Sure, I’m Paranoid by Pat Conrad MD

Are we heading toward a National Medical License program?  Michigan has just become the 25th state “to join the Interstate Medical Licensure Compact, which allows physicians to more easily be licensed in multiple states.”   “‘The expansion of the compact to half of all U.S. states is an incredible achievement and testament to state medical boards’ efforts to innovate and improve license portability,‘ said Humayun Chaudhry, DO, president and CEO of the Federation of State Medical Boards.”

The basic idea is that if you meet the compact’s eligibility requirements, they can avoid more lengthy application processes state by state.  Which sounds pretty reasonable, and a boon to those interested in locums work.  Making physicians more portable could certainly give them more earning opportunities, and might blunt (a little) the coercive reflexes of major health corporations.

 Of course, this convenience is bound to come with an annual fee, on top of fees for each state wherein licensed.  

 – If one surrendered a license in state “A,” would that be a question one would have to answer in all the other states?

– How would this compact deal with board certification?  Why do I already smell the ABMS and their loathsome subordinates creeping around, trying to make MOC currency a mandatory eligibility requirement?  

The one governing body I would probably detest more than a state medical board is a federal one, so anything getting these generally bad groups to cooperate is worrisome.  And as bad as it can be to get justice out of a state board, what chance would a solo doc have at the federal level?  This is certainly laying the scaffold for federal oversight.  Just insert your NPI and turn.  And once a national medical license is created, it could demand adherence to all sorts of fun things:  Medicare/Medicaid participation, a reinforced MOC, politicized CME requirements at the federal level (you mean you haven’t finished the “caring for the transgender geriatric module”??), proof of minimal charity care…add your own.  Naturally, Big Insurance and Big Hospital would say that such a system would save on credentialing expenses and leap to force all doctors into the ranks of the USDA Prime.  It would quickly be used to end any notion of Direct Primary Care.

 And I can’t think of a better major step toward the creeping single-payer system disaster that is coming.    

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