If there was one thing we knew about Rand Paul, it was that he wanted to bring America back to its glory days, when businesses could call the police to evict those meddlesome Negroes from their lunch counters. If we knew another thing, it was that he was Ron Paul’s kid. And if we knew a third thing, it was that he was a board-certified ophthalmologist.
Well, one of those things turns out to be not exactly true. Sadly, it’s not the lunch counter one. And he looks way too much like his dad to have his paternity in doubt. So let’s look behind door number three, shall we?
Rand Paul, who touts his career as a Kentucky eye doctor as part of his outsider credentials in his campaign for U.S. Senate, isn’t certified by his profession’s leading group.
He tried Monday to bat away questions about it by calling it an attack on his livelihood, saying the scrutiny stems from his challenge of a powerful medical group over a certification policy he thought was unfair.
The libertarian-leaning Republican helped create a rival certification group more than a decade ago. He said the group has since recertified several hundred ophthalmologists, despite not being recognized the American Board of Medical Specialties – the governing group for two dozen medical specialty boards.
Hey, to be fair to Rand Paul, I can understand why he did this. I mean, who hasn’t gone out and formed their own ophthalmology licensing board? I know I have. In fact, if you want to be a board-certified ophthalmologist just like Rand Paul, just print out the certificate below, and write your name on it somewhere. Voila! Instant certification!
Okay, sure, Jeff’s Pretty Good Ophthalmology Board isn’t, like, recognized by anyone. But that’s only because we’re sticking it to the man, with his “rules” and “regulations” and “dues.”
Seriously, this does fit with Paul’s worldview — if you’re a Randian superman, you can do whatever you damn well please, and silly things like licensing shouldn’t matter. Hey, if the eye doctor blinds enough people, the magic of the market will ensure that rich people don’t go to him, thus ensuring that the doctor will only be able to make a meager living treating the poor.
Now, Rand Paul might be a great surgeon. Even in libertarian world, some people who set up shop as doctors would turn out to be good at it. But here in the real world, you have to question a surgeon who has certified himself, with assistance from his wife and father-in-law. Moreover, you have to wonder about someone who would flout his industry’s basic rules. Because thankfully, we live in a real world, where doctors have to get real certification from real boards. And that gives those of us going into surgery at least a basic reassurance that the doctor who’s treating us has reached a basic level of competence.
The fact that Paul was willing to go it alone shows a startling arrogance, and a disregard for his patients. But then again, that arrogance is part and parcel of Paul’s persona. He’s a man born on third base who thought he hit a triple, and who sneers at the rules that put him where he is. A man who should be nowhere near the levers of power.
http://www.nytimes.com/2008/04/28/business/28teeth.html?_r=2&sq=Alaska%20dentistry&st=nyt&scp=1&pagewanted=print
You’ve got this all wrong. You don’t need to be board certified in a specialty to be legally entitled to practice that specialty. Board certification in a specialty is certainly an important and valuable accomplishment, and some prestigious hospitals and practice groups require it of their physicians, but practicing opthalmology without being board certified in opthalmology is completely innocent.
CPP is correct in that an MD in principle entitles you to practice all branches of medicine. However, not being board certified by the real board, does suggest a problem. Maybe the problem is that the doctor in question hasn’t gotten his/her act together to recertify. Maybe s/he doesn’t want to take the time. Maybe s/he failed the first recert test. Fine, it’s ok to practice without certification, though many hospitals are rightly leery of credentialing someone who is not board certified. But 99% of the relatively innocent reasons I can think of for not recertifying involve not having enough time to do it right (not getting the CMEs, not studying enough to pass the test, etc). If you don’t have time to take the boards, how do you have time to invent your own board? And Paul’s excuse that he just doesn’t think it’s fair that older physicians don’t have to recert while he does is such total bullshit. Just not plausible. My guess is that he failed the exam and didn’t want to bother doing it right the next time so invented his own board. Spoiled idiot rich kid behavior.
practicing opthalmology without being board certified in opthalmology is completely innocent.
Practicing ophthalmology while not being board certified is innocent. Representing yourself as board certified while you are not is NOT innocent. If Paul had simply not recertified and continued practicing he’d be within his rights. Making up a board is false advertising at best.
Hey, anyone out there have any chance of asking Paul a question at a press conference? Ask him how he’d handle a retinal detachment with an incidental finding of an occular melanoma of 4 mm depth without metastatic lesions. Or a case narrow angle glaucoma in a hypertensive patient. (Hint: These are not hard questions.)
He might not be board certified, but is he a certifiable idiot.
Here’s a dose of Rand Paul satire:
http://bit.ly/asYks5
if Paul is not board certified, he would have a hard time getting credentialed to perform surgery in a JCAHO-accredited hospital, so I guess he had to start his own surgery center, too. wonder if he started a board to get IT accredited too?
Paul has been certified multiple times by the “real” certification board, so the issue doesn’t appear to be his professional competence. He says that he started his DIY board to protest a discriminatory policy; I suppose that could be true. From what I understand, he hasn’t put in the time and money it would take to make his board a genuine alternative. Such systems of accreditation usually start out with good intentions but turn into access-control guilds, and so should be opposed as a matter of principle, anyway.
Jeff,
Your post wrongly implies that he’s not qualified to be doctor. From what I’ve read he is qualified, he’s just a crank that didn’t like the ‘official’ board so he made his own. I have zero problem believing that a libertarian would do something like that. (Okay, he’s not running as a libertarian, but he easily could be.) Regardless, your post makes it sound as if he’s not qualified to be an ophthalmologist and I think (based on the available information) that’s a dishonest charge.
There’s plenty to criticize about him, there’s no need to invent accusations or misrepresent the facts.
Love it!
Regardless, your post makes it sound as if he’s not qualified to be an ophthalmologist
He’s not. In general, describing yourself as an ophthalmologist or an internist or plastic surgeon or medical oncologist or whatever your specialty, you are implying that you are in good standing with the American Board of Medical Specialties* and your particular board. If you are not for any reason then it is not honest to imply that you are. Paul should, at the very least, make it clear to his patients that his “board certification” is NOT the peer accepted standard certification. He may still be competent, but he has not and apparently is unwilling to prove his competence to his peers. So he’s misleading and possibly endangering his patients by his behavior.
*Applies to physicians practicing in the US only, of course.
He may still be competent, but he has not and apparently is unwilling to prove his competence to his peers.
He has been board certified in the past, so this isn’t correct.
He has been board certified in the past, so this isn’t correct.
He has been board certified. He isn’t now. The whole reason that the requirement for every 10 yearly recertification was made was to acknowledge that the standard of care in medicine changes-sometimes rapidly-and a practitioner who was competent 10 years ago might not be so today. And while I agree in principle that it’s not fair that older doctors get out of recertification, that was a compromise that was necessary to get the rule accepted. If Paul can’t deal with compromise then he’s not going to be a very effective politician, however good his ideals.
Fine, the compromise was needed to pass it, that’s the internal politics of the guild. The acceptability of the compromise, however, indicates that a majority of ophthalmologists don’t think that every ten year certification is actually critical. If they do think it’s critical, but are still willing to make the deal, then they think the internal politics of their guild are more important than people’s health. I don’t think they think that; the change was about politics and control, not health.
Dianne Writes:
Exact quote from the linked article: “Neither group has anything to do with medical licensure, which is handled by state boards.”
However I agree that if he has been calling himself “board certified” then he should stop as it might confuse people about what being certified actually means (and especially since he is not promoting his board as an alternative board).
@14: Licensing and specialization are two separate issues. Each state licenses physicians. A licensed physician is entitled to practice any specialty that he or she can convince anyone in that state to hire him/her to practice.
Board specialization is a statement that the physician in question has completed certain training (residency or fellowship) and demonstrated adequate knowledge and practical ability to satisfy the basic requirements considered to be necessary to practice the specialty. However, board certification does not imply that one has the right to practice in any given state.
Robert @13: so certification is meaningless; then why does Rand try to claim it? You can’t have it both ways. Either board certification is a crock of shit, in which case Rand can try to argue the reason he isn’t board-certified is that it’s a crock of shit. If he’s claiming he’s board-certified, it obviously means he thinks there is some advantage to doing so.
You’re also skipping over the fact that he’s the president and owner of the board handing out the certifications.
I confess to be a “grandmothered” life-time board-certified practitioner in my specialty, and I don’t bother with voluntary re-certification. I happen to teach and practice at a medical school, in a low-malpractice specialty, and the hospital doesn’t require re-cert, so I don’t spend money on re-cert. I’d rather spend money on attending national meetings of my specialty, gaining CME in the process. I get a ridiculous amount of CME locally, just doing my job.
Yes, it may seem unfair that the older practitioners don’t have to re-cert. However, the Boards would have to reverse their lifetime certs. RETROACTIVELY, and it isn’t worth it to the Boards to do so (huge legal issues). What usually happens is that to be eligible for hospital staff privileges, which are renewed every year or two, the practitioner must show that he/she has passed voluntary re-cert. . Different hospitals have different policies regarding voluntary or mandatory re-cert.. Practically speaking, in specialties at high risk for malpractice suits, it is wise to voluntarily re-cert.. OB/GYN, neurosurgery, and ophthalmology are traditionally at highest risk for malpractice suits. Rand Paul is a fool not to re-cert. if he does anything more invasive than refracting (measuring for visual correction lenses) patients.
Rand Paul may be fully competent or he may be somewhat out of date (state licensure requires a certain amount of CME units yearly, 25 in my state). He can practice ophthalmology in his office and/or at a hospital or surgicenter that doesn’t require Board cert. or re-cert. for staff privileges.
@Mythago 16
You’re also skipping over the fact that he’s the president and owner of the board handing out the certifications
In my mind. that’s a good criticism. So would be accusing him of bing childish for refusing the compromise. But that’s not what Jeff did. Jeff accused him of being a bad doctor and not caring about the health of his patients.
I have no idea if the compromise on recertification for older doctors was a good one or not. I don’t know if Rand Paul is
a) calling attention to a gross mis justice
b) trying to line his own pocket
c) Being a crank.
or
d) Hiding the fact that he’s not competent.
My money is on C. He was bing crank.
But again, the OP accuses him of D. And that doesn’t seem supported by facts.
Jeff accused him of being a bad doctor and not caring about the health of his patients.
Jeff accused him of “startling arrogance” and “disregard for his patients”, but not of being a bad doctor – in fact he admitted that perhaps Paul is an excellent doctor despite all the BS about certification.
A crank is perfectly capable of setting up an alternative certification system that’s operated in such a way that it doesn’t look like a puppet board; or of eschewing board certification entirely.
Jeff’s post appears to imply that Paul is a self-created doctor. “Even in a libertarian world, some people who set up shop as doctors turn out to be good at it,” is the really questionable sentence I think. I know that’s what I thought before I clicked the link. (And then I was disappointed, because the truth was far less exciting and inflammatory than Paul actually teaching himself ophthalmology and starting up a practice.)