License Pending, Patients Waiting
Dr. Alvarez has held an active optometry license in South Carolina for 12 years and recently moved to North Carolina. She submitted an application for licensure by credentials to the North Carolina State Board of Examiners in Optometry, paid the fee, and arranged for NBEO scores and transcripts to be sent. A Board staff member emailed her: “Your file is complete; it will be reviewed at the next Board meeting in six weeks.” She has not yet taken the North Carolina jurisprudence examination. The practice owner schedules her to begin seeing patients next Monday, four days a week, and tells her to sign charts and prescribe as needed. The front desk adds “Board-certified optometrist now seeing patients” to the website. A new patient calls and asks for Dr. Alvarez’s North Carolina license number before scheduling.
1. May Dr. Alvarez begin seeing patients on Monday based on the Board staff email? Explain your reasoning and what she may and may not do while the application is pending.
Read the worked answer
No. A completed application and a staff email saying the file is complete are not a license. In North Carolina, the practice of optometry is a licensed activity; examining patients, making diagnoses, prescribing, and signing clinical records all fall within that activity. The Board’s review at a future meeting is part of the licensure process, not a provisional grant of authority. Staff members generally cannot issue a license before the Board acts, and a statement about scheduling is not a waiver of licensure requirements.
Dr. Alvarez may complete non-clinical onboarding, observe, review policies, and learn the practice’s record system. She should not perform eye examinations, refract, fit contact lenses, prescribe, dispense under her own authority, or sign charts as the treating optometrist. The owner should assign another licensed optometrist to see her scheduled patients until her North Carolina license is actually issued. Practicing before licensure exposes her and the practice to disciplinary action, billing and insurance problems, and potential liability.
2. What should the practice do about the website statement and the patient’s request for a license number?
Read the worked answer
The practice should remove or correct the “board-certified optometrist” statement unless Dr. Alvarez actually holds a recognized board certification from an optometric certifying body such as the American Board of Optometry. Licensure by a state board is not the same as board certification, and using “board-certified” to imply a credential she does not have is potentially misleading to consumers. The website should not suggest that she is currently licensed and seeing patients in North Carolina before her license is issued.
The patient should not be given a North Carolina license number that has not been issued. The receptionist can explain that Dr. Alvarez’s licensure application is pending and offer an appointment with a currently licensed optometrist. Once the license is issued, the practice should verify the license number through the Board and make accurate credential information available.