The North Carolina Senate is considering a bill that would make it easier for military and foreign doctors to practice in this state. House Bill 125, the NC Health & Human Services Workforce Act, would also provide provider protections from violence in rural hospitals, among other health-related measures in the bill.
The current version is a Proposed Committee Substitute for the House’s earlier version, titled Safe Surrender Infants. The original bill language only addressed providing parents with a safe way to surrender children during a personal crisis. That policy was already passed as part of the SB20 bill, which put multiple laws in place, including an extension of age in the state safe surrender law and restrictions on abortions after 12 weeks of gestation. Gov. Roy Cooper vetoed the bill, but his veto was overridden by the legislature.
The new PCS for HB125, if passed, would:
- Authorize the Board of Medicine to allow a military relocation licenses for physicians, physician assistant service members, and spouses, as well as offer internationally-trained hospital physician employee licenses for foreign-trained physicians
- Modify the State Hearing Aid Dealers and Fitters Board related to over-the-counter hearing aids
- Add the Qualified Applied Behavior Analysis Credentialing Board as a certifying entity for behavior analysts
- Modify the optometry laws
- Extend ambulance transport flexibility to have an uncertified medical person drive an ambulance for one year following the expiration of the public health emergency
- Require the development of a plan to transition the Nurse Aide I education and training program from the Department of Health and Human Services to the Board of Nursing
- Enact the Hospital Violence Protection Act which outlines criteria and increasing penalties for when a person violates a protective order issued by request of the hospital
A lack of Physicians
Both the military relocation licenses and the internationally-trained hospital physician employee licenses that the bill promises are efforts to solve NC’s scarcity of physicians, especially in rural areas.
“North Carolina cannot have two health care systems – one for those in urban areas and another for those in rural communities,” Sen. Benton Sawrey, R-Johnston, stated as one of the supporters of the bill in the Senate.
Under HB 125, sufficiently trained physicians could bypass the residency requirement by proving that they have “previously completed medical school and postgraduate training that” is “ substantially similar to the requirements for licensure” in NC.
Other requirements for the internationally-trained physician employee license would include:
- Being offered full-time employment as a physician in a North Carolina hospital
- Currently licensed to practice medicine in a foreign country, or had the license expire no more than five years before submission of an application
- Completed medical school and post-graduate training that is substantially similar to the requirements for licensure under current law
- Meets the requirements for licensure, other than a US-based residency
- Not subject to a disciplinary action
- Have practiced medicine for at least 5 years
- Be proficient in English
- Legally authorized to work in the US.
According to SHEPS Health Workforce NC, an organization that tracks NC’s health workforce, 15.5% of NC’s current physicians are international medical school graduates, well below the national median which is 19.1%.
Earlier this month, Tennessee became the first state in the country to completely remove medical-residency requirements for top international doctors.
For the military applicant to receive the “military relocation license,” doctors would need to meet the following requirements:
- Reside in NC, pursuant to military orders
- Hold a current license in another jurisdiction that has equivalent or similar licensure requirements
- Holds a license that is in good standing with no disciplinary actions within 5 years
- Has actively practiced medicine for 20 hours per week for the last two years.
Holding these requirements and upon application, the military physician would obtain a “military relocation license” that would remain active for the duration of the military order and be converted to a full license upon completion of the application.
“These are commonsense licensing changes that will allow excellent primary care doctors to enter the workforce and provide services to communities in need,” Sawrey said. “The licensing provision for service members and their spouses is another step in making North Carolina the most military-friendly state in the nation.”
Rural Hospital Safety
On the other end of HB 125 is the Hospital Protection Act. The act would increase penalties for assault on certain hospital personnel and make committing a violent offense at a hospital an “aggravating factor” in the crime.
“I talk to frontline health care workers and hospital executives on a regular basis,” Sawrey said. “They say that violence in our emergency departments is a barrier to filling jobs and adequately staffing our hospitals. People should feel safe when they go to work.”
More than a quarter of all nurses say they have been the victims of violence at work as more hospitals have reported violence since the end of the COVID-19 pandemic. A recent North Carolina Nurses Association’s survey of over 11,800 nurses, found that nearly half of them reported witnessing violence on the job in the last two years.
Sawrey says HB125 is a first step.
“We have more work to do with involuntary commitments and behavioral health and I look forward to working with stakeholders to continue improving conditions in our hospitals.”