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Title: Blog by Novelist William S. Frankl, MD

Archive for May, 2014

Bad News In May

Wednesday, May 28th, 2014

The month of May continued to be as depressing as previous months. The United States is run by a federal government which is clearly either psychotic or stupid beyond belief. There is also an immense corruption within the government. The following are examples of the  issues that continue to make the headlines in the Wall Street Journal and the Washington Examiner but not many other newspapers and in stories generated by Fox News.

The VA Debacle

Long waiting times, deaths due to delays in tests and treatments, false record keeping, and national outrage. That’s the story of the Veterans Administration’sailure to provide adequate, timely, modern care for our nation’s veterans.

After the first stories about veterans’ deaths and hidden waiting lists in Phoenix, information has come out about secret waiting lists, purged records, and more deaths in many places, including New Mexico, Colorado, Texas, California, Florida, North Carolina, and West Virginia.  Twenty-six VA facilities are under investigation by the Office of Inspector General at the Veterans Affairs Department.

Secretary of Veterans Affairs Eric Shinseki told a Senate committee last week that he is “mad as hell” about the allegations of malfeasance at VA hospitals across the country. White House Chief of Staff Denis McDonough told Face the Nation that President Obama is “madder than hell” about it( by the way who cares if he is madder than hell. Didn’t he know about it? Is he going to do anything about it?). The President spent much of his public comments on the matter yesterday praising Secretary Shinseki, taking credit for the cuts in the VA’s case backlog on his watch (remember, we now know that those numbers have been falsified for years), and asking that this scandal not become “another political football.” No, not a political football, another egregious scandal.

Doctors Falling By The Wayside of Government Regulations

The government, hospitals, and third-party payers are demanding that doctors constantly have overseers. In living memory, a medical school diploma and perhaps a year of internship could gain one a medical license. And board certification, showing successful completion of rigorous extra specialty training, was good for life. But starting in the 1970s, specialty boards began issuing time-limited certifications, at first good for 10 years. Now even grandfathered physicians will be stigmatized online for not meeting requirements for maintenance of certification (MOC).

After 40 years of pushing MOC, the American Board of Internal Medicine is unable to demonstrate any value for patient care. Yet doctors may have to go through the process to keep their hospital privileges or to remain on insurance panels, no matter how stellar their record of patient care. But recertification is still claimed to be “voluntary.”

The process keeps getting more expensive and onerous. Examinations may be required every five years or still more often, along with nearly continuous participation in newly added demands such as practice improvement modules.

So one day, a highly trained and experienced physician may be board certified, and the next day after examination results are revealed or deadline for maintenance of certification passes, he may be decertified and unemployable. In that one day, could he have become demented or fallen behind in keeping up with his field?

For some physicians, it may be literally impossible to meet the requirements, say if they miss a deadline dueto illness or family emergency and are ineligible to try again without taking a whole new residency program which likely doesn’t exist.

And so very soon we may see the loss of many of our best physicians who are unable to accede to these increasingly onerous regulations.


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