It’s being spearheaded by a secretive, private, and powerful organization called the Federation of State Medical Boards (FSMB). State-based Action Alerts!
Don’t be deceived. While this is a federation of all seventy state and territorial medical and osteopathic boards, it is not terribly clear who is behind it—we are guessing it is the American Medical Society working together with Big Pharma. Now it has succeeded in launching the Interstate Medical Licensure Compact. To go into effect, the compact required approval by seven state legislatures; so far, eleven states have approved the legislation, with bills pending in nine other states.
You will not be surprised to hear that the FSMB has historically been hostile to integrative medicine. Despite having no public funding, transparency, or accountability, FSMB also wields a tremendous amount of power over the practice of medicine in all fifty states. The organization has demonstrated its antipathy toward natural health since the mid-1990s, when it discussed altering the definition of health fraud to include alternative medical care! It would appear that FSMB considers innovative approaches to healthcare to be nothing more than exercises in “quackery.”
The stated intent of this legislation is to streamline the licensing process for physicians who want to practice in multiple states. That sounds good on the surface. Proponents also argue that the compact will address physician shortages in underserved areas and address a growing need for physicians after millions of new patients have entered the market following the passage of the Affordable Care Act.
You can consult our previous coverage for more detailed background, but here are and major problems with this multi-state compact:
- Increased fees: The compact allows the FSMB to drastically increase the fees it can collect as more states pass its legislation and more doctors take advantage of the streamlined process. A recent analysis found that, of 878,194 licensed physicians in the US, 79% of them held only one license. As another commentator put it, “Many dollars can be made by raising the number of active licenses.”
- Maintenance of Certification programs: The FSMB would require physicians seeking a license through the compact to participate in a credentialing process overseen by one of twenty-four approved medical specialty boards of the American Board of Medical Specialties (ABMS). While ABMS argues that its recertification process maintains high standards, many physicians see this as little more than a money-making endeavor—the American Board of Internal Medicine received more than $55 million in fees from physicians seeking certification—or as a way to screen out integrative doctors. Worse, these certifications are often used as a requirement for hospital employment.
- Lack of accountability: There is a stunning lack of accountability with the FSMB-created Interstate Commission to enforce the compact. While we’ve been critical of the actions of some state medical boards, at least there is some degree of process by which the public can weigh in when rules are created. But when one bad rule can affect at least seven different states, how can the public have any input? Considering FSMB’s record of enmity toward integrative medicine, we should be extremely wary of its legislation.
- Takes power away from the states: The FSMB claims its proposal “reflects the effort of the state medical boards to develop a dynamic, self-regulatory system of expedited state medical licensure over which the participating states maintain control through a coordinated legislative and administrative process,” and is therefore the “ultimate expression of state authority.” Such a claim, however, is frankly not credible—especially considering that the language of the compact clearly states that rules made by the Interstate Commission would have “the force and effect of statutory law in a member state.”
The points about expanding patient access to physicians also seem to be disingenuous. An observer put it this way:
If a doctor in Montana can now practice in Wyoming, some patients there may have access to another doctor. But, if the Montana doctor is spending time with Wyoming patients, then the doctor is spending less time with Montana patients. The net effect is likely to be close to zero. But, also notice that, if the Montana doctor had spare time there, then there is evidence of a surplus of doctors in Montana and not a shortage.
Let’s not forget FSMB’s close ties to Big Pharma. A few years ago we reported that the FSMB asked for $100,000 from the pharmaceutical industry to help create and distribute the organization’s new policy on pain medication to their 700,000 practicing doctors. The federation won’t say how much money it received from industry, but at the time estimated that it would cost $3.1 million for its campaign.
The main benefit of passing the compact, it seems, is not in improving the lives of physicians or expanding patient access to healthcare, but rather in lining the coffers of another unrepresentative bureaucracy. We must oppose this bad legislation.
State-based Action Alerts! Check below to see if your state has either 1) passed the compact or 2) has legislation pending, and send a message to your state representatives urging them to repeal or oppose the FSMB’s legislation. Please send your message immediately.
States where legislation is pending:
States where the compact is enacted:
Other articles in this week’s Pulse of Natural Health: