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From the Executive Director
Some Questions & Answers
“From the Executive Directin'” reestablishes the regular series of commentaries by the NCMB’s executive director that
appeared in the Forum far some years. It will appear in numbers two and four of each annual volume, alternating with
the “President’s Message,” winch will appear in numbers one and three.
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R. David Henderson, JD
NCMB Executive Director
As Executive Director of the North
Carolina Medical Board, I frequent¬
ly receive telephone calls and let¬
ters from physicians, attorneys, and
hospital administrators asking vari¬
ous questions. In this first article,
I’d like to share three questions I’ve
received lately and my answers to
those questions.*
QUESTION: Do physicians who
do not have hospital privileges have a responsibility to direct
their patients to a hospital with a designated physician or group
of physicians who will care for their patients?
ANSWER: Some physicians choose not to have hospital privi¬
leges. A problem arises, however, when the patient of such a
physician requires admission to the hospital. In this case, what is
the physician’s responsibility?
The Board’s Position Statement entitled “Availability of Physi¬
cians to Their Patients” states that “once a physician patient rela¬
tionship is created, it is the duty of the physician to provide care
whenever it is needed or to assure that proper physician backup
is available to take care of the patient during or outside normal
office hours. If the physician is not generally available outside
normal office hours and does not have an arrangement whereby
another physician is available at such times, this fact must be
clearly communicated to the patient, verbally and in writing,
along with written instructions for securing care at such times.”
pital privileges issue, the same reasoning applies. That is, if the
doctor is not able to take care of a patient in the hospital, the
doctor should (1) clearly make this known to the patient, and (2)
provide written instructions for securing hospital care.
Ideally, the physician will have made arrangements in advance
with another physician or practice to admit these patients, and
all relevant parties (patients, ER personnel, etc.) will have been
notified of this arrangement. Regardless, the physician should
make sure that all relevant patients have the physician’s contact
information so he can provide the patient’s medical history and
other important information.
QUESTION: Can a physician who wishes to terminate her re¬
lationship with a patient do so by simply transferring care to a
nursing home?
ANSWER: No. Although termination might be implicit in
this case, the better course of action would be for the physician
to notify the patient in writing. The Board’s Position Statement
entitled “The Physician-Patient Relationship” states that “ter¬
mination must be accompanied by appropriate written notice
given by the physician to the patient or the patient’s representa¬
tive sufficiently far in advance (at least 30 days) to allow other
medical care to be secured. ... It is advisable that the notice of
termination also include instructions for transfer of or access to
the patient’s medical records.”
As with many things, good communication is important, es¬
pecially when terminating a physician-patient relationship.
QUESTION: A patient is seen by a physician specialty group
Although this language does not explicitly apply to the hos- and, due to difficulties with the patient, the practice terminates
In This Issue of the FORUM
Item Page
Some Questions & Answers . 1
Item Page
Weathering the Storm . 9
* R. David Henderson, JD
Letters to a Toung Physician Featured on Web Site . 2
Screening and Brief Intervention for Substance Abuse
and Dependence in the Primary Care Setting . 3
•Sara B. McEwen, MD, MPH, and Jacob A. Lohr, MD
Changing Ourselves Is the Key . 6
•James A. Wilson, JD
Charles L. Garrett, Jr, MD, President of NCMB, Honored
bv MUSC, Medical Alumni Group . 10
Robin N. Hunter-Buskev, PA-C, NCMB Member, Elected
to Board of Federation of State Medical Boards . 11
Santiago Atitlan: The Call of Something Different . 12
•Paul Edward Hill, MD '
Sheps Center Releases Two New Publications on
Allied Health Professions . 7
"Erin P Frailer
Setting a Good Example . 8
* Roselee Papandrea
The Most Powerful Teaching Tool . 9
*Drs Bernadette and Jack Page
Medical License Registration: An Annual Event . 15
*Dena M. Konkel and David B. Shere
Tiendns and Contraband Pharmaceuticals . 16
•David R. Work
Board Actions: February-April 2005 . 17
Board Calendar . 24
•Kelly Carter Nelson, MD
Change of Address Form . 24