What If We Led Differently? Why Patients in North Carolina Deserve Better

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MONICA FELDER, MHA, CEHRS

DEC 4

By Monica Felder, MHA, CEHRS

Some systems break under pressure. Others break by design.

In North Carolina, patients who experience medical neglect, documentation delays, or bias often find themselves shut out of justice not for lack of evidence, but because the law is structured to protect institutions over individuals.

As a certified Electronic Health Records Specialist (CEHRS) with a Master of Healthcare Administration (MHA), I’ve spent time conducting a Root Cause Analysis (RCA) of my own post-surgical experience. I submitted formal complaints to The Joint Commission, HHS OCR, the NC Medical Board, and additional oversight bodies. What I uncovered was more than a single failure it was a systemic blueprint of silence, delay, and structural evasion.

This isn’t just my story. It’s a documented pattern. It’s an urgent call for policy reform, transparency, and leadership that puts patients before profits.

The Legal Deck Is Stacked Against Patients in NC

In North Carolina, even when patients have documentation, delays, and data, they’re often blocked from justice by outdated statutes and restrictive procedures.

Key legal barriers:

Pre-litigation requirements force patients to obtain expensive, specialty-matched expert testimony before even filing a case
Caps on non-economic damages limit what victims can recover, no matter the harm
Strict testimony rules exclude qualified clinicians outside of narrowly defined specialties
Lack of metadata transparency in patient portals means documentation edits often go unchallenged unless a patient specifically knows what to request

Patients should be educated on their right to request full audit trails including timestamps, edits, and note submission history under HIPAA.

2. Holistic Health: The Prevention Model We’ve Underfunded

Prevention doesn’t begin with surgery. It begins with systems that support whole-person health before crisis hits.

Holistic health is more than a wellness trend. It is:

A proactive model that detects imbalance before diagnosis
A stress buffer that reduces ER overuse in chronically marginalized communities
A culturally grounded system of healing, especially vital for Black, Indigenous, and immigrant populations
A complementary ally to Western medicine not a replacement, but an expansion

When we ignore holistic approaches, we ignore cultural legacy, root-cause care, and long-term cost reduction. Prevention isn’t passive. It’s infrastructure.

3. What Henrietta Lacks Taught Us and What We Still Haven’t Learned

We cannot talk about healthcare reform without naming Henrietta Lacks.

Her cells taken without consent in 1951 became one of the most important tools in medical history. But her family saw no justice. No transparency. No autonomy.

Her story reveals a core truth: when systems are allowed to extract without accountability, patients become data points not people.

And while technology has evolved, the patterns haven’t:

Decisions made without full patient knowledge
Documentation changed or delayed without oversight
Voices dismissed because they don’t “fit the chart”

We owe more than tribute. We owe structural change.

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4. Where Leadership Is Falling Short

Behind many care failures is a failure of priority:

Nursing remains one of the most respected professions but today’s nurses are often asked to prioritize speed over presence. We must resource them as advocates, not just task managers.
Emergency care moves too fast to reflect. In the name of efficiency, many providers lose the space for listening, assessing, and healing.
There’s no space for middle-tier care. Patients in real pain but not in visible crisis get caught in systems that label them as low priority. That’s not triage. That’s abandonment.

Healthcare must return to its core function: restoring people, not just processing them.

5. A Servant-Leader’s Policy Blueprint for Reform

A. Audit for Accountability

Fund external, independent audit teams to review chart discrepancies, documentation delays, and access log patterns
Trigger real-time escalation when documentation is altered after complaints or legal action

B. Rebuild Nursing as Advocacy

Require bias mitigation and patient rights education in CEUs
Implement anonymous post-discharge evaluations to reflect the patient’s perspective not just metrics

C. Documentation Reform

Enforce mandatory metadata snapshots in patient portals
Require institutions to flag backdated entries and report trends to internal ethics boards

D. Fund Holistic Prevention

Reallocate public health dollars toward community-based prevention clinics
Partner with licensed herbalists, doulas, and wellness professionals to co-deliver care in underserved areas

E. Reinvent Emergency Infrastructure

Create three-lane ER corridors:
Fast Track for urgent cases
Core Lane for diagnostic clarity
Critical Bay for trauma and crisis
Measure care quality, not just discharge time

6. Final Thoughts: This Isn’t Just an Article. It’s a Design Proposal.

This isn’t about outrage. This is about operational justice.

I’ve filed the complaints. I’ve read the logs. I’ve documented the trail.

And still I believe in healthcare.

Because I’ve seen the good.

Because I’ve felt the silence.

And because I know systems don’t change until someone shows them how.

Justice isn’t theoretical. It’s procedural.

Let’s lead differently. And this time let’s lead with purpose. If this article reaches policymakers, may it be heard as a blueprint, not a grievance. If it reaches media, may it spark accountability, not just attention. And if it reaches a patient who feels silenced, may it remind them: you’re not alone.