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Jul 1 2015

The NCMB: Moving forward with Outreach

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Over the past few months, I have had the pleasure of attending various meetings with some of my colleagues. In one recent conversation, I spoke at some length with a colleague who expressed her passionate belief that the NCMB targets licensees in some of the rural areas of the state. It was clear she viewed the Board as an adversary even though she acknowledged that her personal experiences with the NCMB have been limited to license application and annual renewal. She echoed what I have heard more than once over the past few months – “The last thing I need is to hear from the NCMB.”

Independent of geographic location, specialty mix and practice demographics, when I visit with colleagues it inevitably comes up that most licensees hope to avoid the NCMB at all costs. While I certainly understand the sentiment, and appreciate that often these comments are made in jest, I believe this represents an opportunity to do better. The NCMB views licensees and other stakeholders as important partners in its mission of patient protection and is committed to finding ways we can work together. Making meaningful progress towards this goal is a top priority for the Board and for me personally during my term as Board President.

The Board has been working steadily over the past several years to make the NCMB a fundamentally more open, inclusive and transparent organization. As far back as 2010 the Board’s first DO president, Dr. Don Jablonski, wrote in this very space about the Board’s work to involve stakeholders in key policy decisions by convening roundtable discussions on issues such as administrative medicine, advertising Board certification and physician scope of practice. He wrote that he wished for his term as Board President to be known as a “year of transparency.” Stakeholder roundtables are still going strong, by the way, and have become an important means of gathering feedback.

These meetings are one visible example of how the Board has been trying to break down the wall between regulator and licensee. And yet, it is clear to me that many still feel alienated and unheard.

Recently, as part of its strategic planning process, the Board agreed to devote an unprecedented amount of time and resources to outreach, in hope of changing this.

When I think of outreach, I visualize one hand reaching out to another hand. Outreach is a process that can result in increased and improved communication, collaboration and strength. Outreach increases transparency and leads to better interactions. Outreach leads to improved relationships.

Communication
Board Members see outreach as a means of improving communication among the NCMB, its licensees and other key stakeholders. Board Members value the perspectives gained through the NCMB’s interactions with licensees and other professionals. The insights and information the Board receives help ensure that its policies remain relevant.

At the same time, licensees must understand that the Board is a regulatory body, not a voluntary professional organization that advocates for the best interests of its members. This is a nuanced message for the Board to deliver. We want licensees to know that the NCMB offers many resources to support them and that the Board truly wants licensees to thrive. Its mission, however, is to protect patients. We are ready and willing to hear ideas, questions, comments, concerns and even criticisms from licensees and others representing the profession. In return, I ask licensees to accept that the Board’s actions in response to their comments and suggestions must always be balanced against the mission and the best interest of patients and the public.

Licensee comments can drive and, indeed have driven, positive changes to Board processes and policies. The license application process is one example. For years, hospitals, medical practices, physician recruiting firms and licensees themselves have voiced frustrations about the amount of time it takes the NCMB to process license applications. Applicants are typically advised that it may take approximately four months (longer if the applicant has adverse history) for a license to be issued upon receipt of the application. But we have listened to the complaints and concerns, and we have changed this. Sensible modifications to the application process, such as accepting emailed electronic copies of certain documents and forms in lieu of paper copies, are speeding things up. In the last quarter of 2014 the average time for a license to be issued was just three months. (And this includes applicants who are taking a “casual” approach to the process.)

Collaboration
Outreach provides opportunity for collaboration. With more than 43,000 licensees (nearly 75 percent of whom practice in state), the NCMB’s vision is indeed a shared vision. I believe expanding and strengthening relationships through collaboration will magnify the Board’s ability to fulfill its mission.

As the Board becomes a more active participant in professional meetings and policy discussions statewide, we have found opportunities to partner with organizations that share common goals. For example, last year the NCMB successfully applied for grant funding that it provided to the NC Academy of Family Physicians to help defray the cost of a CME course in opioid prescribing presented at the group’s annual meeting in December. From the NCMB’s perspective, increasing the number of prescribers who are informed about current standards of care can improve quality, which protects patients and prevents situations that might result in regulatory problems.

Another example of collaboration is the Board’s ongoing partnership with the state-run NC Controlled Substances Reporting System (NCCSRS), which tracks all controlled substances dispensed in outpatient settings in North Carolina. New administrative rules will soon allow the NCCSRS to provide the Board with data about the highest volume prescribers, as well as information on prescribers who have had two or more patient deaths from opioid overdose during the previous 12 months. The Board will use this data to identify potentially problematic prescribing and take action, as appropriate, to stop it. This represents a true advance in the NCMB’s ability to protect patients, potentially enabling the Board to address prescribing issues before licensees come to attention due to a patient death or adverse incident.

Strength
The NCMB has been and will continue to be a leader among state medical boards. We could not do this without the support and input from our constituents. Communication and collaboration lead to improved relationships and improved relationships leads to strength.

Obviously, for this to work, the Board needs licensees to be actively engaged. The Board must continue talking with licensees, not just talking to them.

If you are active in a local or state professional society, serve on a hospital staff, or work in a group practice and would like to invite a Board speaker to an upcoming meeting, I encourage you to contact us. The Board has visited with a number of organizations across the state and we look forward to continuing these discussions. Instructions for scheduling a Board speaker are provided in a box accompanying this article. As we move forward this year, Board Members and NCMB senior staff will attend and, where possible, present to as many licensee groups and professional meetings as possible. Outreach is one of the top priorities identified in the 2015-2018 Strategic Plan the Board developed and adopted late last year (see below to read all of the NCMB’s goals).

I am proud to have participated in this process, as I believe that periodically engaging in thoughtful review of challenges and opportunities leads to stronger, more effective organizations. I and my colleagues on the Board look forward to hearing from all of you, meeting with you and working together for the benefit of the people of North Carolina.

Best Regards,

Cheryl L. Walker-McGill, MD, MBA

Schedule a visit with the NCMB
The North Carolina Medical Board if pleased to provide Board Members and/or Board staff to speak to professional groups and other audiences: medical students, residents, professional meetings and conferences, hospital grand rounds, and practice meetings or retreats.

Most programs provide a general overview of the Board’s structure, mission and responsibilities as well as in depth discussion around important issues in medical regulation. The Board is also able to develop programs tailored to specific audiences and events upon request.

If you are intersted in scheduling a speaker, please contact the Board’s Public Affairs Director: Jean Fisher Brinkley, Director at 919-326-1109 x230 or jean.brinkley@ ncmedboard.org

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