Medical license renewals have morphed over time to be quite involved. The Board of Medicine is charged with keeping the public safe. This includes making sure that licensees have no medical or mental health conditions which, with or without treatment, could impact taking care of patients.

In a prototypical renewal form, the following question was par for the course.

Since you last renewed have you become aware of any medical condition that impairs or limits, or could possibly impair or limit, your ability to practice medicine safely? (If you are an anonymous participant in the Physician Health Program and in compliance with your contract, you do not need to list any medical conditions related to that contract).

Medical Condition includes physiologic, psychiatric, or psychologic conditions or disorders including, but not limited to, orthopedic, ophthalmologic, or neuromuscular problems, speech or hearing impairment, or infectious disease.

Do not use abbreviations in your response.

A surgeon developing new onset treat-resistant epilepsy must surely disclose. But, what about an internist with well-controlled atrial fibrillation?

To many, this seemed like a fishing expedition demanding disclosure for many conditions that likely would never impact patient safety.

In North Carolina, change is coming.

Beginning sometime in December or January, the Board will require licensees completing renewal to acknowledge a statement of NCMB’s expectation that they appropriately address personal health conditions, including mental health and substance use issues, without disclosing specific details.

Multiple factors contributed to NCMB’s decision. Over the past year, the Board has spent time considering whether the renewal question may be an obstacle to licensees seeking assistance. Forgoing treatment can contribute to burnout, impact quality of care or, in extreme cases, lead to major depression or suicidal thoughts. This is a growing problem among medical professionals across the nation, as well as in NC. The Board is committed to doing its part to encourage licensees to seek the help they need without fear of repercussion.

As the Board considered its existing renewal question, it became clear that the current question is sufficiently broad in its definition of “medical condition” that licensees frequently over­-report health concerns. This results in unnecessary staff review of renewal applications in which there is no true threat to patient safety. After thoroughly considering the matter, NCMB concluded that the existing renewal question wasn’t effective at identifying licensees who may need review, and might actually be actively deterring individuals from seeking help.

Here’s the draft updated statement in the renewal application.

Important: The Board recognizes that licensees encounter health conditions, including those involving mental health and substance use disorders, just as their patients and other health care providers do. The Board expects its licensees to address their health concerns and ensure patient safety. Options include seeking medical care, self-limiting the licensee’s medical practice, and anonymously self-referring to the NC Physicians Health Program (www.ncphp.org), a physician advocacy organization dedicated to improving the health and wellness of medical professionals in a confidential manner.

The failure to adequately address a health condition, where the licensee is unable to practice medicine with reasonable skill and safety to patients, can result in the Board taking action against the license to practice medicine.

So, there you have it. Doctors in North Carolina will be able to use reasonable judgment in renewing their licenses.

What do you think?

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