A longtime Laurinburg doctor has been accused by the state Medical Board with providing inadequate care to his patients.

Dr. Donald A. Nisbett provided poor care to at least four patients and also failed to meet guidelines set by the state medical board showing he can provide quality care, according to a notice of charges and allegations signed Aug. 5 by N.C. Medical Board President George L. Sanders, III.

A hearing has been set for Feb. 17.

"Nisbett's conduct... constituted unprofessional conduct, including, but not limited to, departure from or failure to conform to the standards of acceptable and prevailing medical practice, or the ethics of the medical profession, irrespective of whether a patient is injured," the notice said.

The medical board can decide to annul, suspend, revoke or limit Nisbett's license to practice medicine. He retains the right to practice through the resolution of this case. Nisbett has been a doctor for 26 years. He could not be reached for comment.

In a four year period, he received a number of complaints from at least four patients, the notice said. The complaints in the notice deal with perceived inadequacies in Nisbett providing patient care, specifically with his failure to examine certain patient complaints and not changing treatment plans when the medical board deemed appropriate.

He prescribed drugs to one patient several times without a corresponding diagnosis or treatment plan, despite urine samples showing the patient was on illegal drugs, the notice said.

Nisbett also failed to administer a pregnancy test before prescribing Bactrim DS, an antibiotic that is potentially harmful to pregnancies, the notice said. The woman turned out to be pregnant and decided to terminate the pregnancy, but the notice said had the child gone to term, there was an increased risk of birth defects.

A third patient said that Nisbett would change medications often, sometimes without explanation or full consideration of possible side effects, the notice said. It also said Nisbett never fully evaluated abnormalities on a magnetic resonance imagining study. According to the notice, Nisbett failed to make a treatment plan for a laceration brought to his attention, nor did he check to see if that patient may have needed a tetanus shot.

The medical board cannot legally reveal the name of patients who file complaints, as it compromises patient confidentiality laws.

The medical board first took issue with Nisbett's patient care in 2006, particularly with his prescription of opiates, the notice said.

The board requested he take a continuing education report on prescribing narcotics, after which the medical board performed a chart review. The board was unhappy with the review and underwent an assessment of his clinical skills at the Center for Personalized Education for Physicians in Denver, Colo.

The evaluation showed significant deficiencies in Nisbett's clinical abilities, according to the notice. The board also conducted another chart review and were unhappy with the results.

Calls to Nisbett's office and home were not returned by press time.

Anytime the medical board pursues charges, it should be seen as potentially serious, according to board spokeswoman Jean Fisher Brinkley.

"By the time it gets to the point where a notice of charges and allegations is issued, there has been some interaction between the board and the licensee," Brinkley said.

A hearing typically means that either the board or the licensee was unhappy with the resolution of an issue through these prior discussions, Brinkley said.

Nisbett graduated from the Albert Einstein School of Medicine of Yeshiva University in New York in 1979 with a degree in medicine and received his post-medical school education at the University of Miami.

Nisbett originally received his license to practice medicine on Aug. 14, 1982 and is next up for renewal on April 7. He is also licensed in the state of Florida.

He has hospital privileges with Sandhills Regional Medical Center but none with the Scotland Health Care System.

Before opening his own practice, Nisbett worked at Laurel Hill Family Medicine.

Nisbett is being represented by R. Johnson Charleston of the Charleston Group in Fayetteville, according to a motion of continuance.

The N.C. Medical Board is the agency charged with licensing physicians and physician assistants, according to Brinkley.