MINUTES North Carolina Medical Board July 21-23, 2010 1203 Front Street Raleigh, North Carolina July 21-23, 2010 Minutes of the Open sessions of the North Carolina Medical Board Meeting held July 21-23, 2010. The July 21-23, 2010, meeting of the North Carolina Medical Board was held at the Board's Office, 1203 Front Street, Raleigh, NC 27609. The meeting was called to order at 8:05 a.m., Wednesday, July 21, 2010, by Donald E. Jablonski, DO, President. Board members in attendance were: George L. Saunders, III, MD, Past President; Janice E. Huff, MD, PresidentElect; William A. Walker, MD, Secretary/Treasurer; Ms. Pamela Blizzard; Thomas R. Hill, MD; Dr. Ralph C. Loomis, MD; Ms. Thelma Lennon; John B. Lewis, Jr., LLB; Peggy R. Robinson, PA-C; Paul S. Camnitz, MD and Karen R. Gerancher. Also attending were R. David Henderson, Executive Director and Thom Mansfield, Board Attorney. Presidential Remarks Dr. Jablonski commenced the meeting by reading from the State Government Ethics Act, “ethics awareness and conflict of interest reminder.” No conflicts were reported. Dr. Jablonski explained the process to the Board members regarding the NCMB Officers and Executive Committee recommendations. Dr. Jablonski had Ms. Blizzard give a brief overview from the ”CPEP Learning Summit” she attended. Minute Approval Motion: A motion passed that the May 19, 2010 Board Minutes and the June 17, 2010 Hearing minutes are approved as presented. Executive Director’s Announcements Mr. Henderson updated the Board members regarding Dr. Scott Kirby becoming the new NCMB Medical Director. It was also noted that Dr. Sheppa would remain at the NCMB but on a parttime basis. Ms. Judie Clark, Director of Complaints, recognized Amy Ingram on her 5 year anniversary at the NCMB. Mr. Henderson noted that the NCPHP Compliance & BOD meeting would be held today at the Renaissance Hotel starting at 3:00pm. Mr. Curt Ellis, Director of Investigations, presented David Hedgecock, NCMB Investigator, for completion of the Certified Medical Board Investigator Certificate. Mr. Henderson noted that Ms. Jean Fisher-Brinkley, Director of Public Affairs, would be doing a Bi-annual program update for the Board on Friday morning. July 21-23, 2010 EXECUTIVE COMMITTEE REPORT The Executive Committee of the North Carolina Medical Board met beginning at 10:40 am, Wednesday July 21, 2010 at the offices of the Board. Committee members present were: Donald E. Jablonski, DO, Chair; Janice E. Huff, MD; George L. Saunders, MD; William A. Walker, MD; and John B. Lewis, Jr. Also present were Ralph C. Loomis, MD, R. David Henderson (Executive Director), Hari Gupta (Director of Operations) and Peter T. Celentano, CPA (Comptroller). Financial Statements Monthly Accounting May 2010: Mr. Celentano, CPA, presented the May 2010 compiled financial statements. May is the seventh month of fiscal year 2010. The Committee recommends the Board accept the financial statements as reported. Old Business Fines: N.C. General Statute 90-14(a) permits the Board to fine a licensee who has violated the Medical Practice Act. The Board previously approved the use of fines in cases where there is other disciplinary action. Senior staff continues to work on the manner in which fines, without accompanying discipline or other public action, should be published or reported. This issue will be discussed further at the September meeting. Change in Staff Privileges: N.C. General Statute Section 90-14.13 states that the chief administrative officer of every licensed hospital shall report to the Board actions involving a physician’s privileges to practice in that institution including any resignation from practice or voluntary reduction of privileges. However, the Board’s online Change in Staff Privileges form only requires hospitals to report “for cause” resignations or reductions in privileges. The Committee believes the current law may be too broad and recommends the Board seek a change to N.C. General Statute Section 90-14-13 to provide that changes in staff privileges are reportable pursuant to rules to be adopted by the Board. New Business Proposed Changes to Rules Regarding Misdemeanor Convictions: The Committee considered proposed changes to rule regarding publication of misdemeanor convictions on the Board’s website. The Committee preliminary approved the proposed changes and asked staff to forward the latest draft to the other Board members for comment. This matter will be discussed further at the September meeting. 2012 Meeting and Hearing Calendars: The Committee reviewed the proposed 2012 Board Meeting and Hearing schedule and recommends adoption. Nomination of New Officers and Executive Committee Members: The Committee nominates the following officers for 2010-2011: Dr. Ralph Loomis, President-Elect; Dr. William Walker, Secretary/Treasurer; and Ms. Pamela Blizzard member at large of the Executive Committee. According to the Bylaws, the current President-Elect, Dr. Janice Huff, shall automatically become President on November 1 and the current President, Dr. Donald Jablonski, will continue to serve on the Executive Committee as Past President. July 21-23, 2010 POLICY COMMITTEE REPORT Committee Members: Dr. Loomis, Dr. Walker, Judge Lewis, and Dr. Camnitz Staff: Todd Brosius, Christina Apperson, and Wanda Long NEW BUSINESS: POSITION STATEMENT REVIEW 1/2010 COMMITTEE RECOMMENDATION: (Loomis/Camnitz) Adopt a 4 year review schedule as presented. All reviews will be offered to the full Board for input. Additionally all reviews will be documented and will be reported to the full Board, even if no changes are made. 1/2010 BOARD ACTION: Adopt the recommendation of the Policy Committee. POSITION STATEMENT Professional Obligation to Report Incompetence, Impairment, and Unethical Conduct Medical, Nursing, Pharmacy Boards: Joint Statement on Pain Management in End-ofLife Care What Are the Position Statements of the Board and To Whom Do They Apply? Contact With Patients Before Prescribing Guidelines for Avoiding Misunderstandings During Physical Examinations Office-Based Procedures Access to Physician Records ADOPTED SCHEDULED FOR REVIEW LAST REVISED/ REVIEWED/ ADOPTED Nov-98 March 2010 Nov-98 Oct-99 May 2010 Oct-99 Nov-99 May 2010 Nov-99 Nov-99 July 2010 Feb-01 May-91 July 2010 Oct-02 REVISED/ REVIEWED REVISED/ REVIEWED REVISED/ REVIEWED REVISED/ REVIEWED Feb-01 Jan-01 May-96 May-93 Mar-02 Sep-97 May-96 Sep-00 Jan-03 Nov-93 Aug-03 Medical SupervisorTrainee Relationship Apr-04 Apr-04 The Treatment of Obesity Oct-87 Jan-05 Mar-96 HIV/HBV Infected Health Care Workers Nov-92 Jan-05 May-96 Writing of Prescriptions May-91 Mar-05 Jul-02 Mar-02 May-96 Laser Surgery Self- Treatment and Treatment of Family Members and Others With Whom Significant Emotional Relationships Exist Jul-99 Jul-05 Aug-02 Mar-02 Jan-00 May-91 Sep-05 Mar-02 May-00 May-96 Advertising and Publicity Nov-99 Sep-05 Mar-01 July 21-23, 2010 Sep-92 Prescribing Legend or Controlled Substances for Other Than Valid Medical or Therapeutic Purposes, with Particular Reference to Substances or Preparations with Anabolic Properties Sale of Goods From Physician Offices Competence and Reentry to the Active Practice of Medicine Availability of Physicians to Their Patients Referral Fees and Fee Splitting Sexual Exploitation of Patients Care of the Patient Undergoing Surgery or Other Invasive Procedure The Physician-Patient Relationship May-98 Nov-05 Jan-01 Jul-98 Mar-01 Mar-06 Jul-06 Jul-06 Jul-93 Jul-06 Oct-03 Jan-01 Nov-93 Jul-06 May-96 May-91 Sep-06 Jan-01 Sep-91 Sep-06 Mar-01 Aug-03 Jul-95 Sep-06 The Retired Physician Physician Supervision of Other Licensed Health Care Practitioners Jan-97 Sep-06 Jul-07 Jul-07 Medical Testimony Mar-08 Mar-08 Jul-93 Mar-08 May-96 Oct-99 Mar-08 May-07 Sep-08 Sep-08 Sep-96 Sep-08 Jul-05 May-94 May-09 May-96 May-98 May-09 Capital Punishment Jan-07 Jul-09 Departures from or Closings of Medical Jan-00 Jul-09 Aug-03 Unethical Agreements in Complaint Settlements Nov-93 Mar-10 May-96 Advance Directives and Patient Autonomy End-of-Life Responsibilities and Palliative Care Drug Overdose Prevention Policy for the Use of Controlled Substances for the Treatment of Pain Medical Record Documentation Retention of Medical Records May-96 Apr-96 Mar-02 Jan-00 Contact with patients before prescribing It is the position of the North Carolina Medical Board that prescribing drugs to an individual the prescriber has not personally examined is inappropriate except as noted in the paragraphs below. Before prescribing a drug, a licensee should make an informed medical judgment based on the circumstances of the situation and on his or her training and experience. Ordinarily, this will require that the licensee personally perform an appropriate history and physical examination, make a diagnosis, and formulate a therapeutic plan, a part of which might be a prescription. This process must be documented appropriately. July 21-23, 2010 Jul-98 Prescribing for a patient whom the licensee has not personally examined may be suitable under certain circumstances. These may include admission orders for a newly hospitalized patient, prescribing for a patient of another licensee for whom the prescriber is taking call, or continuing medication on a short-term basis for a new patient prior to the patient’s first appointment. Established patients may not require a new history and physical examination for each new prescription, depending on good medical practice. Prescribing for an individual whom the licensee has not met or personally examined may also be suitable when that individual is the partner of a patient whom the licensee is treating for gonorrhea or chlamydia. Partner management of patients with gonorrhea or chlamydia should include the following items: a) Signed prescriptions of oral antibiotics of the appropriate quantity and strength sufficient to provide curative treatment for each partner named by the infected patient. Notation on the prescription should include the statement: “Expedited partner therapy.” b) Signed prescriptions to named partners should be accompanied by written material that states that clinical evaluation is desirable; that prescriptions for medication or related compounds to which the partner is allergic should not be accepted; and that lists common medication side effects and the appropriate response to them. c) Prescriptions and accompanying written material should be given to the licensee’s patient for distribution to named partners. d) The licensee should keep appropriate documentation of partner management. Documentation should include the names of partners and a copy of the prescriptions issued or an equivalent statement. It is the position of the Board that prescribing drugs to individuals the licensee has never met based solely on answers to a set of questions, as is common in Internet or toll-free telephone prescribing, is inappropriate and unprofessional. (Adopted November 1999) (Amended February 2001, November 2009) 7/2010 COMMITTEE RECOMMENDATION: No changes are recommended. 7/2010 BOARD ACTION: Adopt the Committee recommendation. Guidelines for avoiding misunderstandings during physical examinations It is the position of the North Carolina Medical Board that proper care and sensitivity are needed during physical examinations to avoid misunderstandings that could lead to charges of sexual misconduct against physicians licensees. In order to prevent such misunderstandings, the Board offers the following guidelines. 1) 2) Sensitivity to patient dignity should be considered by the physician licensee when undertaking a physical examination. The patient should be assured of adequate auditory and visual privacy and should never be asked to disrobe in the presence of the physician licensee. Examining rooms should be safe, clean, and well maintained, and should be equipped with appropriate furniture for examination and treatment. Gowns, sheets and/or other appropriate apparel should be made available to protect patient dignity and decrease embarrassment to the patient while a thorough and professional examination is conducted. Whatever the sex of the patient, a third party, a staff member, should be readily available at all times during a physical examination, and it is strongly advised that a third party be present when the physician licensee performs an examination of the July 21-23, 2010 3) 4) 5) breast(s), genitalia, or rectum. It is the physician’s licensee’s responsibility to have a staff member available at any point during the examination. The physician licensee should individualize the approach to physical examinations so that each patient's apprehension, fear, and embarrassment are diminished as much as possible. An explanation of the necessity of a complete physical examination, the components of that examination, and the purpose of disrobing may be necessary in order to minimize the patient's possible misunderstanding. The physician licensee and staff should exercise the same degree of professionalism and care when performing diagnostic procedures (eg, electro-cardiograms, electromyograms, endoscopic procedures, and radiological studies, etc), as well as during surgical procedures and postsurgical follow-up examinations when the patient is in varying stages of consciousness. The physician licensee should be on the alert for suggestive or flirtatious behavior or mannerisms on the part of the patient and should not permit a compromising situation to develop. (Adopted May 1991) (Amended May 1993, May 1996, January 2001, February 2001, October 2002) 7/2010 COMMITTEE RECOMMENDATION: The Committee recommends that the word “physician” be replaced with “licensee” to be consistent with previous changes made during the Position Statement review process. 7/2010 BOARD ACTION: Adopt the Committee recommendation. OLD BUSINESS: POSITION STATEMENT CONTINUED REVIEW Issue: In November 2009, the Board approved the Policy Committee’s recommendation to review Position Statements at least once every four years. A review schedule has been formulated for the Committee’s consideration. TELEMEDICINE Issue: The Board to consider recent adoptions of telemedicine policies and statements by the Federation, Blue Cross Blue Shield and the AMA. 5/2009 COMMITTEE DISCUSSION: Dr. Rhyne reported that the Federation recently adopted a statement regarding telemedicine. It was also reported that BCBS would be implementing a new e-medicine policy. 5/2009 BOARD ACTION: Mr. Brosius to use information from AMA, Federation, Medical Society and BCBS, to begin working on a comprehensive policy. This policy should include the telepsychiatry issue the Committee addressed last year. 7/2009 COMMITTEE DISCUSSION: Dr. Rhyne reported that the AMA recently passed a policy regarding telemedicine and that Blue Cross Blue Shield may have also taken a position regarding this issue. July 21-23, 2010 7/2009 COMMITTEE RECOMMENDATION: Mr. Brosius is to continue to research this issue. The Committee will report its findings at the September meeting. 7/2009 BOARD ACTION: No action required. 9/2009 COMMITTEE DISCUSSION: Mr. Brosius presented the following proposed Position Statement. Comments were solicited from DHHS and their recommendations were considered and incorporated where the Policy Committee deemed appropriate. 9/2009 COMMITTEE RECOMMENDATION: Present proposed Position Statement to the full Board for consideration. This issue will be revisited at the November 2009 meeting. 9/2009 BOARD ACTION: Have proposed Position Statement published in Forum for comments before final adoption by Board. 11/2009 COMMITTEE RECOMMENDATION: Continue to collect comments. Position Statement and comments will be considered at the January 2010 meeting. 11/2009 BOARD ACTION: Continue to collect comments. Position Statement and comments will be considered at the January 2010 meeting. 1/2010 COMMITTEE DISCUSSION: Comments received are on file and were provided for the Committee’s review. The Committee discussed the need for informed consent. It was the consensus of the Committee that the proposed Position Statement should not be changed. 1/2010 COMMITTEE RECOMMENDATION: (Loomis/Camnitz) Approve proposed Position Statement. Present to full Board for approval. 1/2010 BOARD ACTION: After a full Board discussion, the Board voted to table this issue until the staff could obtain additional information regarding informed consent. 3/2010 COMMITTEE DISCUSSION: The Committee received comments from Dr. Wu and Mr. Bode regarding current standards in telemedicine as it related to radiology. Additional comments were made from public guests, indicating their interest in monitoring the Board’s activity on this issue. 3/2010 COMMITTEE RECOMMENDATION: Mr. Brosius is to prepare new language for the informed consent section of the proposed Position Statement. The proposal will be presented to the Policy Committee at the May meeting for further consideration. 3/2010 BOARD ACTION: Accept the Committee Recommendation. 5/2010 COMMITTEE DISCUSSION: The Committee heard from Dr. Brian S. Kuszyk, MD, Past President, NC Chapter of the American College of Radiology. Dr. Kuszyk explained that the nature of radiology is such that all or nearly all of radiology is teleradiology. He also indicated that the specialty of radiology is not one that relies upon informed consent. The Board discussed the fact that perhaps the section on informed consent is aimed at such a narrow category of cases that it is in fact more distracting than helpful. 5/2010 COMMITTEE RECOMMENDATION: Remove Informed consent section of the position statement as not necessary. 5/2010 BOARD ACTION: Adopt Committee recommendation. July 21-23, 2010 7/2010 COMMITTEE DISCUSSION: Janice Ramquist, Executive Director, North Carolina Integrative Medicine Society provided the Committee with a written statement regarding the Telemedicine position statement. Dr. Walker recommended that the section on fees be deleted. 7/2010 COMMITTEE RECOMMENDATION: Allow full Board to review letter from NCIMS. Approve proposed changes to Telemedicine position statement, which include deleting the informed consent and fee sections. 7/2010 BOARD ACTION: Adopt the Committee recommendation. Telemedicine “Telemedicine” is the practice of medicine using electronic communication, information technology or other means between a licensee in one location and a patient in another location with or without an intervening health care provider. The Board recognizes that technological advances have made it possible for licensees to provide medical care to patients who are separated by some geographical distance. As a result, telemedicine is a potentially useful tool that, if employed appropriately, can provide important benefits to patients, including: increased access to health care, expanded utilization of specialty expertise, rapid availability of patient records, and the reduced cost of patient care. The Board cautions, however, that licensees practicing via telemedicine will be held to the same standard of care as licensees employing more traditional in-person medical care. A failure to conform to the appropriate standard of care, whether that care is rendered in-person or via telemedicine, may subject the licensee to potential discipline by this Board. The Board provides the following considerations to its licensees as guidance in providing medical services via telemedicine: Training of Staff -- Staff involved in the telemedicine visit should be trained in the use of the telemedicine equipment and competent in its operation. Examinations -- Licensees using telemedicine technologies to provide care to patients located in North Carolina must provide an appropriate examination prior to diagnosing and/or treating the patient. However, this examination need not be in-person if the technology is sufficient to provide the same information to the licensee as if the exam had been performed face-to-face. Other examinations may also be considered appropriate if the licensee is at a distance from the patient, but a licensed health care professional is able to provide various physical findings that the licensee needs to complete an adequate assessment. On the other hand, a simple questionnaire without an appropriate examination may be a violation of law and/or subject the licensee to discipline by the Board.1 Licensee-Patient Relationship – The licensee using telemedicine should have some means of verifying that the person seeking treatment is in fact who he or she claims to be. A diagnosis should be established through the use of accepted medical practices, i.e., a patient history, mental status examination, physical examination and appropriate diagnostic and laboratory testing. Licensees using telemedicine should also ensure the availability for appropriate followup care and maintain a complete medical record that is available to the patient and other treating health care providers. 1 See also the Board’s Position Statement entitled “Contact with Patients before Prescribing.” July 21-23, 2010 Medical Records -- The licensee treating a patient via telemedicine must maintain a complete record of the telemedicine patient’s care according to prevailing medical record standards. The medical record serves to document the analysis and plan of an episode of care for future reference. It must reflect an appropriate evaluation of the patient's presenting symptoms, and relevant components of the electronic professional interaction must be documented as with any other encounter. The licensee must maintain the record’s confidentiality and disclose the records to the patient consistent with state and federal law. If the patient has a primary care provider and a telemedicine provider for the same ailment, then the primary care provider’s medical record and the telemedicine provider’s record constitute one complete patient record. Licensure -- The practice of medicine is deemed to occur in the state in which the patient is located. Therefore, any licensee using telemedicine to regularly provide medical services to patients located in North Carolina should be licensed to practice medicine in North Carolina.2 Licensees need not reside in North Carolina, as long as they have a valid, current North Carolina license. North Carolina licensees intending to practice medicine via telemedicine technology to treat or diagnose patients outside of North Carolina should check with other state licensing boards. Most states require physicians to be licensed, and some have enacted limitations to telemedicine practice or require or offer a special registration. A directory of all U.S. medical boards may be accessed at the Federation of State Medical Boards Web site: http://www.fsmb.org/directory_smb.html. Fees – The Board’s licensees should be aware that third-party payors may have differing requirements and definitions of telemedicine for the purpose of reimbursement. Medical, Nursing, Pharmacy Boards: Joint Statement on Pain Management in End-of-Life Care 5/2010 COMMITTEE DISCUSSION: The Committee discussed whether changes should be made to specify that the position statement applies to other licensees as well. It was suggested that, since the position statement was initially propounded as a joint statement, it might be helpful to discuss this matter with the other licensing boards. 5/2010 COMMITTEE RECOMMENDATION: Mr. Brosius to contact the Pharmacy Board and the Nursing Board to determine if they object to the proposed changes and if they will join in those changes. 5/2010 BOARD ACTION: Adopt the Committee recommendation. 7/2010 COMMITTEE RECOMMENDATION: Mr. Brosius to contact the Pharmacy Board and the Nursing Board to determine if they object to the proposed changes and if they will join in those changes. N.C. Gen. Stat. § 90-18(c)(11) exempts from the requirement for licensure: “The practice of medicine or surgery by any nonregistered reputable physician or surgeon who comes into this State, either in person or by use of any electronic or other mediums, on an irregular basis, to consult with a resident registered physician or to consult with personnel at a medical school about educational or medical training. This proviso shall not apply to physicians resident in a neighboring state and regularly practicing in this State.” 2 The Board also notes that the North Carolina General Statutes define the practice of medicine as including, “The performance of any act, within or without this State, described in this subdivision by use of any electronic or other means, including the Internet or telephone.” N.C. Gen. Stat. § 90-1.1(5)f. July 21-23, 2010 7/2010 BOARD ACTION: Adopt the Committee recommendation. Joint Statement on Pain Management in End-of-Life Care (Adopted by the North Carolina Medical, Nursing, and Pharmacy Boards) Through dialogue with members of the healthcare community and consumers, a number of perceived regulatory barriers to adequate pain management in end-of-life care have been expressed to the Boards of Medicine, Nursing, and Pharmacy. The following statement attempts to address these misperceptions by outlining practice expectations for physicians and other health care professionals authorized to prescribe medications, as well as nurses and pharmacists involved in this aspect of end-of-life care. The statement is based on: the legal scope of practice for each of these licensed health professionals; professional collaboration and communication among health professionals providing palliative care; and a standard of care that assures on-going pain assessment, a therapeutic plan for pain management interventions; and evidence of adequate symptom management for the dying patient. It is the position of all three Boards that patients and their families should be assured of competent, comprehensive palliative care at the end of their lives. Physicians, nurses and pharmacists should be knowledgeable regarding effective and compassionate pain relief, and patients and their families should be assured such relief will be provided. Because of the overwhelming concern of patients about pain relief, the physician needs to give special attention to the effective assessment of pain. It is particularly important that the physician frankly but sensitively discuss with the patient and the family their concerns and choices at the end of life. As part of this discussion, the physician should make clear that, in some end of life care situations, there are inherent risks associated with effective pain relief. The Medical Board will assume opioid use in such patients is appropriate if the responsible physician is familiar with and abides by acceptable medical guidelines regarding such use, is knowledgeable about effective and compassionate pain relief, and maintains an appropriate medical record that details a pain management plan. Because the Board is aware of the inherent risks associated with effective pain relief in such situations, it will not interpret their occurrence as subject to discipline by the Board. With regard to pharmacy practice, North Carolina has no quantity restrictions on dispensing controlled substances including those in Schedule II. This is significant when utilizing the federal rule that allows the partial filling of Schedule II prescriptions for up to 60 days. In these situations it would minimize expenses and unnecessary waste of drugs if the prescriber would note on the prescription that the patient is terminally ill and specify the largest anticipated quantity that could be needed for the next two months. The pharmacist could then dispense smaller quantities of the prescription to meet the patient’s needs up to the total quantity authorized. Government-approved labeling for dosage level and frequency can be useful as guidance for patient care. Health professionals may, on occasion, determine that higher levels are justified in specific cases. However, these occasions would be exceptions to general practice and would need to be properly documented to establish informed consent of the patient and family. Federal and state rules also allow the fax transmittal of an original prescription for Schedule II drugs for hospice patients. If the prescriber notes the hospice status of the patient on the faxed document, it serves as the original. Pharmacy rules also allow the emergency refilling of prescriptions in Schedules III, IV, and V. While this does not apply to Schedule II drugs, it can July 21-23, 2010 be useful in situations where the patient is using drugs such as Vicodin for pain or Xanax for anxiety. The nurse is often the health professional most involved in on-going pain assessment, implementing the prescribed pain management plan, evaluating the patient’s response to such interventions and adjusting medication levels based on patient status. In order to achieve adequate pain management, the prescription must provide dosage ranges and frequency parameters within which the nurse may adjust (titrate) medication in order to achieve adequate pain control. Consistent with the licensee’s scope of practice, the RN or LPN is accountable for implementing the pain management plan utilizing his/her knowledge base and documented assessment of the patient’s needs. The nurse has the authority to adjust medication levels within the dosage and frequency ranges stipulated by the prescriber and according to the agency’s established protocols. However, the nurse does not have the authority to change the medical pain management plan. When adequate pain management is not achieved under the currently prescribed treatment plan, the nurse is responsible for reporting such findings to the prescriber and documenting this communication. Only the physician or other health professional with authority to prescribe may change the medical pain management plan. Communication and collaboration between members of the healthcare team, and the patient and family are essential in achieving adequate pain management in end-of-life care. Within this interdisciplinary framework for end of life care, effective pain management should include: thorough documentation of all aspects of the patient’s assessment and care; a working diagnosis and therapeutic treatment plan including pharmacologic and non-pharmacologic interventions; regular and documented evaluation of response to the interventions and, as appropriate, revisions to the treatment plan; evidence of communication among care providers; education of the patient and family; and a clear understanding by the patient, the family and healthcare team of the treatment goals. It is important to remind health professionals that licensing boards hold each licensee accountable for providing safe, effective care. Exercising this standard of care requires the application of knowledge, skills, as well as ethical principles focused on optimum patient care while taking all appropriate measures to relieve suffering. The healthcare team should give primary importance to the expressed desires of the patient tempered by the judgment and legal responsibilities of each licensed health professional as to what is in the patient’s best interest. (October 1999) OLD BUSINESS: BOARD CERTIFICATION DISTINCTION 7/2009 BOARD ACTION: Approve proposed rule. Proceed with rule-making process. 9/2009 COMMITTEE DISCUSSION: It was reported that the following rule has been submitted to the Office of Administrative Hearings to be published in the NC Register. A public hearing for the purpose of collecting any comments will be held at the Board’s office on November 30, 2009 at 11:00 am. The proposed rule will be submitted to the Board at its December meeting for adoption. 9/2009 BOARD ACTION: Accept as information. July 21-23, 2010 11/2009 COMMITTEE DISCUSSION: It was reported that the following rule has been submitted to the Office of Administrative Hearings and was published in the NC Register. A public hearing for the purpose of collecting any comments will be held at the Board’s office on November 30, 2009 at 11:00 am. The Board continues to receive comments. The proposed rule and comments collected will be presented to the Board at its January 2010 meeting for consideration. 11/2009 COMMITTEE RECOMMENDATION: No action necessary. 11/2009 BOARD ACTION: No action necessary. 1/2010 COMMITTEE DISCUSSION: A public hearing was held on November 30, 2009, for the purpose of receiving comments regarding the proposed rule. A taskforce is currently being assembled to further research and consider this issue. No action is necessary at this time. 1/2010 COMMITTEE RECOMMENDATION: For information only. No action necessary at this time. 1/2010 BOARD ACTION: Dr. Jablonski is to appoint a taskforce to further research and consider this issue. 5/2010 COMMITTEE DISCUSSION: The taskforce has been created and its first meeting is scheduled for May 18th, 2010. 5/2010 COMMITTEE DISCUSSION: The taskforce has been created and held its first meeting on May 18, 2010. The taskforce invited additional comments on the issue to those present and will table this matter until sufficient time has transpired to allow for additional comment. 5/2010 COMMITTEE RECOMMENDATION: For information only. No action necessary at this time. 5/2010 BOARD ACTION: Adopt Committee recommendation. 7/2010 COMMITTEE DISCUSSION: Mrs. Apperson addressed the Committee regarding the May 18, 2010, taskforce meeting. It was suggested that the Committee consider adding criteria to the proposed rule in order to specify the requirements that the Board could consider in determining which certifying boards would be approved to use the term “Board Certified.” The Committee indicated that there seemed to be a consensus that a licensee must specify what area they are board certified in when advertising and identify the certifying Board. This would prohibit a licensee from advertising as being board certified and the board certification being in a field unrelated to the one being advertised. Additionally, the Committee pointed out that reporting board certifications for hospital credentialing purposes is not advertising. It was suggested that the Committee consider defining advertising. A representative of the NCMS suggested that the rule might work better in conjunction with a position statement. Dr. Walker pointed out that the Board originally had a position statement and the proposed rule was an effort to establish regulatory authority. 7/2010 COMMITTEE RECOMMENDATION: No action taken. 7/2010 BOARD ACTION: Adopt the Committee recommendation. July 21-23, 2010 21 NCAC 32Y .0101 is proposed for adoption as follows: Subchapter 32Y – SPECIALTY AND BOARD CERTIFICATION ADVERTISING 21 NCAC 32Y .0101 ADVERTISING OF SPECIALTY AND BOARD CERTIFICATION (a) No physician shall advertise or otherwise hold himself or herself out to the public as being “Board Certified” without proof of current certification by a specialty board approved by (1) the American Board of Medical Specialties; (2) the Bureau of Osteopathic Specialists of American Osteopathic Association; (3) the Royal College of Physicians and Surgeons of Canada; (4) a board or association with an Accreditation Council for Graduate Medical Education approved postgraduate training program that provides complete training in that specialty or subspecialty; or (5) a board or association with equivalent requirements approved by the North Carolina Medical Board. (b) Any physicians advertising or otherwise holding himself or herself out to the public as “Board Certified” as contemplated in paragraph (a) shall disclose in the advertisement the specialty board by which the physician was certified. (c) Physicians shall not list their names under a specific specialty in advertisements, including but not limited to, classified telephone directories and other directories unless: (1) they are board certified as defined in paragraph (a); or (2) they have successfully completed a training program in the advertised specialty that is accredited by the Accreditation Council for Graduate Medical Education or approved by the Council on Postdoctoral Training of the American Osteopathic Association. History Note: Authority G.S.90-5.1, 90-5.2, 90-14. LICENSE COMMITTEE REPORT A motion passed to close the session pursuant to Section 143-318.11(a) of the North Carolina General Statutes to prevent the disclosure of information that is confidential pursuant to Sections 90-8, 90-14, 90-16, 90-21.22 of the North Carolina General Statutes and not considered a public record within the meaning of Chapter 132 of the General Statutes and/or to preserve attorney/client privilege. Eleven licensure interviews were considered. A written report was presented for the Board’s review. The Board adopted the Committee’s recommendation to approve the written report. The specifics of this report are not included because these actions are not public information. A motion passed to return to open session. July 21-23, 2010 OPEN SESSION OLD BUSINESS: 1. Statutory Requirement for Postgraduate Training Issue: At the March 2009 meeting a motion was passed for staff to investigate the feasibility of changing NCGS 90-9.1(a)(2)a to require completion of more than 1 year of postgraduate education for graduates of a medical college approved by the Liaison Commission on Medical Education, an osteopathic college approved by the American Osteopathic Association or The Committee for the Accreditation of Canadian Medical Schools after graduation from medical school. 11/09 Board Action: Have legal provide an update at the January 2010 meeting. Tasked to legal 12/9/09 01/2010 Board Action: Recommend special project assignment to contact stake holders and research the repercussions it will have on the medical community. 03/2010 Board Action: Legal to provide update at May 2010 meeting. 05/2010 Board Action: Thom Mansfield to continue to get input from stakeholders. Update: Mr. Mansfield has not undertaken any additional meetings as of yet because it became clear that the input process would be lengthy and that this session of the legislature was going to end quickly without any realistic possibility of getting a bill considered this year. Committee Recommendation: Dr. Kirby and Mr. Mansfield to pursue meetings with stakeholders regarding the impact of changing the statue will have on the GME programs, starting with Dr. Gerancher. Board Action: Dr. Kirby and Mr. Mansfield to pursue meetings with stakeholders regarding the impact of changing the statue will have on the GME programs, starting with Dr. Gerancher. 2. Legal Residence Status – P. Balestrieri Staff continues to investigate the most practical way to verify that an applicant is a legal resident of the US. 11/09 Board Action: Move forward with staff’s proposal. Legal and Licensing Staff have submitted an application to participate in the SAVE program and are awaiting a response to the request. 1/2010 Board Action: Accept as information – Staff to provide update at March meeting. 3/2010 Board Action: Department of Homeland Security has backlog. Legal to provide update at May 2010 meeting. 05/20 10 Board Action: Staff will continue to request status updates from the Department of Homeland Security every 2 months. Legal will provide updates at next committee meeting. Update: No news from Save Program. Mr. Balestrieri will continue to check in with them periodically and report at the September meeting. Committee Recommendation: Staff will continue to contact the SAVE program every two months and report back to the Board until a decision has been made on NCMB’s application. July 21-23, 2010 Board Action: Accept as information. NEW BUSINESS 3. Criteria for PLOCs on “failure to disclose” Issue: Dr. Sheppa requests clarification for consistency – see his 4/9 email to Dr. Huff. The committee discussed setting the criteria for PLOCs. Board Action: Table until July 2010 meeting. Committee Recommendation: Accept as information. Continue to consider each application on an individual basis. Board Action: Accept as information. Continue to consider each application on an individual basis. 4. CME Rule Change Issue: The following amendment to 32B .1303(b) (4) was approved during the June hearings and submitted to Rules Review as a part of the licensing rules rewrite: Issue (4) within the past three years, received a practice-relevant, three-year AMA Physician's Recognition Award or AOA equivalent CME. years completed CME as required by 21 NCAC 32R .0101(a), .0101(b), and .0102 Committee Recommendation: Accept as information. Board Action: Accept as information. 5. Review of AMA/PRA CME by Board Members for applicants Issue: Currently, otherwise clean applications which use the AMA/PRA certificate to satisfy the ten-year rule are routed to Board members for review to make sure the CME is practice relevant. Staff believes this can be handled by the OMD and Board members consulted on an as needed basis. Committee Recommendation: For clean applications in which AMA/PRA certificate is submitted to satisfy the ten-year rule: OMD will review underlying CME to make sure it is practice relevant. If so, staff will issue license. If not, or if there is any question, staff will send out for Board member review. Board Action: For clean applications in which AMA/PRA certificate is submitted to satisfy the ten-year rule: OMD will review underlying CME to make sure it is practice relevant. If so, staff will issue license. If not, or if there is any question, staff will send out for Board member review. 6. Licensing Review Workgroup – Executive Summary Issue: Mr. Henderson has put together an Executive Summary of the changes recently made to the licensing requirements and on-line application. Changes include modifications to the licensing rules. July 21-23, 2010 Committee Recommendation: Accept as information. Send Amy Whitted at NCMS a copy of the new license application and relative forms. Board Action: Accept as information. Send Amy Whitted at NCMS a copy of the new license application and relative forms. 7. Prior out of state actions for applicants. Issue: There was a discussion on whether staff should put prior out of state actions on the licensee information page or allow the licensee to update. Committee Recommendation: License committee will continue to monitor; a work in progress. Board Action: Accept as Information. LICENSE INTERVIEW REPORT A motion passed to close the session pursuant to Section 143-318.11(a) of the North Carolina General Statutes to prevent the disclosure of information that is confidential pursuant to Sections 90-8, 90-14, 90-16, 90-21.22 of the North Carolina General Statutes and not considered a public record within the meaning of Chapter 132 of the General Statutes and/or to preserve attorney/client privilege. Ten licensure interviews were conducted. A written report was presented for the Board’s review. The Board adopted the Committee’s recommendation to approve the written report. The specifics of this report are not included because these actions are not public information. A motion passed to return to open session. PHYSICIAN APPLICANTS PRESENTED TO THE JULY, 2010 MEETING Abraham, William David Abu Ahmed, Tahanie Adamson, Megan Marie Adegoroye, Adeyinka Abimbola Ahiarah, Ahunna Ngozi Ahmad, Tariq Ahmad, Zeeshan Naseer Aitken, Paul Vincent Akbar, Farooq July 21-23, 2010 Akbary, Hares Akbary, Silvija Alauddin, Kashif Allaboun, Kadry Raji Alm, Stephanie Shannon Morgan Andrews, Thomas John Anthony, Robert Ray Appel, James Ziegler Armenta Corona, Jorge Nicolas Arts, Jeff Patrick Ashraf, Muhammad Salman Atisha, Dunya Mary Atli, Aysel Atluri, Tej Kumar Auerbach, Amy Rebecca Ayepah, Rina Bacelieri, Rocky Evan Bailey, Westly Adrian Baillie, Daniel Robert Bain, Jesse Colin Baker, Scott Dillman Balle, David Scott Banks, Jeffrey Allan Barber, Alfred Joseph Barber, Joseph Richard Barker, Joseph Uhalt Barreda, Joyce Ileana Bates, Shayne Ethan Beasley, Benjamin Edward Bellisari, Gregory Ernest Berenzon, Dmitriy Petrovich Berliner, Adam Michael Berman, Lawrence Miller Bermudez, Jennifer Jane Bernacki, Gwen Marie Betro, Joseph R Beyer, Gregory Robert Bigger, Elizabeth Sun-Mee Biswas, Tithi Black, Mitchell Collins Block, Geoffrey Douglas Bocook, Jessica Dawn Boliek, William Gary Bonner, James M Bourjeily, Nabil Abdallah Bowman, Natalie McCarter July 21-23, 2010 Braithwaite, Mary Fox Brown, Angel Aleatha Brown, Caroline Thomas Brumit, James Mark Bruner, David Ingram Buchanan, Cynthia Elton Buckingham, Lisa Caroline Bulsiewicz, William John Bumgarner, Elizabeth Jane Bunch, Jennifer Bucci Butt, Abid Shahzad Callahan, Kathryn Elizabeth Campeau, Lysanne Cannon, Jennifer Cardell, Deborah Lynn Carey, Erin Teeter Carroll, Nicole Summerour Carter, Kevin Sterling Cassidy, Amy Lucille Caudill, Terra Celeste Chaudhary, Nusrat Ahmad Cheng, Sybil K Chia, Stephanie Ming-Way Chiasson, Melissa Ann Choudhary, Varun Clanton, Pamela Anne Clark, Andrew Douglas Clark, Aundrea Lynn Clay, E. Leila Jerome Clements, Wilson Monroe Cohen, Jennifer Diane Collins, Deborah Connelly, Scott Vincent Constant, Douglas Lionel Constant, Peggy Contreras, Jamie Jaqua Coopey, Adrienne Ruth Cox, Natravis Ramon Dailey, Natalie Janine Miriam Dartey-Hayford, Samuel Kwame Daud, Faisal Ahmad Davidson, Deanna Starr Dawkins, John Graves Day, Jonathan Michael De Guzman, Joy Imperial Del Rio Munoz, Jose Mauricio July 21-23, 2010 Demetri, Charalambos Denny, Gerald Blalock D'haenens, Joseph Paul Dickey, Marcy Lynn Dickinson, Jeri Elizabeth Dieter, Benjamin Scott DiGiacomo, Philip John Dimitrova Koutleva, Dobrinka Velikova Dodis, Regina Dolhun, Rachel Marin Dorfman, Todd Andrew Dormois, John Carl Duncan, Scott Meacham D'Urso, Francis Anthony Dusek, David Andrew Eads, Emily Dawn Ebong, Imo Asuquo Edwin, Micah Boaz Obadiah Eichelberger, Kacey Young Elhaimer, Ahmed Elssner, Paul Andreas Erickson, Kimberly McCrudden Farel, Claire Elise Fasina, Abiola Abodunrin Feyissa, Girum Ketema Fisher, David Andrew Foltz, Gretchen Marie Forsha, Daniel Eric Fortgang, Kenneth Francis, Geoffrey Alan Fuller, Lance Robert Gallagher, Meera Patel Ghanami, Racheed Joseph Ghimire, Shanker Mani Gocke, Ryan Thomas Goldblatt, Mark Robert Graham, Rose Corinne Gray, Alice Lee Green, Thomas John Grezaffi, John Adam Grider, Douglas James Gutierrez, Javier Hahn, Paul Sang Do Hampson, Mary Suzanne Hart-Unger, Sarah Hartz, Douglas Joseph July 21-23, 2010 Hash, Kendall Sibley Hash, Thomas Walter Havas, Jeremy D Hayashi, Masanori Helm, David Scott Henderson, Jessica Lynn Hensley, Justin Paul Hensley, Katherine Hampshire Hiestand, Brian Charles Higgins, Ashantice Kenyana Hill, Becki Sue Hines, Chesley Hinton, Joseph Bryan Hollrah, Scott Allen Holmsten, Walter Russell Howell, Diane Michelle Hudson, Christopher John Hudson, Timothy Craig Hulett, Cidney Scott Humsi, Juliette Ann Huneycutt, Benjamin Stuart Hurwitz, Jennie Rachel Hussain, Farid M Ibazebo, Wesley Ivey, Noel Jain-Rodriguez, Anitha Kamla Jakstys, Rima Eleonora James, Jehana Asaidra Janjua, Nadia Khan Jarvis, Amber Marie Jernigan, Nicholas Allen Jha, Shivkumar Johnson, Amy Brook Jolly, Trevor Augustus Jones, Jason Matthew Jonnalagadda, Venkata Ramanamba Jose, Folashade Adebisi Mueenot Jou, Janice Hsiao-Lun Kajoian, Armineh Babaian Kaldas, Amir Ishak Kalisetti, Radhika Kandra, Ajay Kumar Kansara, Sanjay Chinubhai Kanyi, Emmanuel Kaplan, Keith Jacob Kapural, Leonardo July 21-23, 2010 Karim, Zakiya Sultana Karpenko, Matthew J Kelmenson, Robin Deston Khan-Hudson, Alia Khawaja, Fawad Naeem Khazanie, Prateeti Prabhaker Khera-McRackan, Naina Khode, Renu King, Jeffrey Bryan Kipikasa, Joseph Henry Kite, Lisa Lea Klahr, Phillip D Knightshead, Kandi Terell Koch, Spencer Robison Koreen, Irina V. Korrapati, Vinod Kosko, John Herrington Koul, Sharat Krishnamurthy, Ashok Subramanian Krishnan, Pranay Kuzma, Kevin Robert Lacap, Anton Peter Lark, Robert Kamiel Laudate, James Darrell Lee, Rusty Joe Lee, Teng Chun Li, Jing Lipata, Fredilyn Manalo Logan, Scott Donovan Lowery, Ashlei Williams Lowery, William Jeffrey Lustig, David Michael Lynch, Christopher Raymond Machado, Ricardo Maguire, Jennifer Marie Mahmood, Kamran Mahoney, Joseph Peter Makhija, Kanishk Manning, Rebecca Anna Manning, Steven Mark Marshall, Shirley Ann Martin, Daniel John Mathers, Keith Jeffrey Matley, Ryan Christopher Mautner, James F Maximin, Suresh Thomas July 21-23, 2010 May, Monique Danielle Mayans, Laura Christine Mayer, Stephanie Brigitte Mays, Rhett Churchill McCanta, Anthony Charles McConahy, Melissa Lynn McConnell, Stephen David McHale, Robert James McLemore, Jerri Lynn Melvin, James Stuart Meuse, Megan Clare Meuse, Michael Anthony Miller, Thomas Davis Miller, Timothy Bryan Ming, David Yung Mirmow, Dwight Paul Misra, Dipika Missick, Benjamin James Mitchell, Kate Lawrence Mody, Vaishali R Moise, Duane Marvin Mooney, Kimberly L. M. Moore, Robin Michelle Moore, Scott Matthew Moran, Louis Jeffrey Morgan, Justin Wade Morris, Deborah Alissa Moseley, Jonathan Allan Mostak, Richard Grant Mourad, Mervat Mufarrij, Patrick Walid Mullins, Amanda Catherine Munford, Loreli Robin Murphy, James Thomas Murphy, Robert Bryan Murphy, Timothy Daniel Musunuru, Sandeepa Mynster, Christopher John Nakhla, Sammy Ghobrial Nebab, Emmanuel Guillermo Nguyen, Vu Huu Niceler, Brock James Nightingale, Daniel Ray O'Connor, Siobhan Marie Ogugua, Chukwuma Stephen O'Hara, Peggy Elizabeth July 21-23, 2010 Oliver, Lanta Christine Ordman, Stanley Allen Orkubi, Ghada Abdullah Owens-Sloan, Natalie Christina Oyelami, Ifeyemi Oyerinsola Pabon-Ramos, Waleska Michelle Paolillo, Joseph Anthony Pappalardi, Jill M Paquette, Edmond Laurent Parcel, Ted William Park, Chan Woo Paschke, Joshua Kane Patel, Gautam Ghanshyambhai Patel, Pranav Dhaneshkumar Pence, Billy Jack Pepper, Matthew Daniel Peragallo, Rachel Marie Pharr, Emily Poole Pieleanu, Adrian Pieleanu, Irina Pires, Emanuel Lino Pirozzi, Donald J Rabb, Forte Calloway Rahbar, Reza Rathnam, Punitha Ida Rauls, Russell Barnes Ravish, Matthew Edward Ray, Adrienne Phillips Ray, Vincent Lavalles Gills Reece Hartz, Jennifer Leigh Reisenauer, Christopher Scott Rhee, Richard Jinho Riley, Celeste Rita Ro, Richard Youshin Roberson, Diana Combs Rocha, Sean Brian Rodriguez, Raul Rojas Balcazar, Juan Manuel Roman, Philip Emanuel Francois Rosdahl, Jullia Ann Rose-Jones, Lisa Jeannette Rosen, Leslie Bruce Rosenzweig, Laura Beth Ross, Robert R Rossi, Paul Christopher Rubio, Ruth Castro July 21-23, 2010 Rudd, Joshua David Rumbaugh, Christopher Allan Russell, Gregory Alan Russell, Mary Catherine Saenz, Rodrigo Ernesto Sailey, Charles Joseph Salama, April Kelly Scott Salama, Joseph Kamel Salicru, Adriano Nussa Samaropoulos, Xanthia Fallon Sampat, Keeran Ravin Samuel, Colleen Rochelle Say, Emil Anthony Ty Schonberg, Dana Beth Schroeder, Kristin Marie Selser, Helen Gordon Selwane, Pierre Sami Seward, James Bernard Sewell, Kia Renece Shah, Binit Prabhulal Shah, Tilak Upendra Shaikh, Khawar Mushtaq Sharpe, Brent Alexander Shaw, Jeremy Walter Sheppard, John Edward Sherwood, Matthew William Shipley, Melissa Faith Game Shoffeitt, John Paul Sillings, Christine Norton Sincock, Matthew Curren Smith, Mackenzie Marie Smith, Ronald Douglas Smith, Trent William Smrtka, Michael Patrick-Bousson Sodhi, Santosh Spandorfer, Philip Robert Spratt, Donna Lee Stanczak, Jeffrey Steinberg, Benjamin Adam Stepp, Kevin James Edward Sterk, Troy Michael Stevenson, Marvaretta Miesha Stewart, Richard McBee Stokes, Russell Brent Stoutamire, Barney Daniel Strayhorn, Shakonda July 21-23, 2010 Strollo, Stephanie Lauren Subla, Mir Rauf Summers, Aerica Sadler Sumrall, Ashley Love Sweeney, Alison Evelyn Swenson, Jason Alan Syed, Tauseef Gilani Szekeresh, Linda Ann Tacktill, Norman Taylor, Richard Stephen Tepper, Bryan Kenneth Terlecki, Ryan Patrick Theall, Gary Wayne Thekdi, Ashish Dinesh Thiyagarajan, Thanigaiarsu Thomas, Brooke Burkart Thomas, Cherisse Jamala Thomas, J George Thomas, Julian Manuel Thompson, Corey Adam Torres-Sy, Maria Aurora Rivera Trobbiani, Dina Marie Tsirline, Victor B Tunks, Robert Daniel Turakhia, Palak Bipin Ungerleider, Ross Michael Uniat, Reuben Wayne Valentine, Brandon James Van Tassel, Pamela Velasco-Trujillo, Juan Carlos Verdura, Nicholas Vieages, Ananda Leah Viechnicki, Tara Marie Villar, Carlos Eugenio Villarosa, Leonardo Leopando Volk, Matthew John Von Klar, John Lowell Vu, Thuy L. Wajida, Ghousia Walker, Jennifer Azbell Wallace, Suemoy Solone Walsh, Michael Joseph Ware, Patrick Lyle Warner, Kristin Kay Watford, John Wesley Watts, Jonathan Michael July 21-23, 2010 Weatherall, Justin Madison Webb-Wood, Sarah Wei, Benjamin Weiss, Jared Weitenberner, Nicholas Alan Wells, Hamilton Jason Welsh, Ian Robert Wendell, Jonathan Craig Wershba, Elisa Cheryl Westervelt, Justin David Westwater, Joseph James Whitehead, Lisa Ann Whitlock, Sandra Nasrallah Whitlock, Tom Lee Wick, Mark Robert Wilkins, John Jasper Williams, Amy Halbert Williams, Jefferson Gary Willinger, Samuel Michael Wilson, George Dean Woolard, Douglas Winfield Workman, James Leonard Wright, Jean A. Wroblewska-Shah, Joanna Monika Xie, Qingmei Yanagi, Grant Jeffrey Young, Michael Peter Yuan, John Qing Zacharias, Julie Anne Zamor, Philippe Jude Zani, Sabino Zhou, Li Reinstatement Anthony, Robert Ray Barber, Alfred Joseph Bermudez, Jennifer Jane Boliek, William Gary Fisher, David Andrew Fuller, Lance Robert Hill, Becki Sue Hines, Chesley Huneycutt, Benjamin Stuart May, Monique Danielle Mirmow, Dwight Paul Oliver, Lanta Christine July 21-23, 2010 Orkubi, Ghada Abdullah Samuel, Colleen Rochelle Taylor, Richard Stephen Ungerleider, Ross Michael Uniat, Reuben Wayne Reactivation Clanton, Pamela Anne Faculty Limited License Carey, Erin Teeter Francis, Geoffrey Alan Say, Emil Anthony Ty Retired Volunteer License Wilson, George Dean Special Volunteer License Spandorfer, Philip Robert Initial PA Applicants Licensed 05/01/10 – 06/30/10 PA-Cs Name Alston, Veronica Lynn Belabin, Jeffrey Howard Bender, Jenna Daggett Bennett, Kelly Anne Bernal, Lindsay Scales Boles, Katharine Olivia Bortner, Stephanie June Bosley, Jeffrey Scott Boyce, Clifford Vernon Boykin, Ryan Elizabeth Butler, Eric Ryan Cabaniss, William Carlton Chan, Kate Wai-Ki Cockerham, Jessica Danyel Connell, Jennifer Dammen, Peter Scott Davis, TraVonda Downs, Marc Andrew Drabik, Joanna K Entzi, Emily Suzanne 05/26/2010 05/12/2010 05/28/2010 05/03/2010 06/11/2010 06/15/2010 06/23/2010 06/02/2010 05/13/2010 06/08/2010 06/17/2010 06/21/2010 05/21/2010 06/04/2010 06/14/2010 06/11/2010 06/14/2010 06/30/2010 05/21/2010 06/04/2010 July 21-23, 2010 Everidge, Julie Foley, Brianne Galli, Lindsay Marie Geiple, Joshua Scott Girocco, Susanna Lee Halla, Brian Louis Haynes, Elizabeth Miles Heggerick, Gretchen Elizabeth Austin Heins, James Florian Heslep, Mallory Gwen House, Ashley Renee Huber, Tracey Nicole Hunt, Bethany Jordan Ide, Christina Marie Imboden, Lauren Whisenant Jackson, Brittany Amber Kiehle, Adrienne Marie Kline, Britney Dawn Koepp, Peter Christopher Kreger, Edward Lance LaFayette, Sara Lamberson, Faith Nicole Lauer, Thomas M Lyon, Christopher Lyons, Jennings DeWayne McClure, Erin Louise McCutcheon, Leslie Ann McDaniel, Denise Wilson McLamb, Michael Andrew Miedema, Marcia Garris Nordbladh, Louise Ingegerd Charlotta O'Neil, Brianna Jean Parmley, Deidre Jannell Peacock, Brian Barkley Plate, Anne C Reed, Courtnay Works Reese, Niki Rezac, Darcy Jo Rice, Easton Martin RockWiley, Keith Steele Roczniak, Regina Jo Rogers, Samantha Deviney Rutherford, Annie Scott, Rachelle Ranee Shaffer, Simon-Peter Smith, Matthew Thomas 06/17/2010 06/11/2010 06/15/2010 06/07/2010 06/30/2010 06/30/2010 06/04/2010 06/14/2010 06/01/2010 06/04/2010 06/30/2010 06/14/2010 06/07/2010 06/17/2010 06/21/2010 06/11/2010 06/15/2010 06/29/2010 05/24/2010 06/11/2010 06/23/2010 05/26/2010 05/26/2010 06/11/2010 06/24/2010 05/03/2010 06/30/2010 06/11/2010 05/21/2010 06/11/2010 06/18/2010 06/14/2010 06/17/2010 06/18/2010 06/15/2010 06/04/2010 06/28/2010 06/11/2010 05/26/2010 06/23/2010 05/26/2010 06/07/2010 05/26/2010 06/24/2010 05/06/2010 06/23/2010 July 21-23, 2010 Speight, Jamie Leigh Steerman, James G Turner, Lauren Blake Von, Karla Virginia Wall, Philly Marie Weiland, Daniel Mark Wheeler, Kevin Lynn Wilkens, Lyndsay Williams, Mathew Wade Wood, Charles Christopher Zachman, Melissa Clare Zastudil, Amanda Sue 06/23/2010 06/15/2010 06/01/2010 05/04/2010 06/28/2010 06/22/2010 05/24/2010 06/23/2010 06/04/2010 06/22/2010 06/28/2010 05/03/2010 PA-Cs Reactivations/Reinstatements/Re-Entries Johnson, Betty Lynne Wallace Nicholson, Janice Pixton, Jan Maree Seal, James Hargett 06/10/2010 06/16/2010 06/23/2010 06/03/2010 Additional Supervisor List – 05/01/10 – 05/31/10 PA-Cs Name Amos, Clifford Arbogast, Tanya Arbogast, Tanya Babb, Richard Balsly, Josh Barboza, Bryan Barrow, Kern Bath, Deanna Bath, Deanna Belabin, Jeffrey Bennett, Kelly Bonito, Jeffrey Branstetter, Annie Buchanan, Misty Burkes, Cynthia Burns, Tricia Carpenter, Iliana Collins, Amanda Collins, Ann Craig, Dinah Primary Supervisor Blyth, Stacey Burnett, Tara Feinson, Theodore Fogartie, James Idrissi, Rachid Lostetter, Stephen Palega, Gregory Cantuaria, Guilherme McDonald, John Minior, Daniel Vesa, Allin Unks, Dennis Carroll, Eben Nnadi, Victoria Lee, Melvin Lacin, Robert Perez-Navarro, Paul Young, Carol Smith, Jarvis Saini, Hari Practice City Tarboro Raleigh Raleigh Raleigh Benson Gastonia Wallace Charlotte Charlotte Dunn Statesville Asheville Winston Salem Kernersville Fuquay-Varina Raleigh Wilson Fort Bragg Burlington Fayetteville July 21-23, 2010 Craver, Amelia Del Rosario, Josephine Downing, Karol Downing, Karol Driebeek, Mary Drinkwater, Don Dugliss, Malcolm Dye, Jennifer Efird, Mark Emler, Sherlynn Ensign, Todd Farmer, Kimberly Franklin, Amy Galban, Carlos Gocke, Thomas Godwin, Anita Gonzalez, Eugenio Gore, William Hage, Suzanne Harris, Brenda Hayes, Kathleen Hendrix, Anne Herlihy, Michelle Hill, Sylvie Hinds, David Holland, Geoffrey Holler, Teresa Hollingsworth, Robert Hudak, Nicholas Hudak, Nicholas Hudak, Nicholas Hughes, Jo Huynh, Tam Izaj, Nicholas Johannes, Julie Keller, Michael Kellermeyer, Angela Kerchner, Bryan Kerchner, Bryan Kirsch, Eric Kirsch, Eric Kowaleski, Jennie Laws, Steven Lawyer, Christopher Leaman, Jason Lee, Allyson Lee, Melvin Williams, Jonathan Almirall, Peter Forstner, James Keenan, Robert Collins, Roger Groh, Mark Henry, Christy Lutz, Charles Saltz, James Richardson, Wendell Frankos, Mary Aklilu, Mebea Grossell, Michael Messerly, David Wilson, Lisa Lacroix, Christopher Meyer, Mitchell Smithson, Robert Faison, Vanosia King, Lunsford Silver, Marc Okonkwo, Ifeyinwa Daubert, James Broadwell, Richard Harris, William McCann, Shawn Stuart, Dennis Massey, Edward Morgenlander, Joel Skeen, Mark Sena, Carol Olmedo, Mario Le, Tri Naziri, Wade Ballard, William Croland, David Barron, Jerry Homesley, Howard Braunstein, Andrew Giallanza, Peterson Israel, Rodger Moyer, Frank Elmahdy, Wagdy Gibbons, Gregory Barnes-Durity, Monica Clayton Kinston Oak Island Southport Durham Cary Asheville Raleigh Gastonia Snow Hill Emerald Isle Wilmington Winston Salem Shelby Raleigh Kings Mountain Warsaw Wilmington Raleigh Durham Wilmington Raleigh Fayetteville Durham Goldsboro High Point Carolina Beach Lumberton Durham Durham Durham Greensboro Durham High Point Greenville Dobson Waxhaw Charlotte Charlotte Mooresville Mooresville Raleigh Winston Salem Winston Salem Raleigh Newton Grove July 21-23, 2010 Lee, Allyson Lentz, Jennifer Lockett, Amy Lowder, Richard Malivuk, William Marion, Wade Martin, Patrick Martin, Patrick McClure, Erin McHatton, Timothy McLaughlin, Thomas Melgar, Tammy Migdon, Steven Miller, Kevyn Minor, David Mitchell, Russell Mitchell-Barnes, Donna Moretz, Katherine Munn, William Ochs, Jeffrey Paris, Melissa Patel, Roshni Peifer, Jennifer Pennell, Shannon Person, Jennifer Polk, Aimee Porter, Allison Quintero, Tammi Rabon, Patricia Rabon, Patricia Ramsey, Pamela Randolph, Mark Renn, Amber Richardson, Keri Rigsbee, William Rigsbee, William Robb, Sybil Roczniak, Regina Roth, Samuel Russell, Douglas Rutledge-Holt, Debbie Sawyer, Lindsay Schade, Jana Scott, Tracy Shanton, Gregory Sheehan, James Subedi, Rajesh Kelley, Michael Morris, Deborah Tatter, Stephen Forstner, James Rhyne, Darryl Freed, Cindy Hayes, Laneau Zinicola, Daniel DeVirgiliis, Juan Freund, Victor Gootman, Aaron Guha, Subrata Kaminski, David Nanjagowder, Velukumar Hoski, James Ainolhayat, Cecilia Glenn, David Lobao, Celso Cromer, John Hudson, Jennifer Lin, Shu Stouffer, George Hamilton-Brandon, Luredean Playford, Scott Mattox, William Borchelt, Bret Andy, Camille Morris, Deborah Ogunwo, Susannah Fleury, Robert Hooper, Thomas Butler, Brad Chaudhry, Abdul Palega, Gregory Zinicola, Daniel Benitez-Graham, Ana Dickson, Christopher Khoudary, Kevin Elston, Scott Richards, Michael Gibbons, Gregory Williams, Jonathan Shadad, Firas Whitlock, Gary Sullivan, David Newton Grove Charlotte Fayetteville Winston Salem Southport Elkin Murphy Murphy Rocky Point Boone High Point Fayetteville Wilson Burlington Winston Salem Asheville Fayetteville Brevard Rocky Mount Wilmington Salisbury Durham Chapel Hill Lenoir Jacksonville Castle Hayne Winston Salem Oak Ridge Fayetteville Fayetteville Pinehurst Wilson Angier Raleigh Wallace Rocky Point Mebane Greensboro Cary Burlington Fort Mill Knightdale Kinston Greensboro New Bern Charlotte July 21-23, 2010 Sherron, Katherine Shier, Trilby Shirlen, Andrew Skaggs, Bethany Skulavik, Patricia Steimle, Theresa Stephens, Robert Swierz, Jennifer Trent, Margie Turner, Donald Van Vooren, Amy Von, Karla Wallace, Connie Walls, Linda Ward, Tod Weiss, Stanley Wheeler, Merritt White, Dale Williams, Clifton Wrenn, Cynthia Wypych, Kelly Law, Michael Albert, Deborah Kiser, Andy Brezicki, Paul Zellinger, Michael Choi, Jiho Flanders, Paul Young, Carol League-Sobon, Jennifer Pathan, Ayaz Riser, Mark Meyer, Clinton Saltzman, Leonard Rose, Gregory Wiggins, David Palega, Gregory Luoma, David Rehfield, Amy Taylor, Marshall Gootman, Aaron McGinnis, LaMar Raleigh Wilmington Pinehurst Concord Dunn Spring Lake Asheville Ft Bragg High Point Sanford Louisburg Wilmington Albemarle Raleigh Thomasville Wallace Dallas Knightdale Greenville Fayetteville Charlotte Additional Supervisor List – 06/01/10 – 06/30/10 PA-Cs Name Acker, Shekitta Adams, Jason Agresta, Dominic Alcala, Jose Alfano, Brian Alves, Leonilde Ambroise, Marie-Jacques Andrews, Maureene Avery, Leanne Babb, Richard Bacon, Jenise Baker, David Ballenger, Ann Bass Ransom, Julie Beard, Christina Beauman, Glenn Beauman, Glenn Beauman, Glenn Bennett, Kelly Primary Supervisor Weigle, Nancy Gootman, Aaron Frankos, Mary Coleman, Ralph Prather, Trina Epling, Carol Hooper, Jeffrey Kauth, Brian Steinl, Kevin Baule, Raymond Hunt, Mary Kilby, Larry Wofford, Marcia Trani, Paul Aul, Christopher Clark, Edward Clark, Eilis Jones, Jeffrey Thompson, Donovan Practice City Durham Fayetteville Wilmington Durham Durham Durham Durham Hickory Greensboro Rocky Mount Greensboro Taylorsville Winston Salem Hendersonville Fayetteville, Wilson Wilson Wilson Lincolnton July 21-23, 2010 Bennett, Rachel Bernal, Lindsay Binstock, Michael Blelloch, Lawrence Blumenthal, Susan Blumenthal, Susan Bogdanova, Galina Boles, Katharine Bolt, Carol Bolt, Carol Bolt, Carol Bortner, Stephanie Bost, Derek Boykin, Ryan Bradshaw, Johnnie Branum, Stephen Briggs, Melvania Brothers, Shaun Brown, Jennifer Brown, Jessica Buck, Philip Bumgarner, Mary Kathryn Burnett, Kristin Buschemeyer, Kristin Buschemeyer, Kristin Buschemeyer, Kristin Bush, Kenneth Bush, Kenneth Campbell, Kimberly Carlson, William Carter, Alnissa Carter, Paula Carter-Adkins, Danielle Carter-Adkins, Danielle Cawley, Kathryn Chambers, Gregory Chambers, Gregory Chance, Jeffery Chance, Jeffery Chavis, Anthony Chen, Yuegang Chen, Yuegang Chester, David Chester, David Chester, David Chester, David Sloan, Randy Kon, Neal Sloan, Randy Burnett, Tara Graham, Mark Lerro, Keith Cabral, Gonzalo Aklilu, Mebea Allgood, Sara Runyon, Michael Vaden, Tracela Whitman, Bruce Lowry, David Kon, Neal Ohl, Matthew McKaraher, Charles Graddy, Logan Guha, Subrata Sinden, John Hinson, Thomas Gagliano, Louis Hook, Matthew Howard, Chad Bullard, Dennis Carr, James Curzan, Mark Guerrini, James Lue, Alvin Henry, Christy Dewees, Steven Elston, Scott Goad, Bradley Helman, Steven Toborg, Robert Kuo, Paul Barnabei, Robert Barnabei, Robert Cannon, Brett D'Amico, Paul Burnett, Tara Marterre, William Stuart, Samuel Dallis, James Rowley, Mark Rowley, Mark Thompson, David Hampstead Winston Salem Hampstead Raleigh Cary Wilson Wilson Winston Salem Charlotte Charlotte Charlotte Lumberton Lenoir Winston Salem Charlotte Hickory Durham Raleigh Raleigh Winston Salem Fayetteville Raleigh Charlotte Raleigh Raleigh Cary Winston Salem Winston Salem Raleigh Kannapolis Cary Galax Winston Salem Winston Salem Durham Huntersville Huntersville Albemarle Albemarle Raleigh Winston Salem Winston Salem Highpoint High Point Highpoint High Point July 21-23, 2010 Clark, Adam Clark, Adam Clarke, Karen Clarke, Theresa Clement, Ryan Cockerham, Jessica Coggin, Sharon Colley, Harvey Collins, George Collins, Kristin Collins, Kristin Collins, Kristin Collins, Kristin Combs, Glen Connell, Jennifer Connor-Riddick, Tracy Connor-Riddick, Tracy Connot, Tony Cooper, Donna Copeland, Chanel Cowen, Christopher Crenshaw, Sharon Crenshaw, Sharon Cvelic, Patrick Cvelic, Patrick Dale, Henry Dammen, Peter Ball, Frank Moore, Jeffrey O'Donnell, Timothy Oseki, Collins Michau, Kenneth Morgan, Amy Vassallo, Peter Dewees, Steven Gullickson, Matthew Duncan, Catherine Godbout, Christopher Reznik, Mark Singh, Paul Gardner, Donald Elston, Scott Menscer, Darlyne Sullivan, David Gullickson, Matthew Bahner, Richard McCorry, James McFadden, John Griffin, Ashton O'Daniel, Mark Galaska, Piotr Keller, Mark Marshall, William Jacubowitz, Sam Dang, Kim Anh Davidson, Jeremy Davidson, Teresa Davis, Demetria Dawson, Melanie Day, Jerry Deakle, Mary Dec, Brandon DeMio, Brian DeMio, Brian Denton, Ronald DeRose, Sarah DeSantis-Wilcox, Maria Detrick, Joshua Dillard, Wilbert Dillon, Lindsay Dillon, Lindsay Dillon, Lindsay Dochow, Jeffre Antony, Jose Highley, Timothy Highley, Timothy Ladapo, Jumoke Millard, Jonathan Beamer, Mark Holland, James Kirby, Alex Krull, Ronald Palega, Gregory Bowman, Robley Chao, Nelson Robinson, Lindwood Coles, Robert Dockery, Pamela Gioffre, Ronald Gioffre, Ronald Jacubowitz, Sam Bush, Andrew Laurinburg Laurinburg Durham Angier Raleigh Concord Pinehurst Lincolnton Matthews Raleigh Raleigh Raleigh Raleigh Mt. Airy Morrisville Charlotte Charlotte Matthews Wilmington Oxford High Point Goldsboro Rocky Mount Thomasville Mocksville Clemmons Greensboro Roanoke Rapids Hendersonville Hendersonville Fayetteville Charlotte Belhaven Winston Salem New Bern Clinton Wallace Morganton Durham Raleigh Morehead City Winston Salem Greensboro Greensboro Greensboro Sanford July 21-23, 2010 Dore, Mary Dore, Mary Downing, Karol Drago, David Drinkwater, Don Drinkwater, Don Drinkwater, Don Drinkwater, Don Drinkwater, Don Dudley, Gilian Dye, Jennifer Dziminski, Veronica Edwards, Amanda Eisenberg, Lindsey Eley, Katina Ellingwood, Jamie Ellingwood, Jamie Eng, John English, Joan Entzi, Emily Entzi, Emily Evans, Shannon Faircloth, Cristie Faircloth, Marisa Farmer, Joseph Farmer, Kimberly Field, Ronald Fina, Jillian Fisher, Jessica Forbes, Jennifer Forgach, Mary Fox, Elaine Freeman, Leigh Freeman, Leigh Freeman, Leigh Fricklas, Elizabeth Friedman, Erica Fuqua, Mandria Futh, Stephen Gadomski, Ann-Marie Gallagher, Claudia Galli, Lindsay Garbia, Waseem Gatlin, Stephen Geiple, Joshua Gentile, Elizabeth Le, Mark Stowe, Mary Jones, Michelle Freidinger, Brad Alioto, Richard Bullard, Dennis Jones, Monica Krupski, Tracey Visco, Anthony Fowlkes, William Burnett, Tara Cappola, James Holt, Elizabeth Corvino, Timothy Jones, Colin Mahar, Matthew Moretz, Christian Wright, Eugene Shaw, James Neulander, Matthew Okonkwo, Ifeyinwa Whitman, Bruce Boyle, Joseph Stonecipher, Karl Mattox, William Elston, Scott Gullickson, Matthew Kon, Neal Williams, Matthew Sutton, Sidney Gupta, Manoj Harvey, Henry Bell, Joseph Harris, Glenn Harris, Glenn Vlahovic, Gordana Acharya, Anjana Seward, Daniel Oak, Chang Evans, Michael Kuo, Paul LeCroy, Charles Lee, Melvin McCutchen, Jeffrey Steinl, Kevin Price, Billy Charlotte Charlotte Leland Concord Smithfield Raleigh Raleigh Raleigh Durham Louisburg Raleigh Cary Raleigh Gastonia Ahoskie Sylva Sylva Fayetteville Pisgah Forest Charlotte Fayetteville Lumberton Wilmington Greensboro Castle Hayne Wilmington Matthews Winston Salem Wilmington Elizabeth City Fayetteville Greensboro Pembroke Laurinburg Laurinburg Durham Durham Charlotte Washington Smithfield Durham Asheville Cary Monroe Greensboro Mt. Holly July 21-23, 2010 Giddings, Joseph Giglio, Michelle Gilbert, Tonya Gilbert, Tonya Goddard, Alan Goller, Linda Gomes, Alvaro Gomez, Victor Goodwin, Gregory Gould, Laura Grafton, Nancy Granzow, Paul Graudons, Douglas Gregory, Richard Gregory, Richard Grice, Jessica Grosshans, Christina Grullon, Rosemary Gunter, Jane Haikal, Melissa Hall, Laura Harper, John Harrell, Mark Hayes, Kathleen Haynes, Elizabeth Heath, Jerry Hedrick, Jessica Heggerick, Gretchen Hemp, Antoinette Herlihy, Michelle Heslep, Mallory Heslep, Mallory Hiatt, Tiffany Hibbard, James Hipp, Karin Hlavacek, Sarah Hoag, David Hollingsworth, Robert Holmes, Debra Holt, Rebecca Hopkins, Shawn Horton, Ann Horton, Tiffany Horton, Tiffany Horton, Tiffany Hudson, Charles McCaleb, Jane Overton, Edward Sloan, Douglas Spooner, Linda Jones, Colin Morris, John Doohan, Thomas Lowry, Terry Rich, Robert Lee, Kenneth Lindsay, Maryanne Litwak, Joseph Ohl, Matthew Bunn, Barry Kim, Ian Powell, Bayard Seitz, Kent Rish, Carlos Ajao, Olufolarin Schmitz, Todd Brown, Stephanie Rosen, Robert Daly, Claudia Davenport, Barbara Nycum, Lawrence Hubbard, Laura Meier, John Kostuchenko, Paul Wonsick, Melinda Taiwo, Adebukola O'Brien, David OBrien, David Shepherd, Jack Sharma, Anuj Williams, Jennelle Law, Michael Vesa, Allin Gupta, Madhur Jennette, Albert Elston, Scott Barsanti, Christopher Rader, Dale Forstner, James Langston, Bernard Njapa, Anthony Greenberg, Brent Scotland Neck Gastonia Fayetteville Fayetteville Ahoskie Flat Rock Monroe Lumberton Elizabethtown Greenville Winston Salem Rutherford Charlotte Tarboro Greenville Winston Salem Winston Salem Charlotte Gastonia Charlotte Franklinton Winston Salem Greenville Wilmington Winston Salem Hays Raleigh Winston Salem Jefferson Fayetteville Winston Salem Winston Salem Matthews Weddington Chapel Hill Raleigh Statesville Red Springs Durham Cary Greenville Statesville Southport Shallotte Wilmington Greensboro July 21-23, 2010 Hughes, Kristina Hughes, Kristina Hunnings, Blakely Hunt, Bethany Hunt, Hal Hunt, Hal Hunt, J. Hurst, Kathleen Jackson, Kierney James, David Jones, Kathy Jung, Min Jin Kearney Sawyer, Elizabeth Kearns, Amy Kearns, Amy Keeler, Nancy Kelley, Timothy Kelley, William Kern, Christopher Kinnally, Steven Kirsch, Eric Kirsch, Eric Kish, John Kish, John Kish, John Kish, John Knowles, Carol Kobuszewski, Shani Kobuszewski, Shani Kobuszewski, Shani Kobuszewski, Shani Kobuszewski, Shani Kobuszewski, Shani Kowaleski, Jennie Kozlow, Ayanna Kramer, Clifford Kreger, Edward Kunz, Erin Kurtz, Harry LaCombe, Paula LaFayette, Sara LaFuria, Jeffrey Layman, Paul Leamy, Gregory Lechner, Jonathan Leiken, Shuli Kadiev, Steven Kremers, Scott Evans, Michael Wentz, Elliott Bethel, Bradley Rowson, Jonathan Hollar, Larry Shaheen, Nicholas Luoma, David Lutz, Charles Miekley, Scott Nutz, Joseph Armstrong, Robert Applegate, Michael Pinyan, Clark Gibbons, Gregory Armistead, Hal Stroup, Daniel Branyon, David Saunders, George Kanelos, Dino Neulander, Matthew Flanders, Paul Jaffe, Michael Ursin, Gabriela Zellner, Eric Ramos, Richard Adcock, Jimmie Albright, Harold Bullock, William Edwards, Jonathan Resto, Wilma Revis, Sheley Ajmani, Ajay Azzi, Anthony Ohl, Matthew Campos, Kevin Riedel, Richard Bullard, Dennis Anthony, Meredith Faulkenberry, Bradford Reznik, Mark Dewees, Steven Burnett, Tara Hsu, Kevin Bhiwandiwalla, Pouruchis Charlotte Charlotte Smithfield Greensboro Laurinburg Laurinburg Winston Salem Chapel Hill Dallas Gastonia Raeford Morehead City Asheville Asheboro Asheboro Cary Huntersville Murphy Taylorsville Calabash Charlotte Charlotte Asheville Clyde Clyde Clyde Greensboro Charlotte Charlotte Charlotte Charlotte Charlotte Concord Apex Raleigh Charlotte Greensboro Durham Raleigh Fort Bragg Laurinburg Raleigh Shelby Raleigh Charlotte Raleigh July 21-23, 2010 Leiken, Shuli Leiken, Shuli Leiken, Shuli Leiken, Shuli Leiken, Shuli LeSuer, Hayley Levan Elbel, Stephanie Lewis, Michael Liepins, Andrew Lloyd, John Long, Ashley Long, Ashley Long, Michael Loper, Courtney Lordeus, Tajuana Lupton, Amy Lyon, Christopher Mabout, Sonia Mabout, Sonia Maddux, Joseph Maestas, Rebecca Mahar, Suzanne Mahiquez, Jose Mann, Karen Manno, Salvatore Marion, Gail Marion, Wade Martin, Jennifer Martinelli, Kathleen Matkovich, Matthew Mattera, Paul McCaffrey, James McCarty, Martha McDaniel, Denise McDaniel, Denise McIntosh, Dale McKnight, Susan McLaughlin, Todd McNaught, Noelle Bullard, Dennis Gupta, Pankaj Kagan, Steven Mong, James Oschwald, Donald D'Amico, Paul Bowling, Mark Maultsby, James Burnett, Tara Requarth, Jay Jacubowitz, Sam Thomas, Christopher Ohl, Matthew West, Thaddeus Glaser, Mark Daly, Claudia Groh, Gordon Caddick, William Danis, Henry Henry, Christy Oak, Chang Reyes, Rodolfo Evans, Michael Daly, Claudia Flanders, Paul Lichstein, Peter Vargas, Ramon Lee, Melvin Law, Michael Outen, Ronnie McDaniels, Christopher Toborg, Robert Aiken, Christopher Orlowski, Richard Tate, Michael Kincaid, Edward Oak, Chang Ohl, Matthew Kadiev, Steven Melgar, Tammy Melgar, Tammy Melgar, Tammy Mercer, Christopher Mercer, Christopher Miedema, Marcia Migdon, Steven Antony, Jose Ballenger, Clarence Richardson, Wendell Miller, Jon Rodger, Robert Locklear, Jimmy Vu, Khanh Raleigh Cary Raleigh Raleigh Raleigh Albemarle Clayton Clinton Raleigh Winston Salem Greensboro Winston Salem Charlotte Goldsboro Fayetteville Greenville Asheville Gastonia Gastonia Raleigh Plymouth Holly Springs Smithfield Greenville Asheville Winston Salem Elkin Clayton Raleigh Wadesboro Raleigh Winston Salem Winston Salem Hickory Hickory Winston Salem Plymouth Charlotte Charlotte Roanoke Rapids Jacksonville Jacksonville Wilmington Wilmington Raleigh Henderson July 21-23, 2010 Miller, Richard Montgomery, Jeremiah Morcos, Greta Morcos, Greta Morelli, Scott Moreno, Paula Morgan, Leslie Munching, Aaron Mundy, Jonathan Munn, William Murphy, Michael Murphy, Michaela Muse, Rochelle Muse, Rochelle Muse, Rochelle Muse, Rochelle Nazmi, Mehrnoush Nelson, Stacy Newton, Meredith Nguyen, Brigitte Nguyen, Brigitte Nguyen, Brigitte Nicholson, Janice Niehues, Denise Nielsen, Alicia Ogunwale, Michelle Ogunwale, Michelle OKeefe, Shawn Oles, James Olson, Jennifer Orji, Nneka O'Sullivan, Robert Pace, S. Page, Constance Parrish, Thomas Parrish, Thomas Parsons, Dean Patel, Tanaya Patterson, Jimmy Patterson, Miriam Peacock, Brian Perkins, Alison Perrotta, Philip Pettit, Jerome Phillips, James Pineiro, Miguel Zackowski, Scott Riser, Mark Webster, Leslie Zbinden, Louis Minior, Daniel Flitt, Bruce Davis, Ryan Warden, Kendall Malinda, Paul Dauda, Mohamed Spencer, Honnie Guse, Steven Andy, Camille Miller, Stephen Orr, Richard Snider, Alison Kuo, Paul Whitman, Bruce Cheesborough, John Campos, Kevin Pickering, Nathan Tucich, Peter Gerardo, Charles Luckadoo, Laura Raj, Vishwa Semeko, Eric Sunderland, Brent Gullickson, Matthew Clark, David DiOrio, Christopher Gammon, Gary Drake, Almond Brown, Howard Kelley, Steven Hill, Mary Lyons, Esther Crabtree, Thomas Go, Brian Lykins, Kimberly Velez, Ramon Waters, Gregory Skinner, Elizabeth Kuzma, Paul Rosner, Michael Kelley, Steven Norton, Deborah Greensboro Smithfield Charlotte Charlotte Rocky Mount Gastonia Clyde Durham Burlington Rocky Mount Concord Wilmington Kernersville Reston High Point Kernersville Durham Lumberton Sanford Greensboro Greensboro Greensboro Durham Hickory Charlotte Charlotte Charlotte Charlotte Whiteville Huntersville Gastonia Greenville Jacksonville Clinton Ahoskie Ahoskie Avon Raleigh Albemarle Winston Salem Winston Salem Winston Salem Pinehurst Hendersonville Clinton Fuquay-Varina July 21-23, 2010 Poovey, Leah Powell, Debra Powell-Boone, Karen Primak, Michael Pulliam, Charles Purcell, Craig Queen, Julie Quillen, Rocky Ramm, Allen Randolph, Mark Rathey, Kenneth Ray, Kimberly Reagan, Kathleen Reid, Aubrey Reuter, Eric Rezac, Darcy Rice, Easton Rice, Patricia Richards, Dick Rigsbee, William Riley, Elizabeth Rippel, Janet Robb, Sybil RockWiley, Keith Roeser, Julie Rojas, Brian Rojas, Brian Rojas, Brian Rojas, Brian Rojas, Brian Romblad, Katrina Romero, Veronica Royal, Ja-Na' Ruffian, William Ruliffson, Kathryn Russell, Karen Rutherford, Althea Sanborn, Jane Sanders, Gregory Sanford, Frances Santiago, Sarah Satterfield, Sara Sax, Linda Sax, Linda Schuette, Nora Schuette, Nora Rinehart, David Hoffman, Stanley Boyle, Joseph Campbell, Sausan Hester, Laura Godfrey, Wanda Zia, Shams Demas, Ronald Hunt, Jason Brown, Richard Wiener, Dana Connolley, Christopher Pridgen, James Evans, Michael Lawing, William Dickerson, Janice Leggett, Kelly Pancoast, Thomson Dagenhart, Timothy Sloan, Randy Partridge, James Parnell, Jerome Seewaldt, Victoria Nederostek, Douglas Lestini, William Bovard, Scott Inge, Jack Lee, Paula Visco, Anthony Vulgaropulos, Spyro Morgan, Gary Chiodo, Mary Yarnall, Kimberly Williams, Jonathan Ajmani, Ajay Frankos, Mary Singh, Paramjeet St. Clair, Samuel Gullickson, Matthew Campos, Kevin Knapp, Jon Powell, Bayard Carreras, Jorge Wilson, Thomas Bowman, Michael Tim, Richard Belmont Denver Wilmington Asheville Siler City Garner Wilson Wilmington Asheville Wilson Durham Winston Salem Fayetteville Smithfield Winston Salem Wilmington Greensboro Greenville Salisbury Holly Ridge Durham Raleigh Durham Laurinburg Raleigh Wake Forest Raleigh Durham Durham Cary Winston Salem Dunn Durham Kinston Apex Wilmington Cary Raleigh Charlotte Greensboro Greensboro Winston Salem Sylva Sylva Raleigh Raleigh July 21-23, 2010 Schuster, Rikki Scotece, Cecelia Scott-Lavan, Dale Scott-Lavan, Dale Scott-Lavan, Dale Seal, James Lyons, Esther Howard, John Hines, Marcono Oak, Chang Venable, Robert Young, Jordan Sears, Mary Frances Setzler, Heather Shaffer, James Sharpe, Katherine Shaver, Robin Shelton, Carla Sherburne, Emily Sherron, Katherine Sherron, Katherine Shinnick, Joseph Shipman, Jerry Shirlen, Andrew Simon, Spencer Sims, Ginger Smith, Delisa Smith, Laurie Smith, Laurie Smith, Ronald Smith, Sandra Srikantha, Venayagaratnam Stackhouse, Michael Stanley, Glenn Stauffer, Christian Steerman, James Steimle, Theresa Sterling, David Sterling, David Stindt, Diana Stindt, Diana Stindt, Diana Stoltzfus, Ryan Sumner, Lori Svedberg, Kelly Swansiger, David Taylor, Allie Taylor, Brice Thomas, Whitney Thomas, Whitney Thomas, Whitney Thomas, William Betancourt, John Pickett, Lisa Barnes, Daniel Kuo, Paul Harmaty, Myron Kuo, Paul Franco, Jorge Burnett, Tara Henry, Christy Ruch, David Jones, Colin Chaudhry, Abdul Burnett, Tara Lue, Alvin Bagley, Carlos Cargile, Leslie Howard, Willard Griner, Eugene Salahuddin, Abu Gagliano, Louis Dancel, Jose Charlton, Glenn Schmitz, Todd Campos, Kevin Lewis, Marvin Pence, James Riser, Mark Lawrence, Julia Lesser, Glenn Savage, Paul Flanders, Paul Kimball, Robert Nami, Alireza Jordan, Christopher Adams, Gregory Clancy, Thomas Ferris, Andrew Freidinger, Brad Ward, Marc Ohl, Matthew Nags Head Elizabeth City Smithfield Plymouth Plymouth Goldsboro Rutherford College Durham Pinehurst Durham Gastonia Durham Fayetteville Raleigh Raleigh Durham Colerain Raleigh Raleigh Winston Salem Durham Black Mountain Rutherfordton Burlington Fayetteville Goldsboro Fayetteville Henderson Charlotte Greensboro Spring Lake Morehead City Smithfield Winston Salem Winston Salem Winston Salem Asheville Statesville Charlotte Smithfield Boone Wilmington Concord Concord Concord Charlotte July 21-23, 2010 Thompson, Amy Thompson, Joel Thompson, William Timmons, Nikol Torres-Frias, Rebecca Torres-Frias, Rebecca Triplett, Tammy Trombley, Richard Trzcienski, Michael Turrentine, Ennis Upah, Nicole Upstill, Shari Van Rhee, James Velazquez, Louis Venkat, Vidya Venkat, Vidya Vilmann, LeAnn Vinson, Breony Vinson, Keri Wagner, Shawn Wallace, Todd Walters, Thienkim Walton, Anna Waltz, Nichole Wangerin-Lile, David Ward, Blythe Waters, Carrie Watkins, Mai Watson, Steve Weaver, Scott Webber, Sarah Weber, Jeffrey West, Elizabeth Whitaker, Ann Whitaker, Ann White, Hans Whitley, Ashley Whitley, Ashley Whitley, Megan Wiggins, Jeffrey Wilkins, Bobbi Williams, Denise Williams, Ginika Williams, Glenn Williams, Kevin Williams, Mathew Jobe, Robert Johnson, Marc Christopher, Frank Rhodes, Marsha Roth, Heidi Vaughn, Bradley Zackowski, Scott Spillmann, Celia Krupski, Tracey Riedel, Richard Miekley, Scott Jacubowitz, Sam Murinson, Donald Gerlach, Stephan Pershing, John Tokunboh, Julius Harmaty, Myron Blackstone, Thomas Sharts, Michael Pacos, Andrew Almasri, Ghiath Griesen, Dawn Kendall, Jayne Bolin, Lewis Ardaman, Miles Wehbie, Charles Jones, Michelle Howard, Chad Clark, Robert Talbot, David Kelley, Michael Hines, Marcono Riedel, Richard Grossi, Peter Haglund, Michael Chodri, Tanvir Burnett, Tara Parnell, Jerome Harper, James Agner, David Fletcher, Robert Hall, Russell Peace, Robin Dambeck, Allyn Harmaty, Myron Knapp, Jon Raleigh Charlotte Fort Bragg Charlotte Chapel Hill Chapel Hill Greensboro Winston Salem Raleigh Durham Fayetteville Greensboro Greensboro Roanoke Rapids La Crosse Charlotte Charlotte Wilmington Greenville Smithfield Greenville Hickory Gastonia Gastonia Clyde Raleigh Wilmington Charlotte Cary Greensboro Charlotte Smithfield Durham Raleigh Raleigh Asheboro Raleigh Raleigh Wilmington Albemarle Raleigh Fayetteville Lumberton Goldsboro Charlotte Greensboro July 21-23, 2010 Williams, Rufus Winkel, Scott Winn, Jennifer Winter, Monica Woods, Edward Wynn, Chileatha Wynn, Kimberly York, Marianne Young, Danny Young, Danny Young, Richard Yu, I-Ling Zagon, Laura Zastudil, Amanda King-Thiele, Robin Wefald, Franklin Hunt, Jason Campos, Kevin Brown, Frank Partridge, James Peace, Robin Taylor, Melissa Foster, James Gullickson, Matthew Kelley, Steven Tuttle, Harrison Cabral, Gonzalo Ogunwo, Susannah Goldsboro Smithfield Asheville Greensboro Asheville Burlington Lumberton Reidsville Charlotte Charlotte Clinton Raleigh Wilson Fayetteville ALLIED HEALTH COMMITTEE REPORT Present: Thomas Hill, MD, Chairperson, Peggy Robinson PA-C, George Saunders, MD, Lori King, CPCS, Quanta Williams, Jane Paige, Marcus Jimison, Nancy Hemphill, Katharine Kovacs, Audrey Tuttle Open Session Physician Assistants 21 NCAC 32S.0219. Limited Physician Assistant License For Disasters and Emergencies During the May 2010 Board Meeting, the Board heard comments from PAs at the PA Advisory Committee and the Allied Health Committee about concerns they had that the rule regarding PA licensure during a disaster would prevent a PA from being paid even if responding to the disaster was a requirement of his or her employment. Originally, the Board drafted the attached rule to prevent gouging and exploitation of patients during a disaster. However, the Board did not intend PA responders to forego their usual compensation if responding to a disaster was part of their employment. Marcus Jimison, Nancy Hemphill and the Committee discussed. Board Action: Adopt proposed changes to Rule 21 NCAC 32S.0219. 21 NCAC 32S.0202. Qualifications and Requirements for License Immigration Status – Addition to PA Licensure Rule. Nancy Hemphill, Marcus Jimison and the Committee discussed. Board Action: Adopt proposed addition to Rule 21 NCAC 32S.0202. July 21-23, 2010 Open Session NC Emergency Medical Services No items for discussion. A motion passed to close the session pursuant to Section 143-318.11(a) of the North Carolina General Statutes to prevent the disclosure of information that is confidential pursuant to Sections 90-8, 90-14, 90-16, 90-21.22 of the North Carolina General Statutes and not considered a public record within the meaning of Chapter 132 of the General Statutes and/or to preserve attorney/client privilege. The Committee reported on one cases. A written report was presented for the Board’s review. The Board adopted the Committee’s recommendation to approve the written report. The specifics of this report are not included because these actions are not public. A motion passed to return to open session. Open Session Anesthesiologist Assistants Immigration Status Addition to 21 NCAC 32W.0102 Summary: Immigration Status – Addition to AA Licensure Rule. N. Hemphill and M. Jimison to discuss. Committee Recommendation: Approve proposed addition to Rule 21 NCAC 32W.0102 BOARD ACTION: Approve proposed addition to Rule 21 NCAC 32W.0102 Open Session Nurse Practitioners No items for discussion Open Session Clinical Pharmacist Practitioners Protocol Approval Process Summary: In May, the Board approved a new process for approving protocols. They decided to wait until after the CPP Joint Subcommittee meeting on July 20 to implement the process. Board Action: Accept the policy change and begin using the new procedure with applications received on and after August 1, 2010. Mr. Jimison will draft a letter and send it to Dr. Loomis for approval. The letter, which will explain the statutory scope for a CPP, that the CPP is encouraged to keep his or her protocols current, and that practicing outside of the scope of the CPP’s written agreement will subject the CPP to discipline, will be mailed out with CPP approvals. Open Session Perfusionists Immigration Status Addition to 21 NCAC 32V.0103 July 21-23, 2010 Summary: Immigration Status Addition to Rule – Addition to Perfusionist Licensure Rule. N. Hemphill and M. Jimison to discuss. Committee Recommendation: Preemptive approval of proposed addition to Rule 21 NCAC 32V.0103. The PAC will review and discuss this at its August meeting. BOARD ACTION: Preemptive approval of proposed addition to Rule 21 NCAC 32V.0103. The PAC will review and discuss this at its August meeting. A motion passed to close the session pursuant to Section 143-318.11(a) of the North Carolina General Statutes to prevent the disclosure of information that is confidential pursuant to Sections 90-8, 90-14, 90-16, 90-21.22 of the North Carolina General Statutes and not considered a public record within the meaning of Chapter 132 of the General Statutes and/or to preserve attorney/client privilege. The Committee reported on one case. A written report was presented for the Board’s review. The Board adopted the Committee’s recommendation to approve the written report. The specifics of this report are not included because these actions are not public. A motion passed to return to open session. NURSE PRACTITIONER APPROVALS ANESTHESIOLOGIST ASSISTANT, PERFUSIONIST & PROVISIONAL PERFUSIONIST LICENSES ISSUED MAY 14 – JULY 08, 2010 List of Initial NP Applicants NAME CONCIA, CAROLYN CONLIN, JEAN DOUGLAS, TECONDA EVERETT, ARNETTE HOPKINS, KRISTY HSU, BILLIE KUNKEL, JUDITH LAMBERTUS, VIKI LOVINGS, TINA MCDANIEL, CATHERINE PETRUNEY, JENNIE SULLIVAN, PATRICIA TAVAZIVA, PATRICIA TERRELL, KYLE WHALEY, BRIAN PRIMARY SUPERVISOR KLINE, THOMAS STEINWEG, KENNETH NTIMBA, FRANCIS COLSON, LACY SEAGO, JUDITH SMITH, DOUGLAS ROUGEOU, GLENDON LANGSTON, BERNARD RAYMOND, LAWRENCE CRUTCHER, KENNETH DAALEMAN, TIMOTHY WHEELER, ANTHONY CHITTENDEN, TAMARA VEERAMACHANENI, NIRMAL PRICE, WAYNE PRACTICE CITY WILSON GREENVILLE ST. LOUIS RALEIGH SYLVA GASTONIA MURPHY SHALLOTTE GASTONIA COLLETTSVILLE CHAPEL HILL CHARLOTTE CHARLOTTE CHAPEL HILL CHAPEL HILL July 21-23, 2010 ZEKONIS, DONNA AMBA, KATHERYNE BAILEY, ANN BLACK, KAREN BREWER, ALLISON CASEBOLT, KRISTA GORDON, CATHERINE HENDLEY, KEDRON HUFFMAN, DIEDRA JOHNSON, JANE LEONARD, KELLI PARKER, MARY PATEL, SWATIBEN PRATHER, CHRISTIN SANDERS, TARA SMITH, KIM TATE, STACIA WALL, DEBORAH WILLIAMS, TRACY WILLIS, SHADERIKA EARHART, MEGAN HASKINS, LORI HOUSE, KAREN HULME, ARUNA JONES, COURTNEY KEATING, CAROLYN KELL, TIMOTHY MCCABE, ASHLEY PATTON, RONDA PORTER, EVELYN PRICE, RENEA RAULS, AMANDA YOUNGER, ALICIA ELBEERY, JOSEPH KOPEC, ISABELLE CLARK, MICHAEL KRISHNAN, SENDIL ABBOTT, THOMAS CLAGNAZ, PETER CHURCH, SAMUEL FOWLER, WILLIAM ALBRITTON, MARK ROBERTSON, JOHN FERNANDEZ, GONZALO MCQUISTON, CHRISTINA GAMMON, GARY NTIMBA, FRANCIS RUSSELL, MICHAEL BLAND, VEITA MCLANAHAN, CHARLES BENTSEN, BIRGER ANDERSON, JOSEPH HALL, ANDRE STEFFENS, THOMAS MONAHAN, MICHAEL HOWARD, KEVIN HANSEN, KIMBERLEY JORDAN, JOSEPH NICHOLS, JOHN KOPEC, ISABELLE ELBEERY, JOSEPH HEDGEPATH, LARRY MINTZER, MELANIE OAK, CHANG GROSSI, PETER RUSSELL, LARRY GREENVILLE ST. LOUIS GREENSBORO GREENSBORO WINSTON SALEM AHOSKIE HAYESVILLE MARION MARION NEW BERN GARNER ASHEVILLE GASTONIA ST. LOUIS RALEIGH GREENSBORO CHARLOTTE WILMINGTON ASHEVILLE FAYETTEVILLE CONCORD RALEIGH WENTWORTH WINSTON-SALEM CHAPEL HILL ASHEVILLE ST. LOUIS GREENVILLE FOREST CITY CARY PLYMOUTH RALEIGH HENDERSONVILLE NP ADDITIONAL SUPERVISOR LIST BENBOW, DEBRA BOYKIN, WILLIAM CLINE, KIMBERLY CONDON, CHRISTINA COUSINS, MELISSA DAY, TERESA DESAI, SHAKTI DOYLE, MELISSA EASTERWOOD, LAURA FERREE, BETTE JONES, EDWARD BAULE, RAYMOND MYLES, SIDNEY ANDY, CAMILLE ANDY, CAMILLE MCCALL, WILLIAM TYSON, TREVA PHILLIPS, THIRSTON KRISHNAN, SENDIL ANDY, CAMILLE WINSTON SALEM ROCKY MOUNT HICKORY KERNERSVILLE GREENSBORO WINSTON-SALEM RALEIGH FAYETTEVILLE GREENSBORO KERNERSVILLE July 21-23, 2010 GANT, APRIL GRAHAM, JAMIE HARRIS-COLEMAN, JUDITH HAVEN, SHERRI HILL, DORIS HOULIHAN, SANDRA HOWARD, DENISE HUTTO, CHRISTINE JEFFERY, JANIS JNAH, AMY JOHN, WENDELL JORDAN, KATHLEEN KEIGER, JENNIFER LAU, KAREN LEWIS, CHERYL LUMSDEN, LO LYALL, MONICA MCCLAIN, DAMARIS MCCLURE, CHRISTINE MCCULLEN, GINGER METIKO, ESTHER MEYER, DIANE MITCHELL, SUSAN MORRIS, DIANN MORRIS, DIANN NAYLOR, TRACY PAWLAK, COLLEEN PERKINS, JUANITA PROPST, DAVID QUILTY, EILEEN RAGAN, MICHAEL ROSEBROCK, KELLEY ROUNTREE, JANE SNYDER, STEVEN SOLOMON, LORA SPURBECK, BRENDA STEVENS, VERONICA STUBBS, CARLA THACKER, JANET TOLLEY, MARGARET VACHON, LEONIE VERNON, ANN VOGRINC, ASHLEY WATSON, JULIA ADLER, DEBORAH ALEXANDER, TAMARA UBA, DANIEL KIGER, TARA MUNOZ, RIGARDY MACDIARMID, SCOTT VORWALD, FREDERICK SHA, RONALD GARMON-BROWN, OPHELIA WILKINSON, JAMES MORGENSTERN, EVA PRICE, WAYNE KATHARD, HARESH MATKINS, PREETI MURPHY, MARTIN SWYGARD, HEIDI DAVIS, ALONZO KEMP, PETER BYRD, TERRI TRIPP, HENRY BURISHKIN, DANIEL HERRING, RUFUS SWYGARD, HEIDI GONZALEZ, ANNE ANDY, CAMILLE ANDY, CAMILLE JONES, ENRICO RAY, JOHN NACOUZI, VINCENT GIBBS, CAROL COCHRANE, JOSHUA ALEJANDRO, LUIS OSTA, ELIE BARRON, ANGELA BALLARD, WILLIAM BREZINSKI, DAMIAN NEULANDER, MATTHEW BYRD, TERRI SESSOMS, RODNEY BLEVINS, MARY IRION, JAMES VAN DEUSEN, LINDA NIEMEYER, MEINDERT ANDY, CAMILLE ANDY, CAMILLE ALAHARI, DURGA CARLOUGH, MARTHA ESCAJEDA, RICHARD FAYETTEVILLE NEW BERN HICKORY GREENSBORO MOOREVILLE DURHAM CHARLOTTE KITTY HAWK ASHEVILLE CHAPEL HILL LOUISBURG CHARLOTTE WINSTON-SALEM CHAPEL HILL MOREHEAD CITY ENDENTON WILSON KERNERSVILLE ASHEVILLE CLINTON RALEIGH HICKORY CLEMMONS KERNERSVILLE GREENSBORO FAYETTEVILLE RALEIGH DURHAM HICKORY GREENSBORO SNOW HILL MONROE DOBSON WILMINGTON CHARLOTTE WILSON CLINTON ASHEVILLE CLEMMONS BRYSON CITY ELON OAK RIDGE OAK RIDGE FUQUAY VARINA CHAPEL HILL ARCHDALE July 21-23, 2010 AMOAKO, EMELIA ASKEW-JACKSON, TERI BLEVINS, RONDA BLEVINS SPRINKLE, JULIE BROPHY, NOREEN BROWN, CAROL BRUCE, ELIZABETH CARPENTER, LALISA CARTER, ANGELA CAVILEER, DENISE CHILTON, LINDA CLARKE, SUSAN CRATER, SUZANNE CRAWFORD, KARI CRAWFORD, KARI CUDDY, SHERRI CURRY, ROSEMARY DANIELS, MELISSA DANIELS, JULIE DAVIS, DONNA DAVIS, AMANDA DRIGGERS, MILDRED DUPUIS, MONICA EMMERT, KATY FERNANDEZ, ANA-MARIA GANNOTTA, RICHARD GAUGER, SARAH GAULDEN, LAURA GETTELFINGER, JOAN GORECKI, AMANDA GRAHAM, KIMBERLY HAAS, MARILYN HARDY, KIMBERLY HARRISON, DAWN HENDERSON, CHERYL HOBAN, CAROL HOUGH, JENNIFER HUGHES, JANET ISAACS, JANE JONES, ELLEN JORDAN, LINDA KILLGORE, JOHN KOONTS, HEATHER LEE, TRACEY LIEM, GRACE LOHSE, ELIZABETH OSEI-BONSU, GEORGE WRIGHT, JOSEPH TURNER, LINDA TURNER, LINDA VARGAS, CARLOS AGUNOBI, CHARLES BLUE, DEBRA WINKER, GUYTON CATAPANO, GERARD PRIDGEN, JAMES TWERSKY, JACK DAVIS, ALONZO MCQUISTON, CHRISTINA HERLONG, JAMES PEELER, BENJAMIN WALKER, CHERYL HEALY, PAUL FISHER, DAVID MOYA, FERNANDO HANSEN, ROGER ANDERSEN, SUSAN DAVIS, ELLEN JOHNSON, DAVID WALTER, KAREN RAYNOR, EILEEN HODGES, CHARLES LIEN, LILLIAN CHARLESWORTH, AMY GAMBINO, JOHN MILLER, JASON CHEN, HSIUPEI VARGAS, CARLOS BRINN, NATHAN OH, PAUL DAUD, SHAHNAZ TRIMBLE, STEWART CHEN, HSIUPEI SMITH, LARRY KOCH, KENNETH JORGE, CARLOS KINDSCHUH, PETER GERLACH, STEPHAN KROWCHUK, DANIEL BLAKNEY, SANDRA RUPE, CAROL CASERIO, JAMES HIGH POINT KINSTON SPARTA SPARTA ASHEVILLE GASTONIA RALEIGH SPINDALE FAYETTEVILLE WHITEVILLE DURHAM MOREHEAD CITY ASHEVILLE CHARLOTTE CHARLOTTE CHARLOTTE HAVELOCK CHARLOTTE WILMINGTON WINSTON SALEM WILSON GASTONIA RALEIGH ASHEVILLE DURHAM RALEIGH DURHAM BEAUFORT WINSTON-SALEM DURHAM RALEIGH ASHEVILLE GREENVILLE BURLINGTON CARY ROSMAN RALEIGH SHELBY WINSTON-SALEM CORNELIUS WHITEVILLE ROANOKE RAPIDS WINSTON SALEM CARY CHARLOTTE HENDERSONVILLE July 21-23, 2010 MARTIN, TERESA MONTGOMERY, SONYA MORTON, REBECCA OXFORD, WILLIAM PAQUIN, VICTOR PAWLAK, COLLEEN PENNELL, TODD PINTO, ALICIA RAVENSCRAFT, AMY REILLY, JOYCE REPEDE, ELIZABETH REVELS, TIFFANY RICHARDSON, STACY ROCK, ELLA ROWE, VEDA SHARPE, DAPHNE SHORT, JOAN SHUFORD, RICHELLE SINGER, MEREDITH SKAKEY, JOSETTE SMITH, JOYCE SMITH, ALEXIS STEVENS, MARK TASHAKKORI, ZAHRA TERRY, JEVITA THOMPSON, ELIZABETH THOMPSON, SHANNON TIGNER, JENNIFER VACHON, LEONIE VAUGHAN, ANITA VIVIANO, ROBIN WINTERS, ADAM WOOD, BROOKIE WORRELL, TAMMY ANTHONY, ARENNETTE AUTRY, JEFFREY BARNES, MARTHA BROCK, WENDY BYRD, SARAH CALLAHAN, ANGELA CARR, CARLYE COOK, LADONNA CUNNINGHAM, PATRICIA EDINGER, AMY FOSTER, JENNIFER GREENE, NATASHA JOHANSON, WILLIAM GUALTIERI, CAMILLO HALSTENBERG, WILLIAM ROGERS, GARRETT SLADICKA, STEPHEN KANN, JOEL DUBOW, RONALD BLUE, DEBRA MILLSAPS, DAVID GILPIN, ALLEN GARMON-BROWN, OPHELIA GUHA, SUBRATA SHAW, ANDREW NEDEROSTEK, DOUGLAS PETERSON, ERIC HUNT, MARY JORGE, CARLOS DUBOW, RONALD BRADLEY, DIANA GREENBERG, RICHARD HAVERKAMP, JOHN ALMASRI, GHIATH CHARLESWORTH, AMY KISHBAUGH, DAVID WILSON, THEODORE RODRIGUEZ, FABIAN YOUNG, STEPHEN IGHADE, ANDREW BHATTI, MOHAMMAD NEULANDER, MATTHEW MINTZER, MELANIE MORELOCK, SANDRA CHEN, HSIUPEI ZANARD, ROBYN SANDERS, ROBYN KRULL, RONALD DYE, HILARY GALLAHER, KEITH MCDANIELS, CHRISTOPHER LACEY, DAVID MORROW, JASON WALKER, ORRIN MURRAY, MICHAEL HENDLER, JAY HAMP, DIRK BLAKNEY, SANDRA MORGANTON CHAPEL HILL CONCORD GOLDSBORO TAYLORSVILLE RALEIGH LENOIR RALEIGH HICKORY ASHEVILLE CHARLOTTE RALEIGH SPARTA LAURINBURG NEBO GREENSBORO CORNELIUS LENOIR ASHEVILLE HUNTERSVILLE GOLDSBORO GREENVILLE BEAUFORT FAYETTEVILLE ROCKY MOUNT SOUTHERN PINES WILMINGTON CHARLOTTE ELON CHARLOTTE CARY ASHEVILLE RALEIGH GREENSBORO GREENSBORO CLINTON WINSTON-SALEM FAYETTEVILLE RALEIGH WINSTON-SALEM DURHAM CHINA GROVE ASHEVILLE CHARLOTTE WAKE FOREST MEMPHIS July 21-23, 2010 GREGORY, DEBORAH HARDEE, CAMERON HENRICKSON, STACY HERRERA, ALIDA HOUGH, JENNIFER HOUGH, JENNIFER HOWARD, SANDY JAWORSKI, ANN KING, ROBIN KOSKO, DEBRA LAY III, HARRY MARTIN, KATHY MORAN, KELLY NOONE, ANGELA POTTER, ANN REVELS, TIFFANY ROBINSON, MELISSA SCHNEIDER, KAREN SPELL, SUSAN TOLBERT, APRIL WARREN, LENA WHISNANT ROPER, REGINA JOHNSON, JAMES DESSAUER, KATI SCHMIDT, BRIAN LAWRENCE, MARK GULLEY, PAUL CANUPP, TONY HOLMES, MATTHEW WRIGHT, BRENT LAWRENCE, MARK INGRAM, CHRISTOPHER REARDON, DAVID MCMAHON, DANIEL GASTON, KRIS STEGMAN, JOSEPH DYE, HILARY MINIOR, DANIEL DY, MARC ALEJANDRO, LUIS GUHA, SUBRATA GUPTA, MANOJ KRULL, RONALD ASHEVILLE CARY CONCORD WAYNESVILLE ELKIN ELKIN SYLVA WILMINGTON WAYNESVILLE RALEIGH DURHAM CHARLOTTE CHARLOTTE CONCORD WINSTON-SALEM DUNN MIDLAND GREENSBORO WILSON SMITHFIELD CLINTON DOWNS, BRIAN MORGANTON PERFUSIONISTS BENNETT, Mia Eugenia, LP KLIMA, Alan William, LP ALEXANDER, Stanlin, PLP SANIUK, Rachel, PLP SCOTT, Chelsea Lee, PLP ANESTHESIOLOGIST ASSISTANTS BARNETT, Kari Chappell, AA-C CLINICAL PHARMACIST PRACTITIONER JOINT SUBCOMMITTEE Members Present: Ralph Loomis, MD (NCMB); George Saunders, MD (NCMB); Donald Jablonski, MD (NCMB); Thomas Hill, MD (NCMB); Rebecca Chater (NCBOP); Joey McLaughlin (NCBOP); and Gene Minton (NCBOP) Absent Members: Betty Dennis, CPP (NCBOP) Staff Present: Jay Campbell, David Henderson, Marcus Jimison, and Quanta Williams Welcome and Introductions July 21-23, 2010 Dr. Loomis opened the meeting with introductions and thanked everyone for coming. Election of Chair Dr. Loomis asked for motions for a new chair. Since there were none, Dr. Loomis will continue on as Chair of the Committee. Approval of Minutes A motion passed to accept the minutes of the October 2007 meeting. Protocol Approval Process Dr. Hill gave a brief summary of the appearance of and types of protocols that have been received since 2001 when CPP approval began. He also discussed the current process for approving CPP protocols and the logic behind changing the approval process. The Board no longer reviews the protocols for PAs and NPs. This seems to be a natural evolution for the CPPs as well. CPP applicants will no longer be required to submit the written agreements between themselves and their supervising physicians (or protocols) with their applications for review and approval by the two boards. If an application is approved, a letter will be sent out to each CPP that will explain the statutory scope of practice for a CPP, that the CPP is encouraged to keep his or her protocols current, and that practicing outside of the scope of the CPP’s written agreement will subject the CPP to discipline. CPPs will no longer have to submit Change of Status forms requesting additional protocols. There will be a compliance program similar to the one used by the Nurse Practitioner Joint Subcommittee for compliance reviews of CPP protocols. An investigator from each Board will work together to conduct compliance reviews of about 5 CPPs per year. MAD-ID Certification Program This program is not approved by the North Carolina Center for Pharmaceutical Care (NCCPC) or the American Council on Pharmaceutical Education (ACPE). Therefore, it does not meet the requirements stated in the rules for CPP approval. This information will be communicated to the pharmacist that inquired about this program. The pharmacist may direct her inquiry to the two credentialing bodies for information about the process by which a program may be approved by the credentialing body. Future Meetings A motion passed that all future agendas be dictated by Dr. Loomis and that Mr. Henderson and Mr. Campbell will let the Chair know when sufficient need arises for a meeting. Miscellaneous Dr. Saunders thanked the Board of Pharmacy for its spirit of collegial cooperation with the Medical Board. A motion passed to close the session pursuant to Section 143-318.11(a) of the North Carolina General Statutes to prevent the disclosure of information that is confidential pursuant to Sections 90-8, 90-14, 90-16, 90-21.22 of the North Carolina General Statutes and not July 21-23, 2010 considered a public record within the meaning of Chapter 132 of the General Statutes and/or to preserve attorney/client privilege. The Committee reported on one case. A written report was presented for the Board’s review. The Board adopted the Committee’s recommendation to approve the written report. The specifics of this report are not included because these actions are not public. A motion passed to return to open session. REVIEW (COMPLAINT) COMMITTEE REPORT Peggy Robinson, Chair; Thelma Lennon; George L. Saunders, III, MD A motion passed to close the session pursuant to Section 143-318.11(a) of the North Carolina General Statutes to prevent the disclosure of information that is confidential pursuant to Sections 90-8, 90-14, 90-16, 90-21.22 of the North Carolina General Statutes and not considered a public record within the meaning of Chapter 132 of the General Statutes and/or to preserve attorney/client privilege. The Review (Complaint) Committee reported on forty two complaint cases. A written report was presented for the Board’s review. The Board adopted the Committee’s recommendation to approve the written report. The specifics of this report are not included because these actions are not public. A motion passed to return to open session. DISCIPLINARY (COMPLAINTS) COMMITTEE REPORT William Walker, MD, Chair; Dr. Thomas R. Hill, MD; Pamela Blizzard; Paul Camnitz, MD; Karen R. Gerancher, MD; Ralph C. Loomis, MD. A motion passed to close the session pursuant to Section 143-318.11(a) of the North Carolina General Statutes to prevent the disclosure of information that is confidential pursuant to Sections 90-8, 90-14, 90-16, 90-21.22 of the North Carolina General Statutes and not considered a public record within the meaning of Chapter 132 of the General Statutes and/or to preserve attorney/client privilege. The Disciplinary (Complaints) Committee reported on ten complaint cases. A written report was presented for the Board’s review. The Board adopted the Committee’s recommendation to approve the written report. The specifics of this report are not included because these actions are not public. A motion passed to return to open session. July 21-23, 2010 DISCIPLINARY (MALPRACTICE) COMMITTEE REPORT William Walker, MD, Chair; Dr. Thomas R. Hill, MD; Pamela Blizzard; Paul Camnitz, MD; Karen R. Gerancher, MD; Ralph C. Loomis, MD. A motion passed to close the session pursuant to Section 143-318.11(a) of the North Carolina General Statutes to prevent the disclosure of information that is confidential pursuant to Sections 90-8, 90-14, 90-16, 90-21.22 of the North Carolina General Statutes and not considered a public record within the meaning of Chapter 132 of the General Statutes and/or to preserve attorney/client privilege. The Disciplinary (Malpractice) Committee reported on 57 cases. A written report was presented for the Board’s review. The Board adopted the Committee’s recommendation to approve the written report. The specifics of this report are not included because these actions are not public information. A motion passed to return to open session. INFORMAL INTERVIEW REPORT A motion passed to close the session pursuant to Section 143-318.11(a) of the North Carolina General Statutes to prevent the disclosure of information that is confidential pursuant to Sections 90-8, 90-14, 90-16, 90-21.22 of the North Carolina General Statutes and not considered a public record within the meaning of Chapter 132 of the General Statutes and/or to preserve attorney/client privilege. Thirteen informal interviews were conducted. A written report was presented for the Board’s review. The Board adopted the recommendations and approved the written report. The specifics of this report are not included because these actions are not public information. A motion passed to return to open session. DISCIPLINARY (INVESTIGATIVE) COMMITTEE REPORT William Walker, MD, Chair; Dr. Thomas R. Hill, MD; Pamela Blizzard; Paul Camnitz, MD; Karen R. Gerancher, MD; Ralph C. Loomis, MD. A motion passed to close the session pursuant to Section 143-318.11(a) of the North Carolina General Statutes to prevent the disclosure of information that is confidential pursuant to Sections 90-8, 90-14, 90-16, 90-21.22 of the North Carolina General Statutes and not considered a public record within the meaning of Chapter 132 of the General Statutes and/or to preserve attorney/client privilege. The Disciplinary (Investigative) Committee reported on 35 investigative cases. A written report was presented for the Board’s review. The Board adopted the Committee’s recommendation to approve the written report. The specifics of this report are not included because these actions are not public information. A motion passed to return to open session. July 21-23, 2010 REVIEW (INVESTIGATIVE) COMMITTEE REPORT Peggy Robinson, Chair; Thelma Lennon; George L. Saunders, III, MD A motion passed to close the session pursuant to Section 143-318.11(a) of the North Carolina General Statutes to prevent the disclosure of information that is confidential pursuant to Sections 90-8, 90-14, 90-16, 90-21.22 of the North Carolina General Statutes and not considered a public record within the meaning of Chapter 132 of the General Statutes and/or to preserve attorney/client privilege. The Review (Investigative) Committee reported on 37 investigative cases. A written report was presented for the Board’s review. The Board adopted the Committee’s recommendation to approve the written report. The specifics of this report are not included because these actions are not public information. A motion passed to return to open session. NORTH CAROLINA PHYSICIANS HEALTH PROGRAM (NCPHP) COMMITTEE REPORT Thelma Lennon, Chair; Janice Huff, MD; Karen R. Gerancher, MD A motion passed to close the session pursuant to Section 143-318.11(a) of the North Carolina General Statutes to prevent the disclosure of information that is confidential pursuant to Sections 90-8, 90-14, 90-16, 90-21.22 of the North Carolina General Statutes and not considered a public record within the meaning of Chapter 132 of the General Statutes and/or to preserve attorney/client privilege. The Board reviewed 57 cases involving participants in the NC Physicians Health Program. The Board adopted the committee’s recommendation to approve the written report. The specifics of this report are not included as these actions are not public information. A motion passed to return to open session. HEARINGS – July 23, 2010 REECE, Donald, MD – Morehead City, NC Disciplinary Dr. Reece was charged with unprofessional conduct for allegedly practicing below the standard of care with regard to his treatment of eight patients, lack of professional competence to practice medicine with a reasonable degree of skill and safety based on a comprehensive evaluation by CPEP, and failing to provide adequate coverage for his patients at times when he planned to be unavailable. A Panel Hearing was held on April 15, 2010. Members of the Panel were: Dr. Jablonski, Dr. Camnitz and Ms. Blizzard. Thomas Moffitt served as Independent Counsel. Dr. Reece was represented by Daniel Flebotte during the Hearing. The Board was represented by Todd Brosius during the Hearing. July 21-23, 2010 PANEL FINDINGS: The Panel found that Dr. Reece’s care of patients A through H departed from or failed to conform to the standards of acceptable and prevailing medical practice within the meaning of NC Gen. Stat. § 90-14(a)(6). The Panel also found that Dr. Reece’s lack of medical knowledge and clinical reasoning constituted a lack of professional competence to practice medicine with a reasonable degree of skill and safety to patients and failure to maintain acceptable standards of one or more areas of professional physician practice with the meaning of NC Gen. Stat. § 90-14(a)(11). Additionally, the Panel found that by failing to provide adequate coverage for his patients in times that he planned to be unavailable, Dr. Reece engaged in unprofessional conduct within the meaning of NC Gen. Stat. § 90-14(a)(6). PANEL RECOMMENDATION: The Panel recommended that Dr. Reece’s medical license be revoked. A Motion by the Respondent to reopen the case to allow further evidence was heard on July 22, 2010, by Dr. Jablonski and Ms. Blizzard. The Motion was denied. Final Arguments before a Quorum of the Board were heard on July 23, 2010. Members of the Quorum were: Dr. Huff, Dr. Saunders, Dr. Loomis, Dr. Walker, Dr. Hill, Ms. Lennon, Dr. Gerancher, Judge Lewis, and Ms. Robinson. Dr. Reece was represented by K. Edward Greene and Tobias Hampson. The Board was represented by Todd Brosius. BOARD ACTION: To allow 30 days for Dr. Reece to close his practice, his medical license will be indefinitely suspended effective August 26, 2010. Dr. Reece may not reapply for a medical license for one year. ADJOURNMENT This meeting was adjourned at 1:00 p.m., July 23, 2010. _____________________________________________________ William A. Walker, MD Secretary/Treasurer July 21-23, 2010