Texas Strikes Back at JAMA MOC Law Slap

Just because Texas has a new law to protect physicians against mandatory maintenance of certification (MOC) tyranny doesn't mean the battle is over. This is a nationwide contest now between the specialty certifying boards and the physicians they certify. In the newly enacted Texas law, the boards see a trend they don't like — and that they want to stop.

In a commentary that the Journal of the American Medical Association (JAMA) published online Aug. 7, former chair of the American Board of Internal Medicine Board of Directors called Senate Bill 1148 a "threat to professional self-regulation" by physicians. Dallas internist David H. Johnson, MD, went on to write that the bill "weakens [physicians'] claim to self-regulation by establishing a precedent for additional governmental intervention into the practice of medicine."

TMA, which lobbied hard for the bill's passage during the regular session of the 2017 Texas Legislature, wasted no time in responding. In a letter to the editor submitted to JAMA but not yet published, TMA President Carlos J. Cardenas, MD, agrees on the importance of self-regulation to his profession.

"It encompasses our responsibility and our authority to establish and enforce standards of education, training, and practice," Dr. Cardenas wrote. "We routinely defend that responsibility and authority in advocating against the intrusion of all third parties — such as government, private insurers, hospital administrators — into the practice of medicine."

But physicians in Texas and across the country, he argued, do not see the certifying boards as "self."

"They are, instead, profit-driven organizations beholden to their own financial interests," Dr. Cardenas wrote. "In fact, they are now one of the outsiders intruding into the practice of medicine."

Until the boards "completely overhaul their processes, finances, and lack of transparency," he concluded, physicians "will have no choice but to continue to seek statutory defenses against these third-party intrusions into our noble profession."

State Sen. Dawn Buckingham, MD (R-Lakeway), the author of SB 1148, also submitted a response letter to JAMA

"We have received gratitude from thousands of physicians across the country for passing SB 1148," Dr. Buckingham wrote. "The cry of the rank and file has been heard in many states as similar legislation is being considered. One might wonder if the boards can continue to ignore this cry for reform."

Action, Aug. 15, 2017

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