When you went to medical school, did you look forward to joining a great shambling mass of collective thought that would turn out progressively homogenized, increasingly scrutinized, always more restricted actions? Me neither. But that’s what we’ve got now, and the medical profession has become The Blob with no Steve McQueen and no freezer big enough to hold it.
Say you’ve been practicing medicine for oh, I don’t know, 57 years. Your patients love you (with multiple affidavits to prove it), your community needs you, and there are no complaints of negligence, malfeasance, fraud, or incompetence. Sure, you’re in your mid-eighties, but you can still do your job well, which is fine so long as you do things just the same as everyone else.
But if you are Anna Konopka, MD, and you don’t like to use computers, then you are a danger to the community and need to be stopped by a beneficent state before you can non-conform again. The New Hampshire Board of Medicine has pressured Dr. Konopka to surrender her license because she has not been participating in the state’s Prescription Drug Monitoring Program, because she chooses not to use a computer.
(A brief aside: roll your eyes and call me a nut, but I’ve long been against the general notion that state medical boards should control licensure and the delivery of care. Any good that they do can be accomplished by initial board certification and informed consumers. I know that will never happen in a dumbed-down, fearful society, but this case makes my point)
“Last year, state medical officials enacted regulations that require physicians who prescribe opiates and other addictive medicine to register with the PDMP and check online to make sure patients are not receiving opioids or other addictive drugs from other doctors.”
Konopka “insists that her patients abide by pain contracts as required by regulations. And Konopka said she eventually finds out about abuse, either through pharmacists, other physicians or patients themselves.” Oh sure, the state laws allow delegating PDMP data reporting to staff, but the physician is still left kowtowing to the almighty damn state.
But certainly Konopka’s colleagues in such a small state are there for her, right? New Hampshire Medical Society executive vice president James Potter: ” “Unfortunately, we tried to warn people, they (the Board of Medicine) will try to pick somebody out and make an example of them.” At first, the Society voiced concerns over the PDMP requirements and laws, “but the organization now helps its physician members to comply with the regulations.” Apparently, the AAFP and ABMS were busy, or they would’ve jumped on that “assistance” opportunity.
I haven’t been to a medical society meeting since I was in medical school. They are obviously worse than a waste of time, a rubber chicken meeting where attendees get to delude themselves and each other into thinking they are important. They’re not. Potter “stressed that the Medical Society will work with members, especially small practitioners, to meet the requirements. He does not fault the Board of Medicine for its actions against Konopka. ‘That’s their job. Their job is to protect the safety of patients.’”
So they are toothless at best, sniveling collaborators at worst. Meanwhile, a beloved community physician who they should have been defending surrendered her license to preempt the Board suspending it. She is not presently allowed to see patients and has submitted an appropriately handwritten appeal. Konopka has tried five different times to plead her case to establishment GOP Gov. Sununu; the weasel’s spokesman said: “This is a matter between Dr. Konopka and the New Hampshire Board of Medicine.”
Oh yeah, I left out a fairly pertinent point: Konopka is not being accused of mis- or over-prescribing controlled substances. Her only crime, the one that makes her such a danger to patients and to New Hampshire, is that she won’t use a computer to practice. No, Dr. Konopka is proud to reduce pain medication use in some but mindful not to eliminate it in others, as is clinically warranted. She says of the compassionate state: “They practice medicine, and I practice medical art. They manage the patient, and I treat the patient.”
I am without qualification a supporter of Direct Primary Care, but the more it grows, the more government will use levers like mandatory PDMP participation to lever its way into the office and consume it. I’m sorry for Dr. Konopka, but her day is prematurely, tragically past, and I am not optimistic for the rest of us.