Roster of registered physicians in the State of North Carolina |
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Til 15: AW c.a N.C. DOCUMENTS CLEARINGHOUSE SEP 1 1988 ROSTER OF N.C. STATE LIBRARY RALEIGH Registered Physicians IN THE State of North Carolina March 1, 1988 ISSUED BY BOARD OF MEDICAL EXAMINERS OF THE STATE OF NORTH CAROLINA ROSTER OF Registered Physicians IN THE State of North Carolina ^c********** ISSUED BY BOARD OF MEDICAL EXAMINERS OF THE STATE OF NORTH CAROLINA Board of Medical Examiners of the State of North Carolina Eben Alexander, Jr., M.D., President John Thomas Daniel, Jr., M.D., Secretary Bryant D. Paris, Jr., Executive Secretary MEMBERS Eben Alexander, Jr., M.D., Winston-Salem John Thomas Daniel, Jr., M.D., Durham Charles H. Duckett, M.D., Greenville Harold L. Godwin, M.D., Fayetteville Hector Himel Henry, II, M.D., Concord F.M. Simmons Patterson, Jr., M.D., Pinehurst Nicholas E. Stratas, M.D., Raleigh Kathryn Howell Willis, Zirconia FOREWORD This roster is issued by the Board of Medical Examiners of the State of North Carolina. REGISTRATION REQUIRED AS FOLLOWS: Physicians — January 1 every even-numbered year Resident's Training Licenses — January 1 every even-numbered year Professional Corporations — January 1 every even-numbered year Physician Assistants — July 1 annually Nurse Practitioners — July 1 annually The names of all physicians who are licensed to practice medicine in the State of North Carolina who are currently registered with the Board of Medical Examiners of the State of North Carolina on March 1, 1988, are included in this roster. The names of physicians who hold resident's training licenses to practice medicine in specified institutions in the state are not included in this roster. Any information pertaining to omissions or corrections should be brought to the attention of the Board. Bryant D. Paris, Jr., Executive Secretary Board of Medical Examiners of the State of North Carolina 1313 Navaho Drive Raleigh, North Carolina 27609 Telephone (919) 876-3885 in TABLE OF CONTENTS Foreword iii Do's and Don'ts for Physicians v Laws of North Carolina Relating to the Practice of Medicine vii North Carolina Administrative Code (Regulations of the Board) xxi Explanation of Specialty Codes liv Registered Physicians Listed Alphabetically 1 Registered Professional Corporations Listed Alphabetically 540 IV DO'S AND DON'TS FOR PHYSICIANS Practice Suggestions: 1. Use as much care in writing pre-scriptions as you would use in writing personal checks. Specify amounts and do not leave spaces for x's or o's to be added to raise the amount. 2. Do not leave your personal prescrip-tion pads in positions accessible to the public. 3. Do not leave signed, blank prescrip-tion pads in your office. 4. Do not write prescriptions for large quantities of Schedule 2 or 2N con-trolled substances. 5. Do not prescribe controlled sub-stances without seeing the patient. 6. When you receive a call from a pharmacist requesting information about prescriptions you have writ-ten, respond courteously as, by law, a pharmacist is responsible for any forged prescription he fills. 7. Write a prescription for only one substance on each blank. 8. Do not prescribe for yourself or members of your family. Treating one's family is not illegal; but the Board wishes to remind you that such prescribing practices may lead to problems. Written records of all prescriptions for controlled sub-stances and the medical indications for them should be maintained, but in many instances such recording is neglected. Also, any prescriptions issued should be within the scope of your normal medical practice. The Board urges you to delegate the medical care for yourself and mem-bers of your family to one or more of your colleagues in order to pre-clude involvement with govern-mental regulatory agencies who monitor physicians' prescribing practices. 9. Do not prescribe amphetamines or central nervous system stimulants for weight control. In 1972, the N.C. Medical Society adopted a resolution which is supported by the Board of Medical Examiners that '*. . . the members of the N.C. Medical Soci-ety use no amphetamines or meth-amphetamines for appetite control and that the use of these drugs be restricted to the treatment of nar-colepsy, hyperkinetic children and other disorders which in the opinion of the patient's physician will be beneficial . ' ' 10. Do not carry large stocks of con-trolled substances in your bag. Ad-dicts look for these in physicians' offices and cars. 11. If DEA numbers are printed on prescriptions, they should be incom-plete and completed only when the physician validates and signs the prescriptions. LAWS OR REGULATIONS: 1. Sign prescriptions legibly in ink, never in pencil. The body of the prescription must be written legibly in ink or typewritten. 2. Prescriptions must contain the fol-lowing information: full name and DEA # of prescribing physician; name, address and telephone num-ber of prescribing physician's prac-tice; indication of either "product selection permitted" or "dispense as written"; and full name and address of patient. 3. Only in emergency situations should you request pharmacists to fill prescriptions for Schedule 2 or 2N prescriptions over the telephone. 4. Prescribe controlled substances to drug dependent persons only under provisions regulated by law. 5. Dispense controlled substances, in-cluding samples, only when dispens-ing records are maintained for two or more years and containers with safety closure caps are properly labelled according to law. Physi-cians shall maintain a readily retriev-able record of all controlled sub-stances dispensed (or administered) whether or not the practitioner charges the patient for the controlled substance, including samples. 6. Do not write prescriptions for con-trolled substances for office use. The law requires that you purchase Schedule 2 and 2N controlled sub-stances for your office on official order forms obtained from DEA. Schedule 3-5 drugs must be obtained through a wholesale distributor by means of a requisition. 7. Maintain security for any controlled substances including samples. 8. Take a biennial inventory of all con-trolled substances including sam-ples. 9. Before disposing of used syringes or needles, render them inoperative. 10. The destruction of an outdated or un-wanted controlled substance by a physician or his authorized agent shall be witnessed by a federal or state official who is authorized to en-force the Federal or State Controlled Substances Act. Suggested reference material regarding prescribing laws: Code of Federal Regulations, Title 21 of the U.S. Food and Drug Act, Part 1300 to End - published by Superintendent of Documents, U.S. Government Printing Office, Washington, D.C. 20402. North Carolina Controlled Substances Act and Regulations - published by the N.C. Drug Commission, N.C. Department of Human Resources, P.O. Box 19324, Raleigh, N.C. 27619. Below is a listing of addresses and telephone numbers that may be useful to you. Please feel free to write or telephone the North Carolina Drug Commission for additional in-formation pertaining to drug laws and rules and regulations at any time you have a need. N.C. Drug Commission P.O. Box 19324 Raleigh, N.C. 27619 Telephone: (919)733-4555 N.C. Board of Pharmacy P.O. Box H Carrboro, N.C. 27510 Telephone: (919)942-4454 Drug Enforcement Administration 75 Spring St, Suite 740 Atlanta, GA 30303 Telephone: (404)331-7328 State Bureau of Investigation 1150MaynardRd. Suite 101 Cary, N.C. 27511 Telephone: (919)733-4311 DEA 2300 W. Meadowview Rd. Greensboro, N.C. 27401 Telephone: (919)378-5203 Suite 224 VI LAWS OF NORTH CAROLINA RELATING TO THE PRACTICE OF MEDICINE (Including Amendments of 1987) § 90-1. North Carolina Medical Society Incorporated. — The association of regularly graduated physicians, calling themselves the state Medical Society, is hereby declared to be a body politic and corporate, to be known and distinguished by the name of The Medical Society of the State of North Carolina. The name of the society is now the North Carolina Medical Society. § 90-2. Board of Medical Examiners. — (a) In order to properly regulate the practice of medicine and surgery, there is established a Board of Medical Examiners of the State of North Carolina. The Board shall consist of eight members. Seven of the members shall be duly licensed physicians elected and nominated to the Governor by the North Carolina Medical Society. The other member shall be a person chosen by the Governor to represent the public at large. The public member shall not be a health care provider nor the spouse of a health care provider. For purposes of board membership, "health care provider" means any licensed health care professional and any agent or employee of any health care institution, health care insurer, health care professional school, or a member of any allied health profession. For purposes of this section, a person enrolled in a program to prepare him to be a licensed health care professional or an allied health professional shall be deemed a health care provider. For purposes of this section, any person with significant financial interest in a health service or profession is not a public member. (b) No member appointed to the Board on or after November 1, 1981, shall serve more than two complete consecutive three-year terms, except that each member shall serve until his successor is chosen and qualifies. (c) In order to establish regularly overlapping terms, the terms of office of the members currently serving on the Board shall expire as follows: two on October 31, 1982; two on October 31, 1984; three on October 31, 1986. Terms of Board members shall expire in direct relation to their date of appointment by the society; the terms of the two members first appointed shall expire in 1982, and the terms of the three members last appointed shall expire in 1986. No initial physician member of the Board may serve another term until at least three years from the date of expiration of his current term. The Governor shall appoint the public member not later than October 31, 1981. (d) Any initial or regular member of the Board may be removed from office by the Governor for good cause shown. Any vacancy in the initial or regular physician membership of the Board shall be filled for the period of the unexpired term by the Governor from a list of physicians submitted by the North Carolina Medical Society Executive Council. Any vacancy in the public membership of the Board shall be filled by the Governor for the unexpired term. § 90-3. Medical Society nominates Board. — The Governor shall appoint as physician members of the Board physicians elected and nominated by the North Carolina Medical Society. § 90-4. Board elects officers; quorum. — The Board of Medical Examiners is authorized to elect all officers and adopt all bylaws as may be necessary. A majority of the membership of the Board shall constitute a quorum for the transaction of business. VII § 90-5. Meetings of Board. — The Board of Medical Examiners shall assemble once in every year in the City of Raleigh, and shall remain in session from day to day until all applicants who may present themselves for examination within the first two days of this meeting have been examined and disposed of; other meetings in each year may be held at some suitable point in the State if deemed advisable. § 90-6. Regulations governing applicants for license, examination, etc.; appointment of subcommittee. — The Board of Medical Examiners is empowered to prescribe such regulations as it may deem proper, governing applicants for license, admission to examinations, the conduct of applicants during examinations, and the conduct of examinations proper. The Board of Medical Examiners shall appoint and maintain a subcommittee to work jointly with a subcommittee of the Board of Nursing to develop rules and regulations to govern the performance of medical acts by registered nurses, including the determination of reasonable fees to accompany an application for approval not to exceed one hundred dollars ($100.00) and for renewal of such approval not to exceed fifty dollars ($50.00). The fee for reactivation of an inactive incomplete application shall be five dollars ($5.00). Rules and regulations developed by this subcommittee from time to time shall govern the performance of medical acts by registered nurses and shall become effective when adopted by both the Board of Medical Examiners and the Board of Nursing. The Board of Medical Examiners shall have responsibility for securing compliance with these regulations. § 90-7. Bond of secretary. — The secretary of the Board of Medical Examiners shall give bond with good surety, to the president of the Board, for the safekeeping and proper payment of all moneys that may come into his hands. § 90.8 Officers may administer oaths, and subpeona witnesses, records and other materials. — The president and secretary of the Board may administer oaths to all per-sons appearing before it as the board may deem necessary to perform its duties, and to summon and to issue subpoenas for the appearance of any witnesses deemed neces-sary to testify concerning any matter to be heard before or inquired into by the Board, and to order that any documents or other material concerning any matter to be heard before or inquired into by the Board shall be produced before the Board or made avail-able for inspection. Upon written request, the Board shall revoke a subpoena if, upon a hearing, it finds that the evidence the production of which is required does not relate to a matter in issue, or if the subpoena does not describe with sufficient particularity the evidence the production of which is required, or if for any other reason in law the subpoena is invalid. § 90-9. Examination for license; scope; conditions and prerequisites. — It shall be the duty of the Board of Medical Examiners to examine for license to practice medicine or surgery, or any of the branches thereof, every applicant who complies with the following provisions: He shall, before he is admitted to examination, satisfy the Board that he has an academic education equal to the entrance requirements of the University of North Carolina, or furnish a certificate from the superintendent of public instruction of the county that he has passed an examination upon his literary attainments to meet the requirements of entrance in the regular course of the State University. He shall exhibit a diploma or furnish satisfactory proof of graduation from a medical college or an osteopathic college approved by the American Osteopathic Association at the time of his graduation, which time of graduation shall have been on January 1, 1960, or subsequent thereto and which medical and osteopathic schools shall require an attendance of not less than four years or for a lesser period of time approved by the Board, and supply such facilities for clinical and scientific instruction as shall meet the approval of the Board. An applicant shall have graduated from a medical college approved by the Liaison Commission on Medical Education or osteopathic college that has been approved by the American Osteopathic Association; or, if he was graduated from any other medical or osteopathic college, the applicant shall be enrolled in a graduate medical education and training program in North Vlll Carolina which has been approved by the Board. An applicant who has graduated from a medical college not approved by the Liaison Commission on Medical Education or osteopathic college that has not been approved by the American Osteopathic Association and who has not enrolled in a graduate medical education and training program in North Carolina which has been approved by the Board shall satisfy the Board that he has successfully completed three years of graduate medical education in a training program approved by the Board. No applicant from a medical or osteopathic college which has been disapproved by the Board shall be eligible to take the examination. The examination shall cover the branches of medical science and subjects which the Board deems necessary to determine competence to practice medicine. The Board may divide the examination into parts or components. If the applicant successfully passes the examination, as determined by the Board, and if the applicant satisfies the Board that he is of good moral character and that either, (1) if the applicant is a graduate of a medical college approved by the Liaison Commission on Medical Education or osteopathic college approved by the American Osteopathic Association, he has successfully completed one year of training in a medical education program approved by the Board after graduation from medical school; or (2) if the applicant is a graduate of a medical college that has not been approved by the Liaison Commission on Medical Education or osteopathic college that has not been approved by the American Osteopathic Association, he has successfully completed three years of training in a medical education program approved by the Board after graduation from medical school, then the Board shall grant the applicant a license authorizing him to practice medicine in any of its branches. Applicants shall be examined by number only; names and other identifying information shall not appear on examination papers. § 90-10. Provision in lieu of examination. — In lieu of the above examination, the Board may grant a license to an applicant who is found to have passed the examination given by the National Board of Medical Examiners, or who has passed such other examination which the Board deems to be equivalent to the examination given by the Board, provided the applicant meets the other qualifications set forth in this Article. § 90-11. Qualifications of applicant for license. — Every applicant for a license to practice medicine or for approval to perform medical acts in the State shall satisfy the Board of Medical Examiners that such applicant is of good moral character and meets the other qualifications for the issuance of such a license or for such approval before any such license or approval is granted by the Board to such applicant. § 90-12. Limited license. — The Board may, whenever in its opinion the conditions of the locality where the applicant resides are such as to render it advisable, make such modifications of the requirements of G.S. 90-9, 90-10, and 90-11 as in its judgment the interests of the people living in that locality may demand, and may issue to such applicant a special license, to be entitled a "Limited License," authorizing the holder thereof to practice medicine and surgery within the limits only of the districts specifically described therein. The holder of the limited license practicing medicine or surgery beyond the boundaries of the districts as laid down in said license shall be guilty of a misdemeanor, and upon conviction shall be fined not less than twenty-five dollars ($25.00) nor more than fifty dollars ($50.00) for each and every offense; and the Board is empowered to revoke such limited license, in its discretion, after due notice. § 90-13. When license without examination allowed. — The Board of Medical Examiners shall in their discretion issue a license to any applicant to practice medicine and surgery in this State without examination if said applicant exhibits a diploma or satisfactory proof of graduation from a medical or osteopathic college, approved as provided in G.S. 90-9 and requiring an attendance of not less than four years or for such lesser period of time approved by the Board, and a license issued to him to practice medicine and surgery by the IX Board of Medical Examiners of another state, and has successfully completed one year of training after his graduation from medical college in a medical education and training program approved by the Board, in which program the Board may permit him to practice medicine. An applicant for licensing under this section who was graduated from a medical college not approved by the Liaison Commission on Medical Education or osteopathic college that has not been approved by the American Osteopathic Association shall have successfully completed three years of training in a medical education and training program approved by the Board after graduation. The Board may grant a license under this section for any period of time and with any conditions it deems appropriate. No license may be granted to any applicant who was graduated from a medical or osteopathic college which has been disapproved by the Board. § 90-14. Revocation, suspension, annulment or denial of license. — (a) The Board shall have the power to deny, annul, suspend, or revoke a license, or other authority to practice medicine in this State, issued by the Board to any person who has been found by the Board to have committed any of the following acts or conduct, or for any of the following reasons: (1) Immoral or dishonorable conduct; (2) Producing or attempting to produce an abortion contrary to law; (3) Made false statements or representations to the Board, or who has willfully concealed from the Board material information in con-nection with his application for a license; (4) Repealed by Session Laws 1977, c. 838, s, 3. (5) Being unable to practice medicine with reasonable skill and safety to patients by reason of illness, drunkeness, excessive use of alcohol, drugs, chemicals, or any other type of material or by reason of any physical or mental abnormality. The Board is empowered and authorized to require a physician licensed by it to submit to a mental or physical examination by physicians designated by the Board before or after charges may be presented against him, and the results of examination shall be admissible in evidence in a hearing before the Board; (6) Unprofessional conduct, including, but not limited to, any departure from, or the failure to conform to, the standards of acceptable and prevailing medical practice, or the ethics of the medical profession, irrespective of whether or not a patient is injured thereby, or the committing of any act contrary to honesty, justice, or good morals, whether the same is committed in the course of his practice or otherwise, and whether committed within or without North Carolina; (7) Conviction in any court of a crime involving moral turpitude, or the vio-lation of a law involving the practice of medicine, or a conviction of a felony; provided that a felony conviction shall be treated as provided in sub-section (c) of this section; (8) By false representations has obtained or attempted to obtain practice, money or anything of value; (9) Has advertised or publicly professed to treat human ailments under a system of school of treatment or practice other than that for which he has been educated; (10) Adjudication of mental incompetency, which shall automatically suspend a license unless the Board orders otherwise; (11) Lack of professional competence to practice medicine with a reasonable degree of skill and safety for patients. In this connection the Board may consider repeated acts of a physician indicating his failure to properly treat a patient and may require such physician to submit to inquiries or examinations, written or oral, by members of the Board or by other physicians licensed to practice medicine in this State, as the Board deems necessary to determine the professional qualifications of such licensee; (12) Promotion of the sale of drugs, devices, appliances or goods for a patient, or providing services to a patient, in such a manner as to exploit the pa-tient for financial gain of the physician; and upon a finding of the exploi- tation for financial gain, the Board may order restitution be made to the payer of the bill, whether the patient or the insurer, by the physician; pro-vided that a determination of the amount of restitution shall be based on credible testimony in the record; (13) Suspension or revocation of a license to practice medicine in any other state, or territory of the United States, or other country. (14) The failure to respond, within a reasonable period of time and in a reasona-ble manner as determined by the Board, to inquiries from the Board con-cerning any matter affecting the license to practice medicine. For any of the foregoing reasons, the Board may deny the issuance of a license to an applicant or revoke a license issued to him, may suspend such a license for a period of time, and may impose conditions upon the continued practice after such period of suspension as the Board may deem advisable, may limit the accused physician's practice of medicine with respect to the extent, nature or location of his practice as the Board deems advisable. The Board may, in its discretion and upon such terms and conditions and for such period of time as it may prescribe, restore a license so revoked or rescinded. (b) The Board shall refer to the State Medical Society Physician Health and Effec-tiveness Committee all physicians whose health and effectiveness have been sig-nificantly impaired by alcohol, drug addiction or mental illness. (c) A felony conviction shall result in the automatic revocation of a license issued by the Board, unless the Board orders otherwise or receives a request for a hearing from the person within 60 days of receiving notice from the Board, after the con-viction, of the provisions of this subsection. If the Board receives a timely re-quest for a hearing in such a case, the provisions of G.S. 90-14.2 shall be fol-lowed. (d) The Board and its members and staff may release confidential or nonpublic in-formation to any health care licensure board in this State or another state about the issuance, denial, annulment, suspension, or revocation of a license, or the voluntary surrender of a license by a Board-licensed physician, including the rea-sons for the action, or an investigative report made by the Board. The Board shall notify the physician within 60 days after the information is transmitted. A sum-mary of the information that is being transmitted shall be furnished to the physi-cian. If the physician requests, in writing, within 30 days after being notified that such information has been transmitted, he shall be furnished a copy of all infor-mation so transmitted. The notice or copies of the information shall not be pro-vided if the information relates to an ongoing criminal investigation by any law-enforcement agency, or authorized Department of Human Resources personnel with enforcement or investigative responsibilities. (e) The Board and its members and staff shall not be held liable in any civil or criminal proceeding for exercising, in good faith, the powers and duties authorized by law. § 90-14.1. Judicial review of Board's decision denying issuance of a license. — Whenever the Board of Medical Examiners has determined that a person who has duly made application to take an examination to be given by the Board showing his education, training and other qualifications required by said Board, or that a person who has taken and passed an examination given by the Board, has failed to satisfy the Board of his qualifications to be examined or to be issued a license, for any cause other than failure to pass an examination, the Board shall immediately notify such person of its decision, and indicate in what respect the applicant has so failed to satisfy the Board. Such applicant shall be given a formal hearing before the Board upon request of such applicant filed with or mailed by registered mail to the secretary of the Board at Raleigh, North Carolina, within 10 days after receipt of the Board's decision, stating the reasons for such request. The Board shall within 20 days of receipt of such request notify such applicant of the time and place of a public hearing, which shall be held within a reasonable time. The burden of satisfying the Board of his qualifications for licensure shall be upon the applicant. Following such hearing, the Board shall determine whether the applicant is qualified to be examined or is entitled to be licensed as the case may be. Any such decision of the Board shall be subject to judicial review upon appeal to the Superior Court of Wake County upon the filing with the Board of a written notice of appeal with exceptions taken to the decision XI of the Board within 20 days after service of notice of the Board's final decision. Within 30 days after receipt of notice of appeal, the secretary of the Board shall certify to the clerk of the Superior Court of Wake County the record of the case which shall include a copy of the notice of hearing, a transcript of the testimony and evidence received at the hearing, a copy of the decision of the Board, and a copy of the notice of appeal and exceptions. Upon appeal the case shall be heard by the judge without a jury, upon the record, except that in cases of alleged omissions or errors in the record, testimony may be taken by the court. The decision of the Board shall be upheld unless the substantial rights of the applicant have been prejudiced because the decision of the Board is in violation of law or is not supported by any evidence admissible under this Article, or is arbitrary or capricious. Each party to the review proceeding may appeal to the Supreme Court as hereinafter provided in G.S. 90-14.1 1. § 90- 1 4.2. Hearings before revocation or suspension of a license. — Before the Board shall revoke, restrict or suspend any license granted by it, the licensee shall be given a written notice indicating the general nature of the charges, accusation, or complaint made against him, which notice may be prepared by a committee of one or more members of the Board designated by the Board, and stating that such licensee will be given an opportunity to be heard concerning such charges or complaint at a time and place stated in such notice, or at a time and place to be thereafter designated by the Board, and the Board shall hold a public hearing not less than 30 days from the date of the service of such notice upon such licensee, at which such licensee may appear personally and through counsel, may cross-examine witnesses and present evidence in his own behalf. A physician who is mentally incompetent shall be represented at such hearing and shall be served with notice as herein provided by and through a guardian ad litem appointed by the clerk of the court of the county in which the physician has his residence. Such licensee or physician may, if he desires, file written answers to the charges or complaints preferred against him within 30 days after the service of such notice, which answer shall become a part of the record but shall not constitute evidence in the case. § 90-14.3. Service of notices. — Any notice required by this Chapter may be served either personally or by an officer authorized by law to serve process, or by registered mail, return receipt requested, directed to the licensee or applicant at his last known address as shown by the records of the Board. If notice is served personally, it shall be deemed to have been served at the time when the officer delivers the notice to the person addressed. Where notice is served by registered mail, it shall be deemed to have been served on the date borne by the return receipt showing delivery of the notice to addressee or refusal of the addressee to accept the notice. § 90-14.4. Place of hearings for revocation or suspension of license. — Upon written request of the accused physician to the secretary of the Board within 20 days after service of the charges or complaints against him, a hearing for the purpose of determining revocation or suspension of his license shall be conducted in the county in which such physician maintains his residence, or at the election of the Board, in any county in which the act or acts complained of occurred. In the absence of such request, the hearing shall be held at a place designated by the Board, or as agreed upon by the physician and the Board. § 90-14.5. Use of trial examiner or depositions. — Where the licensee requests that the hearing herein provided for be held by the Board in a county other than the county designated for the holding of the meeting of the Board at which the matter is to be heard, the Board may designate in writing one or more of its members to conduct the hearing as a trial examiner or trial committee, to take evidence and report a written transcript thereof to the Board at a meeting where a majority of the members are present and participating in the decision. Evidence and testimony may also be presented at such hearings and to the Board in the form of depositions taken before any person designated in writing by the Board for such purpose or before any person authorized to administer oaths, in accordance with the procedure for the taking of depositions in civil actions in the superior court. xn § 90-14.6 Evidence admissible. — In proceedings held pursuant to this Article the Board shall admit and hear evidence in the same manner and form as prescribed by law for civil actions. A complete record of such evidence shall be made, together with the other proceedings incident to such hearing. § 90-14.7. Procedure where person fails to request or appear for hearing. — If a person who has requested a hearing does not appear, and no continuance has been granted, the Board or its trial examiner or committee may hear the evidence of such witnesses as may have appeared, and the Board may proceed to consider the matter and dispose of it on the basis of the evidence before it. For good cause, the Board may reopen any case for further hearing. § 90-14.8. Appeal from Board's decision revoking or suspending a license. — A physician whose license is revoked or suspended by the Board may obtain a review of the decision of the Board in the Superior Court of Wake County or in the superior court in the county in which the hearing was held or upon agreement of the parties to the appeal in any other superior court of the State, upon filing with the secretary of the Board a written notice of appeal within 20 days after the date of the service of the decision of the Board, stating all exceptions taken to the decision of the Board and indicating the court in which the appeal is to be heard. Within 30 days after the receipt of a notice of appeal as herein provided, the Board shall prepare, certify and file with the clerk of the superior court in the county to which the appeal is directed the record of the case comprising a copy of the charges, notice of hearing, transcript of testimony, and copies of documents or other written evidence produced at the hearing, decision of the Board, and notice of appeal containing exceptions to the decision of the Board. § 90-14.9. Appeal bond; stay of Board order. — The person seeking the review shall file with the clerk of the reviewing court a copy of the notice of appeal and an appeal bond of two hundred dollars ($200.00) at the same time the notice of appeal is filed with the Board. At any time before or during the review proceeding the aggrieved person may apply to the reviewing court for an order staying the operation of the Board decision pending the outcome of the review, which the court may grant or deny in its discretion. § 90-14.10. Scope of review. — Upon the review of the Board's decision revoking or suspending a license, the case shall be heard by the judge without a jury, upon the record, except that in cases of alleged omissions or errors in the record, testimony thereon may be taken by the court. The court may affirm the decision of the Board or remand the case for further proceedings; or it may reverse or modify the decision if the substantial rights of the accused physician have been prejudiced because the findings or decisions of the Board are in violation of substantive or procedural law, or are not supported by competent, material, and substantial evidence admissible under this Article, or are arbitrary or capricious. At any time after the notice of appeal has been filed, the court may remand the case to the Board for the hearing of any additional evidence which is material and is not cumulative and which could not reasonably have been presented at the hearing before the Board. § 90-14.11. Appeal to Supreme Court; appeal bond. — Any party to the review proceeding, including the Board, may appeal to the Supreme Court from the decision of the superior court under rules of procedure applicable in other civil cases. No appeal bond shall be required of the Board. The appealing party may apply to the superior court for a stay of that court's decision or a stay of the Board's decision, whichever shall be appropriate, pending the outcome of the appeal to the Supreme Court. § 90-14.12. Injunctions. — The Board may appear in its own name in the superior courts in an action for injunctive relief to prevent violation of this Article and the superior courts shall have power to grant such injunctions regardless of whether criminal prosecution has been or may be instituted as a result of such violations. Actions under this section shall be commenced in the judicial district in Xlll which the respondent resides or has his principal place of business or in which the alleged acts occurred. § 90-14.13. Reports of disciplinary action by health care insitutions; immunity from liability. — The chief administrative officer of every licensed hospital or other health care institution in the State shall, after consultation with the chief of staff of such institution, report to the Board any revocation, suspension, or limitation of a physician's privileges to practice in that institution. Each such institution shall also report to the Board resignations from practice in that institution by persons licensed under this Article. The Board shall report all violations of this subsection known to it to the licensing agency for the institution involved. The chief administrative officer of each insurance company providing professional liability insurance for physicians who practice medicine in North Carolina, the adminis-trative officer of the Liability Insurance Trust Fund Council created by G.S. 1 16-220, and the administrative officer of any trust fund operated by a hospital authority, group, or provider shall report to the Board within 30 days: (1) Any award of damanges or settlement affecting or involving a physician it in-sures, or (2) Any cancellation or nonrenewal of its professional liability coverage of a physi-cian, if the cancellation or nonrenewal was for cause. The Board may request details about any action and the officers shall promptly fur-nish the requested information. The reports required by this section are privileged and shall not be open to the public. The Board shall report all violations of this paragraph to the Commissioner of Insurance. Any person making a report required by this section shall be immune from any criminal prosecution or civil liability resulting therefrom unless such person knew the report was false or acted in reckless disregard of whether the report was false. § 90-15. License fee; salaries, fees, and expenses of Board. — Each applicant for a license by examination shall pay to the treasurer of the Board of Medical Examiners of the State of North Carolina a fee which shall be prescribed by said Board in an amount not exceeding the sum of four hundred dollars ($400.00) plus the cost of test materials before being admitted to the examination. Whenever any license is granted without ex-amination, as authorized in G.S. 90-13, the applicant shall pay to the treasurer of the Board a fee in an amount to be prescribed by the Board not in excess of two hundred fifty dollars ($250.00). Whenever a limited license is granted as provided in G.S. 90-12, the applicant shall pay to the treasurer of the Board a fee not to exceed one hundred fifty dollars ($150.00), except where a limited license to practice in a medical education and training program approved by the Board for the purpose of education or training is granted, the applicant shall pay a fee of twenty-five dollars ($25.00). A fee of twenty-five dollars ($25.00) shall be paid for the issuance of a duplicate license. All fees shall be paid in advance to the treasurer of the Board of Medical Examiners of the State of North Carolina, to be held by him as a fund for the use of said Board. The compensa-tion and expenses of the members and officers of the said Board and all expenses proper and necessary in the opinion of the Board to the discharge of its duties under and to en-force the laws regulating the practice of medicine or surgery shall be paid out of said fund, upon the warrant of the said Board and all expenses proper and necessary in the opinion of the officers and members of said Board shall be fixed by the Board but shall not exceed one hundred dollars ($100.00) per day per member for time spent in the per-formance and discharge of his duties as a member of said Board, and reimbursement for travel and other necessary expenses incurred in the performance of his duties as a member of said Board. Any unexpended sum or sums of money remaining in the trea-sury of said Board at the expiration of the terms of office of the members thereof shall be paid over to their successors in office. For the initial and annual registration of an assistant to a physician, the Board may require the payment of a fee not to exceed a reasonable amount. § 90-15.1 Registration every two years with Board. — Every person heretofore or hereafter licensed to practice medicine by said Board of Medical Examiners shall, during the month of January, in every even-numbered year thereafter, register with the secretary-treasurer of said Board his name and office and residence address and such xiv other information as the Board may deem necessary and shall pay a registration fee fixed by the Board not in excess of one hundred dollars ($100.00). In the event a physician fails to register as herein provided he shall pay an additional amount of twenty dollars ($20.00) to the Board. Should a physician fail to register and pay the fees imposed, and should such failure continue for a period of 30 days, the license of such physician may be suspended by the Board, after notice and hearing at the next regular meeting of the Board. Upon payment of all fees and penalties which are due, the license of the physi-cian may be reinstated, subject to the Board requiring the physician to appear before the Board for an interview and to comply with other licensing requimements. § 90-16. Board to keep record; publication of names of licentiates; transcript as evidence; receipt of evidence concerning treatment of patient who has not consented to public disclosure. — The Board of Medical Examiners shall keep a regular record of its proceedings in a book kept for that purpose, together with the names of the members of the Board present, the names of the applicants for license, and other information as to its actions. The Board of Medical Examiners shall cause to be entered in a separate book the name of each applicant to whom a license is issued to practice medicine or surgery, along with any information pertinent to such issuance. The Board of Medical Examiners shall publish the names of those licensed in three daily newspapers published in the State of North Carolina, within 30 days after granting the same. A transcript of any such entry in the record books, or certificate that there is not entered therein in the name and proficiency or date of granting such license of a person charged with the violation of the provisions of this Article, certified under the hand of the secretary and the seals of the Board of Medical Examiners of the State of North Carolina, shall be admitted as evidence in any court of this State when it is otherwise competent. The Board may in an executive session receive evidence involving or concerning the treatment of a patient who has not expressly or impliedly consented to the public dis-closure of such treatment as may be necesssary for the protection of the rights of such patient or of the accused physician and the full presentation of relevant evidence. All records, papers, and other documents containing information collected and compiled by the Board, or its members or employees as a result of investigations, inquiries or interviews conducted in connection with a licensing or disciplinary matter shall not be considered public records within the meaning of Chapter 132 of the General Statutes; provided, however, that any notice or statement of charges against any licensee, or any notice to any licensee of a hearing in any proceeding shall be a public record within the meaning of Chapter 132 of the General Statutes, notwithstanding that it may contain information collected and compiled as a result of any such investigation, inquiry or in-terview; and provided, further, that if any such record, paper or other document con-taining information theretofore collected and compiled by the Board, as hereinbefore provided, is received and admitted in evidence in any hearing before the Board, it shall thereupon be a public record within the meaning of Chapter 132 of the General Statutes. In any proceeding before the Board, in any record of any hearing before the Board, and in the notice of the charges against any licensee (notwithstanding any provision herein to the contrary) the Board may withhold from public disclosure the identity of a patient who has not expressly or impliedly consented to the public disclosure of treatment by the accused physician. § 90-17. — Repealed by Session Laws 1967, c. 691, s. 59. § 90-18. Practicing without license; practicing defined; penalties. — No person shall practice medicine or surgery, or any of the branches thereof, nor in any case prescribe for the cure of diseases unless he shall have been first licensed and registered so to do in the manner provided in this Article, and if any person shall practice medicine or surgery without being duly licensed and registered, as provided in this Article, he shall not be allowed to maintain any action to collect any fee for such services. The person so practicing without license shall be guilty of a misdemeanor, and upon conviction thereof shall be fined not less than fifty dollars ($50.00) nor more than one hundred dollars ($100.00), or imprisoned at the discretion of the court for each and every offense. Any person shall be regarded as practicing medicine or surgery within the xv meaning of this Article who shall diagnose or attempt to diagnose, treat or attempt to treat, operate or attempt to operate on, or prescribe for or administer to, or profess to treat any human ailment, physical or mental, or any physical injury to or deformity of another person: Provided, that the following cases shall not come within the definition above recited: ( 1 ) The administration of domestic or family remedies in cases of emergency. (2) The practice of dentistry by any legally licensed dentist engaged in the practice of dentistry and dental surgery. (3) The practice of pharmacy by any legally licensed pharmacist engaged in the practice of pharmacy. (4) The practice of medicine and surgery by any surgeon or physician of the United States army, navy, or public health service in the discharge of his official duties. (5) The treatment of the sick or suffering by mental or spiritual means without the use of any drugs or other material means. (6) The practice of optometry by any legally licensed optometrist engaged in the practice of optometry. (7) The practice of midwifery as defined in G.S. 90-178.2. (8) The practice of chiropody by any legally licensed chiropodist when engaged in the practice of chiropody, and without the use of any drug. (9) The practice of osteopathy by any legally licensed osteopath when engaged in the practice of osteopathy as defined by law, and especially G.S. 90-129. (10) The practice of chiropractic by any legally licensed chiropractor when engaged in the practice of chiropractic as defined by law, and without the use of any drug or surgery. (11) The practice of medicine or surgery by any reputable physician or surgeon in a neighboring state coming into this State for consultation with a resident registered physician. This proviso shall not apply to physicians resident in a neighboring state and regularly practicing in this State. (12) Any person practicing radiology as hereinafter defined shall be deemed to be engaged in the practice of medicine within the meaning of this Article. "Radiology" shall be defined as, that method of medical practice in which demonstration and examination of the normal and abnormal structures, parts or functions of the human body are made by use of X-ray. Any person shall be regarded as engaged in the practice of radiology who makes or offers to make, for consideration, a demonstration or examination of a human being or a part or parts of a human body by means of fluoroscopic exhibition or by the shadow imagery registered with photographic materials and the use of X-rays; or holds himself out to diagnose or able to make or makes any interpretation or explanation by word of mouth, writing or otherwise of the meaning of such fluoroscopic or registered shadow imagery of any part of the human body by use of X-rays; or who treats disease or condition of the human body by the application of X-rays or radium. Nothing in this subdivision shall prevent the practice of radiology by any person licensed under the provision of Articles 2, 7, 8, and 12 of this Chapter. (13) Any act, task or function performed by an assistant to a person licensed as a physician by the Board of Medical Examiners when: a. Such assistant is approved by and annually registered with the Board as one qualified by training or experience to function as an assistant to a physician, except that no more than two assistants may be currently registered for any physician, and b. Such act, task or function is performed at the direction or under the supervision of such physician, in accordance with rules and regulations promulgated by the Board, and c. The services of the assistant are limited to assisting the physician in the particular field or fields for which the assistant has been trained, approved and registered; Provided that this subdivision shall not limit or prevent any physician from delegating to a qualified person any acts, tasks or functions which are otherwise permitted by law or established by custom. xvi (14) The practice of nursing by a registered nurse engaged in the practice of nursing and the performance of acts otherwise constituting medical practice by a registered nurse when performed in accordance with rules and regulations developed by a joint subcommittee of the Board of Medical Examiners and the Board of Nursing and adopted by both boards. § 90-18.1. Limitations on physician's assistants. — (a) Any person who is ap F .o/ed under the provision of G.S. 90-18(13) to perform medical acts, tasks or functions as an assistant to a physician may use the title "Physiciar Assistant." Any other person who uses the title in any form or holds out to be a physician assistant or to be so approved, shall be deemed to be in violation of this Article. (b) Physician assistants are authorized to write prescriptions for drugs under the following conditions: (1 ) The Board of Medical Examiners has adopted regulations governing the approval of individual physician assistants to write prescriptions with such limitations as the Board may determine to be in the best interest of patient health and safety; (2) The physician assistant has current approval from the Board; (3) The Board of Medical Examiners has assigned an identification number to the physician assistant which is shown on the written prescription; and (4) The supervising physician has provided to the physician assistant written instructions about indications and contraindications for prescribing drugs and a written policy for periodic review by the physician of the drugs prescribed. (c) Physician assistants are authorized to compound and dispense drugs under the following conditions: (1) The function is performed under the supervision of a licensed pharmacist; and (2) Rules and regulations of the North Carolina Board of Pharmacy governing this function are complied with. (d) Physician assistants are authorized to order medications, tests and treatments in hospitals, clinics, nursing homes and other health facilities under the following conditions: ( 1 ) The Board of Medical Examiners has adopted regulations governing the approval of individual physician assistants to order medications, tests and treatments with such limitations as the Board may determine to be in the best interest of patient health and safety; (2) The physician assistant has current approval from the Board; (3) The supervising physician has provided to the physician assistant written instructions about ordering medications, tests and treatments, and when appropriate, specific oral or written instructions for an individual patient, with provision for review by the physician of the order within a reasonable time, as determined by the Board, after the medication, test or treatment is ordered; and (4) The hospital or other health facility has adopted a written policy, approved by the medical staff after consultation with the nursing administration, about ordering medications, tests and treatments, including procedures for verification of the physician assistants' orders by nurses and other facility employees and such other procedures as are in the interest of patient health and safety. (e) Any prescription written by a physician assistant or order given by a physician assistant for medications, tests or treatments shall be deemed to have been authorized by the physician approved by the Board as the supervisor of the physician assistant and such supervising physician shall be responsible for authorizing such prescription or order. (f) Any registered nurse or licensed practical nurse who received an order from a physician assistant for medications, tests or treatments is authorized to perform that order in the same manner as if it were received from a licensed physician. xvn § 90-18.2. Limitations on nurse practitioners. — (a) Any nurse approved under the provisions of G.S. 90-18(14) to perform medical acts, tasks or functions may use the title "Nurse Practitioner." Any other person who uses the title in any form or holds out to be a nurse practitioner or to be so approved, shall be deemed to be in violation of this Article. (b) Nurse practitioners are authorized to write prescriptions for drugs under the following conditions: ( 1 ) The Board of Medical Examiners and Board of Nursing have adopted regulations developed by a joint subcommittee governing the approval of individual nurse practitioners to write prescriptions with such limitations as the board may determine to be in the best interest of patient health and safety. (2) The nurse practitioner has current approval from the boards; (3) The Board of Medical Examiners has assigned an identification number to the nurse practitioner which is shown on the written prescription; and (4) The supervising physician has provided to the nurse practitioner written instructions about indications and contraindications for prescribing drugs and a written policy for periodic review by the physician of the drugs prescribed. (c) Nurse practitioners are authorized to compound and dispense drugs under the following conditions: (1) The function is performed under the supervision of a licensed pharmacist; and (2) Rules and regulations of the North Carolina Board of Pharmacy governing this function are complied with. (d) Nurse practitioners are authorized to order medications, tests and treatments in hospitals, clinics, nursing homes and other health facilities under the following conditions: (1) The Board of Medical Examiners and Board of Nursing have adopted regulations developed by a joint subcommittee governing the approval of individual nurse practitioners to order medications, tests and treatments with such limitations as the boards may determine to be in the best interest of patient health and safety; (2) The nurse practitioner has current approval from the boards; (3) The supervising physician has provided to the nurse practitioner written instructions about ordering medications, tests and treatments, and when appropriate, specific oral or written instructions for an individual patient, with provision for review by the physician of the order within a reasonable time, as determined by the Board, after the medication, test or treatment is ordered; and (4) The hospital or health facility has adopted a written policy, approved by the medical staff after consultation with the nursing administration, about ordering medications, tests and treatments, including procedures for verification of the nurse practitioners' orders by nurses and other facility employees and such other procedures as are in the interest of patient health and safety. (e) Any prescription written by a nurse practitioner or order given by a nurse practitioner for medications, tests or treatments shall be deemed to have been authorized by the physician approved by the boards as the supervisor of the nurse practitioner and such supervising physician shall be responsible for authorizing such prescription or order. (0 Any registered nurse or licensed practical nurse who receives an order from a nurse practitioner for medications, tests or treatments is authorized to perform that order in the same manner as if it were received from a licensed physician. § 90-19, 90-20: Repealed by Session Laws 1967, c. 691, s. 59. § 90-21. Certain offenses prosecuted in superior court; duties of Attorney General. — In case of the violation of the criminal provisions of G.S. 90-18, the Attorney General of the State of North Carolina, upon complaint of the Board of xvin Medical Examiners of the State of North Carolina, shall investigate the charges preferred, and if in his judgment the law has been violated, he shall direct the district attorney of the district in which the offense was committed to institute a criminal action against the offending persons. A district attorney's fee of five dollars ($5.00) shall be allowed and collected in accordance with the provisions of G.S. 6-12. The Board of Medical Examiners may also employ, at their own expense, special counsel to assist the Attorney General or the district attorney. Exclusive original jurisdiction of all criminal actions instituted for the violations of G.S. 90- 1 8 shall be in the superior court, the provisions of any special or local act to the contrary notwithstanding. xix NORTH CAROLINA ADMINISTRATIVE CODE TITLE 21 OCCUPATIONAL LICENSING BOARDS CHAPTER 32 BOARD OF MEDICAL EXAMINERS SUBCHAPTER 32A - ORGANIZATION .0001 LOCATION .0002 PURPOSE .0003 STRUCTURE .0004 MEETINGS .0005 REQUIREMENT EXCEPTION .0006 PROVISIONS FOR PETITION FOR A RULE CHANGE .0007 DECLARATORY RULINGS .0008 RECORDS ON FILE .0009 FORMS .0010 DISCARDING APPLICATION MATERIAL SUBCHAPTER 32B - LICENSE TO PRACTICE MEDICINE SECTION SECTION .0100 .0101 .0102 .0103 .0104 .0105 .0106 .0107 .0108 .0109 .0110 .0111 .0112 .0113 .0114 .0200 .0201 .0202 .0203 .0204 .0205 .0206 .0207 .0208 .0209 .0210 .0211 .0212 .0213 .0214 .0300 .0301 .0302 .0303 SECTION .0400 .0401 .0402 .0403 SECTION LICENSE BY WRITTEN EXAMINATION MEDICAL EDUCATION ECFMG CERTIFICATION CERTIFICATION OF GRADUATION CERTIFIED PHOTOGRAPH CITIZENSHIP APPLICATION LETTERS OF RECOMMENDATION MILITARY STATUS FEE DEADLINE PASSING SCORE TIME AND LOCATION GRADUATE MEDICAL EDUCATION AND TRAINING PERSONAL INTERVIEW LICENSE BY ENDORSEMENT MEDICAL EDUCATION ECFMG CERTIFICATION CITIZENSHIP APPLICATION MILITARY STATUS LETTERS OF RECOMMENDATION CERTIFIED PHOTOGRAPH FEE PERSONAL INTERVIEW DEADLINE ENDORSEMENT RELATIONS ROUTINE INQUIRIES POSTGRADUATE TRAINING PASSING FLEX SCORE TEMPORARY LICENSE BY ENDORSEMENT CREDENTIALLING FEE HARDSHIP RESIDENT'S TRAINING LICENSE APPLICATION CERTIFICATION OF GRADUATION CERTIFIED PHOTOGRAPH xxi .0404 LETTERS OF RECOMMENDATION .0405 APPOINTMENT LETTER .0406 FEE .0407 ECFMG CERTIFICATION .0408 MEDICAL EDUCATION SECTION .0500 -- SPECIAL LIMITED LICENSE .0501 APPLICATION .0502 CERTIFICATION OF GRADUATION .0503 CERTIFIED PHOTOGRAPH .0504 LETTERS OF RECOMMENDATION .0505 DIPLOMA OF PSYCHOLOGICAL MEDICINE .0506 FEE .0507 ECFMG CERTIFICATION .0508 PERSONAL INTERVIEW SECTION .0600 -- CERTIFICATE OF REGISTRATION FOR VISITING PROFESSORS .0601 REQUEST .0602 GRADUATION AND LICENSURE .0603 LIMITATION .0604 DURATION .0605 PERSONAL INTERVIEW .0606 FEE .0607 CERTIFIED PHOTOGRAPH SUBCHAPTER 32C - PROFESSIONAL CORPORATIONS .0001 AUTHORITY AND DEFINITIONS .0002 NAME OF PROFESSIONAL CORPORATION .0003 PREREQUISITES FOR INCORPORATION .0004 CERTIFICATE OF REGISTRATION .0005 STOCK AND FINANCIAL MATTERS .0006 GENERAL AND ADMINISTRATIVE PROVISIONS .0007 FORMS .0008 FEES SUBCHAPTER 32D - APPROVAL OF ASSISTANT TO PHYSICI .0001 DEFINITIONS .0002 APPLICATION FOR APPROVAL .0003 REQUIREMENTS FOR APPROVAL .0004 MORAL CHARACTER .0005 REQUIREMENTS FOR RECOGNITION OF TRAINING PROGRAMS .0006 TERMINATION OF APPROVAL .0007 METHOD OF PERFORMANCE .0008 FEES .0009 FORMS SUBCHAPTER 32E - APPROVAL OF REGISTERED NURSE PERFORMING MEDICAL ACTS .0001 DEFINITIONS .0002 APPLICATION FOR APPROVAL .0003 REQUIREMENTS FOR APPROVAL .0004 MORAL CHARACTER .0005 TERMINATION OF APPROVAL .0006 ANNUAL APPROVAL .0007 FEES .0008 FORMS xxn SUBCHAPTER 32F - BIENNIAL REGISTRATION .0001 TIME .0002 REQUIRED INFORMATION .0003 FEE .0004 FAILURE TO REGISTER (REPEALED) .0005 FORMS SUBCHAPTER 32H - MOBILE INTENSIVE CARE SECTION .0100 - GENERAL INFORMATION .0101 AUTHORITY: INTENT AND GOALS .0102 DEFINITIONS SECTION .0200 - PROGRAM STANDARDS AND APPROVAL .0201 MOBILE INTENSIVE CARE PROGRAM CRITERIA .0202 PROGRAM APPROVAL SECTION .0300 - HOSPITAL UTILIZATION .0301 HOSPITAL INVOLVEMENT .0302 PLAN FOR PARTICIPATING HOSPITALS .0303 SPONSOR HOSPITAL .0304 RESOURCE HOSPITAL (REPEALED) SECTION .0400 - TRAINING AND PERFORMANCE OF MOBILE INTENSIVE CARE PERSONNEL .0401 TRAINING PROGRAMS .0402 EMT - PARAMEDIC PERFORMANCE .0403 EMT - INTERMEDIATE PERFORMANCE .0404 MOBILE INTENSIVE CARE NURSE PERFORMANCE .0405 TECHNICIAN PERFORMANCE IN THE PRESENCE OF A PHYSICIAN .0406 EMT - ADVANCED INTERMEDIATE PERFORMANCE .0407 EMT — DEFIBRILLATION PERFORMANCE SECTION .0500 - CERTIFICATION AND APPROVAL REQUIREMENTS FOR MOBILE INTENSIVE CARE PERSONNEL .0501 CERTIFICATION REQUIREMENTS: EMT - PARAMEDIC .0502 CERTIFICATION REQUIREMENTS: EMT - INTERMEDIATE .0503 APPROVAL REQUIREMENTS: MOBILE INTENSIVE CARE NURSE .0504 CERTIFICATION REQUIREMENTS: EMT - ADVANCED INTERMEDIATE .0505 CERTIFICATION REQUIREMENTS: EMT - DEFIBRILLATION SECTION .0600 - ENFORCEMENT .0601 APPROVAL/CERTIFICATION DENIAL, SUSPENSION OR REVOCATION .0602 PROCEDURES FOR DENIAL, SUSPENSION OR REVOCATION .0603 EFFECTIVE DATE (REPEALED) SECTION .0700 - EXCEPTIONS .0701 CONDITIONS .0702 REQUESTS SECTION .0800 - FORMS .0801 REQUIRED FORMS .0802 SOURCE OF FORMS SECTION .0900 — STUDY PROJECTS .0901 CONDITIONS xxin .0902 STUDY PROJECT APPROVAL .0903 STUDY RECOMMENDATIONS SECTION .1000 - MEDICAL CONTROL .1001 MEDICAL CONTROL PROCEDURES . 1 002 MEDICAL CONT/TRANS OUTSIDE/MBLE INTSVE CARE PROG SVC AREA . 1003 MEDICAL CONTROL FOR TRANSPORTS BETWEEN FACILITIES . 1004 AIR AMBULANCE PROGRAM CRITERIA SUBCHAPTER 321 - EPINEPHRINE FOR ADVERSE REACTIONS TO INSECT STINGS .0001 REQUIREMENTS FOR APPROVAL .0002 TRAINING PROGRAMS .0003 CERTIFICATION .0004 FORMS SUBCHAPTER 32J - REINSTATEMENT OF SUSPENDED LICENSE .0001 APPLICATION FOR REINSTATEMENT .0002 CONSIDERATION BY BOARD .0003 HEARING UPON DENIAL SUBCHAPTER 32K — IMPAIRED PHYSICIAN PROGRAM SECTION .0100 - GENERAL INFORMATION .0101 AUTHORITY .0102 DEFINITIONS .0103 PEER REVIEW AGREEMENTS .0104 DUE PROCESS SECTION .0200 - GUIDELINES FOR PROGRAM ELEMENTS .0201 RECEIPT AND USE OF INFORMATION OF SUSPECTED IMPAIRMENT .0202 INTERVENTION AND REFERRAL .0203 MONITORING TREATMENT .0204 MONITORING REHABILITATION AND PERFORMANCE .0205 MONITORING POST-TREATMENT SUPPORT .0206 REPORTS OF INDIVIDUAL CASES TO THE BOARD .0207 PERIODIC REPORTING OF STATISTICAL INFORMATION .0208 CONFIDENTIALITY CHAPTER 32 - BOARD OF MEDICAL EXAMINERS SUBCHAPTER 32A - ORGANIZATION .0001 Location The location of the office of the Board of Medical Examiners is 1313 Navaho Drive, Raleigh, North Carolina 27609. .0002 Purpose The purpose of the Board of Medical Examiners is to regulate the practice of medi-cine and surgery in the State of North Carolina. The board shall maintain the following records in the office of the executive secretary: (1) minutes of each meeting; (2) books of licensure of all physicians licensed in the State of North Carolina; The Board of Medical Examiners shall publish the names of those licensed in three daily newspapers published in the State of North Carolina, within 30 days after grant-ing the license. xxiv .0003 Structure Seven of the members of the board shall be duly licensed physicians elected and nomi-nated to the Governor by the North Carolina Medical Society. The other member shall be a person chosen by the Governor to represent the public at large. Terms shall be no more than two complete consecutive three-year terms. Administrative staff is headed by the executive secretary of the board. .0004 Meetings The board customarily meets seven times a year in January, March, May, June, August, October and December. Other meetings may be called by the president or upon written request of the majority of the members of the board. .0005 Requirement Exception When the board finds that an applicant is unable to comply with the requirements for proof of qualification for licensure because of circumstances beyond his control, the board may accept in lieu of such requirements such other evidence or information which will satisfy the board that such applicant is qualified for licensure or approval as required by law. .0006 Provisions For Petition For A Rule Change Each person desiring to petition for the adoption, amendment or repeal of a rule should submit the following information to the board: (1) name of agency; (2) draft of the proposed rule; (3) reasons for proposal; (4) effect of existing rules or orders; (5) data supporting proposal; (6) effect on existing practices in the area involved (including costs); (7) names of those most likely to be affected, with addresses (if known); (8) name and address of petitioner. The executive secretary shall conduct an interview with board members as appropri-ate to render a decision regarding denial of petition or initiation of rule-making proceed-ings in accordance with G.S. 150-12. .0007 Declaratory Rulings The board may consider the validity of a rule only when the petitioner shows that cir-cumstances are so changed since adoption of the rule that such a ruling would be war-ranted, or that the rule-making record evidences a failure by the agency to consider speci-fied relevant factors. The petitioner shall state the consequences of a failure to issue a ruling. .0008 Records On File All rules and other written statements of policy or interpretations formulated, adopted, or used by the board in the discharge of its functions, all final orders, decisions and opin-ions made after February 1, 1976, together with all materials that were before the decid-ing officers at the time of the final orders, decisions or opinions, except materials properly for good cause held confidential, are on file at the office of the Board of Medical Ex-aminers. .0009 Forms All forms and lists of requirements referred to in regulations of the board, Chapter 21 NCAC 32, may be obtained from the office of the Board of Medical Examiners. .0010 Discarding Application Material Applications must be completed within one year of the date requirements are mailed from the board's office. If not completed within one year, any application materials received will be discarded. xxv SUBCHAPTER 32B — LICENSE TO PRACTICE MEDICINE SECTION .0100 - LICENSE BY WRITTEN EXAMINATION .0101 Medical Education In order to be eligible for N.C. written examination, FLEX (Federation Licensing Examination), a physician applicant must: (1) be a graduate of a medical school approved by either: (a) LCME (Liaison Commission on Medical Education), or (b) AOA (American Osteopathic Association), or (2) if graduated from a medical school not approved by LCME or AOA, the appli-cant must: (a) Be enrolled in a graduate medical education and training program in N.C. ap-proved by the board (see Rule .0113); or (b) furnish proof of satisfactory completion of three years of graduate medical edu-cation and training approved by the board (see Rule .0113). (3) if graduated from a medical school not approved by the LCME or AOA, and if clinical clerkships are taken in the U.S.A., the applicant must: (a) furnish evidence that he has satisfactorily completed clinical clerkships at teach-ing hospitals in the U.S.A. with ACGME (Accreditation Council for Gradu-ate Medical Education) or AOA-approved graduate medical education and train-ing programs in the areas of the specific clerkships. (b) If clerkships do not meet the above requirement, deficiencies may be reme-died as follows: (i) re-apply to medical school so that the school may arrange for the appli-cant to complete approved clinical clerkships as required, or (ii) apply for admission to advanced standing at a medical school approved by the LCME or AOA to repeat one year of clinical clerkships. No applicant graduated from a medical school which has been disapproved by the board shall be eligible for examination or licensure in North Carolina. Burden of proof of medical education is on the applicant. .0102 ECFMG Certification Graduates of medical schools other than those approved by LCME or AOA in order to be eligible to take the North Carolina written examination, FLEX (Federation Licens-ing Examination), must furnish photocopy of standard certificate of ECFMG (Educa-tional Commission for Foreign Medical Graduates). ECFMG certification may be waived by the board under the following conditions: (1) upon successfully passing ECFMG examination and successfully completing an approved Fifth Pathway Program (as defined in Directory of Accredited Residences 1977-1978, American Medical Association, 535 North Dearborn Street, Chicago, Illinois 60610, pp. 30-32); or (2) if the applicant has been licensed in another state on the basis of written examina-tion prior to 1958. .0103 Certification of Graduation Certification of graduation by the dean of applicant's medical school is required. .0104 Certified Photograph Applicant must submit recent photograph (at least 2 inches by 2 inches) certified by the dean or other official of his medical school indicating, "This photograph is certi-fied as a true likeness of Dr. who received the M.D. degree from Med-ical School on ." This photograph must bear the dean's signature and seal of the medical school. .0105 Citizenship U.S.A. or Canadian citizenship is required. Alien registration receipt card is accept-able in lieu of citizenship. Immigrant applicants must present this card at time of inter-view. Failure to present this card constitutes an incomplete application. Naturalized U.S.A. or naturalized Canadian citizens must submit affidavit by Notary Public giving Naturalization Certificate number and date of issue. xxvi .0106 Application Application must be typewritten, containing full name, address, place and date of birth and medical education of applicant (in the form of a letter). A questionnaire regarding personal and professional activities of the applicant and a 'FEDERATION OF STATE MEDICAL BOARDS' application form must also be submitted. .0107 Letters of Recommendation Three letters of recommendation, originals addressed to the N.C. Board of Medical Examiners are required. One of these letters must be from someone who has known the applicant for a period of 10 years. Two of these letters must be from physicians. .0108 Military Status Copy of military discharge or statement as to military status is required. .0109 Fee Fee for both components taken together shall be two hundred and fifty dollars ($250.00), plus the cost of test materials, to be paid at time of application. If the two components are taken separately, two hundred and fifty dollars ($250.00) plus the cost of test materials, shall be paid at the time of application for the first com-ponent, and one hundred and fifty dollars ($150.00), plus the cost of test materials, shall be paid prior to application for the second component. In the event applicant fails to make a passing score on both components taken together or either component taken separately, there will be no refund of fee. In the event ap-plicant does not appear for the regularly scheduled examination or application is with-drawn, no portion of the fee will be refunded. .0110 Deadline For the applicant to be eligible for the examination, all data must be in the hands of the executive secretary of the board at least 75 days prior to examination. An applicant in attendance at a medical school located in North Carolina or a citizen of the State of North Carolina who is in attendance in an AOA or LCME approved med-ical school who may graduate after the 75 day deadline but before the examination date, may satisfy the certification of graduation requirement as follows: (1) not less than 75 days before the date of the examination, the executive secretary must receive a letter from the dean of the medical school of the applicant stating that the applicant is expected to complete all requirements for graduation prior to the date of the examination; and (2) prior to the date of the examination, the executive secretary must receive a letter from the dean of the medical school stating that the applicant has completed all requirements for, and will receive, the M.D. degree from the medical school. .0111 Passing Score To pass the examination successfully, the applicant is required to attain a score of at least 75 on FLEX Component I and a score of at least 75 on FLEX Component II. (Com-ponents may be taken in tandem; any component that is failed may be retaken; how-ever, Component II may not be taken alone unless the applicant has passed Component I within the prior seven years). Both components must be passed within seven years of the date of taking the initial application. .0112 Time and Location The board holds two examinations each year in June and December in Raleigh, North Carolina. .0113 Graduate Medical Education and Training Graduate medical education and training programs approved by ACGME (Accredi-tation Council for Graduate Medical Education) or AOA are approved by the board. Graduate medical education and training is required as follows: (1) Graduates of medical schools approved by the LCME or AOA may take the writ-ten examination, FLEX, after graduation from medical school before graduate med-ical education and training, but must give evidence of successfully completing one year of graduate medical education and training approved by the board prior to issuance of a license to practice medicine. xxvn (2) Graduates of medical schools other than those approved by LCME or AOA who are currently enrolled in graduate medical education and training in North Caro-lina may take the examination before completion of training, but must give evi-dence of successfully completing three years of graduate medical education and training approved by the board "prior to the issuance of a license to practice med-icine in North Carolina" to be eligible. (3) Graduates of medical schools other than those approved by LCME or AOA must give evidence of successfully completing three years of graduate medical educa-tion and training approved by the board to be eligible to apply for the written ex-amination in North Carolina. .0114 Personal Interview Graduates of medical schools not approved by the LCME or AOA and immigrant ap-plicants must appear before the executive secretary upon completion of all credentials for a personal interview which must be conducted at least 75 days prior to the date of the examination. SECTION .0200 - LICENSE BY ENDORSEMENT .0201 Medical Education In order to be eligible for license by endorsement of credentials, a physician appli-cant must: (1) be a graduate of a medical school approved by either: (a) LCME (Liaison Commission on Medical Education), or (b) AOA (American Osteopathic Association), or (2) if graduated from a medical school not approved by LCME or AOA, the appli-cant must: (a) take the North Carolina written examination, FLEX; and (b) furnish proof of satisfactory completion of three years of graduate medical edu-cation and training approved by the board (see Rule .0113). (3) If graduated from a medical school not approved by the LCME or AOA, and if clinical clerkships are taken in the U.S.A., the applicant must: (a) furnish evidence that he has satisfactorily completed clinical clerkships at teach-ing hospitals in the U.S.A. with ACGME (Accreditation Council for Gradu-ate Medical Education) or AOA-approved graduate medical education and train-ing programs in the areas of the specific clerkships: (b) if clerkships do not meet the above requirement, deficiencies may be reme-died as follows: (i) re-apply to medical school so that the school may arrange for the appli-cant to complete approved clinical clerkships as required, or (ii) apply for admission to advanced standing at a medical school approved by the LCME or AOA to repeat one year of clinical clerkships. No applicant graduated from a medical school which has been disapproved by the board shall be eligible for examination or licensure in North Carolina. Burden of proof of medical education is on the applicant. .0202 ECFMG Certification Graduates of medical schools other than those approved by LCME or AOA in order to be eligible to take the North Carolina written examination, FLEX (Federation Licens-ing Examination), must furnish photocopy of standard certificate of ECFMG (Educa-tional Commission for Foreign Medical Graduates). ECFMG certification may be waived by the board under the following conditions: (1) upon successfully passing ECFMG examination and successfully completing an approved Fifth Pathway Program (as defined in Directory of Accredited Residencies 1977-1978, American Medical Association, 535 North Dearborn Street, Chicago, Illinois 60610, pp. 30-32); or (2) if the applicant has been licensed in another state on the basis of written examina-tion prior to 1958. .0203 Citizenship U.S.A. or Canadian citizenship is required. Alien registration receipt card is accept-able in lieu of citizenship. Immigrant applicants must present this card at time of inter-view. Failure to present this card constitutes an incomplete application. Naturalized U.S.A. or naturalized Canadian citizens must submit affidavit by Notary Public giving Naturalization Certificate number and date of issue. xxvni .0204 Application All applicants must complete the application form which requests information regard-ing the applicant's personal, educational and professional background. Required attachments to the application form are: (1) (if applying on the basis of FLEX examination) certified FLEX scores from the Federation of State Medical Boards, 2630 W. Freeway, Suite 138, Fort Worth, Texas 76102; (2) (if applying on the basis of National Board examination) certification of having passed the examination given by the National Board of Medical Examiners, 3930 Chestnut Street, Philadelphia, Pennsylvania 19104; (3) (if applying on the basis of state board written examination other than FLEX) verifi-cation form from state board issuing original license by written examination; (4) (if affiliated) letter of current standing from county or state medical society; (5) if graduate of a medical school other than those approved by LCME or AOA who has been licensed in another state on the basis of examination, which was not FLEX, and has been certified by an American Specialty Board, the board may consider the applicant on an individual basis for a license based on endorsement of creden-tials upon submission of Subparagraph (3) of this Rule and a photocopy of the American Specialty Board certification. .0205 Military Status Copy of military discharge or statement as to military status is required. .0206 Letters of Recommendation Three letters of recommendation, originals addressed to the N.C. Board of Medical Examiners are required. One of these letters must be from someone who has known the applicant for a period of 10 years. Two of these letters must be from physicians. .0207 Certified Photograph Applicant must submit recent photograph (at least 2 inches by 2 inches) certified by the dean or other official of his medical school indicating, "this photograph is certi-fied as a true likeness of Dr. who received the M.D. degree from med-ical school on ." This photograph must bear the dean's signature and the seal of the medical school. .0208 Fee Fee of two hundred and fifty dollars ($250.00) is to be paid at time of application. In the event the applicant does not appear for the next regularly scheduled meeting, no portion of the fee may be refunded. In the event licensure is declined or the application withdrawn, no portion of the fee will be refunded. .0209 Personal Interview All applicants for license by endorsement of credentials must appear for a personal interview before the executive secretary, a board member, or the full board. Immigrant applicants must present their alien registration receipt cards at time of in-terview. Failure to present this card constitutes an incomplete application. .0210 Deadline In order for applicant to be eligible for licensure at a given board meeting, all data must be in the hands of the executive secretary of the board and the personal interview conducted at least 15 days prior to the meeting. .0211 Endorsement Relations The board has no endorsement relations with the government services nor with licens-ing medical boards outside of the United States and its territories. .0212 Routine Inquiries Each applicant must request a report from each state board by which he has ever been licensed to practice medicine regarding the status of the applicant's license and whether or not the license issued by that board has been revoked, suspended or surrendered, or had any probationary terms placed against it. This information must be mailed directly from other state boards to the N.C. Board of Medical Examiners. xxix An AMA Physician Statistics Report from the AMA, 535 N. Dearborn St., Chicago, 111. 60610, is requested by the N.C. board to be mailed directly to the N.C. Board of Medical Examiners regarding each applicant. .0213 Graduate Medical Education and Training Graduate medical education and training programs approved by ACGME and AOA are approved by the board. Graduates of medical schools approved by LCME or AOA must give evidence of suc-cessful completion of one year of graduate medical education and training approved by the board after graduation from medical school prior to issuance of a license to prac-tice medicine in North Carolina. Graduates of medical schools other than those approved by LCME or AOA must give evidence of successful completion of three years of graduate medical education and train-ing approved by the board after graduation from medical school prior to issuance of a license to practice medicine in North Carolina. .0214 Passing FLEX Score Physicians who have been licensed in another state on the basis of a FLEX examina-tion taken before January 1, 1983, who have attained a FLEX weighted average of 75 or more on a single three day examination, may be eligible to apply for a license based on endorsement of credentials. Physicians who have been licensed in another state on the basis of a FLEX examina-tion taken after January 1, 1983, who have attained a FLEX weighted average of 75 or more on a single three day examination, with a score not less than 70 on Day I, a score not less than 75 on Day II, and a score not less than 75 on Day III, may be eligi-ble to apply for a license based on endorsement of credentials. Physicians who have been licensed in another state on the basis of FLEX taken after January 1, 1985, must attain a score of at least 75 on FLEX Component I and a score of at least 75 on FLEX Component II. (Components may be taken in tandem; any com-ponent that is failed may be retaken; however, Component II may not be taken alone unless the applicant has passed Component I within the prior seven years.) Both com-ponents must be passed within seven years of the date of taking the initial examination. SECTION .0300 - TEMPORARY LICENSE BY ENDORSEMENT .0301 Credentialling Applicants for a temporary license must meet all requirements listed under Section .0200, LICENSE BY ENDORSEMENT OF CREDENTIALS, with the exception of the fee requirement. .0302 Fee Fee of fifty dollars ($50.00) is to be paid at time of application. This fee is not ap-plicable to full licensure and is not refundable. .0303 Hardship The board requires documentation from applicant of true hardship. xxx SECTION .0400 - TRAINING AND PERFORMANCE OF MOBILE INTENSIVE CARE PERSONNEL .0401 Training Programs (a) A training program intended to qualify personnel as field technicians or MICN's must be approved by the office of Emergency Medical Services. Proposals for training programs must be submitted for approval at least 20 days prior to the date on which training is scheduled to start. (b) Field technician trainees may perform the services and functions permitted by the rules contained in this Subchapter for their certification level during: (1) the clinical training portion of an approved training program while caring for patients in the sponsor hospital, provided the related didactic work has been completed and that they are under the direct supervision of a physician or reg-istered nurse; (2) a field internship provided that: (A) the related didactic and clinical work of an approved training program has been completed; (B) they are directly supervised and accompanied by a field technician cer-tified at a like or higher certification level or a physician; and (C) the internship is conducted within a mobile intensive care program ap-proved at the same or higher certification level for which the personnel are being trained. .0402 Certification of Graduation Certification of graduation by the dean of applicant's medical school is required. .0403 Certified Photograph Applicant must furnish recent photograph (at least 2 inches by 2 inches), certified as his true likeness by the dean of his medical school with the dean's signature and the seal of the school affixed thereon. .0404 Letters of Recommendation Two letters of recommendation from physicians, originals addressed to the board, are required. .0405 Technician Performance In The Presence Of A Physician When there is a physician licensed to practice medicine present at the scene of a med-ical/ traumatic emergency and that physician chooses to assume medical responsibility for the patient(s), the field technicians at the scene shall: (1) require and allow that physician to contact the sponsor hospital and the physician who receives the call at the sponsor hospital shall make the decision as to whether or not the physician on the scene is to be allowed to take charge of the patient(s) and give orders; (2) if the physician on the scene is allowed to take charge, permit that physician's orders to take precedence over all other procedures and/or protocol normally utilized within that emergency care program; (3) follow the orders of the physician within the limits enumerated in Rules .0402, .0403, .0406 and .0407 of this Section. .0406 Fee Fee of twenty-five dollars ($25.00) is to be paid at the time of application. No por-tion of the application fee is refundable. .0407 EMT—Defibrillation Performance EMT-D's trained in approved programs, certified by the Board of Medical Examiners to perform medical acts and functioning in an approved mobile intensive care program, when confronted with a pulseless non-breathing patient, may perform defibrillation by means of an automatic or semi-automatic defibrillator. Defibrillation may be performed prior to contacting the sponsor hospital. XXXI .0408 Medical Education (a) A physician applicant must be a graduate of a medical school approved by either: (1) LCME (Liaison Commission on Medical Education), or (2) AOA (American Osteopathic Association). (b) If graduated from a medical school not approved by the LCME or AOA, and if clinical clerkships are taken in the U.S.A., the applicant must: (1) furnish evidence that he has satisfactorily completed clinical clerkships at teach-ing hospitals in the U.S.A. with ACGME (Accreditation Council for Gradu-ate Medical Education) or AOA-approved graduate medical education and train-ing programs in the areas of the specific clerkships. (2) If clerkships do not meet the requirement in (b) (1) of this Rule, deficiencies may be remedied as follows: (A) re-apply to medical school so that the school may arrange for the appli-cant to complete approved clinical clerkships as required; or (B) apply for admission to advanced standing at a medical school approved by the LCME or AOA to repeat one year of clinical clerkship. Burden of proof of medical education is on the applicant. SECTION .0500 - SPECIAL LIMITED LICENSE .0501 Application A letter of application is required to include the following information: (1) full name, (2) place and date of birth, (3) medical education (locations and dates), (4) prior internship and residency training (locations and dates), (5) institution in which applicant will be practicing. A questionnaire, supplied to the applicant by the board, regarding personal and profes-sional background must be completed. .0502 Certification of Graduation Certification of graduation by the dean of applicant's medical school is required. .0503 Certified Photograph Applicant must furnish recent photograph (at least 2 inches by 2 inches) certified as his true likeness by the dean of his medical school with the dean's signature and the seal of the school affixed thereon. .0504 Certification Requirements: EMT-Advanced Intermediate (a) To become certified as an EMT-AI a person must meet the following criteria: (1) be currently certified as an emergency medical technician in the State of North Carolina; (2) be affiliated on a continuous basis with an ambulance provider permitted by the Office of Emergency Medical Services and which functions as part of an approved mobile intensive care program; (3) present evidence that he is of suitable character and physically capable of per-forming as an EMT-AI; (4) successfully complete, within one year of application, an EMT-AI training course approved by the Office of Emergency Medical Services following guide-lines established by the Board of Medical Examiners; (When training was com-pleted over one year prior to application, a person must submit evidence of completion of pertinent refresher training in emergency medicine for approval by the Office of Emergency Medical Services.) (5) successfully complete a performance evaluation conducted under the direction of the medical director of the mobile intensive care program assessing his ability to perform the skills and procedures specified in Rule .0406 of this Subchapter; (6) be recommended for certification upon examination by an oral interview panel established by the mobile intensive care program in which he is proposing to function; (7) pass basic life support practical examination approved and/or administered by the Office of Emergency Medical Services; (8) pass EMT-AI written examination administered by the Office of Emergency Medical Services. XXXll (b) Persons holding current certification equivalent to an EMT-AI with the National Registry of Emergency Medical Technicians or in another state where the training/certifi-cation requirements have been approved for reciprocity by the Office of Emergency Med-ical Services may become certified by: (1) presenting evidence of such certification for verification by the Office of Emer-gency Medical Services; and (2) meeting the criteria specified in Subparagraphs (a) (1), (a) (2), (a) (3), (a) (5), and (a) (6) of this Rule. (c) Certification obtained through reciprocity shall be valid for a period not to exceed the length of the current certification or a period not to exceed two years whichever is shorter. No certification shall be valid for a period exceeding two years. Persons must be recertified by presenting documentation to the Office of Emergency Medical Ser-vices that they have successfully completed either of the following options: Option I: (1) an ongoing continuing education program under the direction of the medical director, approved by the Office of Emergency Medical Services, following guidelines established by the Board of Medical Examiners; (2) an advanced life support performance evaluation conducted under the direc-tion of the medical director following guidelines established by the Board of Medical Examiners assessing the ability to perform the skills specified in Rule .0406 of this Subchapter; (3) basic life support practical and EMT-AI written examinations administered by the Office of Emergency Medical Services; or Option II: (1) the criteria specified in Subparagraph (c) (1) and (c) (2) of this Rule; (2) a basic life support skills evaluation(s) conducted under the direction of the medical director assessing the ability to perform the skills required of an emer-gency medical technician as specified by the North Carolina Medical Care Com-mission following guidelines established by the Board of Medical Examiners; (3) an EMT-AI written examination(s) administered under the direction of the med-ical director complying with the test specifications of the state EMT-AI writ-ten examination and following guidelines established by the Board of Medi-cal Examiners. .0505 Certification Requirements: EMT-Defibriliation (a) to become certified as an EMT-D a person must meet the following criteria: (1) be currently certified as an emergency medical technician in the State of North Carolina; (2) be affiliated on a continuous basis with an ambulance provider permitted by the Office of Emergency Medical Services, or an approved first responder or-ganization which functions as part of an approved mobile intensive care pro-gram; (3) present evidence that he is of suitable character and physically capable of per-forming as an EMT-D; (4) successfully complete, within one year of application, an EMT-D training course approved by the Office of Emergency Medical Services following guide-lines established by the Board of Medical Examiners; (When training was com-pleted over one year prior to application, a person must submit evidence of pertinent refresher training in emergency medicine for approval by the Office of Emergency Medical Services.) (5) successfully complete a performance evaluation conducted under the direction of the medical director of the mobile intensive care program assessing his ability to perform the skills and procedures specified in Rule .0407 of this Subchapter; (6) be recommended for certification upon examination by an oral interview panel established by the mobile intensive care program in which he is proposing to function; (7) pass basic life s'*>port practical examination approved and/or administered by the Office of Emergency Medical Services; (8) pass EMT-D written examination administered by the Office of Emergency Medical Services. XXAlll .0506 Fee Fee of one hundred and fifty dollars ($150.00) is to be paid at the time of applica-tion. No portion of the application fee is refundable. .0507 ECFMG Certification Graduates of medical schools other than those approved by LCME or AOA must fur-nish photocopy of standard certificate of the ECFMG (Educational Commission for For-eign Medical Graduates). Upon successfully passing the ECFMG examination and suc-cessfully completing an approved Fifth Pathway Program (as defined in Directory of Accredited Residencies 1977-1978, American Medical Association, 535 North Dear-born Street, Chicago, Illinois 60610, pp. 30-32), ECFMG certification may be waived. .0508 Personal Interview Applicant is required to appear in person before the board at a regular meeting. SECTION .0600 — CERTIFICATE OF REGISTRATION FOR VISITING PROFESSORS .0601 Request The request shall come from the dean of the medical school giving qualifications, po-sition, responsibilities and length of appointment. .0602 Graduation and Licensure Applicant must furnish proof of medical school graduation and licensure in another state or foreign country. .0603 Limitation Practice is limited to the institution requesting the Certificate of Registration. .0604 Duration The Certification of Registration shall be valid for one year. .0605 Personal Interview Applicant is required to appear in person before the full board, a board member, or the executive secretary. .0606 Fee Fee of fifty dollars ($50.00) is to be paid at the time of application. No portion of the application fee is refundable. .0607 Certified Photograph Applicant must furnish recent photograph (at least two inches by two inches), certi-fied as his true likeness by the dean of his medical school with the dean's signature and the seal of the school affixed thereon. SUBCHAPTER 32C - PROFESSIONAL CORPORATIONS .0001 Authority and Definitions Chapter 55B of the General Statutes of North Carolina being "The Professional Cor-poration Act," authorizes the Board of Medical Examiners of the State of North Caro-lina to adopt regulations for professional corporations practicing medicine. The rules in this Subchapter are adopted by the board pursuant to this authority. The rules in this Subchapter supplement the basic statutory law governing professional corporations and shall be interpreted so as not to conflict with such statutory law, as it may be amended from time to time, or with other statutes and laws governing corpo-rations generally. "Board" means the Board of Medical Examiners of the State of North Carolina. "Licensee" means any natural person who is duly licensed to practice medicine in North Carolina. "Professional corporation" means professional corporations organized for the pur-pose of practicing medicine in North Carolina. XXXIV "Secretary" means the Executive Secretary of the Board of Medical Examiners of the State of North Carolina. "Assistant secretary" means the Assistant Executive Secretary of the Board of Medical Examiners of the State of North Carolina. .0002 Name of Professional Corporation The following requirements must be met regarding the corporate name: (1) The name of every professional corporation referred to herein shall be governed by the provisions of Chapter 55, the Business Corporation Act, of the General Sta-tutes of North Carolina; provided that professional corporations may use the words "professional association," or "P. A.," in lieu of corporate designations speci-fied in Chapter 55; and provided further that the name of such corporation shall not include any adjectives or words not in accordance with ethical customs of the medical profession or the use of any words descriptive of any medical surgical spe-cialty unless the specialty designation is preceded by another modifying word or words, such as a geographical area of location designation or a proper name. (2) A professional corporation may not use any name other than its corporate name. (3) Upon proper authorization, the surname of any bona fide shareholder may be re-tained in the corporate name after his death or after his retirement or inactivity be-cause of age or disability, even though he may have disposed of his stock. (4) If a living shareholder in a professional corporation whose surname appears in the corporate name becomes a "disqualified person" as that term is defined in the Professional Corporation Act, the name of the professional corporation shall be promptly changed to eliminate the name of such shareholder, and such shareholder shall promptly dispose of his stock in the corporation. .0003 Prerequisites for Incorporation The following requirements must be met in order to incorporate: (1) The incorporator, whether one or more, of a professional corporation shall be duly licensed to practice medicine in North Carolina. Before the filing of the articles of incorporation with the Secretary of State, the incorporators shall file with the secretary of the board the original articles of incorporation, and additional executed copy, and conformed copy, together with a registration fee of fifty dollars ($50.00). (2) The original articles of incorporation, the executed copy and the conformed copy so filed shall be accompanied by the certificate (P.C. Form 1) to the board certi-fied by all incorporators, setting forth the names and addresses of each person who will be employed by said corporation to practice medicine for said corporation, and stating that all such persons are duly licensed to practice medicine in North Carolina, and representing that the corporation will be conducted in compliance with the Professional Corporation Act and these regulations. The number of shares to be owned by each original shareholder need not be stated. (3) The original articles of incorporation, the executed copy and the conformed copy shall each be accompanied by a form of certificate (P. C. Form 2) for the secre-tary, president or assistant secretary to sign, certifying each of the incorporators and each of the persons who will be original shareholders is duly licensed to practice medicine in North Carolina. It shall be the duty of the secretary, president or as-sistant secretary with the advice of the attorney for the board to review the arti-cles of incorporation for compliance with the laws relating to professional corpo-rations and with these Regulations. If such compliance be found to exist, the secretary, president or assistant secretary shall execute the said certificate (P. C. Form 2) on the original articles of incorporation, on the executed copy and on the conformed copy and return the original and the conformed copies to incorpora-tors for filing with the Secretary of State. The executed copy of the articles of in-corporation with the certificates (P. C. Forms 1 and 2) shall be retained in the of-fice of the secretary. If the articles of incorporation are thereafter in any manner changed before being filed with the Secretary of State, they shall be re-submitted to the secretary of the board and shall not be filed with the Secretary of State until approved by the secretary of the board. .0004 Certificate of Registration The Certificate of Registration shall be issued as follows: (1) If the secretary, president or assistant secretary of the board makes the findi«<*<= XXXV necessary to execute the certificate specified in 21 NCAC 32C .0003 (3) and finds that no disciplinary action is pending before the board against any of the licensed incorporators or persons who will be directors, officers, shareholders or employees of such corporation and it appears to him that such corporation will be conducted in compliance with the law and these Regulations, the secretary, president or as-sistant secretary shall issue a Certificate of Registration (P. C. Form 3) for the professional corporation to become effective only when the professional corpora-tion files the articles of incorporation with the Secretary of State. If the required findings cannot be made the registration fee shall be refunded to the incorporators. (2) The initial Certificate of Registration shall remain effective until December 3 1 preceding the year in which licensees are required to register with the board. (3) The Certificate of Registration may be renewed biennially thereafter for years in which licensees are required to register upon written application (P. C. Form 4) to the secretary, certifying the names and addresses of all licensed officers, direc-tors, shareholders and employees of the corporation and representing that the cor-poration has complied with these regulations and the provisions of the Professional Corporation Act and a finding by the secretary, president or assistant secretary that the facts stated in the certificate and the representations are correct. The applica-tion shall be accompanied by a renewal fee of twenty-five dollars ($25.00). .0005 Stock and Financial Matters The regulation and control of stocks shall be as follows: (1) The chief executive officer of a professional corporation shall be a person duly licensed to practice medicine in North Carolina. (2) A professional corporation may acquire and hold its own stock. (3) No person other than a licensee shall exercise any authority whatsoever over profes-sional matters. (4) The income of a professional corporation attributable to its practice during the time that a living shareholder is a "disqualified person" as defined in G.S. 55B-2(1) shall not in any manner accrue to the benefit of such a shareholder or his shares. (5) Subject to the provision of G.S. 55B-7, a professional corporation may make such agreement with its shareholders or its shareholders may make such agreement be-tween themselves as they deem just for the acquisition of the shares of a deceased or retiring shareholder or of a shareholder who becomes disqualified to own shares under the Professional Corporation Act or under these regulations. (6) There shall be prominently displayed on the face of all certificates of stock in a professional corporation a legend that any transfer of these shares is subject to the provisions of the Professional Corporation Act of North Carolina and the regula-tions of the Board of Medical Examiners of the State of North Carolina issued pur-suant thereto. (7) All shareholders of a professional corporation registered hereunder must at all times be duly licensed to practice medicine in North Carolina. (8) If any licensee who is a shareholder or employee of a professional corporation ceases to be licensed by the board for any reason then his or her employment and financial interest in the corporation must be terminated forthwith. The professional corporation shall report to the board within 30 days after the occurrence the fact that any shareholder or employee has ceased to be licensed by the board. (9) Any interest in a professional corporation belonging to a deceased shareholder shall be acquired by the professional corporation, or shall be acquired by one or more persons licensed by the board. Failure to comply with the requirement within one year after the date of the death of a deceased shareholder shall be grounds for the suspension or revocation of the registration of a professional corporation. The professional corporation shall report to the board within 30 days thereafter the death of any shareholder. (10) The professional corporation shall render medical services only by or through in-dividuals licensed by the board to practice in North Carolina. (11) The professional corporation shall not render any professional service other than services involved in the practice of medicine and such services as may be ancil-lary thereto and shall not engage in business provided, however, such corporation may own real and personal property necessary or appropriate for rendering profes-sional services, and it may own interest in real estate, mortgages, stocks, bonds and other personal property for the purpose of investing its funds. xxxvi .0006 General and Administrative Provisions The following general provisions shall apply to all incorporating professional associ-ations: (1) If the secretary shall decline to execute the certificate required by 21 NCAC 32C .0003 (3), or to issue a Certificate of Registration required by 21 NCAC 32C .0004 (1), or renew the same when properly requested, or shall refuse to take any other action required of him in writing by a professional corporation, the aggrieved party may in writing request a review of such action by the board, and the board shall provide a formal hearing for such aggrieved party before the board or one of its members and such hearing shall be reported upon the request of and at the expense of the aggrieved party. (2) All amendments to and restated charters of professional corporations and all merger and consolidation agreements to which a professional corporation is a party, and all dissolution proceedings and similar changes in the corporate structure of a professional corporation, shall be filed with the secretary of the board for approval before being filed with the Secretary of State. A true copy of the changes filed with the Secretary of State shall be filed with the Secretary of the Board within 10 days after the same are filed with the Secretary of State. (3) The secretary, president or assistant secretary is authorized to issue the certificate (P. C. Form 5) required by G.S. 55B-6 when stock is transferred in a profesional corporation, and such certificate shall be permanently attached to the stub of the transferee's certificate in the stock book of the professional corporation. The fee for such certificate shall be two dollars ($2.00) for each name included in the cer-tificate. The stock books of the corporation shall be kept at the principal office of the corporation and shall be subject to the inspection by the secretary or his dele-gate during business hours at the principal office of the corporation. (4) The corporation shall furnish to the secretary from time to time such information and documents relating to the administration of these regulations as the secretary or the board may reasonably request. .0007 Forms The following single forms may be secured from the office of the Board of Medical Examiners regarding professional corporations: ( 1 ) Regulations Adopted by the Board of Medical Examiners of the State of North Car-olina Relating to Professional Corporations Organized for the Purpose of Practicing Medicine; (2) P. C. Form 1 — Certificate of Incorporators and Application for a Certificate of Registration for a Professional Corporation for the Practice of Medicine; (3) P. C. Form 2 — Certification by the Board of Medical Examiners of the State of North Carolina; (4) P. C. Form 3 — Certificate of Registration of a Professional Corporation for the Practice of Medicine; (5) P. C. Form 4 — Application for Renewal of Certificate of Registration; (6) P. C. Form 5 — Certificate Authorizing Transfer of Stock in Professional Cor-poration Organized to Practice Medicine. .0008 Fees Initial registration fee of fifty dollars ($50.00) is required. Fee for renewal of Certificate of Registration is twenty-five dollars ($25.00). Fee for authorization for transfer of stock is two dollars ($2.00). SUBCHAPTER 32D - APPROVAL OF ASSISTANT TO PHYSICIAN .0001 Definitions The term "board" as herein used refers to the Board of Medical Examiners of the State of North Carolina. The term "secretary" as herein used refers to the Executive Secretary of the Board of Medical Examiners of the State of North Carolina. The term "assistant to a physician" as herein used refers to auxilliary, paramedical personnel who are functioning in a dependent relationship with a physician licensed by xxxvn the board and who are performing tasks or combinations of tasks traditionally performed by the physician himself. Examples of such tasks would include history taking, physi-cal examination, and treatment, such as the application of a cast. The regulations are not intended to cover or in any way prejudice the activities of assistants not engaged in direct patient contact or the performance of assistants with tasks well-defined by statute or recognized custom of medical practice. The term "applicant" as herein used refers to the assistant upon whose behalf an ap-plication is submitted. The term "supervision" is defined by the North Carolina Board of Medical Examiners as incorporating physician backup to assistants to physicians performing medical acts in the following ways: (1) Continuous availability of direct communications by radio, telephone or telecom-munications; (2) The backup physician shall be available on regularly scheduled basis for: (a) referrals; (b) review of their practice between conferences incorporating: (i) consultation; (ii) chart review and co-signing records to document accountability: (A) daily chart review except for situations that might be given individual consideration; (B) prescribing within that practice setting, standing orders and drug pro-tocol for interval between conferences to be part of this regular re-view and documentation; (iii) continuing education; (3) A predetermined plan for emergency services. .0002 Application for Approval Application for approval of an assistant must be made upon forms supplied by the board and must be submitted by the physician with whom the assistant will work and who will assume responsibility for the assistant's performance. Application forms submitted to the board must be completed in every detail. Every supporting document required by the application form must be submitted with each ap-plication. If for any reason an assistant discontinues working at the direction or under the su-pervision of the physician who submitted the application under which the assistant is approved, such assistant shall so inform the board and his approval shall terminate un-til such time as a new application is submitted by the same or another physician and it is approved by the board. When the proposed medical functions of an assistant to a physician shall include the prescribing of drugs, the supervising (backup) physician and the assistant shall review the formulary approved by the board, and shall acknowledge in the application to the board that they are familiar with the formulary and that such formulary will be a part of and incorporated in the approved standing orders. Changes in the formulary are to be approved by the board. In regard to changes the approved formulary may include any over-the-counter or non-prescription drug. Prescriptions, except controlled substances, may upon specific orders of the super-vising physician given before the prescription is issued, be written and issued by such assistant for the use by patients of drugs which are not included in the formulary. Such prescriptions shall be signed by the assistant with a notation thereon that the same was issued upon the specific order of the supervising physician. For example: Mary Smith, P. A., on order of John Poe, M.D. However, no prescription shall be written or issued by such assistant for any drugs which are specified as controlled substances under the Federal Controlled Substances Act. Assistants to physicians who are approved to prescribe drugs as herein provided shall be assigned a number which shall appear on all prescriptions issued by such assistant. The names and numbers of such assistants shall be recorded and transmitted to the North Carolina Board of Pharmacy. .0003 Requirements for Approval Before being approved by the board to perform as an assistant to a physician, an ap-plicant shall: ( 1 ) be of good moral character and have satisfied the requirements of 2 1 NCAC 32D .0004 hereof; xxxvin (2) give evidence that he has successfully completed a training program recognized by the board under 21 NCAC 32D .0005 hereof. Initial approval may be denied for any of the reasons set forth in 21 NCAC 32D .0006, Paragraph (1), hereof, as grounds for termination of approval, as well as for failure to satisfy the board of the qualifications cited in Paragraph (1) of this Rule. In hearings held pursuant to this Rule, the board shall admit and hear evidence in the same manner and form as prescribed by law for civil actions. .0004 Moral Character Every applicant shall be of good moral character, and the applicant shall have the bur-den of proving that he is possessed of good moral character. All information furnished to the board by an applicant, and all answers and questions upon forms furnished by the board shall be deemed material and such forms and infor-mation shall be and become a permanent record of the board. All investigations in reference to the moral character of an applicant may be infor-mal, but shall be thorough, with the object of ascertaining the truth. Neither the hear-say rule, nor any other technical rule of evidence need be observed. Every applicant may be required to appear before the board to be examined about any matter pertaining to his moral character. .0005 Requirements for Recognition of Training Programs Application for recognition of a training program by the board shall be made by let-ter and supporting documents from the director of the program and must demonstrate to the satisfaction of the board that such program fulfills the requirements set forth in the second through the eighth paragraph of this Rule. (All physicians' assistant programs approved by the American Medical Association Council on Medical Education are recog-nized by the board.) The training program must be sponsored by a college or university with appropriate arrangements for the clinical training of its students, such as a hospital maintaining a teaching program. There must be evidence that the program has education as its pri-mary orientation and objective. The program must be under the supervision of a qualified director, who has at his disposal the resources of competent personnel adequately trained in the administration and operation of educational programs. Adequate space, light and modern equipment must be provided for all necessary teach-ing functions. A library, containing up-to-date textbooks, scientific periodicals, and ref-erence material pertaining to clinical medicine, its underlying scientific disciplines, and its specialties, shall be readily accessible to students and faculty. The curriculum must provide adequate instruction in the basic sciences underlying the medical practice to provide the trainee with an understanding of the nature of dis-ease processes and symptoms, abnormal tests, drug actions, etc. This must be combined with instruction, observation and participation in history taking, physical examination, therapeutic procedures, etc. This should be in sufficient depth to enable the graduate to integrate and organize historical and physical findings. The didactic instruction shall follow a planned and progressive outline and shall include an appropriate mixture of classroom lectures, textbook assignments, discussions, demonstrations, and similar ac-tivities. Instruction shall include practical instruction and clinical experience under quali-fied supervision sufficient to provide understanding of a skill in performing those clin-ical functions which the assistant may be asked to perform. There must be sufficient evaluative procedures to assure adequate evidence of competence. Although the student may concentrate his effort and his interest in a particular specialty of medicine, the pro-gram must insure that he possesses a broad general understanding of medical practice and therapeutic techniques. Although some variation may be possible for the individual student, dependent on ap-titude, previous education, and experience, the curriculum shall be designed to require two or more academic years for completion. The program must have a faculty competent to teach the didactic and clinical mate-rial which comprises the curriculum. The faculty shall include at least one instructor who is a graduate of medicine, licensed to practice in the location of the school, and whose training and experience enable him to properly supervise progress and teaching in clinical subjects. He shall be in attendance for sufficient time to insure proper exposure of the student to clinical teaching and practice. The program may utilize instuctors other than XXXIX physicians, but sufficient exposure to clinical medicine must be provided to insure un-derstanding of the patient, his problem, and the diagnostic and therapeutic responses to this problem. The program must, through appropriate entrance requirements, insure that candidates accepted for training possess: (1) ability to use written and spoken language in effec-tive communication with physicians, patients, and others; (2) quantification skills to in-sure proper calculation and interpretation of tests; (3) behavioral characteristics of hon-esty and dependability; and (4) high ethical and moral standards, in order to safeguard the interest of patients and others. To retain its recognition by the board, a recognized program shall: (a) make available to the board yearly summaries of case loads and educational ac-tivities done by clinical affiliates, including volume of outpatient visits, number of inpatients, and the operating budget; (b) maintain a satisfactory record of the entrance qualifications and evaluations of all work done by each student, which shall be available to the board; and (c) notify the board in writing of any major changes in the curriculum or a change in the directorship of the program. Recognition of a program may be withdrawn when, in the opinion of the board, the program fails to maintain the educational standards described above. When a program has not been in operation for a period of two consecutive years, recognition will auto-matically be withdrawn. Withdrawal of recognition from a program will in no way af-fect the status of an assistant who graduated from such program while it was recognized and who has been approved by the board. .0006 Termination of Approval The approval of an assistant shall be terminated by the board when, after due notice and hearing in accordance with the provisions of this Rule, it shall find: (1) that the assistant has held himself out or permitted another to represent him as a licensed physician; (2) that the assistant has in fact performed otherwise than at the direction or under the supervision of a physician licensed by the board; (3) that the applicant has been required to perform, or has performed, a medical task or tasks, function or functions for which the applicant is not approved or for which the applicant is not qualified by training to perform including prescribing or dis-pensing of drugs not included in the approved formulary; or (4) that the assistant is a habitual user of intoxicants or drugs to such extent that he is unable to perform as an assistant to the physician; (5) that the assistant has been convicted in any court, state or federal, of any felony or other criminal offense involving moral turpitude; (6) that the assistant has been adjudicated a mental incompetent or whose mental con-dition renders him unable to safely perform as an assistant to a physician; or (7) that the assistant has failed to comply with any of the provisions of 21 NCAC 32D .0007 hereof. Before the board shall terminate approval granted by it to an assistant it will give to the assistant and to the physician to whom he is certified a written notice indicating the general nature of the charges, accusation, or complaint preferred against him and stat-ing that the assistant will be given an opportunity to be heard concerning such charges or complaints at a time and place stated in such notice, or to be thereafter fixed by the board, and shall hold a public hearing within a reasonable time. Following such hear-ing, the board shall determine on these regulations whether the approval of the assis-tant shall be terminated. In hearings held pursuant to this Rule, the board shall admit and hear evidence in the same manner and form as prescribed by law for civil actions. .0007 Method of Performance An assistant must clearly identify himself as an assistant to a physician, a physician's assistant, or by some other appropriate designation, in order to insure that he is not mis-taken for a licensed physician. This may be accomplished, for example, by the wear-ing of an appropriate name tag. The assistant must generally function in reasonable proximity to the physician. If he is to perform duties away from the responsible physician, such physician must clearly xl specify to the board those circumstances which would justify this action and the writ-ten policies established to protect the patient. The assistant must be prepared to demonstrate upon request to a member of the board or to other persons designated by the board, his ability to perform those tasks assigned to him by his responsible physician. .0008 Fees Fee of one hundred dollars ($100.00) must be paid at the time of the application for approval. Fee for annual registration, due July 1, is twenty-five dollars ($25.00). No portion of the above fees is refundable. .0009 Forms The following forms may be secured from the office of the Board of Medical Ex-aminers regarding approval for assistants to physicians: (1) Rules and Regulations for an Assistant to a Physician; (2) Application for Approval as an Assistant to a Physician; (3) Formulary; (4) Statement of Approval, upon being approved; (5) Notice of Registration; (6) Certificate of Registration, upon registering. SUBCHAPTER 32E - APPROVAL OF REGISTERED NURSE PERFORMING MEDICAL ACTS .0001 Definitions The term "board" as used herein refers to the Board of Medical Examiners of the State of North Carolina. The term "secretary" as used herein refers to the Executive Secr
Object Description
Description
Title | Roster of registered physicians in the State of North Carolina |
Date | 1988 |
Publisher | [Raleigh, N.C.] : Board of Medical Examiners |
Rights | State Document see http://digital.ncdcr.gov/u?/p249901coll22,63754 |
Collection | North Carolina State Documents Collection. State Library of North Carolina |
Type | text |
Language | English |
Digital Characteristics-A | 628 p.; 43.96 MB |
Digital Format | application/pdf |
Pres File Name-M | pubs_pubh_serial_rosterregistered1988.pdf |
Pres Local File Path-M | Preservation_content\StatePubs\pubs_pubh\images_master\ |
Full Text | Til 15: AW c.a N.C. DOCUMENTS CLEARINGHOUSE SEP 1 1988 ROSTER OF N.C. STATE LIBRARY RALEIGH Registered Physicians IN THE State of North Carolina March 1, 1988 ISSUED BY BOARD OF MEDICAL EXAMINERS OF THE STATE OF NORTH CAROLINA ROSTER OF Registered Physicians IN THE State of North Carolina ^c********** ISSUED BY BOARD OF MEDICAL EXAMINERS OF THE STATE OF NORTH CAROLINA Board of Medical Examiners of the State of North Carolina Eben Alexander, Jr., M.D., President John Thomas Daniel, Jr., M.D., Secretary Bryant D. Paris, Jr., Executive Secretary MEMBERS Eben Alexander, Jr., M.D., Winston-Salem John Thomas Daniel, Jr., M.D., Durham Charles H. Duckett, M.D., Greenville Harold L. Godwin, M.D., Fayetteville Hector Himel Henry, II, M.D., Concord F.M. Simmons Patterson, Jr., M.D., Pinehurst Nicholas E. Stratas, M.D., Raleigh Kathryn Howell Willis, Zirconia FOREWORD This roster is issued by the Board of Medical Examiners of the State of North Carolina. REGISTRATION REQUIRED AS FOLLOWS: Physicians — January 1 every even-numbered year Resident's Training Licenses — January 1 every even-numbered year Professional Corporations — January 1 every even-numbered year Physician Assistants — July 1 annually Nurse Practitioners — July 1 annually The names of all physicians who are licensed to practice medicine in the State of North Carolina who are currently registered with the Board of Medical Examiners of the State of North Carolina on March 1, 1988, are included in this roster. The names of physicians who hold resident's training licenses to practice medicine in specified institutions in the state are not included in this roster. Any information pertaining to omissions or corrections should be brought to the attention of the Board. Bryant D. Paris, Jr., Executive Secretary Board of Medical Examiners of the State of North Carolina 1313 Navaho Drive Raleigh, North Carolina 27609 Telephone (919) 876-3885 in TABLE OF CONTENTS Foreword iii Do's and Don'ts for Physicians v Laws of North Carolina Relating to the Practice of Medicine vii North Carolina Administrative Code (Regulations of the Board) xxi Explanation of Specialty Codes liv Registered Physicians Listed Alphabetically 1 Registered Professional Corporations Listed Alphabetically 540 IV DO'S AND DON'TS FOR PHYSICIANS Practice Suggestions: 1. Use as much care in writing pre-scriptions as you would use in writing personal checks. Specify amounts and do not leave spaces for x's or o's to be added to raise the amount. 2. Do not leave your personal prescrip-tion pads in positions accessible to the public. 3. Do not leave signed, blank prescrip-tion pads in your office. 4. Do not write prescriptions for large quantities of Schedule 2 or 2N con-trolled substances. 5. Do not prescribe controlled sub-stances without seeing the patient. 6. When you receive a call from a pharmacist requesting information about prescriptions you have writ-ten, respond courteously as, by law, a pharmacist is responsible for any forged prescription he fills. 7. Write a prescription for only one substance on each blank. 8. Do not prescribe for yourself or members of your family. Treating one's family is not illegal; but the Board wishes to remind you that such prescribing practices may lead to problems. Written records of all prescriptions for controlled sub-stances and the medical indications for them should be maintained, but in many instances such recording is neglected. Also, any prescriptions issued should be within the scope of your normal medical practice. The Board urges you to delegate the medical care for yourself and mem-bers of your family to one or more of your colleagues in order to pre-clude involvement with govern-mental regulatory agencies who monitor physicians' prescribing practices. 9. Do not prescribe amphetamines or central nervous system stimulants for weight control. In 1972, the N.C. Medical Society adopted a resolution which is supported by the Board of Medical Examiners that '*. . . the members of the N.C. Medical Soci-ety use no amphetamines or meth-amphetamines for appetite control and that the use of these drugs be restricted to the treatment of nar-colepsy, hyperkinetic children and other disorders which in the opinion of the patient's physician will be beneficial . ' ' 10. Do not carry large stocks of con-trolled substances in your bag. Ad-dicts look for these in physicians' offices and cars. 11. If DEA numbers are printed on prescriptions, they should be incom-plete and completed only when the physician validates and signs the prescriptions. LAWS OR REGULATIONS: 1. Sign prescriptions legibly in ink, never in pencil. The body of the prescription must be written legibly in ink or typewritten. 2. Prescriptions must contain the fol-lowing information: full name and DEA # of prescribing physician; name, address and telephone num-ber of prescribing physician's prac-tice; indication of either "product selection permitted" or "dispense as written"; and full name and address of patient. 3. Only in emergency situations should you request pharmacists to fill prescriptions for Schedule 2 or 2N prescriptions over the telephone. 4. Prescribe controlled substances to drug dependent persons only under provisions regulated by law. 5. Dispense controlled substances, in-cluding samples, only when dispens-ing records are maintained for two or more years and containers with safety closure caps are properly labelled according to law. Physi-cians shall maintain a readily retriev-able record of all controlled sub-stances dispensed (or administered) whether or not the practitioner charges the patient for the controlled substance, including samples. 6. Do not write prescriptions for con-trolled substances for office use. The law requires that you purchase Schedule 2 and 2N controlled sub-stances for your office on official order forms obtained from DEA. Schedule 3-5 drugs must be obtained through a wholesale distributor by means of a requisition. 7. Maintain security for any controlled substances including samples. 8. Take a biennial inventory of all con-trolled substances including sam-ples. 9. Before disposing of used syringes or needles, render them inoperative. 10. The destruction of an outdated or un-wanted controlled substance by a physician or his authorized agent shall be witnessed by a federal or state official who is authorized to en-force the Federal or State Controlled Substances Act. Suggested reference material regarding prescribing laws: Code of Federal Regulations, Title 21 of the U.S. Food and Drug Act, Part 1300 to End - published by Superintendent of Documents, U.S. Government Printing Office, Washington, D.C. 20402. North Carolina Controlled Substances Act and Regulations - published by the N.C. Drug Commission, N.C. Department of Human Resources, P.O. Box 19324, Raleigh, N.C. 27619. Below is a listing of addresses and telephone numbers that may be useful to you. Please feel free to write or telephone the North Carolina Drug Commission for additional in-formation pertaining to drug laws and rules and regulations at any time you have a need. N.C. Drug Commission P.O. Box 19324 Raleigh, N.C. 27619 Telephone: (919)733-4555 N.C. Board of Pharmacy P.O. Box H Carrboro, N.C. 27510 Telephone: (919)942-4454 Drug Enforcement Administration 75 Spring St, Suite 740 Atlanta, GA 30303 Telephone: (404)331-7328 State Bureau of Investigation 1150MaynardRd. Suite 101 Cary, N.C. 27511 Telephone: (919)733-4311 DEA 2300 W. Meadowview Rd. Greensboro, N.C. 27401 Telephone: (919)378-5203 Suite 224 VI LAWS OF NORTH CAROLINA RELATING TO THE PRACTICE OF MEDICINE (Including Amendments of 1987) § 90-1. North Carolina Medical Society Incorporated. — The association of regularly graduated physicians, calling themselves the state Medical Society, is hereby declared to be a body politic and corporate, to be known and distinguished by the name of The Medical Society of the State of North Carolina. The name of the society is now the North Carolina Medical Society. § 90-2. Board of Medical Examiners. — (a) In order to properly regulate the practice of medicine and surgery, there is established a Board of Medical Examiners of the State of North Carolina. The Board shall consist of eight members. Seven of the members shall be duly licensed physicians elected and nominated to the Governor by the North Carolina Medical Society. The other member shall be a person chosen by the Governor to represent the public at large. The public member shall not be a health care provider nor the spouse of a health care provider. For purposes of board membership, "health care provider" means any licensed health care professional and any agent or employee of any health care institution, health care insurer, health care professional school, or a member of any allied health profession. For purposes of this section, a person enrolled in a program to prepare him to be a licensed health care professional or an allied health professional shall be deemed a health care provider. For purposes of this section, any person with significant financial interest in a health service or profession is not a public member. (b) No member appointed to the Board on or after November 1, 1981, shall serve more than two complete consecutive three-year terms, except that each member shall serve until his successor is chosen and qualifies. (c) In order to establish regularly overlapping terms, the terms of office of the members currently serving on the Board shall expire as follows: two on October 31, 1982; two on October 31, 1984; three on October 31, 1986. Terms of Board members shall expire in direct relation to their date of appointment by the society; the terms of the two members first appointed shall expire in 1982, and the terms of the three members last appointed shall expire in 1986. No initial physician member of the Board may serve another term until at least three years from the date of expiration of his current term. The Governor shall appoint the public member not later than October 31, 1981. (d) Any initial or regular member of the Board may be removed from office by the Governor for good cause shown. Any vacancy in the initial or regular physician membership of the Board shall be filled for the period of the unexpired term by the Governor from a list of physicians submitted by the North Carolina Medical Society Executive Council. Any vacancy in the public membership of the Board shall be filled by the Governor for the unexpired term. § 90-3. Medical Society nominates Board. — The Governor shall appoint as physician members of the Board physicians elected and nominated by the North Carolina Medical Society. § 90-4. Board elects officers; quorum. — The Board of Medical Examiners is authorized to elect all officers and adopt all bylaws as may be necessary. A majority of the membership of the Board shall constitute a quorum for the transaction of business. VII § 90-5. Meetings of Board. — The Board of Medical Examiners shall assemble once in every year in the City of Raleigh, and shall remain in session from day to day until all applicants who may present themselves for examination within the first two days of this meeting have been examined and disposed of; other meetings in each year may be held at some suitable point in the State if deemed advisable. § 90-6. Regulations governing applicants for license, examination, etc.; appointment of subcommittee. — The Board of Medical Examiners is empowered to prescribe such regulations as it may deem proper, governing applicants for license, admission to examinations, the conduct of applicants during examinations, and the conduct of examinations proper. The Board of Medical Examiners shall appoint and maintain a subcommittee to work jointly with a subcommittee of the Board of Nursing to develop rules and regulations to govern the performance of medical acts by registered nurses, including the determination of reasonable fees to accompany an application for approval not to exceed one hundred dollars ($100.00) and for renewal of such approval not to exceed fifty dollars ($50.00). The fee for reactivation of an inactive incomplete application shall be five dollars ($5.00). Rules and regulations developed by this subcommittee from time to time shall govern the performance of medical acts by registered nurses and shall become effective when adopted by both the Board of Medical Examiners and the Board of Nursing. The Board of Medical Examiners shall have responsibility for securing compliance with these regulations. § 90-7. Bond of secretary. — The secretary of the Board of Medical Examiners shall give bond with good surety, to the president of the Board, for the safekeeping and proper payment of all moneys that may come into his hands. § 90.8 Officers may administer oaths, and subpeona witnesses, records and other materials. — The president and secretary of the Board may administer oaths to all per-sons appearing before it as the board may deem necessary to perform its duties, and to summon and to issue subpoenas for the appearance of any witnesses deemed neces-sary to testify concerning any matter to be heard before or inquired into by the Board, and to order that any documents or other material concerning any matter to be heard before or inquired into by the Board shall be produced before the Board or made avail-able for inspection. Upon written request, the Board shall revoke a subpoena if, upon a hearing, it finds that the evidence the production of which is required does not relate to a matter in issue, or if the subpoena does not describe with sufficient particularity the evidence the production of which is required, or if for any other reason in law the subpoena is invalid. § 90-9. Examination for license; scope; conditions and prerequisites. — It shall be the duty of the Board of Medical Examiners to examine for license to practice medicine or surgery, or any of the branches thereof, every applicant who complies with the following provisions: He shall, before he is admitted to examination, satisfy the Board that he has an academic education equal to the entrance requirements of the University of North Carolina, or furnish a certificate from the superintendent of public instruction of the county that he has passed an examination upon his literary attainments to meet the requirements of entrance in the regular course of the State University. He shall exhibit a diploma or furnish satisfactory proof of graduation from a medical college or an osteopathic college approved by the American Osteopathic Association at the time of his graduation, which time of graduation shall have been on January 1, 1960, or subsequent thereto and which medical and osteopathic schools shall require an attendance of not less than four years or for a lesser period of time approved by the Board, and supply such facilities for clinical and scientific instruction as shall meet the approval of the Board. An applicant shall have graduated from a medical college approved by the Liaison Commission on Medical Education or osteopathic college that has been approved by the American Osteopathic Association; or, if he was graduated from any other medical or osteopathic college, the applicant shall be enrolled in a graduate medical education and training program in North Vlll Carolina which has been approved by the Board. An applicant who has graduated from a medical college not approved by the Liaison Commission on Medical Education or osteopathic college that has not been approved by the American Osteopathic Association and who has not enrolled in a graduate medical education and training program in North Carolina which has been approved by the Board shall satisfy the Board that he has successfully completed three years of graduate medical education in a training program approved by the Board. No applicant from a medical or osteopathic college which has been disapproved by the Board shall be eligible to take the examination. The examination shall cover the branches of medical science and subjects which the Board deems necessary to determine competence to practice medicine. The Board may divide the examination into parts or components. If the applicant successfully passes the examination, as determined by the Board, and if the applicant satisfies the Board that he is of good moral character and that either, (1) if the applicant is a graduate of a medical college approved by the Liaison Commission on Medical Education or osteopathic college approved by the American Osteopathic Association, he has successfully completed one year of training in a medical education program approved by the Board after graduation from medical school; or (2) if the applicant is a graduate of a medical college that has not been approved by the Liaison Commission on Medical Education or osteopathic college that has not been approved by the American Osteopathic Association, he has successfully completed three years of training in a medical education program approved by the Board after graduation from medical school, then the Board shall grant the applicant a license authorizing him to practice medicine in any of its branches. Applicants shall be examined by number only; names and other identifying information shall not appear on examination papers. § 90-10. Provision in lieu of examination. — In lieu of the above examination, the Board may grant a license to an applicant who is found to have passed the examination given by the National Board of Medical Examiners, or who has passed such other examination which the Board deems to be equivalent to the examination given by the Board, provided the applicant meets the other qualifications set forth in this Article. § 90-11. Qualifications of applicant for license. — Every applicant for a license to practice medicine or for approval to perform medical acts in the State shall satisfy the Board of Medical Examiners that such applicant is of good moral character and meets the other qualifications for the issuance of such a license or for such approval before any such license or approval is granted by the Board to such applicant. § 90-12. Limited license. — The Board may, whenever in its opinion the conditions of the locality where the applicant resides are such as to render it advisable, make such modifications of the requirements of G.S. 90-9, 90-10, and 90-11 as in its judgment the interests of the people living in that locality may demand, and may issue to such applicant a special license, to be entitled a "Limited License," authorizing the holder thereof to practice medicine and surgery within the limits only of the districts specifically described therein. The holder of the limited license practicing medicine or surgery beyond the boundaries of the districts as laid down in said license shall be guilty of a misdemeanor, and upon conviction shall be fined not less than twenty-five dollars ($25.00) nor more than fifty dollars ($50.00) for each and every offense; and the Board is empowered to revoke such limited license, in its discretion, after due notice. § 90-13. When license without examination allowed. — The Board of Medical Examiners shall in their discretion issue a license to any applicant to practice medicine and surgery in this State without examination if said applicant exhibits a diploma or satisfactory proof of graduation from a medical or osteopathic college, approved as provided in G.S. 90-9 and requiring an attendance of not less than four years or for such lesser period of time approved by the Board, and a license issued to him to practice medicine and surgery by the IX Board of Medical Examiners of another state, and has successfully completed one year of training after his graduation from medical college in a medical education and training program approved by the Board, in which program the Board may permit him to practice medicine. An applicant for licensing under this section who was graduated from a medical college not approved by the Liaison Commission on Medical Education or osteopathic college that has not been approved by the American Osteopathic Association shall have successfully completed three years of training in a medical education and training program approved by the Board after graduation. The Board may grant a license under this section for any period of time and with any conditions it deems appropriate. No license may be granted to any applicant who was graduated from a medical or osteopathic college which has been disapproved by the Board. § 90-14. Revocation, suspension, annulment or denial of license. — (a) The Board shall have the power to deny, annul, suspend, or revoke a license, or other authority to practice medicine in this State, issued by the Board to any person who has been found by the Board to have committed any of the following acts or conduct, or for any of the following reasons: (1) Immoral or dishonorable conduct; (2) Producing or attempting to produce an abortion contrary to law; (3) Made false statements or representations to the Board, or who has willfully concealed from the Board material information in con-nection with his application for a license; (4) Repealed by Session Laws 1977, c. 838, s, 3. (5) Being unable to practice medicine with reasonable skill and safety to patients by reason of illness, drunkeness, excessive use of alcohol, drugs, chemicals, or any other type of material or by reason of any physical or mental abnormality. The Board is empowered and authorized to require a physician licensed by it to submit to a mental or physical examination by physicians designated by the Board before or after charges may be presented against him, and the results of examination shall be admissible in evidence in a hearing before the Board; (6) Unprofessional conduct, including, but not limited to, any departure from, or the failure to conform to, the standards of acceptable and prevailing medical practice, or the ethics of the medical profession, irrespective of whether or not a patient is injured thereby, or the committing of any act contrary to honesty, justice, or good morals, whether the same is committed in the course of his practice or otherwise, and whether committed within or without North Carolina; (7) Conviction in any court of a crime involving moral turpitude, or the vio-lation of a law involving the practice of medicine, or a conviction of a felony; provided that a felony conviction shall be treated as provided in sub-section (c) of this section; (8) By false representations has obtained or attempted to obtain practice, money or anything of value; (9) Has advertised or publicly professed to treat human ailments under a system of school of treatment or practice other than that for which he has been educated; (10) Adjudication of mental incompetency, which shall automatically suspend a license unless the Board orders otherwise; (11) Lack of professional competence to practice medicine with a reasonable degree of skill and safety for patients. In this connection the Board may consider repeated acts of a physician indicating his failure to properly treat a patient and may require such physician to submit to inquiries or examinations, written or oral, by members of the Board or by other physicians licensed to practice medicine in this State, as the Board deems necessary to determine the professional qualifications of such licensee; (12) Promotion of the sale of drugs, devices, appliances or goods for a patient, or providing services to a patient, in such a manner as to exploit the pa-tient for financial gain of the physician; and upon a finding of the exploi- tation for financial gain, the Board may order restitution be made to the payer of the bill, whether the patient or the insurer, by the physician; pro-vided that a determination of the amount of restitution shall be based on credible testimony in the record; (13) Suspension or revocation of a license to practice medicine in any other state, or territory of the United States, or other country. (14) The failure to respond, within a reasonable period of time and in a reasona-ble manner as determined by the Board, to inquiries from the Board con-cerning any matter affecting the license to practice medicine. For any of the foregoing reasons, the Board may deny the issuance of a license to an applicant or revoke a license issued to him, may suspend such a license for a period of time, and may impose conditions upon the continued practice after such period of suspension as the Board may deem advisable, may limit the accused physician's practice of medicine with respect to the extent, nature or location of his practice as the Board deems advisable. The Board may, in its discretion and upon such terms and conditions and for such period of time as it may prescribe, restore a license so revoked or rescinded. (b) The Board shall refer to the State Medical Society Physician Health and Effec-tiveness Committee all physicians whose health and effectiveness have been sig-nificantly impaired by alcohol, drug addiction or mental illness. (c) A felony conviction shall result in the automatic revocation of a license issued by the Board, unless the Board orders otherwise or receives a request for a hearing from the person within 60 days of receiving notice from the Board, after the con-viction, of the provisions of this subsection. If the Board receives a timely re-quest for a hearing in such a case, the provisions of G.S. 90-14.2 shall be fol-lowed. (d) The Board and its members and staff may release confidential or nonpublic in-formation to any health care licensure board in this State or another state about the issuance, denial, annulment, suspension, or revocation of a license, or the voluntary surrender of a license by a Board-licensed physician, including the rea-sons for the action, or an investigative report made by the Board. The Board shall notify the physician within 60 days after the information is transmitted. A sum-mary of the information that is being transmitted shall be furnished to the physi-cian. If the physician requests, in writing, within 30 days after being notified that such information has been transmitted, he shall be furnished a copy of all infor-mation so transmitted. The notice or copies of the information shall not be pro-vided if the information relates to an ongoing criminal investigation by any law-enforcement agency, or authorized Department of Human Resources personnel with enforcement or investigative responsibilities. (e) The Board and its members and staff shall not be held liable in any civil or criminal proceeding for exercising, in good faith, the powers and duties authorized by law. § 90-14.1. Judicial review of Board's decision denying issuance of a license. — Whenever the Board of Medical Examiners has determined that a person who has duly made application to take an examination to be given by the Board showing his education, training and other qualifications required by said Board, or that a person who has taken and passed an examination given by the Board, has failed to satisfy the Board of his qualifications to be examined or to be issued a license, for any cause other than failure to pass an examination, the Board shall immediately notify such person of its decision, and indicate in what respect the applicant has so failed to satisfy the Board. Such applicant shall be given a formal hearing before the Board upon request of such applicant filed with or mailed by registered mail to the secretary of the Board at Raleigh, North Carolina, within 10 days after receipt of the Board's decision, stating the reasons for such request. The Board shall within 20 days of receipt of such request notify such applicant of the time and place of a public hearing, which shall be held within a reasonable time. The burden of satisfying the Board of his qualifications for licensure shall be upon the applicant. Following such hearing, the Board shall determine whether the applicant is qualified to be examined or is entitled to be licensed as the case may be. Any such decision of the Board shall be subject to judicial review upon appeal to the Superior Court of Wake County upon the filing with the Board of a written notice of appeal with exceptions taken to the decision XI of the Board within 20 days after service of notice of the Board's final decision. Within 30 days after receipt of notice of appeal, the secretary of the Board shall certify to the clerk of the Superior Court of Wake County the record of the case which shall include a copy of the notice of hearing, a transcript of the testimony and evidence received at the hearing, a copy of the decision of the Board, and a copy of the notice of appeal and exceptions. Upon appeal the case shall be heard by the judge without a jury, upon the record, except that in cases of alleged omissions or errors in the record, testimony may be taken by the court. The decision of the Board shall be upheld unless the substantial rights of the applicant have been prejudiced because the decision of the Board is in violation of law or is not supported by any evidence admissible under this Article, or is arbitrary or capricious. Each party to the review proceeding may appeal to the Supreme Court as hereinafter provided in G.S. 90-14.1 1. § 90- 1 4.2. Hearings before revocation or suspension of a license. — Before the Board shall revoke, restrict or suspend any license granted by it, the licensee shall be given a written notice indicating the general nature of the charges, accusation, or complaint made against him, which notice may be prepared by a committee of one or more members of the Board designated by the Board, and stating that such licensee will be given an opportunity to be heard concerning such charges or complaint at a time and place stated in such notice, or at a time and place to be thereafter designated by the Board, and the Board shall hold a public hearing not less than 30 days from the date of the service of such notice upon such licensee, at which such licensee may appear personally and through counsel, may cross-examine witnesses and present evidence in his own behalf. A physician who is mentally incompetent shall be represented at such hearing and shall be served with notice as herein provided by and through a guardian ad litem appointed by the clerk of the court of the county in which the physician has his residence. Such licensee or physician may, if he desires, file written answers to the charges or complaints preferred against him within 30 days after the service of such notice, which answer shall become a part of the record but shall not constitute evidence in the case. § 90-14.3. Service of notices. — Any notice required by this Chapter may be served either personally or by an officer authorized by law to serve process, or by registered mail, return receipt requested, directed to the licensee or applicant at his last known address as shown by the records of the Board. If notice is served personally, it shall be deemed to have been served at the time when the officer delivers the notice to the person addressed. Where notice is served by registered mail, it shall be deemed to have been served on the date borne by the return receipt showing delivery of the notice to addressee or refusal of the addressee to accept the notice. § 90-14.4. Place of hearings for revocation or suspension of license. — Upon written request of the accused physician to the secretary of the Board within 20 days after service of the charges or complaints against him, a hearing for the purpose of determining revocation or suspension of his license shall be conducted in the county in which such physician maintains his residence, or at the election of the Board, in any county in which the act or acts complained of occurred. In the absence of such request, the hearing shall be held at a place designated by the Board, or as agreed upon by the physician and the Board. § 90-14.5. Use of trial examiner or depositions. — Where the licensee requests that the hearing herein provided for be held by the Board in a county other than the county designated for the holding of the meeting of the Board at which the matter is to be heard, the Board may designate in writing one or more of its members to conduct the hearing as a trial examiner or trial committee, to take evidence and report a written transcript thereof to the Board at a meeting where a majority of the members are present and participating in the decision. Evidence and testimony may also be presented at such hearings and to the Board in the form of depositions taken before any person designated in writing by the Board for such purpose or before any person authorized to administer oaths, in accordance with the procedure for the taking of depositions in civil actions in the superior court. xn § 90-14.6 Evidence admissible. — In proceedings held pursuant to this Article the Board shall admit and hear evidence in the same manner and form as prescribed by law for civil actions. A complete record of such evidence shall be made, together with the other proceedings incident to such hearing. § 90-14.7. Procedure where person fails to request or appear for hearing. — If a person who has requested a hearing does not appear, and no continuance has been granted, the Board or its trial examiner or committee may hear the evidence of such witnesses as may have appeared, and the Board may proceed to consider the matter and dispose of it on the basis of the evidence before it. For good cause, the Board may reopen any case for further hearing. § 90-14.8. Appeal from Board's decision revoking or suspending a license. — A physician whose license is revoked or suspended by the Board may obtain a review of the decision of the Board in the Superior Court of Wake County or in the superior court in the county in which the hearing was held or upon agreement of the parties to the appeal in any other superior court of the State, upon filing with the secretary of the Board a written notice of appeal within 20 days after the date of the service of the decision of the Board, stating all exceptions taken to the decision of the Board and indicating the court in which the appeal is to be heard. Within 30 days after the receipt of a notice of appeal as herein provided, the Board shall prepare, certify and file with the clerk of the superior court in the county to which the appeal is directed the record of the case comprising a copy of the charges, notice of hearing, transcript of testimony, and copies of documents or other written evidence produced at the hearing, decision of the Board, and notice of appeal containing exceptions to the decision of the Board. § 90-14.9. Appeal bond; stay of Board order. — The person seeking the review shall file with the clerk of the reviewing court a copy of the notice of appeal and an appeal bond of two hundred dollars ($200.00) at the same time the notice of appeal is filed with the Board. At any time before or during the review proceeding the aggrieved person may apply to the reviewing court for an order staying the operation of the Board decision pending the outcome of the review, which the court may grant or deny in its discretion. § 90-14.10. Scope of review. — Upon the review of the Board's decision revoking or suspending a license, the case shall be heard by the judge without a jury, upon the record, except that in cases of alleged omissions or errors in the record, testimony thereon may be taken by the court. The court may affirm the decision of the Board or remand the case for further proceedings; or it may reverse or modify the decision if the substantial rights of the accused physician have been prejudiced because the findings or decisions of the Board are in violation of substantive or procedural law, or are not supported by competent, material, and substantial evidence admissible under this Article, or are arbitrary or capricious. At any time after the notice of appeal has been filed, the court may remand the case to the Board for the hearing of any additional evidence which is material and is not cumulative and which could not reasonably have been presented at the hearing before the Board. § 90-14.11. Appeal to Supreme Court; appeal bond. — Any party to the review proceeding, including the Board, may appeal to the Supreme Court from the decision of the superior court under rules of procedure applicable in other civil cases. No appeal bond shall be required of the Board. The appealing party may apply to the superior court for a stay of that court's decision or a stay of the Board's decision, whichever shall be appropriate, pending the outcome of the appeal to the Supreme Court. § 90-14.12. Injunctions. — The Board may appear in its own name in the superior courts in an action for injunctive relief to prevent violation of this Article and the superior courts shall have power to grant such injunctions regardless of whether criminal prosecution has been or may be instituted as a result of such violations. Actions under this section shall be commenced in the judicial district in Xlll which the respondent resides or has his principal place of business or in which the alleged acts occurred. § 90-14.13. Reports of disciplinary action by health care insitutions; immunity from liability. — The chief administrative officer of every licensed hospital or other health care institution in the State shall, after consultation with the chief of staff of such institution, report to the Board any revocation, suspension, or limitation of a physician's privileges to practice in that institution. Each such institution shall also report to the Board resignations from practice in that institution by persons licensed under this Article. The Board shall report all violations of this subsection known to it to the licensing agency for the institution involved. The chief administrative officer of each insurance company providing professional liability insurance for physicians who practice medicine in North Carolina, the adminis-trative officer of the Liability Insurance Trust Fund Council created by G.S. 1 16-220, and the administrative officer of any trust fund operated by a hospital authority, group, or provider shall report to the Board within 30 days: (1) Any award of damanges or settlement affecting or involving a physician it in-sures, or (2) Any cancellation or nonrenewal of its professional liability coverage of a physi-cian, if the cancellation or nonrenewal was for cause. The Board may request details about any action and the officers shall promptly fur-nish the requested information. The reports required by this section are privileged and shall not be open to the public. The Board shall report all violations of this paragraph to the Commissioner of Insurance. Any person making a report required by this section shall be immune from any criminal prosecution or civil liability resulting therefrom unless such person knew the report was false or acted in reckless disregard of whether the report was false. § 90-15. License fee; salaries, fees, and expenses of Board. — Each applicant for a license by examination shall pay to the treasurer of the Board of Medical Examiners of the State of North Carolina a fee which shall be prescribed by said Board in an amount not exceeding the sum of four hundred dollars ($400.00) plus the cost of test materials before being admitted to the examination. Whenever any license is granted without ex-amination, as authorized in G.S. 90-13, the applicant shall pay to the treasurer of the Board a fee in an amount to be prescribed by the Board not in excess of two hundred fifty dollars ($250.00). Whenever a limited license is granted as provided in G.S. 90-12, the applicant shall pay to the treasurer of the Board a fee not to exceed one hundred fifty dollars ($150.00), except where a limited license to practice in a medical education and training program approved by the Board for the purpose of education or training is granted, the applicant shall pay a fee of twenty-five dollars ($25.00). A fee of twenty-five dollars ($25.00) shall be paid for the issuance of a duplicate license. All fees shall be paid in advance to the treasurer of the Board of Medical Examiners of the State of North Carolina, to be held by him as a fund for the use of said Board. The compensa-tion and expenses of the members and officers of the said Board and all expenses proper and necessary in the opinion of the Board to the discharge of its duties under and to en-force the laws regulating the practice of medicine or surgery shall be paid out of said fund, upon the warrant of the said Board and all expenses proper and necessary in the opinion of the officers and members of said Board shall be fixed by the Board but shall not exceed one hundred dollars ($100.00) per day per member for time spent in the per-formance and discharge of his duties as a member of said Board, and reimbursement for travel and other necessary expenses incurred in the performance of his duties as a member of said Board. Any unexpended sum or sums of money remaining in the trea-sury of said Board at the expiration of the terms of office of the members thereof shall be paid over to their successors in office. For the initial and annual registration of an assistant to a physician, the Board may require the payment of a fee not to exceed a reasonable amount. § 90-15.1 Registration every two years with Board. — Every person heretofore or hereafter licensed to practice medicine by said Board of Medical Examiners shall, during the month of January, in every even-numbered year thereafter, register with the secretary-treasurer of said Board his name and office and residence address and such xiv other information as the Board may deem necessary and shall pay a registration fee fixed by the Board not in excess of one hundred dollars ($100.00). In the event a physician fails to register as herein provided he shall pay an additional amount of twenty dollars ($20.00) to the Board. Should a physician fail to register and pay the fees imposed, and should such failure continue for a period of 30 days, the license of such physician may be suspended by the Board, after notice and hearing at the next regular meeting of the Board. Upon payment of all fees and penalties which are due, the license of the physi-cian may be reinstated, subject to the Board requiring the physician to appear before the Board for an interview and to comply with other licensing requimements. § 90-16. Board to keep record; publication of names of licentiates; transcript as evidence; receipt of evidence concerning treatment of patient who has not consented to public disclosure. — The Board of Medical Examiners shall keep a regular record of its proceedings in a book kept for that purpose, together with the names of the members of the Board present, the names of the applicants for license, and other information as to its actions. The Board of Medical Examiners shall cause to be entered in a separate book the name of each applicant to whom a license is issued to practice medicine or surgery, along with any information pertinent to such issuance. The Board of Medical Examiners shall publish the names of those licensed in three daily newspapers published in the State of North Carolina, within 30 days after granting the same. A transcript of any such entry in the record books, or certificate that there is not entered therein in the name and proficiency or date of granting such license of a person charged with the violation of the provisions of this Article, certified under the hand of the secretary and the seals of the Board of Medical Examiners of the State of North Carolina, shall be admitted as evidence in any court of this State when it is otherwise competent. The Board may in an executive session receive evidence involving or concerning the treatment of a patient who has not expressly or impliedly consented to the public dis-closure of such treatment as may be necesssary for the protection of the rights of such patient or of the accused physician and the full presentation of relevant evidence. All records, papers, and other documents containing information collected and compiled by the Board, or its members or employees as a result of investigations, inquiries or interviews conducted in connection with a licensing or disciplinary matter shall not be considered public records within the meaning of Chapter 132 of the General Statutes; provided, however, that any notice or statement of charges against any licensee, or any notice to any licensee of a hearing in any proceeding shall be a public record within the meaning of Chapter 132 of the General Statutes, notwithstanding that it may contain information collected and compiled as a result of any such investigation, inquiry or in-terview; and provided, further, that if any such record, paper or other document con-taining information theretofore collected and compiled by the Board, as hereinbefore provided, is received and admitted in evidence in any hearing before the Board, it shall thereupon be a public record within the meaning of Chapter 132 of the General Statutes. In any proceeding before the Board, in any record of any hearing before the Board, and in the notice of the charges against any licensee (notwithstanding any provision herein to the contrary) the Board may withhold from public disclosure the identity of a patient who has not expressly or impliedly consented to the public disclosure of treatment by the accused physician. § 90-17. — Repealed by Session Laws 1967, c. 691, s. 59. § 90-18. Practicing without license; practicing defined; penalties. — No person shall practice medicine or surgery, or any of the branches thereof, nor in any case prescribe for the cure of diseases unless he shall have been first licensed and registered so to do in the manner provided in this Article, and if any person shall practice medicine or surgery without being duly licensed and registered, as provided in this Article, he shall not be allowed to maintain any action to collect any fee for such services. The person so practicing without license shall be guilty of a misdemeanor, and upon conviction thereof shall be fined not less than fifty dollars ($50.00) nor more than one hundred dollars ($100.00), or imprisoned at the discretion of the court for each and every offense. Any person shall be regarded as practicing medicine or surgery within the xv meaning of this Article who shall diagnose or attempt to diagnose, treat or attempt to treat, operate or attempt to operate on, or prescribe for or administer to, or profess to treat any human ailment, physical or mental, or any physical injury to or deformity of another person: Provided, that the following cases shall not come within the definition above recited: ( 1 ) The administration of domestic or family remedies in cases of emergency. (2) The practice of dentistry by any legally licensed dentist engaged in the practice of dentistry and dental surgery. (3) The practice of pharmacy by any legally licensed pharmacist engaged in the practice of pharmacy. (4) The practice of medicine and surgery by any surgeon or physician of the United States army, navy, or public health service in the discharge of his official duties. (5) The treatment of the sick or suffering by mental or spiritual means without the use of any drugs or other material means. (6) The practice of optometry by any legally licensed optometrist engaged in the practice of optometry. (7) The practice of midwifery as defined in G.S. 90-178.2. (8) The practice of chiropody by any legally licensed chiropodist when engaged in the practice of chiropody, and without the use of any drug. (9) The practice of osteopathy by any legally licensed osteopath when engaged in the practice of osteopathy as defined by law, and especially G.S. 90-129. (10) The practice of chiropractic by any legally licensed chiropractor when engaged in the practice of chiropractic as defined by law, and without the use of any drug or surgery. (11) The practice of medicine or surgery by any reputable physician or surgeon in a neighboring state coming into this State for consultation with a resident registered physician. This proviso shall not apply to physicians resident in a neighboring state and regularly practicing in this State. (12) Any person practicing radiology as hereinafter defined shall be deemed to be engaged in the practice of medicine within the meaning of this Article. "Radiology" shall be defined as, that method of medical practice in which demonstration and examination of the normal and abnormal structures, parts or functions of the human body are made by use of X-ray. Any person shall be regarded as engaged in the practice of radiology who makes or offers to make, for consideration, a demonstration or examination of a human being or a part or parts of a human body by means of fluoroscopic exhibition or by the shadow imagery registered with photographic materials and the use of X-rays; or holds himself out to diagnose or able to make or makes any interpretation or explanation by word of mouth, writing or otherwise of the meaning of such fluoroscopic or registered shadow imagery of any part of the human body by use of X-rays; or who treats disease or condition of the human body by the application of X-rays or radium. Nothing in this subdivision shall prevent the practice of radiology by any person licensed under the provision of Articles 2, 7, 8, and 12 of this Chapter. (13) Any act, task or function performed by an assistant to a person licensed as a physician by the Board of Medical Examiners when: a. Such assistant is approved by and annually registered with the Board as one qualified by training or experience to function as an assistant to a physician, except that no more than two assistants may be currently registered for any physician, and b. Such act, task or function is performed at the direction or under the supervision of such physician, in accordance with rules and regulations promulgated by the Board, and c. The services of the assistant are limited to assisting the physician in the particular field or fields for which the assistant has been trained, approved and registered; Provided that this subdivision shall not limit or prevent any physician from delegating to a qualified person any acts, tasks or functions which are otherwise permitted by law or established by custom. xvi (14) The practice of nursing by a registered nurse engaged in the practice of nursing and the performance of acts otherwise constituting medical practice by a registered nurse when performed in accordance with rules and regulations developed by a joint subcommittee of the Board of Medical Examiners and the Board of Nursing and adopted by both boards. § 90-18.1. Limitations on physician's assistants. — (a) Any person who is ap F .o/ed under the provision of G.S. 90-18(13) to perform medical acts, tasks or functions as an assistant to a physician may use the title "Physiciar Assistant." Any other person who uses the title in any form or holds out to be a physician assistant or to be so approved, shall be deemed to be in violation of this Article. (b) Physician assistants are authorized to write prescriptions for drugs under the following conditions: (1 ) The Board of Medical Examiners has adopted regulations governing the approval of individual physician assistants to write prescriptions with such limitations as the Board may determine to be in the best interest of patient health and safety; (2) The physician assistant has current approval from the Board; (3) The Board of Medical Examiners has assigned an identification number to the physician assistant which is shown on the written prescription; and (4) The supervising physician has provided to the physician assistant written instructions about indications and contraindications for prescribing drugs and a written policy for periodic review by the physician of the drugs prescribed. (c) Physician assistants are authorized to compound and dispense drugs under the following conditions: (1) The function is performed under the supervision of a licensed pharmacist; and (2) Rules and regulations of the North Carolina Board of Pharmacy governing this function are complied with. (d) Physician assistants are authorized to order medications, tests and treatments in hospitals, clinics, nursing homes and other health facilities under the following conditions: ( 1 ) The Board of Medical Examiners has adopted regulations governing the approval of individual physician assistants to order medications, tests and treatments with such limitations as the Board may determine to be in the best interest of patient health and safety; (2) The physician assistant has current approval from the Board; (3) The supervising physician has provided to the physician assistant written instructions about ordering medications, tests and treatments, and when appropriate, specific oral or written instructions for an individual patient, with provision for review by the physician of the order within a reasonable time, as determined by the Board, after the medication, test or treatment is ordered; and (4) The hospital or other health facility has adopted a written policy, approved by the medical staff after consultation with the nursing administration, about ordering medications, tests and treatments, including procedures for verification of the physician assistants' orders by nurses and other facility employees and such other procedures as are in the interest of patient health and safety. (e) Any prescription written by a physician assistant or order given by a physician assistant for medications, tests or treatments shall be deemed to have been authorized by the physician approved by the Board as the supervisor of the physician assistant and such supervising physician shall be responsible for authorizing such prescription or order. (f) Any registered nurse or licensed practical nurse who received an order from a physician assistant for medications, tests or treatments is authorized to perform that order in the same manner as if it were received from a licensed physician. xvn § 90-18.2. Limitations on nurse practitioners. — (a) Any nurse approved under the provisions of G.S. 90-18(14) to perform medical acts, tasks or functions may use the title "Nurse Practitioner." Any other person who uses the title in any form or holds out to be a nurse practitioner or to be so approved, shall be deemed to be in violation of this Article. (b) Nurse practitioners are authorized to write prescriptions for drugs under the following conditions: ( 1 ) The Board of Medical Examiners and Board of Nursing have adopted regulations developed by a joint subcommittee governing the approval of individual nurse practitioners to write prescriptions with such limitations as the board may determine to be in the best interest of patient health and safety. (2) The nurse practitioner has current approval from the boards; (3) The Board of Medical Examiners has assigned an identification number to the nurse practitioner which is shown on the written prescription; and (4) The supervising physician has provided to the nurse practitioner written instructions about indications and contraindications for prescribing drugs and a written policy for periodic review by the physician of the drugs prescribed. (c) Nurse practitioners are authorized to compound and dispense drugs under the following conditions: (1) The function is performed under the supervision of a licensed pharmacist; and (2) Rules and regulations of the North Carolina Board of Pharmacy governing this function are complied with. (d) Nurse practitioners are authorized to order medications, tests and treatments in hospitals, clinics, nursing homes and other health facilities under the following conditions: (1) The Board of Medical Examiners and Board of Nursing have adopted regulations developed by a joint subcommittee governing the approval of individual nurse practitioners to order medications, tests and treatments with such limitations as the boards may determine to be in the best interest of patient health and safety; (2) The nurse practitioner has current approval from the boards; (3) The supervising physician has provided to the nurse practitioner written instructions about ordering medications, tests and treatments, and when appropriate, specific oral or written instructions for an individual patient, with provision for review by the physician of the order within a reasonable time, as determined by the Board, after the medication, test or treatment is ordered; and (4) The hospital or health facility has adopted a written policy, approved by the medical staff after consultation with the nursing administration, about ordering medications, tests and treatments, including procedures for verification of the nurse practitioners' orders by nurses and other facility employees and such other procedures as are in the interest of patient health and safety. (e) Any prescription written by a nurse practitioner or order given by a nurse practitioner for medications, tests or treatments shall be deemed to have been authorized by the physician approved by the boards as the supervisor of the nurse practitioner and such supervising physician shall be responsible for authorizing such prescription or order. (0 Any registered nurse or licensed practical nurse who receives an order from a nurse practitioner for medications, tests or treatments is authorized to perform that order in the same manner as if it were received from a licensed physician. § 90-19, 90-20: Repealed by Session Laws 1967, c. 691, s. 59. § 90-21. Certain offenses prosecuted in superior court; duties of Attorney General. — In case of the violation of the criminal provisions of G.S. 90-18, the Attorney General of the State of North Carolina, upon complaint of the Board of xvin Medical Examiners of the State of North Carolina, shall investigate the charges preferred, and if in his judgment the law has been violated, he shall direct the district attorney of the district in which the offense was committed to institute a criminal action against the offending persons. A district attorney's fee of five dollars ($5.00) shall be allowed and collected in accordance with the provisions of G.S. 6-12. The Board of Medical Examiners may also employ, at their own expense, special counsel to assist the Attorney General or the district attorney. Exclusive original jurisdiction of all criminal actions instituted for the violations of G.S. 90- 1 8 shall be in the superior court, the provisions of any special or local act to the contrary notwithstanding. xix NORTH CAROLINA ADMINISTRATIVE CODE TITLE 21 OCCUPATIONAL LICENSING BOARDS CHAPTER 32 BOARD OF MEDICAL EXAMINERS SUBCHAPTER 32A - ORGANIZATION .0001 LOCATION .0002 PURPOSE .0003 STRUCTURE .0004 MEETINGS .0005 REQUIREMENT EXCEPTION .0006 PROVISIONS FOR PETITION FOR A RULE CHANGE .0007 DECLARATORY RULINGS .0008 RECORDS ON FILE .0009 FORMS .0010 DISCARDING APPLICATION MATERIAL SUBCHAPTER 32B - LICENSE TO PRACTICE MEDICINE SECTION SECTION .0100 .0101 .0102 .0103 .0104 .0105 .0106 .0107 .0108 .0109 .0110 .0111 .0112 .0113 .0114 .0200 .0201 .0202 .0203 .0204 .0205 .0206 .0207 .0208 .0209 .0210 .0211 .0212 .0213 .0214 .0300 .0301 .0302 .0303 SECTION .0400 .0401 .0402 .0403 SECTION LICENSE BY WRITTEN EXAMINATION MEDICAL EDUCATION ECFMG CERTIFICATION CERTIFICATION OF GRADUATION CERTIFIED PHOTOGRAPH CITIZENSHIP APPLICATION LETTERS OF RECOMMENDATION MILITARY STATUS FEE DEADLINE PASSING SCORE TIME AND LOCATION GRADUATE MEDICAL EDUCATION AND TRAINING PERSONAL INTERVIEW LICENSE BY ENDORSEMENT MEDICAL EDUCATION ECFMG CERTIFICATION CITIZENSHIP APPLICATION MILITARY STATUS LETTERS OF RECOMMENDATION CERTIFIED PHOTOGRAPH FEE PERSONAL INTERVIEW DEADLINE ENDORSEMENT RELATIONS ROUTINE INQUIRIES POSTGRADUATE TRAINING PASSING FLEX SCORE TEMPORARY LICENSE BY ENDORSEMENT CREDENTIALLING FEE HARDSHIP RESIDENT'S TRAINING LICENSE APPLICATION CERTIFICATION OF GRADUATION CERTIFIED PHOTOGRAPH xxi .0404 LETTERS OF RECOMMENDATION .0405 APPOINTMENT LETTER .0406 FEE .0407 ECFMG CERTIFICATION .0408 MEDICAL EDUCATION SECTION .0500 -- SPECIAL LIMITED LICENSE .0501 APPLICATION .0502 CERTIFICATION OF GRADUATION .0503 CERTIFIED PHOTOGRAPH .0504 LETTERS OF RECOMMENDATION .0505 DIPLOMA OF PSYCHOLOGICAL MEDICINE .0506 FEE .0507 ECFMG CERTIFICATION .0508 PERSONAL INTERVIEW SECTION .0600 -- CERTIFICATE OF REGISTRATION FOR VISITING PROFESSORS .0601 REQUEST .0602 GRADUATION AND LICENSURE .0603 LIMITATION .0604 DURATION .0605 PERSONAL INTERVIEW .0606 FEE .0607 CERTIFIED PHOTOGRAPH SUBCHAPTER 32C - PROFESSIONAL CORPORATIONS .0001 AUTHORITY AND DEFINITIONS .0002 NAME OF PROFESSIONAL CORPORATION .0003 PREREQUISITES FOR INCORPORATION .0004 CERTIFICATE OF REGISTRATION .0005 STOCK AND FINANCIAL MATTERS .0006 GENERAL AND ADMINISTRATIVE PROVISIONS .0007 FORMS .0008 FEES SUBCHAPTER 32D - APPROVAL OF ASSISTANT TO PHYSICI .0001 DEFINITIONS .0002 APPLICATION FOR APPROVAL .0003 REQUIREMENTS FOR APPROVAL .0004 MORAL CHARACTER .0005 REQUIREMENTS FOR RECOGNITION OF TRAINING PROGRAMS .0006 TERMINATION OF APPROVAL .0007 METHOD OF PERFORMANCE .0008 FEES .0009 FORMS SUBCHAPTER 32E - APPROVAL OF REGISTERED NURSE PERFORMING MEDICAL ACTS .0001 DEFINITIONS .0002 APPLICATION FOR APPROVAL .0003 REQUIREMENTS FOR APPROVAL .0004 MORAL CHARACTER .0005 TERMINATION OF APPROVAL .0006 ANNUAL APPROVAL .0007 FEES .0008 FORMS xxn SUBCHAPTER 32F - BIENNIAL REGISTRATION .0001 TIME .0002 REQUIRED INFORMATION .0003 FEE .0004 FAILURE TO REGISTER (REPEALED) .0005 FORMS SUBCHAPTER 32H - MOBILE INTENSIVE CARE SECTION .0100 - GENERAL INFORMATION .0101 AUTHORITY: INTENT AND GOALS .0102 DEFINITIONS SECTION .0200 - PROGRAM STANDARDS AND APPROVAL .0201 MOBILE INTENSIVE CARE PROGRAM CRITERIA .0202 PROGRAM APPROVAL SECTION .0300 - HOSPITAL UTILIZATION .0301 HOSPITAL INVOLVEMENT .0302 PLAN FOR PARTICIPATING HOSPITALS .0303 SPONSOR HOSPITAL .0304 RESOURCE HOSPITAL (REPEALED) SECTION .0400 - TRAINING AND PERFORMANCE OF MOBILE INTENSIVE CARE PERSONNEL .0401 TRAINING PROGRAMS .0402 EMT - PARAMEDIC PERFORMANCE .0403 EMT - INTERMEDIATE PERFORMANCE .0404 MOBILE INTENSIVE CARE NURSE PERFORMANCE .0405 TECHNICIAN PERFORMANCE IN THE PRESENCE OF A PHYSICIAN .0406 EMT - ADVANCED INTERMEDIATE PERFORMANCE .0407 EMT — DEFIBRILLATION PERFORMANCE SECTION .0500 - CERTIFICATION AND APPROVAL REQUIREMENTS FOR MOBILE INTENSIVE CARE PERSONNEL .0501 CERTIFICATION REQUIREMENTS: EMT - PARAMEDIC .0502 CERTIFICATION REQUIREMENTS: EMT - INTERMEDIATE .0503 APPROVAL REQUIREMENTS: MOBILE INTENSIVE CARE NURSE .0504 CERTIFICATION REQUIREMENTS: EMT - ADVANCED INTERMEDIATE .0505 CERTIFICATION REQUIREMENTS: EMT - DEFIBRILLATION SECTION .0600 - ENFORCEMENT .0601 APPROVAL/CERTIFICATION DENIAL, SUSPENSION OR REVOCATION .0602 PROCEDURES FOR DENIAL, SUSPENSION OR REVOCATION .0603 EFFECTIVE DATE (REPEALED) SECTION .0700 - EXCEPTIONS .0701 CONDITIONS .0702 REQUESTS SECTION .0800 - FORMS .0801 REQUIRED FORMS .0802 SOURCE OF FORMS SECTION .0900 — STUDY PROJECTS .0901 CONDITIONS xxin .0902 STUDY PROJECT APPROVAL .0903 STUDY RECOMMENDATIONS SECTION .1000 - MEDICAL CONTROL .1001 MEDICAL CONTROL PROCEDURES . 1 002 MEDICAL CONT/TRANS OUTSIDE/MBLE INTSVE CARE PROG SVC AREA . 1003 MEDICAL CONTROL FOR TRANSPORTS BETWEEN FACILITIES . 1004 AIR AMBULANCE PROGRAM CRITERIA SUBCHAPTER 321 - EPINEPHRINE FOR ADVERSE REACTIONS TO INSECT STINGS .0001 REQUIREMENTS FOR APPROVAL .0002 TRAINING PROGRAMS .0003 CERTIFICATION .0004 FORMS SUBCHAPTER 32J - REINSTATEMENT OF SUSPENDED LICENSE .0001 APPLICATION FOR REINSTATEMENT .0002 CONSIDERATION BY BOARD .0003 HEARING UPON DENIAL SUBCHAPTER 32K — IMPAIRED PHYSICIAN PROGRAM SECTION .0100 - GENERAL INFORMATION .0101 AUTHORITY .0102 DEFINITIONS .0103 PEER REVIEW AGREEMENTS .0104 DUE PROCESS SECTION .0200 - GUIDELINES FOR PROGRAM ELEMENTS .0201 RECEIPT AND USE OF INFORMATION OF SUSPECTED IMPAIRMENT .0202 INTERVENTION AND REFERRAL .0203 MONITORING TREATMENT .0204 MONITORING REHABILITATION AND PERFORMANCE .0205 MONITORING POST-TREATMENT SUPPORT .0206 REPORTS OF INDIVIDUAL CASES TO THE BOARD .0207 PERIODIC REPORTING OF STATISTICAL INFORMATION .0208 CONFIDENTIALITY CHAPTER 32 - BOARD OF MEDICAL EXAMINERS SUBCHAPTER 32A - ORGANIZATION .0001 Location The location of the office of the Board of Medical Examiners is 1313 Navaho Drive, Raleigh, North Carolina 27609. .0002 Purpose The purpose of the Board of Medical Examiners is to regulate the practice of medi-cine and surgery in the State of North Carolina. The board shall maintain the following records in the office of the executive secretary: (1) minutes of each meeting; (2) books of licensure of all physicians licensed in the State of North Carolina; The Board of Medical Examiners shall publish the names of those licensed in three daily newspapers published in the State of North Carolina, within 30 days after grant-ing the license. xxiv .0003 Structure Seven of the members of the board shall be duly licensed physicians elected and nomi-nated to the Governor by the North Carolina Medical Society. The other member shall be a person chosen by the Governor to represent the public at large. Terms shall be no more than two complete consecutive three-year terms. Administrative staff is headed by the executive secretary of the board. .0004 Meetings The board customarily meets seven times a year in January, March, May, June, August, October and December. Other meetings may be called by the president or upon written request of the majority of the members of the board. .0005 Requirement Exception When the board finds that an applicant is unable to comply with the requirements for proof of qualification for licensure because of circumstances beyond his control, the board may accept in lieu of such requirements such other evidence or information which will satisfy the board that such applicant is qualified for licensure or approval as required by law. .0006 Provisions For Petition For A Rule Change Each person desiring to petition for the adoption, amendment or repeal of a rule should submit the following information to the board: (1) name of agency; (2) draft of the proposed rule; (3) reasons for proposal; (4) effect of existing rules or orders; (5) data supporting proposal; (6) effect on existing practices in the area involved (including costs); (7) names of those most likely to be affected, with addresses (if known); (8) name and address of petitioner. The executive secretary shall conduct an interview with board members as appropri-ate to render a decision regarding denial of petition or initiation of rule-making proceed-ings in accordance with G.S. 150-12. .0007 Declaratory Rulings The board may consider the validity of a rule only when the petitioner shows that cir-cumstances are so changed since adoption of the rule that such a ruling would be war-ranted, or that the rule-making record evidences a failure by the agency to consider speci-fied relevant factors. The petitioner shall state the consequences of a failure to issue a ruling. .0008 Records On File All rules and other written statements of policy or interpretations formulated, adopted, or used by the board in the discharge of its functions, all final orders, decisions and opin-ions made after February 1, 1976, together with all materials that were before the decid-ing officers at the time of the final orders, decisions or opinions, except materials properly for good cause held confidential, are on file at the office of the Board of Medical Ex-aminers. .0009 Forms All forms and lists of requirements referred to in regulations of the board, Chapter 21 NCAC 32, may be obtained from the office of the Board of Medical Examiners. .0010 Discarding Application Material Applications must be completed within one year of the date requirements are mailed from the board's office. If not completed within one year, any application materials received will be discarded. xxv SUBCHAPTER 32B — LICENSE TO PRACTICE MEDICINE SECTION .0100 - LICENSE BY WRITTEN EXAMINATION .0101 Medical Education In order to be eligible for N.C. written examination, FLEX (Federation Licensing Examination), a physician applicant must: (1) be a graduate of a medical school approved by either: (a) LCME (Liaison Commission on Medical Education), or (b) AOA (American Osteopathic Association), or (2) if graduated from a medical school not approved by LCME or AOA, the appli-cant must: (a) Be enrolled in a graduate medical education and training program in N.C. ap-proved by the board (see Rule .0113); or (b) furnish proof of satisfactory completion of three years of graduate medical edu-cation and training approved by the board (see Rule .0113). (3) if graduated from a medical school not approved by the LCME or AOA, and if clinical clerkships are taken in the U.S.A., the applicant must: (a) furnish evidence that he has satisfactorily completed clinical clerkships at teach-ing hospitals in the U.S.A. with ACGME (Accreditation Council for Gradu-ate Medical Education) or AOA-approved graduate medical education and train-ing programs in the areas of the specific clerkships. (b) If clerkships do not meet the above requirement, deficiencies may be reme-died as follows: (i) re-apply to medical school so that the school may arrange for the appli-cant to complete approved clinical clerkships as required, or (ii) apply for admission to advanced standing at a medical school approved by the LCME or AOA to repeat one year of clinical clerkships. No applicant graduated from a medical school which has been disapproved by the board shall be eligible for examination or licensure in North Carolina. Burden of proof of medical education is on the applicant. .0102 ECFMG Certification Graduates of medical schools other than those approved by LCME or AOA in order to be eligible to take the North Carolina written examination, FLEX (Federation Licens-ing Examination), must furnish photocopy of standard certificate of ECFMG (Educa-tional Commission for Foreign Medical Graduates). ECFMG certification may be waived by the board under the following conditions: (1) upon successfully passing ECFMG examination and successfully completing an approved Fifth Pathway Program (as defined in Directory of Accredited Residences 1977-1978, American Medical Association, 535 North Dearborn Street, Chicago, Illinois 60610, pp. 30-32); or (2) if the applicant has been licensed in another state on the basis of written examina-tion prior to 1958. .0103 Certification of Graduation Certification of graduation by the dean of applicant's medical school is required. .0104 Certified Photograph Applicant must submit recent photograph (at least 2 inches by 2 inches) certified by the dean or other official of his medical school indicating, "This photograph is certi-fied as a true likeness of Dr. who received the M.D. degree from Med-ical School on ." This photograph must bear the dean's signature and seal of the medical school. .0105 Citizenship U.S.A. or Canadian citizenship is required. Alien registration receipt card is accept-able in lieu of citizenship. Immigrant applicants must present this card at time of inter-view. Failure to present this card constitutes an incomplete application. Naturalized U.S.A. or naturalized Canadian citizens must submit affidavit by Notary Public giving Naturalization Certificate number and date of issue. xxvi .0106 Application Application must be typewritten, containing full name, address, place and date of birth and medical education of applicant (in the form of a letter). A questionnaire regarding personal and professional activities of the applicant and a 'FEDERATION OF STATE MEDICAL BOARDS' application form must also be submitted. .0107 Letters of Recommendation Three letters of recommendation, originals addressed to the N.C. Board of Medical Examiners are required. One of these letters must be from someone who has known the applicant for a period of 10 years. Two of these letters must be from physicians. .0108 Military Status Copy of military discharge or statement as to military status is required. .0109 Fee Fee for both components taken together shall be two hundred and fifty dollars ($250.00), plus the cost of test materials, to be paid at time of application. If the two components are taken separately, two hundred and fifty dollars ($250.00) plus the cost of test materials, shall be paid at the time of application for the first com-ponent, and one hundred and fifty dollars ($150.00), plus the cost of test materials, shall be paid prior to application for the second component. In the event applicant fails to make a passing score on both components taken together or either component taken separately, there will be no refund of fee. In the event ap-plicant does not appear for the regularly scheduled examination or application is with-drawn, no portion of the fee will be refunded. .0110 Deadline For the applicant to be eligible for the examination, all data must be in the hands of the executive secretary of the board at least 75 days prior to examination. An applicant in attendance at a medical school located in North Carolina or a citizen of the State of North Carolina who is in attendance in an AOA or LCME approved med-ical school who may graduate after the 75 day deadline but before the examination date, may satisfy the certification of graduation requirement as follows: (1) not less than 75 days before the date of the examination, the executive secretary must receive a letter from the dean of the medical school of the applicant stating that the applicant is expected to complete all requirements for graduation prior to the date of the examination; and (2) prior to the date of the examination, the executive secretary must receive a letter from the dean of the medical school stating that the applicant has completed all requirements for, and will receive, the M.D. degree from the medical school. .0111 Passing Score To pass the examination successfully, the applicant is required to attain a score of at least 75 on FLEX Component I and a score of at least 75 on FLEX Component II. (Com-ponents may be taken in tandem; any component that is failed may be retaken; how-ever, Component II may not be taken alone unless the applicant has passed Component I within the prior seven years). Both components must be passed within seven years of the date of taking the initial application. .0112 Time and Location The board holds two examinations each year in June and December in Raleigh, North Carolina. .0113 Graduate Medical Education and Training Graduate medical education and training programs approved by ACGME (Accredi-tation Council for Graduate Medical Education) or AOA are approved by the board. Graduate medical education and training is required as follows: (1) Graduates of medical schools approved by the LCME or AOA may take the writ-ten examination, FLEX, after graduation from medical school before graduate med-ical education and training, but must give evidence of successfully completing one year of graduate medical education and training approved by the board prior to issuance of a license to practice medicine. xxvn (2) Graduates of medical schools other than those approved by LCME or AOA who are currently enrolled in graduate medical education and training in North Caro-lina may take the examination before completion of training, but must give evi-dence of successfully completing three years of graduate medical education and training approved by the board "prior to the issuance of a license to practice med-icine in North Carolina" to be eligible. (3) Graduates of medical schools other than those approved by LCME or AOA must give evidence of successfully completing three years of graduate medical educa-tion and training approved by the board to be eligible to apply for the written ex-amination in North Carolina. .0114 Personal Interview Graduates of medical schools not approved by the LCME or AOA and immigrant ap-plicants must appear before the executive secretary upon completion of all credentials for a personal interview which must be conducted at least 75 days prior to the date of the examination. SECTION .0200 - LICENSE BY ENDORSEMENT .0201 Medical Education In order to be eligible for license by endorsement of credentials, a physician appli-cant must: (1) be a graduate of a medical school approved by either: (a) LCME (Liaison Commission on Medical Education), or (b) AOA (American Osteopathic Association), or (2) if graduated from a medical school not approved by LCME or AOA, the appli-cant must: (a) take the North Carolina written examination, FLEX; and (b) furnish proof of satisfactory completion of three years of graduate medical edu-cation and training approved by the board (see Rule .0113). (3) If graduated from a medical school not approved by the LCME or AOA, and if clinical clerkships are taken in the U.S.A., the applicant must: (a) furnish evidence that he has satisfactorily completed clinical clerkships at teach-ing hospitals in the U.S.A. with ACGME (Accreditation Council for Gradu-ate Medical Education) or AOA-approved graduate medical education and train-ing programs in the areas of the specific clerkships: (b) if clerkships do not meet the above requirement, deficiencies may be reme-died as follows: (i) re-apply to medical school so that the school may arrange for the appli-cant to complete approved clinical clerkships as required, or (ii) apply for admission to advanced standing at a medical school approved by the LCME or AOA to repeat one year of clinical clerkships. No applicant graduated from a medical school which has been disapproved by the board shall be eligible for examination or licensure in North Carolina. Burden of proof of medical education is on the applicant. .0202 ECFMG Certification Graduates of medical schools other than those approved by LCME or AOA in order to be eligible to take the North Carolina written examination, FLEX (Federation Licens-ing Examination), must furnish photocopy of standard certificate of ECFMG (Educa-tional Commission for Foreign Medical Graduates). ECFMG certification may be waived by the board under the following conditions: (1) upon successfully passing ECFMG examination and successfully completing an approved Fifth Pathway Program (as defined in Directory of Accredited Residencies 1977-1978, American Medical Association, 535 North Dearborn Street, Chicago, Illinois 60610, pp. 30-32); or (2) if the applicant has been licensed in another state on the basis of written examina-tion prior to 1958. .0203 Citizenship U.S.A. or Canadian citizenship is required. Alien registration receipt card is accept-able in lieu of citizenship. Immigrant applicants must present this card at time of inter-view. Failure to present this card constitutes an incomplete application. Naturalized U.S.A. or naturalized Canadian citizens must submit affidavit by Notary Public giving Naturalization Certificate number and date of issue. xxvni .0204 Application All applicants must complete the application form which requests information regard-ing the applicant's personal, educational and professional background. Required attachments to the application form are: (1) (if applying on the basis of FLEX examination) certified FLEX scores from the Federation of State Medical Boards, 2630 W. Freeway, Suite 138, Fort Worth, Texas 76102; (2) (if applying on the basis of National Board examination) certification of having passed the examination given by the National Board of Medical Examiners, 3930 Chestnut Street, Philadelphia, Pennsylvania 19104; (3) (if applying on the basis of state board written examination other than FLEX) verifi-cation form from state board issuing original license by written examination; (4) (if affiliated) letter of current standing from county or state medical society; (5) if graduate of a medical school other than those approved by LCME or AOA who has been licensed in another state on the basis of examination, which was not FLEX, and has been certified by an American Specialty Board, the board may consider the applicant on an individual basis for a license based on endorsement of creden-tials upon submission of Subparagraph (3) of this Rule and a photocopy of the American Specialty Board certification. .0205 Military Status Copy of military discharge or statement as to military status is required. .0206 Letters of Recommendation Three letters of recommendation, originals addressed to the N.C. Board of Medical Examiners are required. One of these letters must be from someone who has known the applicant for a period of 10 years. Two of these letters must be from physicians. .0207 Certified Photograph Applicant must submit recent photograph (at least 2 inches by 2 inches) certified by the dean or other official of his medical school indicating, "this photograph is certi-fied as a true likeness of Dr. who received the M.D. degree from med-ical school on ." This photograph must bear the dean's signature and the seal of the medical school. .0208 Fee Fee of two hundred and fifty dollars ($250.00) is to be paid at time of application. In the event the applicant does not appear for the next regularly scheduled meeting, no portion of the fee may be refunded. In the event licensure is declined or the application withdrawn, no portion of the fee will be refunded. .0209 Personal Interview All applicants for license by endorsement of credentials must appear for a personal interview before the executive secretary, a board member, or the full board. Immigrant applicants must present their alien registration receipt cards at time of in-terview. Failure to present this card constitutes an incomplete application. .0210 Deadline In order for applicant to be eligible for licensure at a given board meeting, all data must be in the hands of the executive secretary of the board and the personal interview conducted at least 15 days prior to the meeting. .0211 Endorsement Relations The board has no endorsement relations with the government services nor with licens-ing medical boards outside of the United States and its territories. .0212 Routine Inquiries Each applicant must request a report from each state board by which he has ever been licensed to practice medicine regarding the status of the applicant's license and whether or not the license issued by that board has been revoked, suspended or surrendered, or had any probationary terms placed against it. This information must be mailed directly from other state boards to the N.C. Board of Medical Examiners. xxix An AMA Physician Statistics Report from the AMA, 535 N. Dearborn St., Chicago, 111. 60610, is requested by the N.C. board to be mailed directly to the N.C. Board of Medical Examiners regarding each applicant. .0213 Graduate Medical Education and Training Graduate medical education and training programs approved by ACGME and AOA are approved by the board. Graduates of medical schools approved by LCME or AOA must give evidence of suc-cessful completion of one year of graduate medical education and training approved by the board after graduation from medical school prior to issuance of a license to prac-tice medicine in North Carolina. Graduates of medical schools other than those approved by LCME or AOA must give evidence of successful completion of three years of graduate medical education and train-ing approved by the board after graduation from medical school prior to issuance of a license to practice medicine in North Carolina. .0214 Passing FLEX Score Physicians who have been licensed in another state on the basis of a FLEX examina-tion taken before January 1, 1983, who have attained a FLEX weighted average of 75 or more on a single three day examination, may be eligible to apply for a license based on endorsement of credentials. Physicians who have been licensed in another state on the basis of a FLEX examina-tion taken after January 1, 1983, who have attained a FLEX weighted average of 75 or more on a single three day examination, with a score not less than 70 on Day I, a score not less than 75 on Day II, and a score not less than 75 on Day III, may be eligi-ble to apply for a license based on endorsement of credentials. Physicians who have been licensed in another state on the basis of FLEX taken after January 1, 1985, must attain a score of at least 75 on FLEX Component I and a score of at least 75 on FLEX Component II. (Components may be taken in tandem; any com-ponent that is failed may be retaken; however, Component II may not be taken alone unless the applicant has passed Component I within the prior seven years.) Both com-ponents must be passed within seven years of the date of taking the initial examination. SECTION .0300 - TEMPORARY LICENSE BY ENDORSEMENT .0301 Credentialling Applicants for a temporary license must meet all requirements listed under Section .0200, LICENSE BY ENDORSEMENT OF CREDENTIALS, with the exception of the fee requirement. .0302 Fee Fee of fifty dollars ($50.00) is to be paid at time of application. This fee is not ap-plicable to full licensure and is not refundable. .0303 Hardship The board requires documentation from applicant of true hardship. xxx SECTION .0400 - TRAINING AND PERFORMANCE OF MOBILE INTENSIVE CARE PERSONNEL .0401 Training Programs (a) A training program intended to qualify personnel as field technicians or MICN's must be approved by the office of Emergency Medical Services. Proposals for training programs must be submitted for approval at least 20 days prior to the date on which training is scheduled to start. (b) Field technician trainees may perform the services and functions permitted by the rules contained in this Subchapter for their certification level during: (1) the clinical training portion of an approved training program while caring for patients in the sponsor hospital, provided the related didactic work has been completed and that they are under the direct supervision of a physician or reg-istered nurse; (2) a field internship provided that: (A) the related didactic and clinical work of an approved training program has been completed; (B) they are directly supervised and accompanied by a field technician cer-tified at a like or higher certification level or a physician; and (C) the internship is conducted within a mobile intensive care program ap-proved at the same or higher certification level for which the personnel are being trained. .0402 Certification of Graduation Certification of graduation by the dean of applicant's medical school is required. .0403 Certified Photograph Applicant must furnish recent photograph (at least 2 inches by 2 inches), certified as his true likeness by the dean of his medical school with the dean's signature and the seal of the school affixed thereon. .0404 Letters of Recommendation Two letters of recommendation from physicians, originals addressed to the board, are required. .0405 Technician Performance In The Presence Of A Physician When there is a physician licensed to practice medicine present at the scene of a med-ical/ traumatic emergency and that physician chooses to assume medical responsibility for the patient(s), the field technicians at the scene shall: (1) require and allow that physician to contact the sponsor hospital and the physician who receives the call at the sponsor hospital shall make the decision as to whether or not the physician on the scene is to be allowed to take charge of the patient(s) and give orders; (2) if the physician on the scene is allowed to take charge, permit that physician's orders to take precedence over all other procedures and/or protocol normally utilized within that emergency care program; (3) follow the orders of the physician within the limits enumerated in Rules .0402, .0403, .0406 and .0407 of this Section. .0406 Fee Fee of twenty-five dollars ($25.00) is to be paid at the time of application. No por-tion of the application fee is refundable. .0407 EMT—Defibrillation Performance EMT-D's trained in approved programs, certified by the Board of Medical Examiners to perform medical acts and functioning in an approved mobile intensive care program, when confronted with a pulseless non-breathing patient, may perform defibrillation by means of an automatic or semi-automatic defibrillator. Defibrillation may be performed prior to contacting the sponsor hospital. XXXI .0408 Medical Education (a) A physician applicant must be a graduate of a medical school approved by either: (1) LCME (Liaison Commission on Medical Education), or (2) AOA (American Osteopathic Association). (b) If graduated from a medical school not approved by the LCME or AOA, and if clinical clerkships are taken in the U.S.A., the applicant must: (1) furnish evidence that he has satisfactorily completed clinical clerkships at teach-ing hospitals in the U.S.A. with ACGME (Accreditation Council for Gradu-ate Medical Education) or AOA-approved graduate medical education and train-ing programs in the areas of the specific clerkships. (2) If clerkships do not meet the requirement in (b) (1) of this Rule, deficiencies may be remedied as follows: (A) re-apply to medical school so that the school may arrange for the appli-cant to complete approved clinical clerkships as required; or (B) apply for admission to advanced standing at a medical school approved by the LCME or AOA to repeat one year of clinical clerkship. Burden of proof of medical education is on the applicant. SECTION .0500 - SPECIAL LIMITED LICENSE .0501 Application A letter of application is required to include the following information: (1) full name, (2) place and date of birth, (3) medical education (locations and dates), (4) prior internship and residency training (locations and dates), (5) institution in which applicant will be practicing. A questionnaire, supplied to the applicant by the board, regarding personal and profes-sional background must be completed. .0502 Certification of Graduation Certification of graduation by the dean of applicant's medical school is required. .0503 Certified Photograph Applicant must furnish recent photograph (at least 2 inches by 2 inches) certified as his true likeness by the dean of his medical school with the dean's signature and the seal of the school affixed thereon. .0504 Certification Requirements: EMT-Advanced Intermediate (a) To become certified as an EMT-AI a person must meet the following criteria: (1) be currently certified as an emergency medical technician in the State of North Carolina; (2) be affiliated on a continuous basis with an ambulance provider permitted by the Office of Emergency Medical Services and which functions as part of an approved mobile intensive care program; (3) present evidence that he is of suitable character and physically capable of per-forming as an EMT-AI; (4) successfully complete, within one year of application, an EMT-AI training course approved by the Office of Emergency Medical Services following guide-lines established by the Board of Medical Examiners; (When training was com-pleted over one year prior to application, a person must submit evidence of completion of pertinent refresher training in emergency medicine for approval by the Office of Emergency Medical Services.) (5) successfully complete a performance evaluation conducted under the direction of the medical director of the mobile intensive care program assessing his ability to perform the skills and procedures specified in Rule .0406 of this Subchapter; (6) be recommended for certification upon examination by an oral interview panel established by the mobile intensive care program in which he is proposing to function; (7) pass basic life support practical examination approved and/or administered by the Office of Emergency Medical Services; (8) pass EMT-AI written examination administered by the Office of Emergency Medical Services. XXXll (b) Persons holding current certification equivalent to an EMT-AI with the National Registry of Emergency Medical Technicians or in another state where the training/certifi-cation requirements have been approved for reciprocity by the Office of Emergency Med-ical Services may become certified by: (1) presenting evidence of such certification for verification by the Office of Emer-gency Medical Services; and (2) meeting the criteria specified in Subparagraphs (a) (1), (a) (2), (a) (3), (a) (5), and (a) (6) of this Rule. (c) Certification obtained through reciprocity shall be valid for a period not to exceed the length of the current certification or a period not to exceed two years whichever is shorter. No certification shall be valid for a period exceeding two years. Persons must be recertified by presenting documentation to the Office of Emergency Medical Ser-vices that they have successfully completed either of the following options: Option I: (1) an ongoing continuing education program under the direction of the medical director, approved by the Office of Emergency Medical Services, following guidelines established by the Board of Medical Examiners; (2) an advanced life support performance evaluation conducted under the direc-tion of the medical director following guidelines established by the Board of Medical Examiners assessing the ability to perform the skills specified in Rule .0406 of this Subchapter; (3) basic life support practical and EMT-AI written examinations administered by the Office of Emergency Medical Services; or Option II: (1) the criteria specified in Subparagraph (c) (1) and (c) (2) of this Rule; (2) a basic life support skills evaluation(s) conducted under the direction of the medical director assessing the ability to perform the skills required of an emer-gency medical technician as specified by the North Carolina Medical Care Com-mission following guidelines established by the Board of Medical Examiners; (3) an EMT-AI written examination(s) administered under the direction of the med-ical director complying with the test specifications of the state EMT-AI writ-ten examination and following guidelines established by the Board of Medi-cal Examiners. .0505 Certification Requirements: EMT-Defibriliation (a) to become certified as an EMT-D a person must meet the following criteria: (1) be currently certified as an emergency medical technician in the State of North Carolina; (2) be affiliated on a continuous basis with an ambulance provider permitted by the Office of Emergency Medical Services, or an approved first responder or-ganization which functions as part of an approved mobile intensive care pro-gram; (3) present evidence that he is of suitable character and physically capable of per-forming as an EMT-D; (4) successfully complete, within one year of application, an EMT-D training course approved by the Office of Emergency Medical Services following guide-lines established by the Board of Medical Examiners; (When training was com-pleted over one year prior to application, a person must submit evidence of pertinent refresher training in emergency medicine for approval by the Office of Emergency Medical Services.) (5) successfully complete a performance evaluation conducted under the direction of the medical director of the mobile intensive care program assessing his ability to perform the skills and procedures specified in Rule .0407 of this Subchapter; (6) be recommended for certification upon examination by an oral interview panel established by the mobile intensive care program in which he is proposing to function; (7) pass basic life s'*>port practical examination approved and/or administered by the Office of Emergency Medical Services; (8) pass EMT-D written examination administered by the Office of Emergency Medical Services. XXAlll .0506 Fee Fee of one hundred and fifty dollars ($150.00) is to be paid at the time of applica-tion. No portion of the application fee is refundable. .0507 ECFMG Certification Graduates of medical schools other than those approved by LCME or AOA must fur-nish photocopy of standard certificate of the ECFMG (Educational Commission for For-eign Medical Graduates). Upon successfully passing the ECFMG examination and suc-cessfully completing an approved Fifth Pathway Program (as defined in Directory of Accredited Residencies 1977-1978, American Medical Association, 535 North Dear-born Street, Chicago, Illinois 60610, pp. 30-32), ECFMG certification may be waived. .0508 Personal Interview Applicant is required to appear in person before the board at a regular meeting. SECTION .0600 — CERTIFICATE OF REGISTRATION FOR VISITING PROFESSORS .0601 Request The request shall come from the dean of the medical school giving qualifications, po-sition, responsibilities and length of appointment. .0602 Graduation and Licensure Applicant must furnish proof of medical school graduation and licensure in another state or foreign country. .0603 Limitation Practice is limited to the institution requesting the Certificate of Registration. .0604 Duration The Certification of Registration shall be valid for one year. .0605 Personal Interview Applicant is required to appear in person before the full board, a board member, or the executive secretary. .0606 Fee Fee of fifty dollars ($50.00) is to be paid at the time of application. No portion of the application fee is refundable. .0607 Certified Photograph Applicant must furnish recent photograph (at least two inches by two inches), certi-fied as his true likeness by the dean of his medical school with the dean's signature and the seal of the school affixed thereon. SUBCHAPTER 32C - PROFESSIONAL CORPORATIONS .0001 Authority and Definitions Chapter 55B of the General Statutes of North Carolina being "The Professional Cor-poration Act," authorizes the Board of Medical Examiners of the State of North Caro-lina to adopt regulations for professional corporations practicing medicine. The rules in this Subchapter are adopted by the board pursuant to this authority. The rules in this Subchapter supplement the basic statutory law governing professional corporations and shall be interpreted so as not to conflict with such statutory law, as it may be amended from time to time, or with other statutes and laws governing corpo-rations generally. "Board" means the Board of Medical Examiners of the State of North Carolina. "Licensee" means any natural person who is duly licensed to practice medicine in North Carolina. "Professional corporation" means professional corporations organized for the pur-pose of practicing medicine in North Carolina. XXXIV "Secretary" means the Executive Secretary of the Board of Medical Examiners of the State of North Carolina. "Assistant secretary" means the Assistant Executive Secretary of the Board of Medical Examiners of the State of North Carolina. .0002 Name of Professional Corporation The following requirements must be met regarding the corporate name: (1) The name of every professional corporation referred to herein shall be governed by the provisions of Chapter 55, the Business Corporation Act, of the General Sta-tutes of North Carolina; provided that professional corporations may use the words "professional association," or "P. A.," in lieu of corporate designations speci-fied in Chapter 55; and provided further that the name of such corporation shall not include any adjectives or words not in accordance with ethical customs of the medical profession or the use of any words descriptive of any medical surgical spe-cialty unless the specialty designation is preceded by another modifying word or words, such as a geographical area of location designation or a proper name. (2) A professional corporation may not use any name other than its corporate name. (3) Upon proper authorization, the surname of any bona fide shareholder may be re-tained in the corporate name after his death or after his retirement or inactivity be-cause of age or disability, even though he may have disposed of his stock. (4) If a living shareholder in a professional corporation whose surname appears in the corporate name becomes a "disqualified person" as that term is defined in the Professional Corporation Act, the name of the professional corporation shall be promptly changed to eliminate the name of such shareholder, and such shareholder shall promptly dispose of his stock in the corporation. .0003 Prerequisites for Incorporation The following requirements must be met in order to incorporate: (1) The incorporator, whether one or more, of a professional corporation shall be duly licensed to practice medicine in North Carolina. Before the filing of the articles of incorporation with the Secretary of State, the incorporators shall file with the secretary of the board the original articles of incorporation, and additional executed copy, and conformed copy, together with a registration fee of fifty dollars ($50.00). (2) The original articles of incorporation, the executed copy and the conformed copy so filed shall be accompanied by the certificate (P.C. Form 1) to the board certi-fied by all incorporators, setting forth the names and addresses of each person who will be employed by said corporation to practice medicine for said corporation, and stating that all such persons are duly licensed to practice medicine in North Carolina, and representing that the corporation will be conducted in compliance with the Professional Corporation Act and these regulations. The number of shares to be owned by each original shareholder need not be stated. (3) The original articles of incorporation, the executed copy and the conformed copy shall each be accompanied by a form of certificate (P. C. Form 2) for the secre-tary, president or assistant secretary to sign, certifying each of the incorporators and each of the persons who will be original shareholders is duly licensed to practice medicine in North Carolina. It shall be the duty of the secretary, president or as-sistant secretary with the advice of the attorney for the board to review the arti-cles of incorporation for compliance with the laws relating to professional corpo-rations and with these Regulations. If such compliance be found to exist, the secretary, president or assistant secretary shall execute the said certificate (P. C. Form 2) on the original articles of incorporation, on the executed copy and on the conformed copy and return the original and the conformed copies to incorpora-tors for filing with the Secretary of State. The executed copy of the articles of in-corporation with the certificates (P. C. Forms 1 and 2) shall be retained in the of-fice of the secretary. If the articles of incorporation are thereafter in any manner changed before being filed with the Secretary of State, they shall be re-submitted to the secretary of the board and shall not be filed with the Secretary of State until approved by the secretary of the board. .0004 Certificate of Registration The Certificate of Registration shall be issued as follows: (1) If the secretary, president or assistant secretary of the board makes the findi«<*<= XXXV necessary to execute the certificate specified in 21 NCAC 32C .0003 (3) and finds that no disciplinary action is pending before the board against any of the licensed incorporators or persons who will be directors, officers, shareholders or employees of such corporation and it appears to him that such corporation will be conducted in compliance with the law and these Regulations, the secretary, president or as-sistant secretary shall issue a Certificate of Registration (P. C. Form 3) for the professional corporation to become effective only when the professional corpora-tion files the articles of incorporation with the Secretary of State. If the required findings cannot be made the registration fee shall be refunded to the incorporators. (2) The initial Certificate of Registration shall remain effective until December 3 1 preceding the year in which licensees are required to register with the board. (3) The Certificate of Registration may be renewed biennially thereafter for years in which licensees are required to register upon written application (P. C. Form 4) to the secretary, certifying the names and addresses of all licensed officers, direc-tors, shareholders and employees of the corporation and representing that the cor-poration has complied with these regulations and the provisions of the Professional Corporation Act and a finding by the secretary, president or assistant secretary that the facts stated in the certificate and the representations are correct. The applica-tion shall be accompanied by a renewal fee of twenty-five dollars ($25.00). .0005 Stock and Financial Matters The regulation and control of stocks shall be as follows: (1) The chief executive officer of a professional corporation shall be a person duly licensed to practice medicine in North Carolina. (2) A professional corporation may acquire and hold its own stock. (3) No person other than a licensee shall exercise any authority whatsoever over profes-sional matters. (4) The income of a professional corporation attributable to its practice during the time that a living shareholder is a "disqualified person" as defined in G.S. 55B-2(1) shall not in any manner accrue to the benefit of such a shareholder or his shares. (5) Subject to the provision of G.S. 55B-7, a professional corporation may make such agreement with its shareholders or its shareholders may make such agreement be-tween themselves as they deem just for the acquisition of the shares of a deceased or retiring shareholder or of a shareholder who becomes disqualified to own shares under the Professional Corporation Act or under these regulations. (6) There shall be prominently displayed on the face of all certificates of stock in a professional corporation a legend that any transfer of these shares is subject to the provisions of the Professional Corporation Act of North Carolina and the regula-tions of the Board of Medical Examiners of the State of North Carolina issued pur-suant thereto. (7) All shareholders of a professional corporation registered hereunder must at all times be duly licensed to practice medicine in North Carolina. (8) If any licensee who is a shareholder or employee of a professional corporation ceases to be licensed by the board for any reason then his or her employment and financial interest in the corporation must be terminated forthwith. The professional corporation shall report to the board within 30 days after the occurrence the fact that any shareholder or employee has ceased to be licensed by the board. (9) Any interest in a professional corporation belonging to a deceased shareholder shall be acquired by the professional corporation, or shall be acquired by one or more persons licensed by the board. Failure to comply with the requirement within one year after the date of the death of a deceased shareholder shall be grounds for the suspension or revocation of the registration of a professional corporation. The professional corporation shall report to the board within 30 days thereafter the death of any shareholder. (10) The professional corporation shall render medical services only by or through in-dividuals licensed by the board to practice in North Carolina. (11) The professional corporation shall not render any professional service other than services involved in the practice of medicine and such services as may be ancil-lary thereto and shall not engage in business provided, however, such corporation may own real and personal property necessary or appropriate for rendering profes-sional services, and it may own interest in real estate, mortgages, stocks, bonds and other personal property for the purpose of investing its funds. xxxvi .0006 General and Administrative Provisions The following general provisions shall apply to all incorporating professional associ-ations: (1) If the secretary shall decline to execute the certificate required by 21 NCAC 32C .0003 (3), or to issue a Certificate of Registration required by 21 NCAC 32C .0004 (1), or renew the same when properly requested, or shall refuse to take any other action required of him in writing by a professional corporation, the aggrieved party may in writing request a review of such action by the board, and the board shall provide a formal hearing for such aggrieved party before the board or one of its members and such hearing shall be reported upon the request of and at the expense of the aggrieved party. (2) All amendments to and restated charters of professional corporations and all merger and consolidation agreements to which a professional corporation is a party, and all dissolution proceedings and similar changes in the corporate structure of a professional corporation, shall be filed with the secretary of the board for approval before being filed with the Secretary of State. A true copy of the changes filed with the Secretary of State shall be filed with the Secretary of the Board within 10 days after the same are filed with the Secretary of State. (3) The secretary, president or assistant secretary is authorized to issue the certificate (P. C. Form 5) required by G.S. 55B-6 when stock is transferred in a profesional corporation, and such certificate shall be permanently attached to the stub of the transferee's certificate in the stock book of the professional corporation. The fee for such certificate shall be two dollars ($2.00) for each name included in the cer-tificate. The stock books of the corporation shall be kept at the principal office of the corporation and shall be subject to the inspection by the secretary or his dele-gate during business hours at the principal office of the corporation. (4) The corporation shall furnish to the secretary from time to time such information and documents relating to the administration of these regulations as the secretary or the board may reasonably request. .0007 Forms The following single forms may be secured from the office of the Board of Medical Examiners regarding professional corporations: ( 1 ) Regulations Adopted by the Board of Medical Examiners of the State of North Car-olina Relating to Professional Corporations Organized for the Purpose of Practicing Medicine; (2) P. C. Form 1 — Certificate of Incorporators and Application for a Certificate of Registration for a Professional Corporation for the Practice of Medicine; (3) P. C. Form 2 — Certification by the Board of Medical Examiners of the State of North Carolina; (4) P. C. Form 3 — Certificate of Registration of a Professional Corporation for the Practice of Medicine; (5) P. C. Form 4 — Application for Renewal of Certificate of Registration; (6) P. C. Form 5 — Certificate Authorizing Transfer of Stock in Professional Cor-poration Organized to Practice Medicine. .0008 Fees Initial registration fee of fifty dollars ($50.00) is required. Fee for renewal of Certificate of Registration is twenty-five dollars ($25.00). Fee for authorization for transfer of stock is two dollars ($2.00). SUBCHAPTER 32D - APPROVAL OF ASSISTANT TO PHYSICIAN .0001 Definitions The term "board" as herein used refers to the Board of Medical Examiners of the State of North Carolina. The term "secretary" as herein used refers to the Executive Secretary of the Board of Medical Examiners of the State of North Carolina. The term "assistant to a physician" as herein used refers to auxilliary, paramedical personnel who are functioning in a dependent relationship with a physician licensed by xxxvn the board and who are performing tasks or combinations of tasks traditionally performed by the physician himself. Examples of such tasks would include history taking, physi-cal examination, and treatment, such as the application of a cast. The regulations are not intended to cover or in any way prejudice the activities of assistants not engaged in direct patient contact or the performance of assistants with tasks well-defined by statute or recognized custom of medical practice. The term "applicant" as herein used refers to the assistant upon whose behalf an ap-plication is submitted. The term "supervision" is defined by the North Carolina Board of Medical Examiners as incorporating physician backup to assistants to physicians performing medical acts in the following ways: (1) Continuous availability of direct communications by radio, telephone or telecom-munications; (2) The backup physician shall be available on regularly scheduled basis for: (a) referrals; (b) review of their practice between conferences incorporating: (i) consultation; (ii) chart review and co-signing records to document accountability: (A) daily chart review except for situations that might be given individual consideration; (B) prescribing within that practice setting, standing orders and drug pro-tocol for interval between conferences to be part of this regular re-view and documentation; (iii) continuing education; (3) A predetermined plan for emergency services. .0002 Application for Approval Application for approval of an assistant must be made upon forms supplied by the board and must be submitted by the physician with whom the assistant will work and who will assume responsibility for the assistant's performance. Application forms submitted to the board must be completed in every detail. Every supporting document required by the application form must be submitted with each ap-plication. If for any reason an assistant discontinues working at the direction or under the su-pervision of the physician who submitted the application under which the assistant is approved, such assistant shall so inform the board and his approval shall terminate un-til such time as a new application is submitted by the same or another physician and it is approved by the board. When the proposed medical functions of an assistant to a physician shall include the prescribing of drugs, the supervising (backup) physician and the assistant shall review the formulary approved by the board, and shall acknowledge in the application to the board that they are familiar with the formulary and that such formulary will be a part of and incorporated in the approved standing orders. Changes in the formulary are to be approved by the board. In regard to changes the approved formulary may include any over-the-counter or non-prescription drug. Prescriptions, except controlled substances, may upon specific orders of the super-vising physician given before the prescription is issued, be written and issued by such assistant for the use by patients of drugs which are not included in the formulary. Such prescriptions shall be signed by the assistant with a notation thereon that the same was issued upon the specific order of the supervising physician. For example: Mary Smith, P. A., on order of John Poe, M.D. However, no prescription shall be written or issued by such assistant for any drugs which are specified as controlled substances under the Federal Controlled Substances Act. Assistants to physicians who are approved to prescribe drugs as herein provided shall be assigned a number which shall appear on all prescriptions issued by such assistant. The names and numbers of such assistants shall be recorded and transmitted to the North Carolina Board of Pharmacy. .0003 Requirements for Approval Before being approved by the board to perform as an assistant to a physician, an ap-plicant shall: ( 1 ) be of good moral character and have satisfied the requirements of 2 1 NCAC 32D .0004 hereof; xxxvin (2) give evidence that he has successfully completed a training program recognized by the board under 21 NCAC 32D .0005 hereof. Initial approval may be denied for any of the reasons set forth in 21 NCAC 32D .0006, Paragraph (1), hereof, as grounds for termination of approval, as well as for failure to satisfy the board of the qualifications cited in Paragraph (1) of this Rule. In hearings held pursuant to this Rule, the board shall admit and hear evidence in the same manner and form as prescribed by law for civil actions. .0004 Moral Character Every applicant shall be of good moral character, and the applicant shall have the bur-den of proving that he is possessed of good moral character. All information furnished to the board by an applicant, and all answers and questions upon forms furnished by the board shall be deemed material and such forms and infor-mation shall be and become a permanent record of the board. All investigations in reference to the moral character of an applicant may be infor-mal, but shall be thorough, with the object of ascertaining the truth. Neither the hear-say rule, nor any other technical rule of evidence need be observed. Every applicant may be required to appear before the board to be examined about any matter pertaining to his moral character. .0005 Requirements for Recognition of Training Programs Application for recognition of a training program by the board shall be made by let-ter and supporting documents from the director of the program and must demonstrate to the satisfaction of the board that such program fulfills the requirements set forth in the second through the eighth paragraph of this Rule. (All physicians' assistant programs approved by the American Medical Association Council on Medical Education are recog-nized by the board.) The training program must be sponsored by a college or university with appropriate arrangements for the clinical training of its students, such as a hospital maintaining a teaching program. There must be evidence that the program has education as its pri-mary orientation and objective. The program must be under the supervision of a qualified director, who has at his disposal the resources of competent personnel adequately trained in the administration and operation of educational programs. Adequate space, light and modern equipment must be provided for all necessary teach-ing functions. A library, containing up-to-date textbooks, scientific periodicals, and ref-erence material pertaining to clinical medicine, its underlying scientific disciplines, and its specialties, shall be readily accessible to students and faculty. The curriculum must provide adequate instruction in the basic sciences underlying the medical practice to provide the trainee with an understanding of the nature of dis-ease processes and symptoms, abnormal tests, drug actions, etc. This must be combined with instruction, observation and participation in history taking, physical examination, therapeutic procedures, etc. This should be in sufficient depth to enable the graduate to integrate and organize historical and physical findings. The didactic instruction shall follow a planned and progressive outline and shall include an appropriate mixture of classroom lectures, textbook assignments, discussions, demonstrations, and similar ac-tivities. Instruction shall include practical instruction and clinical experience under quali-fied supervision sufficient to provide understanding of a skill in performing those clin-ical functions which the assistant may be asked to perform. There must be sufficient evaluative procedures to assure adequate evidence of competence. Although the student may concentrate his effort and his interest in a particular specialty of medicine, the pro-gram must insure that he possesses a broad general understanding of medical practice and therapeutic techniques. Although some variation may be possible for the individual student, dependent on ap-titude, previous education, and experience, the curriculum shall be designed to require two or more academic years for completion. The program must have a faculty competent to teach the didactic and clinical mate-rial which comprises the curriculum. The faculty shall include at least one instructor who is a graduate of medicine, licensed to practice in the location of the school, and whose training and experience enable him to properly supervise progress and teaching in clinical subjects. He shall be in attendance for sufficient time to insure proper exposure of the student to clinical teaching and practice. The program may utilize instuctors other than XXXIX physicians, but sufficient exposure to clinical medicine must be provided to insure un-derstanding of the patient, his problem, and the diagnostic and therapeutic responses to this problem. The program must, through appropriate entrance requirements, insure that candidates accepted for training possess: (1) ability to use written and spoken language in effec-tive communication with physicians, patients, and others; (2) quantification skills to in-sure proper calculation and interpretation of tests; (3) behavioral characteristics of hon-esty and dependability; and (4) high ethical and moral standards, in order to safeguard the interest of patients and others. To retain its recognition by the board, a recognized program shall: (a) make available to the board yearly summaries of case loads and educational ac-tivities done by clinical affiliates, including volume of outpatient visits, number of inpatients, and the operating budget; (b) maintain a satisfactory record of the entrance qualifications and evaluations of all work done by each student, which shall be available to the board; and (c) notify the board in writing of any major changes in the curriculum or a change in the directorship of the program. Recognition of a program may be withdrawn when, in the opinion of the board, the program fails to maintain the educational standards described above. When a program has not been in operation for a period of two consecutive years, recognition will auto-matically be withdrawn. Withdrawal of recognition from a program will in no way af-fect the status of an assistant who graduated from such program while it was recognized and who has been approved by the board. .0006 Termination of Approval The approval of an assistant shall be terminated by the board when, after due notice and hearing in accordance with the provisions of this Rule, it shall find: (1) that the assistant has held himself out or permitted another to represent him as a licensed physician; (2) that the assistant has in fact performed otherwise than at the direction or under the supervision of a physician licensed by the board; (3) that the applicant has been required to perform, or has performed, a medical task or tasks, function or functions for which the applicant is not approved or for which the applicant is not qualified by training to perform including prescribing or dis-pensing of drugs not included in the approved formulary; or (4) that the assistant is a habitual user of intoxicants or drugs to such extent that he is unable to perform as an assistant to the physician; (5) that the assistant has been convicted in any court, state or federal, of any felony or other criminal offense involving moral turpitude; (6) that the assistant has been adjudicated a mental incompetent or whose mental con-dition renders him unable to safely perform as an assistant to a physician; or (7) that the assistant has failed to comply with any of the provisions of 21 NCAC 32D .0007 hereof. Before the board shall terminate approval granted by it to an assistant it will give to the assistant and to the physician to whom he is certified a written notice indicating the general nature of the charges, accusation, or complaint preferred against him and stat-ing that the assistant will be given an opportunity to be heard concerning such charges or complaints at a time and place stated in such notice, or to be thereafter fixed by the board, and shall hold a public hearing within a reasonable time. Following such hear-ing, the board shall determine on these regulations whether the approval of the assis-tant shall be terminated. In hearings held pursuant to this Rule, the board shall admit and hear evidence in the same manner and form as prescribed by law for civil actions. .0007 Method of Performance An assistant must clearly identify himself as an assistant to a physician, a physician's assistant, or by some other appropriate designation, in order to insure that he is not mis-taken for a licensed physician. This may be accomplished, for example, by the wear-ing of an appropriate name tag. The assistant must generally function in reasonable proximity to the physician. If he is to perform duties away from the responsible physician, such physician must clearly xl specify to the board those circumstances which would justify this action and the writ-ten policies established to protect the patient. The assistant must be prepared to demonstrate upon request to a member of the board or to other persons designated by the board, his ability to perform those tasks assigned to him by his responsible physician. .0008 Fees Fee of one hundred dollars ($100.00) must be paid at the time of the application for approval. Fee for annual registration, due July 1, is twenty-five dollars ($25.00). No portion of the above fees is refundable. .0009 Forms The following forms may be secured from the office of the Board of Medical Ex-aminers regarding approval for assistants to physicians: (1) Rules and Regulations for an Assistant to a Physician; (2) Application for Approval as an Assistant to a Physician; (3) Formulary; (4) Statement of Approval, upon being approved; (5) Notice of Registration; (6) Certificate of Registration, upon registering. SUBCHAPTER 32E - APPROVAL OF REGISTERED NURSE PERFORMING MEDICAL ACTS .0001 Definitions The term "board" as used herein refers to the Board of Medical Examiners of the State of North Carolina. The term "secretary" as used herein refers to the Executive Secr |