As the FSMB finishes one year and begins another, the world is still in the grip of a stubborn and deadly pandemic — and facing a variety of daunting issues on many fronts. Our capacity for hope and optimism is certainly being tested. Yet, we push on — making progress with new initiatives, policies and partnerships.
Our highest priority at the FSMB continues to be our efforts, as a part of the larger health care community, to help fight against COVID-19.
Early on in the pandemic, we played an instrumental role in helping develop and facilitate data-sharing initiatives and other emergency measures that ensured the availability of health care workers in hard-pressed areas — including through Provider-Bridge.org, our new online resource that supports medical license portability.
More recently, we have led efforts to address misinformation and disinformation by health care providers. The FSMB’s public statement last July, reminding doctors that spreading COVID-19 misinformation could put medical licenses at risk, was widely covered by the media — and we have continued to advocate strongly on this issue. Many other health care organizations have issued statements in support of our work and, increasingly, state and territorial medical boards are taking action, especially against purveyors of knowingly inaccurate information.
One of the byproducts of the pandemic has been significant growth in the use of telemedicine to deliver health care, and we are working closely with peer organizations to ensure the safety of patients in this fast-shifting environment. Our Telemedicine Workgroup, chaired by Shawn Parker, JD, MPA, of the FSMB’s Board of Directors, is finalizing new telemedicine policy recommendations for state medical boards. The workgroup’s recommendations will be considered by our House of Delegates at the FSMB’s Annual Meeting — to be held in New Orleans from April 28–30 as an in-person event for the first time in two years.
Telemedicine’s effectiveness in ensuring the delivery of health care during the pandemic has been helped along significantly by the Interstate Medical Licensure Compact (IMLC), which the FSMB continues to vigorously support. The IMLC is making exciting progress across the United States and its territories, with a total of 36 jurisdictions now participating, and several more states pursuing IMLC legislation. In December, the IMLC reached an exciting milestone of having processed more than 18,000 applications, resulting in 27,860 licenses to practice medicine issued to qualified physicians.
On another front, the FSMB’s Workgroup on Emergency Preparedness and Response, chaired by FSMB Past Chair Cheryl Walker-McGill, MD, MBA, has also finalized new policy recommendations for consideration by our House of Delegates. Now in its second year supporting member boards during the pandemic, the workgroup has been one of the most active in the FSMB’s history. With input from national experts on emergency preparedness, it has created an action blueprint for state boards to help them effectively deal with a host of potential public emergencies, should they arise in the future.
The FSMB Foundation, FSMB’s philanthropic arm, is also playing a part in the FSMB’s multi-pronged effort to address the COVID-19 pandemic, funding a variety of new research projects nationally that are helping identify and evaluate lessons learned from the pandemic and developing new response strategies. The Foundation, led by former FSMB Chair Jan Rhyne, MD, will announce its next cycle of grants very soon.
Beyond these direct efforts to address COVID-19, the FSMB continues to move forward on other longstanding priorities — many of which have been impacted by the pandemic.
An example is our work on physician wellness, burnout and impairment. Along with adopting formal policies on physician wellness and burnout (2018) and physician impairment (2021), the FSMB has advocated widely for greater awareness and more proactive measures to keep U.S. physicians healthy and productive. We now face a new challenge, as Covid-19 has alarmingly raised the levels of burnout among U.S. physicians who have been valiantly treating patients over the last two years.
According to recent research published in Mayo Clinic Proceedings, approximately one in three physicians intend to reduce their work hours in the next few years, and one in five physicians intend to leave the profession altogether. When physician health suffers, sadly, the public’s health also suffers, making our efforts on their behalf more important than ever — including our role as a member of the National Academy of Medicine’s Action Collaborative on Clinician Well-Being and Resilience.
The opioid epidemic in the United States has also been intertwined with the COVID-19 pandemic. We have seen a major increase in drug overdoses in the past year (to more than 100,000 a year). For more than a decade, our efforts to counteract opioid use disorder and inappropriate prescribing have been a top priority — and now we must work harder than ever on this issue.
We are responding with new initiatives, including the recently launched Opioid Regulatory Collaborative, which includes the leadership of the FSMB, the National Council of State Boards of Nursing, the National Association of Boards of Pharmacy and the American Association of Dental Boards. This effort is both timely and necessary to discuss regulatory best practices and, where possible, align guidance for state boards of medicine, nursing, pharmacy and dentistry. The Collaborative has begun quarterly meetings and is planning a formal summit meeting in Washington, D.C., in March.
One of the troubling realities of COVID-19 has been the emergence of health inequities, in terms of the pandemic’s impact on people of color and marginalized communities in the United States. Yet again, we have seen how the pandemic magnifies and adds complexity to already-existing issues — and how important it is for organizations like the FSMB to continue to move forward the national dialogue about systemic racism.
The FSMB’s Workgroup on Diversity, Equity and Inclusion in Medical Regulation, launched last year under the leadership of Dr. Walker-McGill and now chaired by FSMB Board Member Jeffrey Carter, MD, is identifying best practices for state medical boards to mitigate and eliminate systemic inequities in medical regulation and patient care, and will present its findings and recommendations in a report to our House of Delegates at the FSMB’s upcoming Annual Meeting. Our work continues in other venues and settings, as well — including in this issue of JMR, which features the first in a series of articles it will publish on diversity, equity and inclusion.
Throughout the pandemic, we have worked more closely than ever with peer organizations — ranging from the Coalition for Physician Accountability and Tri-Regulator Collaborative to the American Medical Association, American Osteopathic Association and others — sharing resources and strategies to benefit the public. Internationally, our work as the Secretariat of the International Association of Medical Regulatory Authorities (IAMRA) ensures that we are well aligned with the pandemic-related activities of the international regulatory community.
In the midst of this extraordinary and difficult period, the FSMB’s many operational activity centers have had to be agile and responsive: As an example, working with our partners at NBME, we made critical pandemic-related adjustments last year to the administration of the United States Medical Licensing Examination, including the discontinuation of the program’s in-person Clinical Skills examination. Our Federation Credentials Verification Service (FCVS) team had to reconfigure itself to ensure expanded delivery of vital services in a remote setting. Across the board, in fact, FSMB departments and divisions have had to make similar adjustments — as have the dedicated staff and appointed leadership of all of the nation’s state and territorial medical boards.
Through it all, I can say with confidence that the U.S. medical regulatory community has managed to weather the pandemic storm — with a renewed determination and commitment to the vital mission of public protection.
The work continues apace, and we at the FSMB are honored to help it advance. We are grateful for the contributions of all who worked with us in 2021, and we look forward to the year ahead.
