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Audit says public can't be sure N.C. Medical Board properly oversees physician misconduct; board disagrees

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State auditors say they were blocked from completing a thorough audit of North Carolina Medical Board investigations. As a result, auditors say there's no way to know whether medical board investigations into doctors are adequately protecting the public.

In response, the medical board says it is bound by state law to keep the investigation records confidential, and that it is providing the proper oversight to protect patients.

Auditors say the state law provides an exception for them, and that they would be bound by the same confidentiality requirement. They say they are not asking for the full public release of these records, only that they be turned over to the auditor's office, which would keep them confidential as required by law.

Audit started to review how the board handles complaints against providers

State auditor Beth Wood's office is charged with watching over agencies and organizations that serve the public good; it completes several audits every year. The N.C. Medical Board is not a state agency, but was established by the N.C. General Assembly more than 160 years ago to regulate the medical field and protect patients in North Carolina.

The audit was initiated to review how the board handled complaints it received against medical providers, and what kinds of discipline it meted out.

As a result, legislators and the public have no way to know whether or how well the Board protected North Carolina citizens from imminent threats, including malpractice and inappropriate behavior such as sexual assault.
North Carolina Medical Board Investigations of Medical Providers

However, when auditors sought investigation records, they were largely blocked by the medical board. Of the 4,432 investigations performed by the board over a two year period, auditors say they were unable to include information from 4,214 of those investigations due to the limited material they received from the board. That amounts to little or no information for more than 95% of medical board investigations over the two year period, which ran from July 1, 2019 to June 30, 2021.

Even with the limitations, auditors noted examples where physicians kept practicing for months even after arrests or criminal convictions, including one physician charged with indecent exposure, one physician indicted for sexually assaulting a patient, and one physician convicted of assaulting a female.

In the report, auditors note these examples to illustrate "why legislators and the public need assurance that the Board's investigations are protecting the public."

Auditors also found examples where physicians licensed in North Carolina who were disciplined in other states for which the board "delayed or took no public reciprocal actions against these providers."

Board says it's bound by state law to keep investigation records confidential

When it receives a complaint, the medical board has three main categories for adjudication. In the first, it accepts the complaint as information, but finds no violation. It keeps the complaint in the physician's confidential file. In the second, the board finds a violation but takes a private action against the physician that is kept confidential. The third is when the board finds a violation and takes a public action.

Auditors say the board restricted information it released to them only to those public actions. However even in those cases auditors say the board redacted information that limited their ability to review the files.

In a 13-page response to the audit, Medical Board CEO David Henderson argues the board is bound by state law to keep these investigation records confidential. He also argues that auditors applied incorrect standards in order to draw some of its conclusions.

"NCMB's (North Carolina Medical Board) monitoring program was designed to track licensees who were required to perform an action for the purposes of improving their clinical practice," Henderson wrote. "It was not designed to track individuals who lost a license and indefinitely ensure they are not continuing to practice medicine without a license, which is a crime."

State audits usually allow auditors to respond back to the subject of the audit. In this case, auditors say many of Henderson's claims are not true or misleading. They say state law has a clear exemption that allows them to view these records, and also binds them to confidentiality. And that they applied appropriate standards for their review, but were rebuffed.

"As a result, legislators and the public have no way to know whether or how well the Board protected North Carolina citizens from imminent threats, including malpractice and inappropriate behavior such as sexual assault," the audit said.

Jason deBruyn is the WUNC health reporter, a beat he took in 2020. He has been in the WUNC newsroom since 2016.
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