of all active, licensed physician assistants and nearly half of all active, licensed
physicians had logged in to the Board’s online data-entry system. The Board appreciates its licensees’ assistance with this
important project.
To update your Licensee Information page, go to www.ncmedboard.org and select ‘Update Licensee Info Page’ from
the green Quick Links box at the right of the screen. The system is available 24 hours a day, seven days a week.