To the Editor:
I am writing to bring urgent attention to a workforce crisis unfolding inside the North Carolina Office of the Chief Medical Examiner — one that threatens the integrity of death investigations, the pursuit of justice, and the dignity owed to the families of the deceased.
A Crushing and Growing Workload
North Carolina's medical examiners are responsible for investigating all unnatural and unattended deaths across one of the fastest-growing states in the nation. The caseloads these professionals carry have grown substantially in recent years — driven by population growth, the opioid crisis, and increasing demands from law enforcement and the courts. Medical examiners are the backbone of the state's death investigation system. Without their work, homicides could go unsolved, overdose patterns could go undetected, and families would be left without answers.
No Raise Since 2015 — While Others Around Us Got Paid More
Despite this growing burden, North Carolina's medical examiners, who are paid a fee per completed case, have not received an increase in that fee since 2015. That is more than a decade of stagnant pay, through inflation, through a pandemic, through year after year of record caseloads. What makes this especially difficult to justify is what has happened around us in that same period: the chief medical examiner’s salary has increased, the fee to the pathologist performing an autopsy has doubled, and payment rates for body transporters — who perform a far less specialized function — have also been raised. The professionals who perform death investigations and sign death certificates have been left behind.
There is required and on-going specialized training required to be a medical examiner. This is in addition to the licensure that we must maintain for our primary jobs. The current pay structure undervalues the expertise required to conduct accurate, legally defensible death investigations.
Proposed, Then Taken Away
This is not a case where the problem has gone unacknowledged. Fee increases for medical examiners were proposed in the state budget in 2024 and again in 2025. Unfortunately, a legislative stalemate prevented the overall budget from being passed. When the failed 2025 budget was proposed again in 2026, the section on fee increases was no longer included. Shortly after, Senate Bill 847 was introduced to address this directly, but it has stalled in the legislature with no clear path forward. Medical examiners have watched the proposal for fair compensation come and go, year after year, while the work continues to pile up.
Senate Bill 847 Is Going Nowhere
Senate Bill 847, which would have addressed medical examiner compensation, has stalled in the legislature since the day after its introduction, nearly three weeks ago. Despite the documented need, despite the evident inequity, and despite the consequences of inaction, this bill appears to be going nowhere. Legislative inertia is, in effect, a policy choice — and that choice is driving experienced forensic professionals out of public service and discouraging the next generation from entering it.
The Consequences Are Real
When medical examiners are underpaid and overworked, the consequences are not abstract. Cases are delayed. Death certificates are backlogged. Criminal prosecutions are jeopardized when expert witnesses are unavailable. Families wait months for answers about how their loved ones died. The professionals who remain do so out of a sense of duty — but duty has limits, and the retention and resignation of experienced examiners is already a concern.
We Have Asked for Help — and Heard Nothing
This is not for lack of effort on our part. We have reached out to legislators repeatedly and the chief medical examiner, seeking guidance and meaningful action. More recently, we have extended those efforts to the governor’s office, the attorney general, and the secretary of the North Carolina Department of Health and Human Services. To date, we have not received any significant reply.
The Public Deserves to Know
North Carolinians deserve to know that the state agency responsible for determining the cause and manner of their loved ones' deaths is being allowed to deteriorate through neglect and broken budget promises. We have counties in North Carolina that have no available Medical Examiners on call for weeks at a time. Someone outside their county is being tasked with answering calls and arranging the decedent's care. We expect that this lack of coverage will increase in many counties. The media has a critical role to play in bringing this situation to light. We are asking journalists and editors to investigate the medical examiner staffing and compensation crisis, to ask the legislature why Senate Bill 847 has been allowed to languish, and to ask the governor's office why the pay increase that was proposed and approved by both chambers in a prior budget was removed in 2026.
North Carolina's medical examiners show up for their communities to perform one of the most demanding and emotionally taxing jobs in public service. At the very least, their state can pay them fairly. It is past time for the legislature to act — and past time for the public to demand it.
Respectfully,
Richmond County
