So how does this movement affect self-regulation? One of the ways a profession is defined is that its members possess special knowledge or training not available to the other members of society and consequently, society grants those with that special knowledge the ability to self-regulate its members. The reasons for this are clear – doctors know much more about the practice of medicine and so should set the standards and measures for the quality of patient care.
By supporting legislation that will prohibit the use of that last bit of professional self-regulation (the certifying boards), physicians are basically saying that self-regulation is at the individual physician level (“I got my 25 units of CME, so I don’t need any organization to ensure I practice up-to-date quality medicine”). In this political era of independence and anti-regulation, this is a true “feel-good” moment for physicians.
The problem is that if these bills become law, physicians will have delegated regulation to legislatures. Basically, physicians are saying they need legislative help to throw off certification requirements. It will only be a matter of time before legislatures will realize that there has to be some quality measure of medical practice and that since the certifying boards are no longer part of that process, government will have to develop its own standards and measures. This may seem far-fetched, but I can easily see a family member of a prominent legislator injured or killed in a medical misadventure which will result in the development of a government-led standard setting and measurement process to fill the void left by the absence of physician self-regulation. And, given our experience with government medical programs, it will be rigid regulations with lots of red tape that will be much worse than board certification and MOC as they currently exist.
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