Resolution Opposing the Interstate Medical Licensure Compact
Whereas, the goal of the Federation of State Medical Boards (FSMB) is to entice all states to join the Interstate Medical Licensure Compact in order to form yet another bureaucracy which will exercise regulatory authority over physicians and the practice of medicine—the Interstate Commission,
Whereas, another layer of bureaucracy will be more costly to physicians and patients, as the various participating states will be forced to pay dues to this new organization, thus further escalating the cost of medical licensure,
Whereas, the Interstate Medical Licensure Compact redefines who a physician is, and does not recognize the Webster dictionary definition, but rather, defines a physician as one who “holds specialty certification or a time-unlimited specialty certificate recognized by the American Board of Medical Specialties, or the American Osteopathic Association’s Bureau of Osteopathic Specialists”,
Whereas, under this new definition of “physician”, those physicians who do not participate in Maintenance of Certification will not be eligible for licensure. Furthermore, this new Interstate Commission will force physicians to fund American Board of Medical Specialties and its subsidiaries and/or the American Osteopathic Association and its subsidiaries. Note that failure to pay dues to the American Osteopathic Association is construed as relinquishing current specialty board certification. Such has no relationship to the ability to practice medicine/osteopathy, but rather, whether one pays the required fees.
Whereas, there is no relationship with a physician’s quality of medical care and participation with Maintenance of Certification (MOC) programs, and such activities merely serve to siphon physicians’ struggling incomes in order to enrich the MOC industry,
Whereas, there are other novel new definitions of “physician” which cause the participating states to cede control over the practice of medicine to an amorphous bureaucracy at a great financial cost, in spite of FSMB protests that “state medical boards would retain their licensing and disciplinary authority,”
Whereas, this new Interstate Commission will “enforce compliance with Compact provisions. . . using all necessary and proper means, including but not limited to the use of judicial process,” and, the Interstate Compact “may, by majority vote of the Commissioners, initiate legal action. . . against a member state in default”,
Whereas, member states discovering that the new Interstate Compact over rules the state at excessive cost, will find it difficult, expensive, and perhaps impossible to extricate itself from such Interstate Commission,
Whereas, there are other ways of providing for telemedicine and “expedited physician licensure”,
So be it resolved, that the {insert name of state medical association} strongly oppose FSMB’s Interstate Medical Licensure Compact,
So be it resolved, that the {insert name of state medical association} request that our American Medical Association likewise oppose the Interstate Medical Licensure Compact.
Resolution Opposing State Medical Board Participation in FSMB
Whereas, the Federation of State Medical Boards (FSMB) is composed of 70 separate state medical and osteopathic boards across the United States and its territories,
Whereas, each state medical board can potentially be adversely affected via pressures from the FSMB,
Whereas, each state medical board should be completely free to regulate the practice of medicine within its borders, without interference from the federal government or any other state or group of states,
Whereas, recent FSMB efforts have attempted to impose rigid Maintenance of Certification (MOC) requirements on physicians, in spite of no evidence of MOC participation on the part of FSMB’s current CEO,
Whereas, state medical board participation in FSMB is expensive and adds to the cost of medical licensure/relicensure, and there is no significant gain from FSMB membership,
Whereas, there is no legal nor constitutional requirement for a state medical board to participate in FSMB activities, and there are reasons to question where the FSMB obtains authority for its actions, or even its very existence,
So be it resolved, that the {insert name of state medical society} strongly oppose the {insert name of state medical board} continuing its membership in the FSMB, and that it withdraw its membership and payment of dues to FSMB immediately.
Resolution on Maintenance of Certification (MOC) and Licensure (MOL) vs Board Certification, CME and Lifelong Commitment to Learning.
WHEREAS, TCMS is resolved to oppose interference with the patient-physician relationship including the opposition to and pursuit of actively defeating efforts by The American Board of Medical Specialties (ABMS) the Federation of State Medical Boards, INC. (FSMB), in their efforts to impose effective mandatory Maintenance of Certification (MOC) and Maintenance of Licensure (MOL) in Oklahoma as such efforts have no evidence of improving patient care, will decrease access to physician care by excluding non-certified licensed physicians and encourage early retirement and place an undue time and financial burden on physicians; and
WHEREAS, TCMS joins other medical associations to oppose and actively defeat efforts by ABMS and the FSMB that suggest the use of MOC as a condition of employment, licensure or reimbursement (such as occurred in Ohio in 2012 by the Ohio State Medical Association); and
WHEREAS, The American Board of Medical Specialties (ABMS) and FSMB have and continue to press legislation coupling, insurance payments, hospital privileges and other employment opportunities to active enrollment in “time limited” Board Certification and the associated MOC program in a nationwide fashion, imposing this upon the practice of medicine in Oklahoma; and
WHEREAS, the MOC program is expensive, unproven, directed toward bureaucratic compliance and entry level medical knowledge, wastes resources by requiring participation in time limited MOC-CME programs directly benefiting selectively the ABMS only; and
WHEREAS, the ABMS has changed the actual concept of Board Certification for life as representing quality of specialty training (just as a diploma bestows the lifelong medical degree to physicians) to a business model of “time limited” and further implemented yearly participation enrollment (MOC) to further corporate profits in the 100’s of millions of dollars and against active physician opposition; and
WHEREAS, the ABMS has lobbied and succeeded to terminate “grandfathered” life-long unlimited certifications through passage of Oklahoma Administrative Code 435:10-7-2 (see attachment 1) preventing the use of terms “Certified by” or “Diplomat” or “Fellow” through insertion of MOC without physician’s vote; and
WHEREAS, The American Medical Association’s Physician Recognition Award and CME program was successfully formed in the late 1960’ and meets all needs of documenting lifelong commitment to learning to include individual physician’s choice and competitive offering of educational materials in CME, that experience and reason is an accepted and important aspect to excellent care, and that licensing of Oklahoma physicians to practice medicine does not, and should never require certification; and
WHEREAS, these ABMS and FSMB national efforts continue to impose on the physicians of Oklahoma in an adverse manner, imposing the regulatory capture of medical care at the national level and have resulted in active AMA opposition on a national level; and now, therefore, be it
RESOLVED, that the Oklahoma State Medical Association pursues to uphold and maintain the importance of the patient-physician relationship independent of outside interference as the key to excellent medical care, that physicians are bound by generally accepted professional and ethical values in pursuit of best care for patients, and be it further
RESOLVED, that the Oklahoma State Medical Association continues to support and advocate lifelong continuing medical education and lifelong Specialty Board Certification as determined by the physician him/herself, to advocate against time-limited specialty medical board certificates, and advocate against discrimination against physicians who are not certified or are certified and choose NOT to engage in corporate re-certification programs labeled as “voluntary” by the specialty medical boards, and be it further
RESOLVED, that the Oklahoma State Medical Association seek legislation in Oklahoma that will prohibit discrimination by hospitals and any employer, the Oklahoma State Board of Medical Licensure and Supervision, insurers, Medicare, Medicaid, and other entities, which might restrict a physician’s right to practice medicine without interference (including economic discrimination by varying fee schedules) due to lack of certification, lack of participation in FSMB/ABMS prescribed corporate programs including Maintenance of Licensure or expiration of time limited Board Certification, and be it further
RESOLVED, that the Oklahoma State Medical Association promote and/or implement a policy forbidding discrimination by hospitals or employers, the Oklahoma State Board of Medical Licensure and Supervision, insurers, Medicare, Medicaid, and other entities, which might restrict a physician’s right to practice medicine without interference (including economic discrimination by varying fee schedules) due to lack of certification or participation in FSMB/ABMS prescribed corporate programs including Maintenance of Licensure or time limited Board certification, and be it further
RESOLVED, that the Oklahoma State Medical Association urge the AMA to adopt as policy this resolution forbidding discrimination by hospitals or employers, by any state board of medical licensure and supervision, insurers, Medicare, Medicaid, and other entities, which might restrict a physician’s right to practice medicine without interference (including economic discrimination by varying fee schedules) due to lack of certification or participation in FSMB/ABMS prescribed corporate programs including Maintenance of Licensure or time limited Board certification as was suggested by the AMA Young Physicians Section Governing Council in 2007.
Model Resolution on Maintenance of Licensure (MOL)
Whereas: in 2010 the Federation of State Medical Boards, Inc., (FSMB) House of Delegates adopted the Maintenance of Licensure (MOL) framework, a process by which physicians periodically provide, as a condition of license renewal, evidence that they are actively participating in a program of continuous professional development that is relevant to their areas of practice, measured against objective data sources and aimed at improving performance over time; and
Whereas: the FSMB website states that, in lieu of MOL, the American Board of Medical Specialties Maintenance of Certification (MOC) program and the American Osteopathic Association Bureau of Osteopathic Specialists’ Osteopathic Continuous Certification (OCC) program incorporate activities generally consistent with the intentions of MOL, state licensing boards may elect to substantially or fully qualify licensees engaged in these activities; and
Whereas: medical organizations have for years opposed any effort to mandate the content of continuing medical education (CME) required for licensure because physicians themselves are in the best position to determine what educational opportunities will be most helpful in improving their practice, based on the type of patients that they see and the procedures that they perform; and
Whereas: there is no evidence that physicians who have completed the maintenance of board certification procedure make more accurate diagnoses or are more skillful at performing their treatments; and
Whereas: maintenance of board certification is extremely costly and time consuming, requiring time away from patient care or from more relevant study, and greatly exceeds the level of knowledge needed for basic medical licensure; and
Whereas: the materials that physicians are forced study to meet maintenance of board certification requirements may be biased, outdated, or irrelevant to the physician’s actual practice; and
Whereas: granting certain organizations the equivalent of monopoly power over maintenance of board certification, and thus licensing and medical practice itself, will tend to increase costs, potentially violate federal antitrust and interstate commerce legislation, and hamper innovation; and
Whereas: the reasons to oppose maintenance of board certification apply to MOL; and
Whereas: state licensing boards are free to adopt or reject the FSMB MOL program; and
Whereas: highly variable licensure requirements, including lack of mandatory continuing medical education (CME), have existed in different jurisdictions for decades, without noticeable difference in quality of medicine related to these varying requirements; and
Whereas: there is no evidence to indicate that the vast majority of physicians have any need for mandatory, government-prescribed CME to maintain excellent levels of ongoing education and competency; and
Whereas: as many as 25% of all physicians currently practicing medicine in the U.S. have never been board certified and are thus actively excluded from entry into MOC programs, creating hardship if imposed; and
Whereas: 50% of all board-certified physicians in the U.S. currently have lifelong certificates, have been and continue to practice as board-certified physicians and are also similarly non-eligible for MOC programs; and
Whereas: legislation has greatly expanded the scope of practice of care to lesser educated “midlevel providers” (i.e. nurse pacticitioners, physician’s assistants, CRNAs, etc.); and
Whereas: driving experienced physicians out of practice because of onerous, costly requirements will result in still more patients being forced to turn to nonphysicians for care, now, therefore, be it
RESOLVED, That the _____ Medical Association oppose any efforts by the _____ Medical Board to require the FSMB “maintenance of licensure (MOL)” program as a condition of licensure.
