NCMB Audit - Part 1 - NC Medical Board Completely Thwarted Authorized State Performance Audit

NCMB appears to be running its own licensing, investigations, and hearings operation with completely NO OVERSIGHT and NO ASSURANCE IT IS ABIDING BY FEDERAL AND STATE LAW.

(psst - this is a longish post, the first of several in a series, so I did a skinny recap below – you’ll get the gist and can always come back to your email or on Substack and read the whole shebang.)

I was wondering how long it would take the NC Auditor to conduct a Performance Audit on NCMB, the state’s legislatively empowered medical licensing board.

She just did! Well, that’s not true. She just DIDN’T. You see, NCMB refused to cooperate.

The big takeaway is this:

It’s not just what she found, it’s what she was prevented from finding, how they’re preventing her, and why.

I don’t have the ‘why’ answer, but I’ve got some pretty likely hypotheses.

She just posted her report about a week ago and, wowzer, it’s pretty disturbing. You see, they blocked her from seeing more than 95% of their records and basically told her she’d have to get a search warrant - from the state legislature (in NC, The General Assembly).

A footnote on this post and the series.¹

Here’s the Skinny

In This Piece:

NC Auditor Audits Refusing-to-be-audited NCMB

There’s a significant decade-old back story that’s created some bad blood between the board and the auditor. The bad blood’s coming from the Executive Director of the board who doesn’t like how she outed them in their failure to oversee the NC Physician Health Program’s wholesale violation of the due process rights of 1,140 physicians and then revealed that they, NCMB, also had no oversight.

Even more so than the NCPHP audit, this NCMB audit - and refusal - is a profoundly significant event!

What Ms. Wood and Her Team Were Looking At

She’s coming in - manifestly because there’s a few notable NC docs who’ve had some bad publicity re their behavior. The allegations are diverse - boundary violations, inappropriate prescribing, etc. Whether factually valid or not, they’re sensational. And I also know how the attention-seeking press runs on sensation, dramatizing stories that may alter their actual reality and how these often result in character defamation and career destruction. For some of these news-tainment outlets, that’s the whole idea, not a byproduct. Nevertheless, these physician licensees have apparently, per the auditor, gotten away with either no board investigation or a gloss-over investigation resulting in minimal punishment. She’s on their case because she feels NCMB’s being lax in its discipline and unequal in its punishment as well. I’m not convinced that’s the only, or even main, reason why she’s there. I think she’s savvy and wily and I admire her for her persistent commitment to her public service mission, unpopular though it may be amongst those she’s called out. In a way, she’s an internal whistleblower.

NCMB Blocks The Audit

NCMB essentially blocked the audit by refusing to give her access to the requisite investigative and deliberative records that she needed to ensure that NCMB’s got some modicum of a protocol, and that they’re actually conducting their case investigations and disciplinary charges not only fairly but in full compliance with state and federal law. NCMB says the law protects that investigative information from oversight by anybody except whom NCMB gives access to. She says she’s the auditor and the auditor statute empowers her to demand that everyone open up when she conducts an audit. NCMB offers about four reasons why they’re resisting. She not only addresses those concerns but also calls out in numerous places NCMB Executive Director Henderson’s untrue assertions, straightforwardly stating that his response to this or that particular issue was knowingly untrue and that his elaborate responses were frequently a distortion and only served to obscure the facts. She was diplomatic enough to stop short of overtly calling him a #$% liar. You’ll see her confrontative responses peppered throughout this steamy report. I think she’s right on all counts and NCMB’s just buying time to stall so they can get her off their case while they try to purge their Gestapo files. Do they have things to hide? My hunch? – she knows they’re a bully operation, a privatized parajudicial system, a career hit-job squad and an inside dealer on PHP referrals. She knows that their acceptance of NCPHP’s due process deprived reports and NCMB’s resultant discipline and license sanction was itself a denial of due process which NCMB failed to take ownership of and mitigate and address. (They did ~sort of~ address it, in a rather crafty way - see “Out of the Blue…” below.) She also knows there’s a lot at stake; I’m not sure she knows there may be powers beyond the immediate board that don’t want her snooping around and screwing with their territory.

Why She’s Got a Right To Audit NCMB

She’s the state equivalent of the DOJ and IRS combined. When she says “Open up, I wanna see XYZ,” my read of the NC auditor law (of course written in a time when legislators had integrity and believed that everyone was equal under the law) suggests you either say “yes ma’am, here’s XYZ, what else would you like to see” or you’ll be charged with a criminal obstruction charge. NCMB seems to be banking on their numerous buds in the legislature. And they too may not want this operation opened up either, for various reasons. They’re liable to stab her in the back and support NCMB on this legal authority question. Very bad decsion, but what she’s uncovering is potentially very bad stuff that could ultimately be quite costly to the state. If the state recognized the gift she’s giving them, namely showing NCMB acted without oversight, then the state could save a lot of money and retain some shred of integrity. But the legislature may be thinking short term ‘buddy buddy – look out for each other’. There’s a good chance if they lock her out, a federal body could come in. And I suspect there’s no saying no to them. Unless NCMB manages to pull strings in high places and get their “preferred people” assigned to the case, the pool of which seems to be considerable.

Stand-off

Why NCMB’s Slamming the Door On the Auditor Is Important

For one, it reveals whether or not the state truly wants an ethical, impartial auditor to hold state agencies accountable. The law empowering the auditor’s work seems explicitly clear in its intent to keep the state above board. For another, if they succeed in keeping her out, there will be great suspicion that this board, and perhaps other boards and other agencies, are corrupt inside dealers and this state government overall is not to be trusted. And third (amongst numerous others), keeping the auditor out could compel one or more federal agencies to come in, simply on the basis of an absence of requisite state oversight of licensing boards and concerns about mounting civil rights violations. And I suspect this is a group you don’t want snooping around, especially if you’re running a RICO.  Personally, I think it’d be a huge mistake for the legislature to shun her and protect NCMB. Very short-lived gain for the buddy buddies; huge long-term risk for the state.

Overview of Critical Components That She Finds So Far:

But, as they won’t give her access to the protocol and the investigative files and case deliberations - and perhaps most importantly make clear to her the reasoning behind those dispositions, they’re telling her they won’t budge. And that she’s got to go to the legislature, the writer of the laws, to get that body’s thoughtful order. So, she’s going. I’d suggest there might be some other avenues that could be more effective.

But here’s what she learned even with near-total blockade:

• There’s a mind-boggling number of NCMB “investigations” annually - but there’s a capricious approach, and no discernible internal oversight (i.e. “controls” in auditor-speak).

• There’s no protocol for the workflow - the triage of complaints»> investigation by their watergate plumbers’ team »> to issuing formal charges »> to so-called informal resolution agreement »> to oh-so-fair public hearing of licensee who’s essentially presented for trial in cuffs and orange jumpsuit.

• NCMB repeatedly breaks the law - in ~ ⅓ of the cases it investigates by extending the allowed investigation - and thus the gentlemanly-agreed NPA (non-practice agreement) - duration beyond the max 6 months set by the NC legislature, while not informing the licensee as required of the rationale. Just doing it willy-nilly.

If all you want and need right now is the skinny, that’s it. But you ARE going to want to come back and read the whole shebang, including the footnotes.

End of the Skinny

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First, a little backstory on this NCMB Performance Audit …

The Groundbreaking 2014 NC PHP Audit

You may recall that it was in 2014 that NC State Auditor Beth Wood, fortunately an elected position, conducted a comprehensive Performance Audit of the NC Physicians Health Program (NCPHP), NCMB’s exclusively contracted, corporately unlicensed, incontestable state psychiatrist conducting so-called “peer review” on command of NCMB. In response to licensee complaints, particularly spearheaded by Dr. Jesse Cavenar, Jr, former Vice-Chair of Psychiatry at Duke, and three other senior psychiatric colleagues, NCOSA - the state auditor’s agency - conducted a comprehensive review of NCPHP’s conduct of its “peer review” program. Dr. Cavenar and his colleagues were alarmed that NCPHP seemed to be systematically misdiagnosing the physicians they referred “for treatment” with mental illness and substance abuse diagnoses they didn’t have, sentencing them to costly assessments at centers in their and NCMB’s “preferred network” and then, following on, virtually interminable treatment and “monitoring.”

While not even delving into the camouflaged identity of this agency and the actual involuntary psychiatric exams it was conducting, it found that NCPHP had systematically, as a matter of practice, denied due process to all 1,140 physicians it had “peer-reviewed” over the preceding decade.², ³ It found that NCPHP refused to provide them their diagnostic evaluation reports (claiming they were “state privileged”) and that NCPHP thus claimed that its diagnostic finding was infallible and could not - apparently by a magically invented law - be challenged by independent expert opinion.⁴ Sending people to exorbitantly costly private centers for special assessments at diverse “preferred programs” across the country, the auditor found that there existed no criteria to add a facility to such a “preferred program” list. Such "preferred programs" are a misnomer - they’re actually the only programs NCMB “accepts” for the assessment and treatment “recommended” by its officially sanctioned state psychiatrist. It also concluded that there appeared to be a financial conflict of interest.

The NCPHP Follow-up Audit

She went back about five years later and did a follow-up audit and produced a caricature of a report that resembled what cops hear when a domestic violence victim tries to cancel their 911 call. “Oh no, officer, it was a mistake. He’s not really beating me up. Everything’s fine.” Truly, section after section consisting of one or two sentence paragraphs saying “Just amazing, everything’s fine. In all my years as auditor, I’ve never seen such a fraudulent outfit so thoroughly clean up their books act performance state-sanctioned peer review operation.” When I and colleagues read it, it sounded more like a “Really, I’m being well taken care of … so far” ransom note coming from someone who was being held hostage at gunpoint. “Don’t you worry, they told me they’ll let me go home soon … so whatever you do, don’t make a big scene and send in the police to get me. They told me very clearly there’s no need for that, as long as we let the whole thing go away.”

Out of the Blue, a Surprise NC Law Change re NCPHP No Longer Doing Peer Review.

General Assembly Designates NCPHP As Official State Psychiatrist Empowered to Interrogate Any Licensee It Wishes

Of course, under its banner of “protecting the public.” Which would mean that, a priori, NCMB would then do well to retroactively, unilaterally, use their crack investigations and legal teams to document their suspicion that the licensee they’re “referring” to NCPHP for forensic psychiatric interrogation meets sufficient criteria that can pass muster as “unsafe,” or at least as “potentiallly unsafe” (“you just can never be sure enough, ya’ know”). Their reasoning in this caper seems to have been “as long as we can give the appearance of us erudite people [implying those stethescope-bearing white-coated people who are the official board] having seemingly reasonable concerns about a doc’s performance of the practice of medicine and its potential adverse impact on patient care, we’re good.” And by good they mean, we can’t be sued for our reasonability. And via this capricious imperial determination, just about anything could be declared “unsafe” and “potentially a danger to patient care” and thus “the doctor is a nutcase and a danger to society and needs to be carted off to NCPHP and then on to Kansas for ‘the 4 day assessment’ to confirm NCPHP’s diagnosis.”

Soon after the audit, the language of which seemed to be tortured so as not to create a bonfire of litigation (that is, if the lawyer community supposedly representing physicians’ rights even gave a damn enough to read and understand the report), parties in the NCMB, NCPHP, NCMS cabal had apparently secretly gone to the NC General Assembly (NC’s legislature which seems to operate on the insider “who you know” principle). And they actually changed the Medical Practice Act - the law governing the board of medicine - specifically NCGS 90-21.22 - to remove any reference to NCPHP or anybody doing “peer review” and to newly give NCPHP the exact powers it had already been exercising illegally previously.⁵ No accountability or mitigation for the decades of wrongdoing and wrecked careers under its faux peer review identity. Surely that would be too cumbersome, not to mention costly. Let’s just give them the powers NCMB and NC Medical Society want them to have: “Official infallible psychiatrist of the Medical Board of the State of North Carolina. All Diagnoses Final and Incontestable.” Any treatment intervention they in their medical & psychiatric wisdom deem warranted, including the taking of any bodily tissue they deem needed for examination and employing any interrrogation technique they find necessary to ‘get to the bottom of things,’ is hereby permissible. And since this is no longer ‘peer review’ but a bona fide medical procedure done by a white-coated physician accompanied by a social worker, no need for that pesky ‘due process’ provision.

No wonder everything’s fine! They rewrote the law to legalize the crime. Now that’s creative.

I and a colleague followed that bill (buried in a Fire Redistricting bill!) before it became law and saw both its defects and its grave dangers to physician licensees and tried to alert the head of the senate and others to its fundamental flaws, but were completely ignored.⁶ Our arguments were pretty clear; its defects are quite glaring and not based on some finer interpretation of law. It’s definitional legerdemain – suddenly removing any reference to NCPHP’s role in peer review and newly anointing it as the official state psychiatrist while removing any reference to requisite due process – made our jaws drop. One would even wonder if it’s enforceable, it’s so flawed.

You would think that bills might pass through some rudimentary screening process to see whether there might be something that could conflict with other laws, maybe even constitutional protections. You know, something like "uhhh…I don't think you can scoop up a professional and send them for involuntary psychiatric examination, or authorize an unlicensed medical corporation to send people out of state for brass-knuckle interrogation, or biopsy any body tissue you want whenever you want to. What's to stop you from ordering a brain biopsy? You guys really ought to reel this back a little, don't you think? Just because the revisions came from the medical board* and the medical society doesn’t mean they actually thought them out or that they’re even legit.⁷ I mean, this is embarrassing. What would other states think? What about the ACLU? How would this look to the Supreme Court? Did their trade associations FSMB and FSPHP, and medical societies AMA and APA, say this looked okay? Really? Surely, they've got compliance lawyers that these originator agencies here don't."

Your thinking would be wrong.

NCMB Continues Its Same Bullying Behavior And Declarations of “Unsafe and Dangerous” Undeterred

But meanwhile, back at Stasi headquarters, NCPHP’s primary funder NCMB was continuing to open case files on a veritable crowd of physicians, more than 2,000 investigations per year! That’s a helluva lot of referrals to lawyers holding out their shingles as possessing the undeclared specialty of “professional license defense.” Quite the operation too. And a veritable SWAT team investigation could be initiated by NCMB simply on the basis of an anonymous complaint saying “my doctor was rude to me and he looked bleary-eyed. I think he’s on drugs.” Those are magic words to this and apparently every other medical board in the country. It’s the 911 equivalent of “help, he’s beating me, come quick.”

NCMB Gets a “Knock, Knock, It’s Your Old Friend, the Auditor.”

So, the NC Auditor, apparently about a year ago, set out to begin an audit of the purported state agency* NCMB, specifically focusing on its complaints and investigations division and its work product, i.e. the 4,432 investigations it undertook growing out of diversely sourced complaints (including perhaps from the board itself under the veil of anonymity) over the preceding two years.⁸

One gets the sense that NCMB maintains a seething hatred of NCOSA’s Auditor-in-Chief Beth Wood.⁹ She did after all stir things up a bit for both NCPHP and NCMB in that 2014 audit. She revealed that not only did NCPHP systematically violate all of its 1,140 board-ordered physicians’ due process rights by denying them access to their evaluation records, they prevented them from challenging the validity of NCPHP’s infallible diagnostic assessments and the reasonableness of its draconian recommendations for its exorbitant $10,000 4-day assessment at its preferred program. And she of course explored “who’s overseeing this operation?” And she learned that both NCMB and the NC Medical Society were charged with its oversight and had completely failed in that obligation. Basically, all medical licensees had been hijacked for a joy ride in a clown car and she just pointed out that nobody’s at the wheel. She also noted in a subsequent audit that same year that NCMB itself (along with most other NC occupational licensing boards) had virtually no governmental oversight. Now clearly, that might pose some liability problems, especially considering that denial of due process of 1,140 physicians you’ve evaluated, a significant number of whom you’ve infallibly declared impaired and needful of your “preferred program’s” specially designed “impaired physician rehabilitation” program could be rather costly.

So, given that’s the sort of “keep it in the family” secret that you don’t want to blabber about ‘cause it could just upset everybody and everything everywhere – especially in their state-sponsored highly lucrative “impaired physicians program” referral pipeline, it’s understandable why there might be some bad blood.

And That Brings Us To The Current NCMB Performance Audit

Here’s the link to the audit: https://www.auditor.nc.gov/media/4344/open

Auditor’s Manifest Concern

The manifest reason - though she doesn't need one - was that docs who are unprofessional, impaired, or incompetent may be on the loose in NC threatening the safety of the public, and concern that NCMB isn’t doing enough to address it. Are their investigations sufficiently prompt and impartial?

She offered a rather sensational rationale for this audit’s urgency which she supported by spicing her report with several attention-grabbing cases and alleging that NCMB didn’t investigate and discipline them sufficiently, if at all. And she questioned if there is a pattern of intentional non-investigation of some docs, say those with institutional or political pull, while other poor schmuck docs investigated for the same or lesser concerns were being publicly flogged by the board’s disciplinarians and its spectator-pleasing press.

This storyline – “drunk white-coated, loose-zippered predator docs on the loose” is a classic script, pulled out when needed to grab attention. It’s borrowed almost verbatim from the omnipresent alarmism of Public Citizen, calling for “more discipline” of the entire profession, as you just can’t take your eyes off these sorts. Whether Ms. Wood actually buys this tabloid trash is another matter.¹⁰

But playing to such a moral panic can sure help get you in the door and rouse a “we’re gonna get to the bottom of this right now” response among legislators and the public. I suspect (hope) what she’s really trying to do is just get in the door so she can examine this “independent agency’s” Stasi-like operations, specifically its FBI-wannabe complaints and investigations division.

What She Seems to Want To Find Out

She wants to get to the heart of their investigations operation.

What’s the protocol for how this board receives complaints, how it determines what to investigate, what that investigation consists of, who on the NCMB staff and on the Board (proper) are involved in that deliberative process; the length of the investigation; what gets charged; how is that charge then handled; is the “informal conference” back room justice; the “non-practice agreement”; the hearing.

And she wants to find out if it’s a fair process, not slanted in any way, and being done in full compliance with state and federal law.

Why This Performance Audit of NCMB Is So Important For Physicians (And Their Patients)

The main reason: Its investigation may expose a patttern of grievous wrongdoing that has harmed licensees and patients, and the profession of medicine and the reputation of the state. And uncovering that wrongdoing is necessary to hold offenders accountable and to begin the process of restoring the system so that it is in compliance with law and best practices.

The reality is that when you give any group of humans power over other humans, and you don’t put a leash on those power distributors, the probability is about 100% that those free-roaming regulators will a) turn into tyrants; and b) default toward using their power and the commonwealth they oversee for their own interests. And the more embedded they become, the more in bed they get with other powers, and they become like a devouring malignancy on the whole body. Sounds so quaintly simplistic, invoking the ‘founding fathers,’ but bottom line is – you either have checks and balances or no checks and imbalances.

When an occupational licensing agency like a medical board, founded on the basic premise that we want to make sure citizens get qualified medical care from duly trained persons and not from charlatans, claims that it governs all things medical and ethical and then is given legal machine guns to shoot anyone who challenges their infallibility, bad things happen. And when that agency then insulates itself not only from litigation but even from independent examination by the state that empowered it, then you’ve got big problems. You’ve got a Frankenstein that doesn’t like the limitations its creators put on it. It’s very similar to the challenge we face with intelligence agencies. We empower them, we let them do secret and nasty stuff in the name of the good of the country, they go beyond the bounds of legitimate nasty, they use their secrecy and power to strongarm the entities that empowered them, and they then become a privatized hit squad, hirable by the highest bidder.

Ultimately, this dynamic is self-destructive to any social system. But not before it does a helluva lotta damage. It’s like an anaerobic infection. The most effective antidote is fresh oxygen-rich air and sunlight. These gone-deranged operations can’t survive exposure. And exposure is the only therapy, and assured ongoing oversight and accountability the only antidote.

Shutting out the state overseer of last-resort - in this case, NCMB’s only overseer - is like a corporation firing its compliance and audit teams because they spoke their truth about potential wrongdoing. Any company that does that is just about screaming that it’s dying from an anaerobic infection.

And a state medical licensing board that as a matter of course over years ignores licensee and citizen detailed complaints - and medical professional expert documented concerns - about its potentially illegal and endangering operations, and then strives to shut out the very last state governmental person capable of digging deeper into these concerns on behalf of the public’s and the state’s good - has become an operation that’s gone rogue, an uncaged Frankenstein, and must be subdued.

Why The Standoff Itself Is So Important

Gives us a clear understanding of why docs can’t win

It’s such a lopsided game, any licensee is easy pickins.

And both the audit itself, and the arguments accompanying the showdown, give us a great opportunity to examine a trove of critically important physicians’ rights issues.

Next up …

Over the next several articles / podcasts, we’ll take the whole audit crisis apart, piece by piece. We’ll:

• do a drill-down on NCMB’s refusal to cooperate, and the huge significance of the standoff;

• explore why it’s not only in NC docs’ interests but all licensed medical professionals’ – in and outside of NC - for NCOSA to conduct this audit;

• consider some alternate ways she might achieve her desired endpoint and side-step this NC Constitutional crisis;

• highlight what she’s learned so far, despite NCMB’s near-total shutout;

• examine the structural anatomy of this medical board, and MLBs in general, and the dangerous phenomenon of non-overseen board and PHP weaponization;

• and float some win-win solutions, approaches that could help protect physicians’ rights while also meeting the legitimate overarching mission of the medical board.

Hope you’ll stay tuned …

… because this is about every doc practicing today, not just in NC but throughout the country

I know … it’s a head-full. And why I knew I had to break this “Auditor–NCMB Constitutional Crisis” tome into manageable chunks. Otherwise, you’d be at high risk for hitting your head against the wall (which, alas, I’ve done repeatedly). (And, oy, what a headache. I don’t know whether it’s from the mental strain of trying to wrap my disbelieving mind around their elaborately orchestrated rights deprivation scheme, or the repetitiveness of my banging. Then again, could just be my NCPHP- diagnosed illness acting up again.)

And if this resonates with you, be sure to share, click a heart emoji, and leave a comment. And if it stirs up rage, you don’t have to click a heart, but do ….

1. First, a note on the somewhat confusing concurrent “article / podcast” paths. Some may already know that I have an accompanying Physician Interrupted podcast that I try to do in sync with the written pieces. While it may seem redundant, I’ve learned that some people love reading, some people love listening, some people love both – even of the same post, and some people are chronically unhappy and don’t love nothin’. The good news is, those people don’t subscribe.

After I did my initial NCMB Audit podcast last week – based on my first draft of the article that I was going to post right after – I realized there was so much to cover on the audit, and the questions - and the opportunities - it raises, that I thought I better break it up, as it’s just too much to take in in one sitting without your brain unraveling.

So, I broke up this NCMB Audit examinaiton and made it into a series; they’ll be published one or two a week. They’re not going to be like my long-ass pieces of yore. I’m sure it must’ve been like reading War and Peace. For me too. By the end of writing each one, I’d grown a Tolstoy beard. And I’ll do an accompanying - comparably short - podcast on the same content, perhaps with a little bit of off-script improvisation, you know, an explanation here, a jab there, some snark for spice. If I refer to other resources I think you ought to grab, they’ll be in the footnotes in the written piece, just like this one.

The good news is they’re not written by ChatGPT, and the even better news is they’re not delivered by the affectless android voice of Alexa or Siri.

And, nudge nudge, the good news about subscribing to PI is that the newsletter comes to you via email. You don’t have to worry about whether you missed any of these gems. Even better, when you have the Substack app on your snazzy smartphone, presuming you’ve selected PI as one of your “followed” newsletters (on Substack, all writing is called a newsletter), it’s always there at your fingertips so you can read or listen to it waiting for your state-ordered psychiatric exam or your kangaroo-populated board hearing.

Since you’re reading this, you’re probably already a subscriber (… but if not, you know what to do). You know how when you find a gem, you say “Oh man, that’s great, I’ve got to send this to so-and-so,” I’ve included (most of the time) a “share” box and you can zap it to “them” right then and there, even if them isn’t a them.

And of course, would love love love to get your “heart” clicks and even more, to hear your crisp comments. It’s by us interacting that we can begin to make a difference and hold these rogue agencies turned regulatory terrorists accountable.

One more thing: if I’m in error about something factual, I won’t take it personally if you set me straight. If it’s just an opinion I’ve expressed … that’s not a fact. And I do have some strong opinions. So, instead of setting me straight, let me know yours in the comments.

2. I suspect Ms. Wood and her team were not even aware of this masterful deception. Naive to any public entity daring to conduct such a masquerade, no one thought to question what exactly NCPHP was doing. They were only authorized to oversee a program of “peer review” (at that, the authorizing wording suggests they weren’t even authorized to conduct it). But peer review, as essentially benchmark-designed by the Health Care Quality Improvement Act of 1983, is neither the same as a psychiatric evaluation nor does it ever even include one as a matter of course. Theirs met none - zero - of the fundamental definitional criteria of peer review. It would be like a legislatively delegated task force being authorized to develop and encourage physical fitness standards and then actually conducting brain surgery. And pulling off this assaultive violation of rights not just with the ‘wink, wink’ permission of the overseeing entity, but with that agency’s police-empowered order to conduct such. It leaves one so aghast, it’s no surprise the auditor didn’t drill down on it. Nor did she really recognize the significance of the willful failure of both NCMB and NC Medical Society to oversee it as was required. The even greater significance is that, by NCMB allowing NCPHP to remain unlicensed as a medical corporation though such was required under state corporation law (NCGS 55B), it thus conveniently enabled NCMB to not oversee it. This way, NCMB didn’t have to investigate its unauthorized practice of forensic psychiatry under the deceptive identity of peer review and could allow it to continue doing its rigged fitness-for-duty evaluations and to employ its SAMHSA-prohibited experimental alcohol biomarker known-to-be false-positive drug tests on all of its involuntary subjects and thus tidily packaged with unquestioned rationale for sending the doc off to Kansas for the 4 day special. I guess it’s no surprise that NCMB’s a little irked that here comes this snoopy auditor, perhaps still not fully aware of this grand deception, but who might start connecting more dots.

3. Other source documents suggest that the number of physicians NCPHP actually evaluated during that time period was closer to twice the number they reported to the auditor.

4. Perhaps they were then invoking the same exception NCMB currently is, essentially implying that they too were an unchallengeable state agency enjoying the same range of immunities non-state agency NCMB claims.

5. You mean that – BAM! – just like that, the state of NC that gave an unlicensed medical corporation state-sanctioned peer review powers in its Medical Practice Act and which infallible and incontestable determinations may have resulted in physician license sanction and reporting to the National Practitioner Data Bank and may have resulted in complete career annihilation of untold numbers of physicians, suddenly removes a “protecting the public” function that it considered so essential, and doesn’t transition that vital safety function to another entity? What might that say about how the state saw the need for that function? What might it say about a state that intentionally sneaks it out of view without having taken ownership of the harm it did? That it and its board which were assigned to its oversight failed in that function and both refused to acknowledge the decades-long gross malfeasance. Worse, they shirked their responsibility to mitigate the harms done, not just to that physician who brought it to their attention and with whom they adamantly refused to correspond, but to all who’d been harmed? And physicians are supposed to trust a government and a state medical board that treats its professionals this way, and slinks away to avoid responsibility?

6. This included the NC Medical Society that you’d think would’ve been appreciative and hopped on it … but ….

7. This by the way is a naive misattribution by many. As you’ll see subsequently, “the board” and “The Board” are actually two different entities. It is highly unlikely that this expansion of NCPHP’s powers rose de novo from The Board, i.e. the 13 members appointed by the Governor. My hunch is that it was a patchwork creation of the operational staff (“the board”) in conjunction with others who had a vested interest.

8. Whether NCMB is actually a state agency is a critically important question. Believe it or not, NCMB asserts quite emphatically that it is NOT. One would think that might have some implications for their enrobing themselves in diverse immunities.

9. NCOSA having provided NCMB Executive Director R. David Henderson its draft report, Mr. Henderson’s reply forgoes the universally accepted professional salutation format “Dear [name], and simply begins with the impolite, almost commanding “Auditor Wood:” I can certainly understand that he might have some hurt feelings as in her report, she repeatedly called him a g/d liar., though not quite so frankly. But still, decorum is decorum. Then again, others who have had correspondence with this man have experienced similar arrogant condescension. This seems to be the prevailing style of this lawless board.

10. This is not to deny that there are in fact some predator docs out there and they do need to be apprehended and disciplined. And there are also docs who’ve become impaired in some way and who could benefit from genuinely beneficent services to help them recover and return to practice. Fortunately, the Supreme Board and its investigations team know how difficult physicianing has become and will arrange with its exclusively contracted partner NCPHP for you to be suitably diagnosed as a mental cripple and assign you to be cared for (out of pocket only, please). You will never have to worry yourself silly about working as a phytsician again.