Sunday, September 6, 2009

A Ruined Holiday

While most of our family is enjoying the lake, my husband and I are stuck here on Labor Day Weekend because he has to take some online tests for the American Board of Family Medicine --in order to continue as a "board diplomate." Some insurance companies require it of him --and hospitals, etc. Does it MEAN anything to how he practices medicine? No. The tests have two knowledge assessment sections in areas he chooses, and then have a ridiculous element called a "clinical simulation," where he treats an imaginary patient online. That's just tricky to do in a computer format. Treating the patient isn't the challenge; it's making the format work!

He is not a computer buff. What he knows about computers is that they are always "down" at hospitals and occasionally at the clinic --along with the failing phone systems. And that he often waits longer for windows to open than he'd like. So that means that Rob and I guide him on the internet into the ABFM maze of a website --with all its tutorial materials that confuse rather than clarify. We're on phone with the help-desk guy, saying, "NOW WHAT!!!" And then my husband takes the phone to rant to the poor tech about these lousy tests! Only thing, THIS year, the tech is on vacation just when we need him! I tell you, if anything can make a good Christian lose his sanctification, it's these tests!

A test can TEACH if it provides the answers with the questions as a follow-up convenience --but first we had to figure out how to down-load the questions --and then he took the test on line, and sometimes the computer balked and the system refused his answers. Eventually, he marked his answers --then he had to go back and re-mark the correct answers on the hard copy --so I held the book and looked up the questions --as they weren't in the same order as on the screen --and then he'd mark all the right answers after the test for future study --just in case they show up on the national board exam he has to take in 3 years.

This online system enabled him to have a 3 year extension on the testing --so he wouldn't have to go study for the boards at some hotel for a week, after having the study hang over his head for at least a year -- and then go to a testing site and have his livelihood up for grabs every 7 years. This way, with the online updates every 2 years, he gets tested at a testing site with a risk to his career every 10 years. If you fail, you take it over. I don't think they can take away one's license, but with out the ABFM seal of approval, he can fall out of favor --even though he thinks their tests are esoteric, out of touch, and unnecessary to the practice of medicine. He also has found errors in their "right" answers --outdated info.

Continuing education for him comes from the doctor's speeches on Audio-Digest --for which he pays nearly a thousand dollars a year and listens in his car. Those are followed by tests, too, but they are more user-friendly.

My husband is one of those people who is NOT a 'test taker.' But if you want good healthcare, there are hundreds who will attest that they get it from him. He put off taking these boards until 14 years ago --when all the provider-payers made it a requirement. He passed twice. Now he would have to take it next spring, if he doesn't pass these on line tests. You CAN keep taking until you pass, I guess.

But he thinks the test-makers like to play, "Gotcha!" instead of being practical.

So many doctors have complained, however. Hopefully, the current on-line tests are more practical than they were. We don't know about the clinical simulation yet, because he still has that to do.

We wonder if these specialty boards are providing jobs for doctors who probably can't build a practice. Doctors pay a huge amount to belong to this organization just to be put through this grueling, agonizing rigmarole which threatens their careers.

Yeah, yeah --I know --doctors wanted some way to weed out the charlatans --or to provide continuing education and evaluation so doctors would be current.

It used to be less painful --the drug reps would pay an MD speaker to speak at a dinner --and the doc would get continuing education credit for it. I think they STILL DO have to get CE credit --that's what the Audio Digest CD's do for my husband.

NOW, ABOUT NATIONAL HEALTHCARE!!! It's bad enough what doctors do to themselves with these tests, but let's get some REAL REFORM! TORT REFORM. Get the lawyers off the doctors' backs --and you'll see an improvment in the cost of healthcare. Less of this "defensive medicine" which causes so much office rigmarole.

CALL YOUR SENATORS AND CONGRESSMEN AND DEMAND REAL REFORM. 1-202-224-3121 --and call the White House at 1-202-456-1111

People now know that all they have to do is sue and they and their lawyers will get a settlement --because the doctors do not want to risk a jury's sympathy for someone with self-imposed bad health or any condition regardless of the doctor's fault--a jury's exorbitant million dollar demand, thinking the insurance company should pay for a sad situation since the doctor has the insurance. Doctors would rather settle because of the hours away from their practices and the expense of defense attorneys. It may cost them more to defend themselves.

We need to enrich the economy, shame the lawyers, CEO's and the university administrations for their exorbitant salaries and bonuses while down-sizing and getting gov't subsidies --remove their gov't subsidies --make them return the bonuses--get back to fixed salaries for executives of subsidized companies who downsize. These CEO's don't need what they demand in order to stay in their jobs. If they threaten to leave, let 'em go!!! They are replaceable for a lot less money!!!

"God is not willing that any should perish, but that all should come to repentance and have eternal life."--the Bible

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