Humayun J. Chaudhry, D.O., M.S., MACP, FACOI, President and Chief Executive Officer, Federation of State Medical Boards
1. Firstly, Hank, thanks so much for spending a few minutes with our readers. As you know, hospitalists devote most of their time in acute and subacute settings. Many of their clinical apprehensions relate to hospital and physician regulation and quality monitoring and how these rules intersect with inpatient care. The Federation of State Medical Boards (FSMB) has a broad mission. What should hospitalists know about your organization given these concerns and do you have a role to play in assisting inpatient providers to improve patient care?
To understand the mission of the Federation of State Medical Boards (FSMB), it’s helpful to understand the mission of state medical boards. States are authorized under the 10th Amendment to the U.S. Constitution to establish laws and regulations protecting the health, safety and general welfare of their citizens. To protect the public from the unprofessional, improper, unlawful or incompetent practice of medicine, each of the U.S. states and territories has adopted a Medical Practice Act, which defines the requirements for the practice of medicine within their borders and gives authority to a medical board to enforce the Act’s provisions.
The FSMB is a not-for-profit organization representing all 70 state medical boards – which license and regulate physicians (MDs and DOs) and, in many jurisdictions, physician assistants and other health care professionals – within the United States, its territories and the District of Columbia. We assist these boards as they go about their mandate of protecting the public’s health, safety and welfare through proper licensing and discipline of these health care professionals. The FSMB offers relevant policy, programs, education and services to medical boards that result in improved quality and safety of patient care through effective and fair medical regulation. We’re perhaps best known among physicians as a co-manager, with the National Board of Medical Examiners, of the USMLE examination.
2. Physicians often hear the term “state medical board” and quiver. Should hospitalists feel threatened when the term surfaces in conversation?
No. The state medical boards are there to protect the public but they are also there to assure the delivery of quality health care by all physicians. In that respect, they look out for patients as well as physicians as a whole. The existence of state medical boards, in fact, attests to the value of self-regulation that society has bestowed upon physicians. Medical boards are well aware that the vast majority of physicians comport themselves with appropriate professional standards and practice medicine safely and competently. Less than one percent of the nation’s 878,000 actively licensed are disciplined by medical boards each year. Medical boards work with disciplined physicians to address competency or knowledge deficiencies, or to rehabilitate physicians with substance abuse issues. When necessary to protect patients, medical boards will revoke or place restrictions on physicians’ licenses.
3. Has the FSMB mission changed since your arrival as CEO, and if yes, how so?
At its core, the FSMB’s mission remains the same as it was when the organization was founded more than a century ago: To support state medical boards in their mission of public protection. To this end, the FSMB seeks to promote excellence in medical practice, licensure and regulation. During my tenure with FSMB, I have worked closely with our Board of Directors and our member boards to enhance our mission through a wide variety of initiatives: We are diligently exploring the feasibility of an Interstate Medical Licensure Compact, which would significantly streamline in the future the ability of physicians to obtain licensure in multiple states; we are working with our regulatory counterparts in other nations to share best practices on physician regulation; and we recently mined our large repository of physician licensure data to produce the first-ever census of actively licensed physicians, a valuable resource for researchers and policymakers that we repeated last year. A big focus for me has been about communicating who we are and what we do, which is why I am delighted to be highlighted in The Hospital Leader.
4. How do you work with organizations hospitalists might be more familiar with, say the ACP, AAP, ABMS, DOHs, or DEA?
The FSMB works closely with all of those organizations and agencies, as well as many others in the house of medicine and state and federal government. In recent years, we have significantly expanded our presence in Washington, D.C., where we also have an office and advocate on behalf of state medical boards in a rapidly evolving health care environment by leading, anticipating and responding to trends in medical regulation here and abroad. We also frequently speak at meetings of the American Medical Association and the American Osteopathic Association, to name just two organizations.
The FSMB also actively seeks opportunities to partner with other organizations to advance public protection. For example, last year we partnered with the ACP – the largest medical specialty organization in the United States – on developing a white paper about the appropriate use of social media by physicians that was published in Annals of Internal Medicine. In another initiative, the FSMB and several partner organizations have developed Data Commons, an innovative new data-accessibility system that will make data available from multiple organizations through a shared and secure data-hub. We are joined in Data Commons by the American Board of Pediatrics, the Association of American Medical Colleges, the American Board of Family Medicine, the Educational Commission for Foreign Medical Graduates, and the National Board of Medical Examiners,
5. Given the many organizations physicians deal with, e.g., question #4, where should a practitioner turn if they wish to express concern about a colleague. Do you think the “white coat” wall of silence still interferes with reporting?
Practitioners should turn to their state’s medical board when they are concerned about a colleague. FSMB’s national recommendations, adopted as policy by our House of Delegates many years ago, call upon states to require all licensed health care providers to report to the Medical Board promptly, and in writing, any information that they have that indicates a licensee is, or may be guilty of, engaging in unprofessional conduct. To our knowledge, most if not all states have statutes requiring physicians to report unprofessional conduct by peers.
We still see some reluctance by physicians to report colleagues, however. In this era of increased transparency I think most physicians understand that it is in the best interests of the profession to report unprofessional conduct by a colleague. The privilege of self-regulation requires physicians to be proactive and engaged on behalf of the entire professional community to ensure that everyone adheres to the highest standards of conduct. What one physician does can obviously reflect poorly on the whole community — so each individual physician has a vested interest and a legal/ethical duty in helping to address ethical and competency issues.
Thanks so much Hank. Would you like to leave our readers with a link or contact info if they wish to learn more?
Absolutely. To learn more about the Federation of State Medical Boards and its 70 member boards, please visit our website at www.fsmb.org.
Bradley Flansbaum, DO, MPH, MHM works for Geisinger Health System in Danville, PA in both the divisions of hospital medicine and population health. He began working as a hospitalist in 1996, at the inception of the hospital medicine movement. He is a founding member of the Society of Hospital Medicine and served as a board member and officer. He speaks nationally in promoting hospital medicine and has presented at many statewide meetings and conferences. He is also actively involved in house staff education.
Currently, he serves on the SHM Public Policy Committee and has an interest in payment policy, healthcare market competition, health disparities, cost-effectiveness analysis, and pain and palliative care. He is SHM’s delegate for the AMA House of Delegates.
Dr. Flansbaum received his undergraduate degree from Union College in Schenectady, NY and attended medical school at the New York College of Osteopathic Medicine. He completed his residency and chief residency in Internal Medicine at Long Island Jewish Medical Center in New York. He received his M.P.H. in Health Policy and Management at Columbia University.
He is a political junky, and loves to cook, stay fit, read non-fiction, listen to many genres of music, and is a resident of Danville, PA.