CORRECTION

A story on Page 1B of the City & State section Wednesday did not give a complete title for Polly Johnson. She is executive director of the N.C. Board of Nursing and president and chairwoman of the board of the Foundation for Nursing Excellence.

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The N.C. Medical Board, widely criticized for slack oversight of the state's 21,000 physicians, is seeking broader legal authority to discipline doctors.

The board has proposed draft legislation that would greatly increase its ability to publicly censure errant doctors.

Today, physician misconduct is publicly disclosed in two ways: Either the doctor acknowledges it and agrees to be disciplined, or the medical board holds a public hearing and imposes punishment. Other actions by the medical board, such as letters of warning sent to physicians under review, are kept private. Patients have no way to know a doctor has been cautioned, let alone for what reason.

Critics say that system allows problem doctors to practice under the radar in North Carolina, resulting in harm to patients.

Last year, for example, The News & Observer and other news media reported extensively on Dr. Steven Olchowski, a Wilmington surgeon who performed risky weight loss surgery on dozens of patients who had agreed to a safer procedure. Olchowski, who surrendered his license and no longer lives in the state, maintained a spotless record and unrestricted license to practice medicine in North Carolina, even as the medical board conducted its more than two-year investigation of him.

Currently, state law provides the medical board with two main remedies for punishing misconduct: It can suspend a doctor's license or revoke it. The board estimates it gets 1,000 complaints in a given year, including accusations of fraud, substance abuse and sexual misconduct as well as allegations of poor quality care.

Dr. Jesse Roberts, the board's medical director, said that very few cases involve misconduct that warrants yanking a physician's license, even temporarily.

"[Revoking or suspending the medical license] is like killing a fly with an atomic bomb, or at least a sledgehammer," he said.

Lawyers want more

Under the proposed legislation, the medical board would gain sweeping powers to publicly sanction doctors. And it could use all of them without first having to get the physician's consent.

Under the proposed changes, the board could impose public reprimands and public letters of concern. It could place doctors on probation, order them to provide free medical services and require them to complete treatment programs or remedial or educational training. It could also levy fines, place providers on probation or limit the scope of their practice.

If the board took any of those actions against a physician, it would be publicly disclosed to anyone who contacted the board about that doctor or looked up the doctor on the board's Web site.

"It's definitely going to move more actions from non-public to public," said Thomas Mansfield, the medical board's chief prosecutor and legislative liaison.

He discussed the draft legislation last week at a meeting of a House subcommittee.

"The clear message I got was that the medical board needs to step up and put forward recommendations, or we might get mandates [the board] doesn't like and might not be as effective," Mansfield said.

The proposed changes are winning early support from trial lawyers, a group more accustomed to battling doctors over medical malpractice awards. Mansfield said the medical board hopes to enlist the help of the N.C. Academy of Trial Lawyers in urging lawmakers to adopt the proposed reforms.

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