The NC Medical Board Wants to Demystify the Process When a Complaint is Filed
The life of a Medical Board complaint
Imagine checking your email and finding a message indicating that you are the subject of a complaint to the North Carolina Medical Board (Board). While no licensee of the Board wants to receive such a message, knowledge of the Board’s investigatory process may help reduce the stress and anxiety related to the experience. It should be noted that in most Board investigations, the Board’s case review process determines that there is not evidence of misconduct or substandard care.
This article will walk you through the life of a Board complaint from start to finish, to demystify the process and provide you with information to respond appropriately, should the need arise.
Step 1: Information received
The Board is a complaint-driven organization that receives information from a variety of sources, the largest of which is complaints from patients and the public. Staff carefully review each complaint to determine if there is a possible basis for Board action in the form of a violation of the NC Medical Practice Act, the Board’s authorizing statute. In a typical year, staff determine about one in four patient complaints do not allege actionable misconduct or they allege matters outside the Board’s jurisdiction, and the matter ends there with no further investigation. Licensees are notified of ALL complaints but are only asked to respond if the Board investigation advances. You should never ignore a request for information – failure to respond to a Board inquiry is itself a basis for the Board to take disciplinary action, and the licensee’s written response is your first chance to tell your story and ensure that the Board has enough information to understand what occurred.
Step 2: Investigation
Next, Board staff will investigate the allegations. If the case involves the quality of medical care provided, staff review the licensee’s statement, the medical records and, when appropriate, an outside medical review by a medical professional who practices in the same specialty as the licensee, to determine whether care met accepted standards. In some instances, a Board investigator may also seek to interview you and others involved in the case. If you have any doubt about whether you are being contacted by a legitimate agent of the Board, contact the Board by telephone at 919-326-1100 and ask to speak with the Investigations Department.
Step 3: Senior Staff review
At this stage, a committee of senior staff members that includes representatives from the Office of the Medical Director and the Investigations and Legal Departments review the results of the investigation and recommend a possible resolution for each case. If senior staff find insufficient evidence of a violation, the case is closed without further action, and the licensee and complainant are notified. If senior staff determine the case involves one or more violations, they will recommend the Board take either public or private action to resolve the case and submit those recommendations for review by members of the Board.
Step 4: Board review and case resolution
The Board’s Disciplinary Committee reviews all cases in which private or public action is recommended. Board Members who serve on the Committee may accept the staff
recommendation, recommend something new, or request more information. The Board does not decide cases lightly and has the authority to extend an investigation if it does not feel it has a clear understanding of what occurred.
Once the Board votes on a case, the licensee is notified of the resolution. If public action is authorized, Board attorneys negotiate the specific terms of the case resolution with the licensee or, if applicable, their attorney. If the licensee refuses to accept the authorized case resolution, they have the right to a hearing, which is a process similar to a trial, with a panel of Board Members sitting as judges. The Board strongly encourages licensees to obtain counsel to advocate for their interests, but it is ultimately up to you to decide.
At the end of the day, each case is decided on its unique facts and circumstances. Where discipline or remediation is called for, the Board favors a targeted approach to ensure any concerns are addressed fairly and the public is protected.
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