Posts Tagged ‘California Society of Anesthesiologists’

I wish I knew who coined the term “DRexit” so I could send flowers or a bottle of whiskey as a thank-you gift. There couldn’t be a more perfect term to describe the growing exodus of physicians from our beloved profession, which is turning into a morass of computer data entry and meaningless regulations thought up by people who never touch a patient.

The one bright note on the horizon for me is that physicians are starting to wake up to the trap of MOC, or mandatory maintenance of certification. It’s surprising that the Federal Trade Commission hasn’t recognized already that this is quite a racket, forcing physicians to do CME activities dictated by monopolistic certification boards which profit handsomely.

No one else knows what I need to read or do to stay current in my specialty better than I do, and I think that over the course of my career I’ve demonstrated the judgment and the sense of responsibility that prompt me to do it. I’ve provided solid evidence of my CME activities to earn recertification from the National Board of Physicians and Surgeons (NPBAS), a far better alternative to the MOC process controlled by the American Board of Medical Specialties.

At the most recent meeting of the CSA (California Society of Anesthesiologists) House of Delegates on June 4, the delegates unanimously passed this resolution:

WHEREAS the American Board of Medical Specialties Maintenance of Certification (MOC) process is costly, time-intensive, and results in significant disruption to the availability of physicians for patient care; and

WHEREAS the professionalism of individual physicians qualifies them to determine the best means and methods for their own lifelong learning and maintenance of their knowledge and skills;

THEREFORE, be it

RESOLVED, That CSA supports and encourages the individual physician anesthesiologist’s choice in the pursuit of lifelong learning and ongoing development of up-to-date, evidence-based practice; and be it further

RESOLVED, That CSA affirms that MOC should not be a mandated requirement for state licensure, credentialing, reimbursement, insurance panel participation, medical staff membership, or employment; and be it further

RESOLVED, That CSA opposes any initiative by the California State Department of Consumer Affairs or the Medical Board of California to endorse or require the Federation of State Medical Boards Maintenance of Licensure (MOL) program as a condition of medical licensure; and be it further

RESOLVED, That a copy of this resolution be transmitted to the California Medical Association’s House of Delegates.

I wrote that resolution. As the new President of CSA, I am delighted that it was championed without dissent. If other professional societies stand up against mandatory MOC, there may still be a chance of saving our profession and slowing — if not stopping — the flight of physicians in their prime to careers outside of clinical practice.

Since my son just finished medical school and is starting his internship, I have personal as well as political reasons to cheer for our profession and hope for its survival. Here’s hoping other physicians do their part to fight for it too. None of us should have to choose between MOC and DRexit.

“I’m here to say ‘Yes, they can,’ which is different from ‘Yes, they always do,’” says James Moore, MD, President-Elect of the California Society of Anesthesiologists (CSA).

To the contrary, enthusiasm for electronic medical records (EHRs) is part of a “syndrome of inappropriate overconfidence in computing,” argues Christine Doyle, MD, the CSA’s Speaker of the House.

The two physician anesthesiologists (and self-identified “computer geeks”) squared off in a point-counterpoint debate in New Orleans as part of the American Society of Anesthesiologists (ASA) annual meeting, with Dr. Moore defending the benefits of EHRs and Dr. Doyle arguing against them. Dr. Doyle chairs the ASA’s Committee on Electronic Media and Information Technology, while Dr. Moore leads the implementation of the anesthesia information management system (AIMS) at UCLA.

Legibility, accuracy, quality

Dr. Moore defined safety in anesthesia care as “minimizing patient injury resulting from or occurring during anesthesia, and keeping surgeons from harming patients any more than they have to.” He said that computerization contributes to safe anesthesia care by improving legibility, offering clinical decision support with readily available reference information, and providing alerts and reminders.

Computer tracking of the anesthetized patient’s vital signs is more accurate, Dr. Moore said. It prevents the “normalization” of blood pressure that tends to appear on the paper record. Quality reports are easier to generate and outcomes are easier to measure with EHRs in place, he noted. “Postop troponin levels and acute kidney injury are easy to track.”

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