Physicians everywhere: You are good people, but you are doing evil by your complacency.

I am writing this to every physician who is frustrated with the certification system that we have in place and that is becoming increasingly encoded into our laws. We have reached a crossroads in the evolution of health care in America. We, as physicians, have been under assault literally for decades.

We have suffered degradations and loss of prestige as an army of administrators has constructed a fortress of policy around the hospitals and issued ‘guidelines’ which now are treated as treatment mandates for our patients. And, I am very sorry to say, many of us have been complicit in this tragedy.

Some physicians have been overtly complicit by taking non-practicing administrative positions and dictating not only how we should care for our patients, but also implying that we are not competent to do so. Many others have been silently complicit, as we have sat by and let the rot set in. As the great theologian and anti-Nazi dissident Dietrich Bonhoeffer said “Silence in the face of evil is itself evil: God will not hold us guiltless. Not to speak is to speak. Not to act is to act.”

We are now subjected to MOC in order to somehow prove ourselves, when by the very act of treating our patients and looking up information to do so shows that we are dedicated to maintaining our profession. Our profession: that is what is being called into doubt and what many bureaucrats would like to do away with. Instead of dedicated professionals seeking out the best treatments for our patients, they would prefer us to be interchangeable widgets.

Enough! It is time for ACTION.

Our leaders have abandoned us, and it is not enough to moan and complain to your colleagues. I have faith that you will continue to keep your knowledge up to date, but it is time to STOP ALL MOC ACTIVITY. DO NOT PAY ANOTHER PENNY TO THE ABMS, ABIM, or whatever specialty board you fall under.

CALL the hospital executives. ASK about the bylaws. PROPOSE changes to any language regarding maintenance of certification, and make sure the NBPAS is included as an acceptable alternative. DEMAND that these things be discussed at the hospital board meetings.

To anyone who is grandfathered in, or beyond the last needed certification, you are HURTING MEDICINE if you do not act. You need to help the people behind you who may be taking care of you when you are sick and dying.

Nelson Mandela said “We fought injustice wherever we found it, no matter how large, or how small, and we fought injustice to preserve our own humanity.” This is precisely how we need to shape our fight.

We must take action. Signing petitions is not enough. You should call your hospital administrators on a regular basis and let them know that the physicians are not happy.

Burnout is at an all-time high, and good men and women are leaving the field of medicine in record numbers. The surveys show that it is bureaucracy and maintenance of certification that is driving good people away. We must put a stop to this. Do not hang your head and say that the fight is lost, because the very future of American medicine is at stake.

The administrators of every hospital should be harassed until every single hospital in this country accepts alternate board certification rather than the ABMS monopoly.

Be brave and act boldly. I will leave you with a last quote to remember when you have doubts. “You should never let your fears prevent you from doing what you know is right.” – Aung San Suu Kyi

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