Great insight and perspective by Heath McAnally, MD, MSPH, regarding the sometimes reactive, albeit good intentioned, response of gov’t and private entities to the opioid crisis. Worth the read for sure.
Pendulum swings in medicine aren’t new, but damping the oscillation rarely bears such urgency. To paraphrase the original document, we call on our leaders to:
Recognize that opioid tapering requires evidence-based careful selection, patient-centered methods, realistic goals, and close monitoring for adverse events.
Include the expertise of pain management subspecialists at every level of decision-making about future opioid policies and guidelines.
Put a halt to policies forcing opioid tapering/cessation outside the contexts of diversion or unequivocal, documented harm: benefit ratio imbalance
Dr. McAnally is a board-certified anesthesiologist, pain physician, and addictionologist practicing in Alaska (the military sent him there and he decided to stay). If he wasn’t trying to guide people in improving their own lives, teaching medical students to do the same, or writing about it, he’d probably be outdoors right now slogging up a mountain with a good friend or two.
At some point in the future, observers may joke that one side is willing to accept more smoking if one teenager forgoes vaping while the other side is willing tohave lots of vapers if it means one less smoker.
Dr. Goodman’s article is a fantastic foray into the dark history organized medicine, culminating with a brutally honest assessment of the cartel that resulted. He gives a great preview of the good stuff in Greg Scandlen’s new book, Myth Busters: Why Health Reform Always Goes Awry, summarizing the oft-repeated myths we hear about healthcare economics thrown around like dogma.
Over the past few years, the definition of “board certified” has changed from a one-time test to an ongoing series of tests, hoops, and fees to maintain certification through the MOC program. Not participating in any portion of the convoluted and expensive MOC program results in loss of board certification, but so what? Board certification, either as initial certification or 20 years into maintaining certification is voluntary, so what’s the big deal?
Well, it turns out, not complying with MOC is a big deal. Not only has the definition of “board certified” changed, apparently so has the definition of “voluntary.”
The American Board of Medical Specialties (ABMS), purveyor of the MOC programs required to maintain board certification, says it is pleased that the FSMB “included it [board certification] among its criteria for this Compact.” And in its statement praising the Compact, the ABMS admits that this “exceeds current state licensing requirements.”
The Interstate Compact puts physicians who do not participate in ABMS & AOABOS products at a competitive disadvantage. A state legislature should not be passing laws that are handouts to such private, unaccountable organizations.
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