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Reform the Medical Practice Act

Reform the Medical Practice Act

If you were going to fly on a plane that needed repairs, you would expect that the person repairing the plane was adequately qualified to get the job done properly. However, if you seek medical treatment in Texas, this is not always the case.

The Medical Practice Act essentially allows anyone with a medical license to do anything they want. To get a medical license, a person must: complete medical school, complete one year of supervised training (an internship), and pass a written test. That’s it.

This made more sense in the past, when a country doctor may have served a vital need by being a “one-stop shop” who delivered babies, treated fractures, managed high blood pressure, lanced boils, etc. And rural areas still need more doctors. But in Texas today, most folks live near urban areas, and most medical care is partitioned such that, for example, most leg fractures are treated by orthopedic surgeons, and most baby deliveries are done by obstetricians. And this is a good thing, frankly, because there is a lot more to know today than, say, fifty years ago.

While there are some good doctors who have NOT completed a residency (years of extra training in a specific field), most doctors in this day and age do. And no hospital will let a doctor practice, for example, brain surgery unless they have completed a appropriate residency in neurosurgery. So the hospitals have functioned as a system independent from the law to regulate what kind of doctors get to do what kind of procedures.

Lately, though, as doctors have felt financial pressure from our current system (which has seen a steady decline in physician payments), more and more doctors are starting to practice outside their normal area of training in areas that are cash-pay. Examples include: breast implants, varicose vein treatments, hair transplants, hormone therapy, liposuction, and a whole bunch of skin therapies. While any licensed doctor might get the job done safely, if I personally needed, say, laser treatment of a varicose vein, I would go to a board-certified vascular surgeon, who by virtue of training and experience not only can get the job done safely, but can manage any complications appropriately.

Currently, “Buyer Beware” is the predominant safety measure in place to protect the public. Is this the best we can do? In Texas, in 2010? Really? Some people figure out the system, but a whole bunch of people do not. They trust that the system would only allow qualified doctors to work on them, when the system in fact allows any licensed doctor to do anything they want.

We need more transparency in doctors’ credentials. We need improved advertising rules that clarify the qualifications of the doctor. We need some checks on the system, so that, for example, doctors with little or no surgical training are not allowed to perform major surgery.

“First do no harm” is a concept in medicine from the days of the Hippocratic Oath. The Texas Medical Board mission statement is to, “protect and enhance the public’s health, safety, and welfare…” Our system is failing the public, and people are getting hurt. It is time to update the Medical Practice Act — the public deserve it.