I would like to serve on the Board. How do Board members get selected?
The Board has four members, three of whom must be podiatrists licensed and having practiced in NC for not less than seven years. Nominees are selected by current Board members, and all licensees who reside in NC may vote in the election conducted by the Board. The Governor then makes the appointment. See N.C.G.S. 90.202-4 and 21 NCAC 52.1301 and .1302.
When considering nominees, existing Board members look for individuals with the following attributes, skill sets, and past experiences: Board members must be balanced, selfless....placing the needs of the citizens of NC and the profession above any personal need, have an understanding of human behavior, have the capacity to interpret state law and other legal documents with the assistance of staff and counsel, appreciate the history of our profession as it relates to new situations that come before the board, innovate and create--all with professional integrity. This individual must work well with others and be comfortable building consensus. The nominee should have demonstrated leadership capabilities and knowledge of parliamentary procedures by having served on committees and/or as chairs of the NCFAS or other governing boards.
New board members develop their skills under guidance of a senior board member, because it takes several years for someone newly appointed to fully appreciate the complexities of the job. Board members are therefore encouraged to commit to serving two consecutive, three-year terms.
Board members are expected to have familiarity with and respect for the various laws and administrative rules that govern occupational licensing boards (specific training covering these laws must be taken every two years):
- Chapter 150B, The Administrative Procedure Act.
- Chapter 132, The Public Records Law.
- Article 33C of Chapter 143, The Open Meetings Act.
- Articles 31 and 31A of Chapter 143, The State Tort Claims Act and The Defense of State Employees Law.
- Chapter 138A, The State Government Ethics Act.
- Chapter 120C, Lobbying.
They should also be familiar with and have respect for the Podiatry Practice Act and the Medical and Allied Professions Act and related Administrative Rules. Specifically, the Secretary-Treasurer of the Board must also be familiar with the State Budget Manual policies concerning per diems and reimbursement of travel expenses. Board members must also be willing to undergo the scrutiny of the State Ethics Commission by submitting an annual, financial Statement of Economic Interest (http://www.ethicscommission.nc.gov).
May a podiatrist administer anesthesia other than local?
No, a podiatrist may not administer non-local anesthesia per state statute:
§ 90-202.2. `Podiatry' defined.
(a) Excluded from the definition of podiatry....... is the administration of an anesthetic other than local.....
May an anesthesiologist administer and direct anesthesia for a podiatrist?
Yes. Both anesthesiologists and anesthesiologist assistants are licensed by the NC Medical Board. Anesthesiologist assistants must be under the supervision of a licensed anesthesiologist.
§ 90‑21.11. Definitions.
The following definitions apply in this Article:
- Health care provider. – Without limitation, any of the following:
- A person who pursuant to the provisions of Chapter 90 of the General Statutes is licensed, or is otherwise registered or certified to engage in the practice of or otherwise performs duties associated with any of the following: medicine, surgery, dentistry, pharmacy, optometry, midwifery, osteopathy, podiatry, chiropractic, radiology, nursing, physiotherapy, pathology, anesthesiology, anesthesia, laboratory analysis, rendering assistance to a physician, dental hygiene, psychiatry, or psychology.
§ 90‑18.5. Limitations on anesthesiologist assistants.
- Any person who is licensed to provide anesthesia services as an assistant to an anesthesiologist licensed under Article 1 of this Chapter may use the title "anesthesiologist assistant." Any other person who uses the title in any form or holds himself or herself out to be an anesthesiologist assistant or to be so licensed without first obtaining a license shall be deemed in violation of this Article. A student in any anesthesiologist assistant training program shall be identified as a "student anesthesiologist assistant" or an "anesthesiologist assistant student," but under no circumstances shall the student use or permit to be used on the student's behalf the terms "intern," "resident," or "fellow."
- Anesthesiologist assistants are authorized to provide anesthesia services under the supervision of an anesthesiologist licensed under Article 1 of this Chapter under the following conditions:
- The North Carolina Medical Board has adopted rules governing the provision of anesthesia services by an anesthesiologist assistant consistent with the requirements of subsection (c) of this section.
- The anesthesiologist assistant holds a current license issued by the Board or is a student anesthesiologist assistant participating in a training program leading to certification by the National Commission for Certification of Anesthesiologist Assistants and licensure as an anesthesiologist assistant under G.S. 90‑9.4.
- That an anesthesiologist assistant be supervised by an anesthesiologist licensed under this Article who is actively engaged in clinical practice and immediately available on‑site to provide assistance to the anesthesiologist assistant.
- That an anesthesiologist may supervise no more than two anesthesiologist assistants or student anesthesiologist assistants at one time. The limitation on the number of anesthesiologist assistants and student anesthesiologist assistants that an anesthesiologist may supervise in no way restricts the number of other qualified anesthesia providers an anesthesiologist may concurrently supervise. After January 1, 2010, the Board may allow an anesthesiologist to supervise up to four licensed anesthesiologist assistants concurrently and may revise the supervision limitations of student anesthesiologist assistants such that the supervision requirements for student anesthesiologist assistants are similar to the supervision requirements for student nurse anesthetists.
- That anesthesiologist assistants comply with all continuing education requirements and recertification requirements of the National Commission for Certification of Anesthesiologist Assistants or its successor organization.
- Nothing in this section shall limit or expand the scope of practice of physician assistants under existing law. (2007‑146, s. 4; 2008‑187, s. 14.)
Can a podiatrist perform any amputation, ankle surgery or club foot surgery in his or her office?
No, with exception as described in the law below.
§ 90-202.2. `Podiatry' defined.
(b) Except for procedures for bone spurs and simple soft tissue procedures, any surgery on the ankle or on the soft tissue structures related to the ankle, any amputations, and any surgical correction of clubfoot shall be performed by a podiatrist only in a hospital licensed under Article 5 of Chapter 131E of the General Statutes or in a multi-specialty ambulatory surgical facility that is not a licensed office setting, and that is licensed under Part D of Article 6 of Chapter 131E of the General Statutes.
What are defined as a simple soft tissue procedure on the ankle that I may perform in my office?
Simple soft tissue procedures are defined by state Administrative Rules are:
21 NCAC 52.1400 SCOPE OF PRACTICE - SOFT TISSUE PROCEDURES
SIMPLE SOFT TISSUE PROCEDURES PURSUANT TO G.S. 90-202.2(b) ARE PROCEDURES INVOLVING STRUCTURES PROXIMAL TO A LINE PARALLEL WITH THE DOME OF THE TALLUS THAT MAY BE PERFORMED BY A PODIATRIST IN AN OFFICE SETTING INCLUDE:
- LIGATION OF SUPERFICIAL VEINS OR VESSELS;
- REPAIR OF SOFT TISSUE LACERATIONS AND ABRASIONS:
- INCISION, DRAINAGE AND DEBRIDEMENT OF ABCESSES, HEMATOMAS, AND ULCERATIONS;
- EXCISION OF FOREIGN BODIES AND SOFT TISSUES MASSES WHICH ARE NOT KNOWN OR THOUGHT TO BE MALIGNANT;
- BIOPSY AND CAUTERIZATION OF SOFT TISSUE LESIONS;
- LIGAMENTS AND TENDON REPAIRS FOUND DURING THE AFOREMENTIONED PROCEDURES;
- RELEASE OF NERVE ENTRAPMENT FOUND IN CONJUNCTION WITH AN EXTENSION OF NERVE ENTRAPMENT PROCEDURES OF THE FOOT.
Should I apply to the Board of Podiatry Examiners for privileges to perform amputations, surgery on the ankle, or clubfoot?
Yes. To do so without obtaining privileges from the NCBPE may increase your legal exposure and that of the facility at which you operate.
§ 90-202.2. `Podiatry' defined.
(c) The North Carolina Board of Podiatry Examiners shall maintain a list of podiatrists qualified to perform the surgeries listed in subsection (b) of this section [refers to amputations, ankle surgery, and club foot], along with specific information on the surgical training successfully completed by each licensee. (1919, c. 78, s. 2; C.S., s. 6763; 1945, c. 126; 1963, c. 1195, s. 2; 1971, c. 1211; 1975, c. 672, s. 1; 1995, c. 248, s. 1.)
May I perform procedures on the hand like they do in some other states?
The NC Podiatry Board and the NC Medical Board worked through the definition of Podiatry very thoroughly in 1995. Podiatry practice in this state is confined to the FOOT AND ANKLE. By definition, hands (or other parts of the human body above the myotendinous junction) are NOT included in the practice of podiatry in NC.
There a lot of issues that I wish the board would lobby to change, for example, supervising physician assistants and restrictions on performance of physical exams in hospitals, etc. Why doesn't the board address these issues?
Occupational Licensing Boards are prohibited from lobbying by state statute:
§ 93B‑6. Use of funds for lobbying prohibited.
Occupational licensing boards shall not use any funds to promote or oppose in any manner the passage by the General Assembly of any legislation. (1973, c. 1302.)
May a podiatrist administer hyperbaric oxygen for wound care?
The Board of Podiatry Examiners deems that wound care treatments using hyperbaric oxygen fall within the scope of podiatry as part of the “…surgical, medical, or mechanical treatment of all ailments of the human foot and ankle…” (NCGS 90-202.2) The governing board of the facility housing the hyperbaric oxygen chamber has the authority to determine the scope and privileges for each podiatrist performing these treatments at that facility. (NCGS 131E-85).
Who needs to wear a name badge when providing medical care to a patient?
According to NCGS 90-640, identification badges are required for any health care practitioner who is licensed, registered, or certified in the State of North Carolina to engage in the practice of medicine, nursing, dentistry, pharmacy, or any related occupation involving the direct provision of health care to patients (e.g., podiatry) while providing health care to a patient. The name badge, or other form of identification, must be readily visible with the practitioner’s name and license, certification, or registration held by the practitioner (e.g., DPM, RN, LPN, CRNA, MD, etc.) The badge or other form of identification is not required to be worn if the patient is being seen in the health care practitioner's office and, the name and license of the practitioner can be readily determined by the patient from a posted license, a sign in the office, a brochure provided to patients, or otherwise. Violation of this law is grounds for disciplinary action against the health care practitioner by the practitioner's licensing board or other regulatory authority.
Does the NCBPE use specialty board certification in its licensure determination?
The Board does not determine licensure dependent upon certification status. Hospitals and surgery centers use surgical and medical board certification status to make determinations about privileging requests. Hospitals and surgery centers may be selective regarding which boards they accept as demonstrating specialty proficiency.