State Medical Boards Beginning to Address ‘Medical Drift’
More than half of the states in the U.S. do not require the accreditation or licensure of offices where surgery is performed. Ohio is one of only 21 states that protect patients by requiring that not only the doctors who perform surgery but the surgical sites themselves be licensed or accredited by the state. In states that require surgical sites to be licensed or accredited, regulations specify adherence to strict safety procedures in areas such as recordkeeping, anesthesia and cleanliness and require that emergency life-saving equipment and drugs be kept onsite. Surgical facilities are also subject to inspection to ensure that required safety standards are being maintained.
Accreditation and licensure of surgical facilities is just one aspect of what many call “practice drift.” The term refers to doctors who practice medicine outside the field in which they are board certified.
As note in an article published in the January 1, 2012 issue of the Journal of Medicine, the professional publication of the National College of Physicians, practice drift is creating increasing concern within the political and medical communities. Consumer complaints and several tragic instances in which patients died have put cosmetic surgery at the forefront of the practice-drift debate.
A triple tragedy in Phoenix led Arizona to publish guidelines outlining competency training for physicians who wish to practice outside their specialty. Patient complaints caused North Carolina to require that doctors practicing outside their field of expertise be held to the same standards as experienced physicians in the field. Statutes requiring physicians to meet competency requirements for procedures they perform are on also on the books in at least nine additional states.
“This is on the radar of many state boards,” physician and Federation of State Medical Boards CEO Humayun Chaudhry told the Journal of Medicine. “What doctors should or shouldn’t do when they change their area of focus is a concern for everyone.”