Sibley v. North Carolina Board of Therapy Examiners

GREENE, Judge,

dissenting.

As the Board’s findings and the evidence presented are inadequate to support the conclusion that petitioner’s conduct amounted to incompetence and could result in harm or injury to the public, I dissent.

The Board found petitioner, a physical therapist licensed in North Carolina, had engaged in sexual relations with one of his patients at a time when she was still his patient and had engaged in full-body hugs and kissed another patient on the lips during a treatment session. The Board further found that:

3. A physical attraction confuses the relationship between the patient and the therapist, particularly in cranial sacral therapy, which can induce a somato emotional release that requires a very strong level of trust between the physical therapist and the patient.
4. [Petitioner] knew it would be wrong to take advantage of a patient during somato emotional release.
5. [Petitioner] knew that an attraction between himself and a patient would interfere with physical therapy treatment.
6. [Petitioner] knew in 1991 that it was not permissible for a licensed physical therapist to have a sexual relationship with a patient outside the office.
*3777. During his physical therapy education, [petitioner] was taught not to have sex with a patient.
8. Licensees, including [petitioner], should have known that it was in violation of the Physical Therapy Practice Act in 1991 to engage in full body hugs with a patient, kiss a patient on the lips, or have sexual intercourse with a patient.

Based on these findings, the Board concluded petitioner’s conduct amounted to incompetence in violation of N.C. Gen. Stat. § 90-270.36(7) and could result in harm or injury to the public in violation of N.C. Gen. Stat. § 90-270.36(9).

Pursuant to section 90-270.36, grounds for disciplinary action against a physical therapist in North Carolina include “[t]he commission of an act or acts of malpractice, gross negligence or incompetence” and “conduct that could result in harm or injury to the public.” N.C.G.S. §§ 90-270.36(7), (9) (2001). North Carolina’s Physical Therapy Act, however, does not give a definition of what it means to be incompetent. See N.C.G.S. ch. 90, art. 18B (2001). “ ‘Where the language of a statute is clear and unambiguous,... the courts must give it its plain and definite meaning.’ ” State v. Camp, 286 N.C. 148, 162, 209 S.E.2d 754, 756 (1974) (citation omitted). “[C]ourts may... resort to dictionaries for assistance in determining the common and ordinary meaning of words and phrases.” State v. Martin, 7 N.C. App. 532, 533, 173 S.E.2d 47, 48 (1970). According to Black’s Law Dictionary, incompetence is defined as “[t]he state or fact of being unable or unqualified to do something.” Black’s Law Dictionary 768 (7th ed. 1999).

In this case, the Board’s findings, as well as the evidence, fail to reflect how petitioner was unable or unqualified to perform his duties as a physical therapist. If anything, the findings indicate petitioner was a licensed physical therapist who had received the proper training and possessed the ability to apply this training. While a finding that petitioner ignored the rules of his profession by engaging in the conduct alleged by his patients may amount to malpractice or gross negligence, it is insufficient to justify the conclusion he was incompetent to perform his job. See In re Dailey v. Bd. of Dental Examiners, 309 N.C. 710, 725, 309 S.E.2d 219, 228 (1983) (findings of fact based on the evidence must support conclusions of law).

The Board’s findings are also silent as to the potential harm the public could suffer as a result of petitioner’s conduct. I realize our *378Supreme Court has previously held that “a general risk of endangering the public is inherent in any practices which fail to conform to the standards of ‘acceptable and prevailing’ medical practice in North Carolina,” and that “[t]here is no requirement . . . that every action taken by the Board specifically identify or address a particular injury or danger to any individual or to the public.” In re Guess, 327 N.C. 46, 52-54, 393 S.E.2d 833, 837-38 (1990) (emphasis omitted), cert. denied, 498 U.S. 1047, 112 L. Ed. 2d 774 (1991). Guess, however, was decided pursuant to N.C. Gen. Stat. § 90-14(a)(6), which “allow[ed] the Board to act against any departure from acceptable medical practice, ‘irrespective of whether or not a patient [was] injured thereby.’ ” Id. at 53, 393 S.E.2d at 837 (citation omitted); N.C.G.S. § 90-14(a)(6) (2001) (disciplinary grounds under the Practice of Medicine Act include “[unprofessional conduct, including, but not limited to, 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”). Unlike section 90-14(a)(6), the statute at issue in this case rests specifically on the potential for harm that could result to the public due to a therapist’s conduct. See N.C.G.S. § 90-270.36(9). Accordingly, the Board was under a duty to make findings as to the harm that generally could result to patients, and thus the public, based on petitioner’s conduct.1 Such findings must be based on the evidence and cannot merely rest on the Board’s expertise with respect to the practice of physical therapy. See Leahy v. N.C. Bd. of Nursing, 346 N.C. 775, 780, 488 S.E.2d 245, 248 (1997) (rejecting the petitioner’s argument that the Board’s order could not stand due to a lack of expert testimony defining the standard of care for registered nurses because there was evidence in the record which the Board could use its expertise to interpret). As there were, however, no findings that speak to the potential harm which can result when a therapist hugs, kisses, and engages in sexual *379intercourse with a patient and the evidence failed to establish such potential harm, the Board erred in concluding petitioner had violated section 90-270.36(9). I would therefore reverse the trial court’s order affirming the Board’s decision.

. If the holding in Guess that “a general risk of endangering the public is inherent in any practices which fail to conform to the standards of ‘acceptable and prevailing’ medical practice in North Carolina” were to apply in the context of section 90-270.36(9) of the Physical Therapy Act, it would essentially read out of the statute the need for many of the other grounds warranting disciplinary action. See N.C.G.S. § 90-270.36(1)-(8); Woodlief v. N.C. State Bd. of Dental Examiners, 104 N.C. App. 52, 59, 407 S.E.2d 596, 600 (1991) (a dentist’s negligence or incompetence is to be measured by the standard of practice). Such a construction would defeat the legislature’s purpose in delineating more than nine separate grounds for disciplinary action against a physical therapist. See Woodlief, 104 N.C. App. at 58, 407 S.E.2d at 600 (citation omitted) (“ ‘the primary rule of [statutory] construction [states] the intent of the legislature controls’ ...[;] [w]e must avoid a construction which will defeat or impair the object of a statute”).