Opposing Maintenance of Licensure in Iowa: An Update and A Petition

I’m a licensed and board-certified psychiatrist in the state of Iowa and I’m opposed to the Federation of State Medical Board’s (FSMB) promulgation of the process known as Maintenance of Licensure (MOL), which is an extension of the Maintenance of Certification (MOC). I believe in the principle of continuous improvement in clinical skills and medical knowledge of physicians. I respectfully disagree with the American Board of Medical Specialties (ABMS) and the FSMB about the effectiveness of the MOC and MOL processes in that endeavor. The link to a recent post which summarizes the current MOL issue as it’s being studied by the Iowa Board of Medicine is Reflections on the MOC and MOL…and Excellence – The Practical Psychosomaticist.

There are several states including Iowa charged with implementing pilot projects studying the proposed implementation of MOL, which would tie medical licensure to MOC, essentially. What it means is that a physician’s license would not be renewable unless the physician is participating in the MOC. The MOC itself is controversial because of its cost, complicated structure, and time-consuming processes which draw time away from patient care, the practice of which, ultimately, is the best teacher.

The petition to oppose MOL is also my proposed resolution to oppose it in Iowa, which I’ve submitted to the Iowa Medical Society (IMS). I have also contacted the Iowa Board of Medicine (IBM). Both bodies acknowledge my objection as an individual physician. I’m not representing any organization regarding this resolution. I have asked the Iowa Psychiatric Society (IPS) to co-sponsor the resolution and my request has been forwarded to the IPS President and Executive Council for review and approval. Please read the petition at link http://www.ipetitions.com/petition/iowa-medical-society-house-of-delegates/.Amos MOL resolution

My proposed resolution has been forwarded to the IMS House of Delegates Speaker and Vice Speaker. The Reference Committee deliberations about it would be discussed at the next IMS House of Delegates meeting on April 20, 2013 in Coralville, Iowa. IMS has invited me to attend the meeting as the author of the resolution.

Although I’m acting as an individual physician, not representing any organization, I’m encouraging my colleagues in medicine, surgery, psychiatry, and every specialty to learn more about the MOL and consider for themselves whether this is right for Iowans.

Speaking for myself, I think we can do better for our patients than to take what looks like could be the path of least resistance by simply allowing MOL to happen in Iowa. There are no controlled studies showing that MOL improves the physician-patient relationship or improves treatment outcomes. One of the goals of MOL is to encourage us as physicians to reflect on our practice and honestly assess its effectiveness, based on the medical evidence.

I have reflected on the MOL…and found it wanting.

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