BEFORE THE NORTH CAROLINA MEDICAL BOARD. This Re-Entry Agreement is agreed to between the North

Transcription

1 BEFORE THE NORTH CAROLINA MEDICAL BOARD In re: Trudy Jo Kerlin, PA-C, Applicant. ) ) ) ) ) RE-ENTRY AGREEMENT This Re-Entry Agreement is agreed to between the North Carolina Medical Board ("Board"), Trudy Jo Kerlin, P.A. ("Ms. Kerlin" or "Mentee") and David Fisher, M.D., ("Dr. Fisher" or "Mentor") solely in his capacity as an agent of the Board. Ms. Kerlin has not practiced as a physician assistant since 2003 and acknowledges the need to complete a program of re-entry into the practice as a physician assistant in order for the Board to issue her a physician assistant license; and Ms. Kerlin met with members of the Board in November 2011 to discuss her application, including the possible need for a program of re-entry to ensure her safe transition back into practice as a physician assistant. Based on the foregoing and by agreement with Ms. Kerlin, it is ORDERED that: 1. The Board shall issue Ms. Kerlin a physician assistant license. Re-Entry Agreement - Trudy Jo Kerlin, P.A. Page 1 of 10

2 2. Ms. Kerlin shall undertake a program of re-entry into practice as a physician assistant pursuant to a re-entry plan that shall consist of a period of mentoring by her mentor. Dr. Fisher shall serve as Ms. Kerlin's mentor and provide the Board with a series of letters that describe his mentoring and make an assessment of Ms. Kerlin's competency to practice as a physician assistant. 3. Ms. Kerlin may not practice as a physician assistant outside of the scope of this Re-Entry Agreement. 4. Ms. Kerlin shall arrange to have Dr. Fisher mentor her during the Re-Entry Period. The Re-Entry Period shall consist of the following three phases: a. Phase I - Observation of Mentor: The first phase ("Observation Phase") of the Re-Entry Period shall last a minimum of one (1) week. During this period, Ms. Kerlin shall observe the Men tor for a minimum of thirty-six (36) hours. It is expected that the Mantee shall observe the Men tor provide care to approximately patients a day. The Observation Phase shall consist of observation-only practice during which time Mentee shall not directly evaluate, treat, or manage any patients, but shall observe the Mentor in these activities. Mantee and Re-Entry Agreement - Trudy Jo Kerlin, P.A. Page 2 of 10 f ' I

3 Mentor shall discuss aspects of the Mentor's practice that shall include: (1) Patient care; (2) Medical knowledge; (3) Communication; (4) Practice based learning; (5) Systems based care; and (6) Professionalism. For the remainder of this Re-Entry Agreement, the above (1) - (6) shall be referred to collectively as the "Core Mentor Practice Areas." b. Phase II - Direct Mentoring of Patient Care: The second phase ("Direct Mentoring Phase") of the Re-Entry Period shall last approximately three (3) weeks. During this three week period, Mentee will see approximately 5-7 patients a day. The Mentor II I appropriate exam. The degree of directly l will be physically present to directly witness Mentee's ability to take a history and perfor.m an witnessed supervision will lessen as Mentor feels I I appropriate, but will occur during this phase. All pertinent aspects of Mentee' s patient care Re-Entry Agreement - Trudy Jo Kerlin, P.A. Page 3 of 10

4 and records will be reviewed by Mentor prior to the patient's discharge during this time. c. Phase III - Independent Mentored Patient Care: The third phase of the Re-Entry Period shall last three (3) months. ("Independent Mentored Phase"). During this phase, Mentee will see approximately 6-12 patients a day. The Independent Mentored Phase shall consist of Mentee's independent, mentored practice during which time Mentee shall be involved in the evaluation and management of patients. Mentee will present new patients not previously seen by Mentee during Phase I or II and existing patients with new medical issues not addressed in Phase I or II to Mentor for review prior to discharge. Further, all acuity level 4 patients seen by Mentee will be seen by the Mentor prior to discharge. All charts will be reviewed and signed by Mentor no later than the end of the workday during which the patient is seen. Mentor will continue to review and sign all patient charts and review any cases of interest. Mentee and Mentor shall set aside one (1) hour per week and discuss aspects of Mentee's practice Re-Entry Agreement - Trudy Jo Kerlin, P.A. Page 4 of 10

5 that shall include the Core Mentor Practice Areas. 5. Ms. Kerlin shall ensure that a Mentor delivers letters to the Board's Director of Compliance no later than 30 days after the end of each phase which describe with detail the nature of the mentoring and state an opinion as to the level of competency with which Ms. Kerlin practiced during each of the three mentoring phases. The detailed description of the nature of the mentoring will include comments about Ms. Kerlin's competency in each of the Core Mentor Practice Areas. 6. If the Board requests, Ms. Kerlin shall meet with members of the Board at such dates, times and places as directed by the Board to discuss her transition back into practice as a physician assistant, her clinical skills and any other subject the Board may deem necessary to discuss. 7. Any failure to comply completely and specifically with all terms, conditions and provisions of this Re-Entry Agreement shall constitute unprofessional conduct within the meaning of N.C. Gen. Stat (a) (6) and shall be grounds, after any required notice and hearing, for the Board to annul, suspend, revoke, condition, limit and/or otherwise take action against Ms. Kerlin's physician assistant license or to deny any application she might make in the future or then have pending for a physician assistant license. Ms. Kerlin acknowledges that Re-Entry Agreement - Trudy Jo Kerlin, P.A. Page 5 of 10 1 ' 1 I \ l

6 this Re-Entry Agreement including, and not limited to, the admissions contained herein shall be admissible in any hearing before the Board that relates in any way to Ms. Kerlin. 8. This Re-Entry Agreement shall be treated as a public record within the meaning of Chapter 132 of the North Carolina General Statutes and shall be subject to public inspection and dissemination pursuant to the provisions thereof. 9. Ms. Kerlin shall notify the Board in writing of any change in her home address and practice address within ten (10) days of the change. 10. This Re-Entry Agreement shall take effect upon full execution by Mentee, the Board and the Mentor and shall continue in effect until Men tee receives written confirmation from the Board that she has satisfactorily completed all requirements herein. 11. Mentor shall have the right, upon written notice to the Board, to withdraw as the Mentor. Such written notice shall state with particularity the reasons for withdrawal. Mentee's approval is not required for the Mentor to withdraw as Mentor. 12. It is specifically understood and agreed upon by all parties to this Re-Entry Agreement that the Mentor is acting solely as an agent of the Board pursuant to its powers contained in N.C. Gen. Stat As an agent of the Board, the Re-Entry Agreement - Trudy Jo Kerlin, P.A. Page 6 of 10

7 Men tor shall be immune from civil liability pursuant to N.C. Gen. Stat (e) and 90-14(f). 13. Indemnification: Ms. Kerlin agrees to and does hereby indemnify, save and hold harmless the Mentor in his re-entry mentoring capacity and the Board from any and all loss and damage (including court costs and reasonable attorneys' fees) arising out of a complaint, suit and/or any type of legal action against the Board and/or the Mentor, the subject of which concerns care rendered during the Re-Entry Period to a patient by Ms. Kerlin. The intent of this paragraph is for Ms. Kerlin to indemnify and hold harmless the Board and Mentor in his reentry mentoring capacity in the event that Ms. Kerlin is sued along with the Board and Mentor arising out of patient care that Ms. Kerlin rendered during the Re-Entry Period. 14. Ms. Kerlin agrees not to seek any remedy or commence any action or legal proceeding of any nature or kind against the Mentor arising out of the performance of the Mentor's good faith duties as a Mentor. 15. The timeframes, terms, provisions and conditions of the Re-Entry Period may be changed in Mentor's discretion, except that written approval from the Board's Medical Director is required if the timeframes provided in the Re-Entry Period are to be reduced in any way. Such Medical Director approval Re-Entry Agreement - Trudy Jo Kerlin, P.A. Page 7 of 10

8 shall not be unreasonably withheld and shall be confirmed in writing or by electronic mail. By consent and agreement of all parties and by Order of the North Carolina Medical Board this the 5th day of December, NORTH CAROLINA MEDICAL BOARD By: Re-Entry Agreement - Trudy Jo Kerlin, P.A. Page 8 of 10

9 Consented to this the day of ~-- L. -~'~ ' State of NetLTI-f <::;4,g.p t.cr'am _ County of \Q/A~c I, 5', ti. A i;-o({lau a Notary Public for the above named County and State, do hereby certify that Trudy Jo Kerlin, PA-C personally appeared before me this day and acknowledged the due execution of the foregoing instrument. Witness my h~d and official seal, this the _L day of DfL-C-/L.~(JJ::jL, Re-Entry Agreement - Trudy Jo Kerlin, P.A. Page 9 of 10

10 Consented to this the Z day of ~ -Q, State of Octih (\Qft))wra county of la)) he ~~ ~ Fisher, M.D. Agent of the North Carolina Medical Board I, Je::nicn 1Sae \AJCOdj, a Notary Public for the above named County and State, do Fisher, M.D. personally appeared acknowledged the due execution of the Witness my hand and official seal, this the 2J]c\day of't cewber ' hereby certify that David before me this day and foregoing instrument. expires: La- cx9 ~ JDI I ( Re-Entry Agreement - Trudy Jo Kerlin, P.A. Page 10 of 10