Court Opinion

ID: 9579037
Source: CourtListenerOpinion
Date Created: 2023-08-21 21:50:55.121714+00
Date Added: 2024-06-11T13:34:13.061384
License: Public Domain

Justice Frye
dissenting.
The underlying and essential question in this case is whether the Board may revoke a physician’s license to practice medicine for “unprofessional conduct” under N.C.G.S. § 90-14(a)(6) based on a deviation from “the standards of acceptable and prevailing medical practice” without a finding that the deviation carries with it a potential for harm to the physician’s patients or to the public. The Court of Appeals held that the Board may not do so. I agree and therefore dissent from the majority’s holding to the contrary.
I believe that the majority has construed subsection (6) of N.C.G.S. § 90-14(a) in a manner inconsistent with its purpose and legislative intent. N.C.G.S. § 90-14(a) provides that the Board shall have the power to deny, annul, suspend, or revoke a physician’s license to practice medicine in this State for any of some thirteen reasons. In addition to “unprofessional conduct,” a license may be revoked for immoral or dishonest conduct; for producing or attempting to produce an abortion contrary to law; for making false statements to the Board; for being unable to practice medicine with reasonable skill and safety to patients by reason of illness, drunkenness, etc.; for conviction of a crime involving moral turpitude; for making false representations in order to obtain practice, money or anything of value; for advertising or publicly professing to treat human ailments under a system or school of treatment or practice other than that for which the person has been educated; for mental incompetency; for lack of professional competence to practice medicine with a reasonable degree of skill and safety for *59patients; for promotion of the sale of drugs, etc., in such a manner as to exploit the patient for financial gain; upon suspension or revocation of a license to practice medicine in another state; or for failure to respond, within a reasonable period of time and in a reasonable manner, to inquiries from the Board concerning any matter affecting the license to practice medicine. Even a cursory review of subsection (6) shows that it is directed to protecting the health and safety of patients and the public. The common thread running through each of these reasons for revocation of a license is the threat or potential for harm to patients and the public.
Subsection (6) of N.C.G.S. § 90-14(a) provides that the Board shall have the power to deny, annul, suspend, or revoke a physician’s license for:
(6) unprofessional conduct, including, but not limited to, any departure from, or the failure to conform to, the standards of acceptable and prevailing medical practice, or the ethics of the medical profession, irrespective of whether or not a patient is injured thereby, or the committing of any act contrary to honesty, justice or good morals, whether the same is committed in the course of his practice or otherwise, and whether committed within or without North Carolina[.]
The majority treats the language “irrespective of whether or not a patient is injured thereby” as meaning irrespective of whether there is an injury or threat of injury caused by the deviation. I do not believe that the legislature so intended. Dr. Guess argues, and I agree, that this language gives the Board authority to act before injury occurs, but does not eliminate the public purpose requirement that the medical practice pose some threat or potential for harm to the public. The phrase “unprofessional conduct” connotes dishonorable or unethical behavior, In re Wilkins, 294 N.C. 528, 242 S.E.2d 829 (1978), and, in the context of the statute, means substandard medical practice that cannot be tolerated because of the risk of harm such treatment poses to the public. Subsection (6), like the remainder of section 9044(a), was enacted for t'he purpose of regulating the medical profession to protect the public health and safety and not simply to prevent a doctor from being the first one in the State to use a particular medicine or form of healing.
A careful examination of the evidence presented before the Board shows that Dr. Guess’ practice of homeopathy is not un*60professional conduct within the meaning of N.C.G.S. § 90-14(a)(6). All of the evidence tended to show that Dr. Guess is a highly qualified practicing physician who uses homeopathic medicines as a last resort when allopathic medicines are not successful. He takes 150 credits of continuing medical education approved by the American Medical Association every three years and from fifty to eighty hours of homeopathic continuing medical education each year. The homeopathic medications prescribed by him are listed in the Homeopathic Pharmacopoeia of the United States and are regulated by the United States Federal Food, Drug and Cosmetic Act. The homeopathic approach is often preferred, in Dr. Guess’ words, “primarily because of its well documented safety.” This is not a case of a quack beguiling the public with snake oil and drums, but a dedicated physician seeking to find new ways to relieve human suffering. The legislature could hardly have intended this practice to be considered “unprofessional conduct” so as to revoke a physician’s license in the absence of some evidence of harm or potential harm to the patients or to the public. Nothing in the record before the Board or this Court justifies so broad a sweep in order to secure the public “against the consequences of ignorance and incapacity as well as of deception and fraud.” See Dent v. West Virginia, 129 U.S. 114, 122, 32 L.Ed. 623, 626 (1889).
I also disagree with the majority’s conclusion that Dr. Guess’s evidence presented to the Board concerning the efficacy of homeopathy and its use outside North Carolina was not relevant to the issue before the Board. North Carolina does not and should not exist as an island to itself. The evidence that homeopathy is accepted in other states and in other countries of the world and that it has a beneficial rather than harmful effect certainly ought to be of some significance to the Board and to the citizens of this State concerned about the public health and safety. The majority rejects evidence of the legitimacy of homeopathy in other states and countries throughout the world as being irrelevant because homeopathy is not currently an acceptable and prevailing system of medical practice in North Carolina. This raises the legitimate question of how the acceptable and prevailing practice can be improved in North Carolina if we do not even consider what happens in other states and countries.
Lastly, I disagree with the majority’s conclusion that Dr. Guess’ remedy lay with the legislature. As I have stated earlier, N.C.G.S. § 90-14(a) is intended to protect the public from harmful or dangerous *61practices. In light of this policy, I do not believe that the General Assembly would require a physician to undergo a possibly lengthy wait for legislative action while it is attending to other matters before allowing him to make non-dangerous, beneficial treatments available to members of the public who knowingly consent. Where there is no showing of danger, I do not believe specific legislative approval is a prerequisite to a physician engaging in a practice which is by all indications helpful when used wisely.
I vote to affirm the unanimous decision of the Court of Appeals.