Current Bulletin

  • NCMS Joins Challenge of Nursing Council on Scope of Practice

    The North Carolina Medical Society (NCMS) has joined the AMA and other state and specialty medical societies calling on the National Council of State Boards of Nursing (NCSBN) to revise parts of its Advanced Practice Registered Nurse (APRN) Compact. The Compact creates a multistate license for all four types of APRNs, which would supersede state laws requiring APRNs to practice under physician supervision, collaboration or oversight, and potentially grants prescriptive authority to APRNs in states where they who do not currently enjoy that privilege such as North Carolina. Read the Compact.

    NCSBN approved the Compact in May 2015, and says it will be implemented when 10 states have enacted corresponding legislation. In the letter to NCSBN President Katherine Thomas the AMA, the NCMS and other societies “strongly object[s] to the use of interstate licensure compacts as a mechanism through which to expand scope of practice laws, and call on NCSBN to reconsider inclusion of the relevant sections.”

    Many of the medical societies would “consider support of or neutrality on APRN Compact legislation” if NCSBN revises the compact to focus on facilitating license portability for APRNs, the letter adds.

    It urges NCSBN to consider this at their annual meeting, which is scheduled for August.

    Read the letter.

     
  • NC Division of Public Health Issues Memos on Arboviral and Tick-Borne Illnesses

    The North Carolina Division of Public Health has distributed its annual clinician memos for arboviral and tick-borne disease surveillance and diagnosis. You may also access them here.

    Memo on arboviral disease surveillance and diagnosis.

    Memo on tickborne disease surveillance and diagnosis.

     
  • Opioid Prescribing Article Didn’t Tell Full Story

    A recent article in that first appeared in the Raleigh News & Observer with the headline, “Thousands of NC Doctors Are Over Prescribing Opioids Despite a New State Law,” was based on data that does not tell the complete story of why the prescriptions may have exceeded the STOP Act rules. The North Carolina Medical Society (NCMS) responded to the article with a written opinion piece we hope will be published on the paper’s editorial page. In the meantime, we offer our response to you to help set the record straight. Read NCMS CEO Robert W. Seligson’s response.

    The NC Department of Health and Human Services and the NC Medical Board also submitted the joint statement below in response to the article as well as background information clarifying the facts.

    JOINT STATEMENT to the News & Observer sent May 4, 2018:

    Below is a joint statement from the North Carolina Department of Health and Human Services and the North Carolina Medical Board. We feel that the story, even with the recent changes, still does not frame things accurately. We are asking that this statement be added to the Sunday print edition of the News & Observer and updated online as well. 

    Joint Statement

    The North Carolina Department of Health and Human Services and the North Carolina Medical Board are committed to fighting the opioid overdose epidemic and ensuring North Carolinians are receiving appropriate medical care. Based on the limited prescribing information available in the Controlled Substances Reporting System and a preliminary report, there is absolutely no way to know that any prescribers are breaking the law. At no point has either agency expressed that any prescriber is violating state law, and suggesting such is a gross mischaracterization of the facts. North Carolina’s doctors are expected to educate themselves about the prescribing limits imposed by the STOP Act and comply as appropriate, but should not fear being investigated for writing legitimate prescriptions.

    INFORMATION/BACKGROUND sent to the paper on May 2, 2018

    • The headline and much of the framing in your article is incorrect.  It is incorrect to say “According to the state health department, more than 16,000 physicians across the state prescribed too many opioids in March alone.
    • The most you could possibly claim is that these 16,000 prescribers have at least one prescription where more information is necessary to determine if the prescription is consistent with the STOP Act.
    • We have no specific reason to think any of these prescriptions violate the law, and to suggest otherwise is inaccurate. 
    • The data you reference, which was pulled from the CSRS, was simply an initial report using data parameters discussed with the North Carolina Medical Board.
    • It does not equate to prescriptions written in violation of the STOP Act.
    • The CSRS – by law – includes certain data elements about the prescriber and the prescription that was written.  It does not contain detailed information about an individual’s health care history.
    • Whether or not a given prescription complies with the terms of the STOP Act depends on a variety of factors related to the individual patient, their medical history, and their relationship with the provider.  Most of those data elements are not part of the CSRS record. 
      • More specifically, the STOP Act limits prescriptions only for certain prescribers during the initial consultation with a patient for acute pain or after surgery.
      • Prescriptions written after that initial consultation, or any prescriptions administered in a hospital, nursing home licensed under Chapter 131E of the General Statutes, hospice facility, or residential care facility, or written for patients who have cancer, are in hospice or palliative care, or under medication-assisted treatment for substance use disorder are not limited by the STOP Act.
    • The CSRS contains no data on, for example, whether the patient has cancer, whether a patient is in palliative care, or whether there has been a prior consultation for pain that did not result in an opioid prescription. 
    • This data is simply a list of providers who had at least one patient with an opioid prescription of over a week and who had not had a prescription within the last six months.  A great deal of additional information, which is not included in the CSRS, is necessary to determine which, if any, of those prescriptions are inconsistent with the STOP Act. 
    • It is ultimately the responsibility of NCMB to enforce the requirements of the STOP Act with its licensees.
    • The CSRS is not intended as primarily an enforcement tool, but rather as a tool to help prescribers understand a specific patient’s history with controlled substances schedule II through V. This prescriber should use this knowledge alongside their own assessment of the patient’s status to determine the appropriate and lawful prescription based on their own clinical judgement. 

     

     
  • Beware: DEA Scam Targeting Physicians Uncovered in Other States

    Our colleagues at the Medical Society of New Jersey and providers in Kansas recently shared that con artists have targeted physicians in their states with a phony questionnaire asking for vital, confidential information, including the physician’s Drug Enforcement Agency (DEA) numbers, social security number and credit card data.

    The New Jersey State Attorney General is investigating this mailing sent to physicians on what appears to be New Jersey Division of Consumer Affairs letterhead, which seeks to “update physician profiles in our system.” The letter claims that by responding, a physician could order controlled substances over the phone or via the internet.

    Not only could the solicited personal information make the physician a victim of financial fraud, but the confidential professional information – such as DEA number – could facilitate illegal drug trafficking. In fact, the fraudulent questionnaire asks the physician to provide two signature samples … “as you sign on your prescription pad.”

    The North Carolina Medical Society (NCMS) has not received any reports of such a scam in our state, but please be aware of this scam. Do not respond if you have received such a questionnaire and contact the NC Department of Justice Scam Hotline at 1-877-5-NO-SCAM (1-877-566-7226) or (919) 716-6000. The NCDOJ website has more information on how to file a complaint.

    Please let the NCMS know if you have been a victim of any scam targeted at physicians or PAs so we can alert fellow members and follow up with the proper authorities. Contact our Solution Center at 919-833-3836 x142 or bmckoy@ncmedsoc.org.

     
  • NC Medical Board Honored With National Awards

    R. David Henderson, JD

    David Henderson, JD, the CEO of the North Carolina Medical Board (NCMB) received the Federation of State Medical Boards’ (FSMB) Distinguished Service Award at their meeting earlier this month. This award recognizes the highest level of service and commitment to the FSMB; the advancement of the profession of medical regulation; and the strengthening of public protection.

    The NCMB also received the 2018 Best of Boards award from the Administrators in Medicine (AIM), the national professional organization for medical board staff, for its work to address the opioid epidemic in North Carolina through its Safe Opioid Prescribing Initiative (SOPI). This multifaceted initiative aims to reduce inappropriate opioid prescribing, and related overdoses and deaths, both through expanded oversight and increased education of prescribers and the public.

    NCMB has worked with other state agencies, regulatory boards, and the Attorney General’s office, as well as the North Carolina Medical Society (NCMS) and malpractice carriers, to disseminate information and make NCMB more accessible to its licensees around this initiative and others.

    Congratulations to David Henderson and the NCMB on this recognition!

    Shawn Parker, JD, MPA

    Also, congratulations to Shawn Parker, JD, MPA, who was elected during the meeting to serve as a Director-at-Large on the FSMB Board of Directors. Parker, who practices law with Smith Anderson in Raleigh, currently is a member of the NCMB’s Board.

     
  • Way to Go ‘Healthiest You’ Challenge Winner!

    Congratulations to Nathan Teague, the Durham-Orange County Medical Society (DOCMS) team member who was a first place winner of the 2018 WCHL “Healthiest You” Challenge.”

    DOCMS sponsors this community program in which 64 contestants work in teams to improve their overall health with mentorship from their sponsors. Health goals include reducing weight and circumference, decreasing cholesterol and blood pressure.  The Challenge concluded earlier this month at the UNC Wellness Center. DOCMS team member Teague, of Durham, was the top male overall winner! Hear the finale broadcast and to learn what Nathan won.

     
  • NCMS Member Offers Guidance on Hip Pain in Seniors in New Book

    Longtime North Carolina Medical Society (NCMS) member James Hundley, MD, a Wilmington-area orthopaedic surgeon, recently published a book titled: My Hip Hurts! Causes and Treatment of Hip Pain in Seniors. Dr. Hundley, along with his co-author and fellow orthopaedic surgeon, Richard Nasca, MD, offer advice on what can be done for those suffering from hip pain often afflicting older adults. The two physicians have over 100 combined years of training and experience in treating such conditions.

    The title is available now on Amazon.com in a Kindle edition.

     
  • In the News

     
  • Learning Opportunities

    Join Caravan Health for a webinar, May 23 at 1 p.m. when a panel of industry experts discuss “The #1 Reason ACOs Fail.” Learn more and register.

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    The Mountain Area Health Education Center (MAHEC) is offering “Makin’ It Happen: Successful Primary Care in 2018” on Saturday, June 2. Learn more and register.

    MAHEC has also started a new, online 1-hour opioid prescribing course, “Treating Pain Safer,” for those physicians who are prescribing controlled substances and want to do just one hour per year to meet their three hours every three years opioid prescribing CME requirement. Learn more and register.

    This is in addition to the existing online 3-hour course, “A Guide to Rational Opioid Prescribing for Chronic Pain,” already available for those physicians who prescribe controlled substances and want to knock out all three hours at once. Learn more and register for this option.

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    The Mayo Clinic School of Continuous Professional Development will offer its 25th Annual Clinical Reviews and Primary Care Update 2018 June 18-22 at Amelia Island, FL. The meeting seeks to update physicians on the latest recommendations of medical subspecialties important to the primary care physician. It is a comprehensive program consisting of lectures, workshops and panel discussions on topics of general interest in various areas of medicine. Learn more and register.

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    MAHEC is offering two courses to help treat patients with opioid use disorders: “Providers’ Clinical Support System: Buprenorphine Office-Based Treatment for Opioid Use Disorders, The “Half and Half” Course,” and “Recovery Within Reach: Building Team Expertise in Office-Based Opioid Treatment (OBOT).” Sessions will be held June 22 and Sept. 28. Learn more and register.

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    Registration for Erlanger’s 11th Annual Trauma Symposium is open. The Symposium will be held Aug. 9-10, at the Chattanooga Convention Center.  Learn more and register.

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    The 30th Annual Fall Foliage Cancer Conference will be held Oct. 12-13 at the Omni Grove Park Inn Resort & Spa in Asheville, NCLearn more and register.

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    Save the Date: The Southeast Institute for Innovation in Palliative and Supportive Care at the University of Alabama will hold the Forging the Future of Palliative Care Summit 2018 on Nov. 1-2, in Birmingham, AL. Learn more.

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    NCTracks has Computer-Based Training (CBT) courses on a variety of topics available to providers 24 hours a day, 7 days a week, every day of the year. Anyone who is a registered user with NCID access to the NCTracks secure Provider Portal can access and take a self-paced course. A list of courses available can be found here and under Quick Links on the NCTracks Provider Training page of the public Provider Portal.

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    MAHEC, working with the North Carolina Academy of Family Physicians, The Governor’s Institute on Substance Abuse and Project Lazarus: A Project of CCNC, is offering A Guide to Rational Opioid Prescribing for Chronic Pain, an online education course. The course is designed for all prescribing health care practitioners who are interested in an overview of the rational prescribing approaches for persons with chronic pain disorders. It will fulfill the North Carolina Medical Board’s requirement of at least one hour of continuing education designed specifically to address prescribing practices for chronic pain management. The course cost is $15 for the first 6 months. Offers 3 hours of AAFP, AMA/AAFP Equivalency, and CDE; www.mahec.net/opioid.

     

     

     
  • How Do You Feel About the Practice of Medicine? Make Sure Your Voice Is Heard

    The Physicians Foundation biennial survey of the nation’s physicians is underway and now is the time to share your insights into the practice of medicine. Have things changed since the 2016 survey when:

    • More than half of U.S. physicians rated their morale as somewhat or very negative,
    • Almost half said they often or always feel burnt out.
    • 80 percent said they were overextended or at capacity
    • 72 percent said external factors such as third-party authorizations significantly detract from the quality of care they are able to provide.

    Review all the 2016 results. Has anything changed? The 2018 survey is currently under way and is your chance to report back. Take the survey now!

    The Physicians Foundation, a nonprofit grant-making organization, conducts the survey every two years to better understand the morale, career plans, and practice realities of today’s physicians.

    The 34-question survey asks for your thoughts on issues such as telemedicine, the opioid crisis, value-based compensation, maintenance of certification, electronic health records and the future of medicine.

    The results of the previous five surveys conducted by The Physicians Foundation have been used by policy makers and are often quoted in the media including publications like The Wall Street Journal, Forbes and USA Today.

    The survey may be taken anonymously, or you may include your email address to enter a drawing for a $5,000 Amazon gift card or one of five $500 Amazon gift cards.

    The greater the response, the greater the impact on policy makers and the public!

    Check your email throughout May for a message directly from The Physicians Foundation about the survey, or take the survey online now.