The photo above was taken at the 104th Annual Meeting of the Federation of State Medical Boards (FSMB) held in San Diego April 28-30 and tweeted last night in reference to the partnership between the FSMB and the Federation of State Physician Health Programs (FSPHP) with the caption:
“How a healing profession heals itself #FSMB2016 partnerships #FSPHP trust and faith in oversight and system.”
Within the the allotted 140 character twitter limit this succinct observation is nevertheless very revelatory. Both systems and the oversight of systems demand accountability and answerability to outside and independent agencies. Trust and Faith are not in the equation. Why has this lesson not been learned?
Answerability requires the obligation to answer questions regarding decisions and actions. Accountability requires transparency, explanation and justification. What was done and why? Standards, rules, regulations, codes, laws and other objective benchmarks need to be applied by outside actors. This is critical. It is the very essence of oversight.
“Trust and faith in oversight and system” is both oxymoronic and nonsensical. “Faith and trust” in oversight equates with an “absence” of oversight. “Faith and trust” in systems inevitably results in “systems failure” and therein lies the problem.
Blind faith and deference to authority has led to a systems failure in the regulation of the medical profession. Physician health programs (PHP’s) have convinced state medical boards to give them complete deference. Medical board’s in turn have convinced state attorney generals and law enforcement to give them complete deference. This has led to a complete systems failure. No investigatory or oversight body exists. No one is minding the minders. It is a complete and utter free for all.
Making sound decisions about regulation calls for an understanding of the problem it is intended to solve. Legitimate policy must be based on recognized institutions and experts. Regulatory changes demand methodologically sound science and evidence-based facts arrived at through rigorous peer review and professional oversight. The science must be reliable and unbiased. Legitimate policy must be based on recognized institutions and experts. If the information regulatory agencies rely on to discipline doctors and protect the public is unreliable then serious consequences can occur.
The validity and reliability of opinions lie in their underlying methodology and evidence base. Reliance on the personal authority of any expert or group of experts is the fallacy of appeal to authority and a more apt and accurate twitter caption to the photo above would be Algernon Sidney’s 1683 statement that:
“Implicit Faith belongs to Fools, and Truth is comprehended by examining Principles”