This year at the FSMB was all about what we can do to support our state medical boards, many of which are facing limited resources and staff turnover as they continue to fulfill their mission to protect the public. We have realigned our staffing and services to better address the issues created or intensified by the COVID-19 pandemic, including supporting systemic and cultural shifts in health care delivery, changes to the function and structure of regulatory authorities, and the use of technology to enhance the ability of state medical boards to serve patients and providers within their state. This has meant innovating with our services to members, increasing member engagement with groups such as state board attorneys and executive directors, and providing software solutions to interested boards to better help with licensing and disciplinary processes.
Beginning late in 2021, state legislators in several states began introducing legislative bills that would have significantly altered or curbed the ability of state medical boards to discipline physicians. In February 2022 the FSMB’s Board of Directors issued a statement urging state legislators to work with state medical boards before advancing regulation that could have unintended consequences to patients and physicians alike.
Our first in-person Annual Meeting since 2019 was successfully held in New Orleans, LA, where our House of Delegates adopted updated recommendations related to telemedicine, tackling areas such as licensure, standards of care and equitable access. At the meeting, reports related to emergency preparedness and response, and to diversity, equity and inclusion in medical regulation, were also released. The FSMB Foundation, under the capable leadership of Jan Rhyne, MD, and a diverse and dynamic board of directors, continued to fulfill its mission by providing grant funds to state medical boards and other stakeholders to advance education and research in meaningful medical regulation.
Recognizing that the opioid overdose epidemic has only gotten worse during the pandemic, the FSMB collaborated with the leadership of the National Council of State Boards of Nursing, the National Association of Boards of Pharmacy, and the American Association of Dental Boards to create the Opioid Regulatory Collaborative, which met earlier this year in Washington, DC, at the offices of the National Academy of Medicine (NAM). The collaborative identified several priorities worthy of pursuing, including harmonizing continuing education specific to substance use disorder and opioid use disorder across the four health professions. The FSMB is continuing its partnership with the NAM in its Action Collaborative to Counter the US Opioid Epidemic, with FSMB Past Chair Dan Gifford, MD, serving on two workgroups and me serving on the Steering Committee that is co-chaired by NAM President Victor Dzau, MD, and US Assistant Secretary of Health Admiral Rachel Levine, MD.
The FSMB’s Advocacy Office continues to support state medical boards on a variety of legislative, regulatory, and policy matters. This year the FSMB Advocacy team increased the reach and frequency of the FSMB Advocacy Network News, expanded public accessibility to legislative tracking available on FSMB.org, and regularly met with Congress and federal agencies on matters of importance to state medical boards, including telehealth, emergency preparedness, and reporting by VA facilities. FSMB Advocacy continues to support and advocate for the Interstate Medical Licensure Compact, which consists of 37 states, the District of Columbia, and Guam, while helping support interested boards with the launch of an interstate compact for physician assistants.
Additionally, in 2022, the FSMB’s Advocacy Office actively partnered with the Dr. Lorna Breen Heroes’ Foundation to support the adoption of the Dr. Lorna Breen Health Care Provider Protection Act (HR 1667), which was signed into law by President Biden on March 18, 2022. The legislation authorizes grants for programs that offer behavioral health services for health care workers. Corey Feist, JD, MBA, the co-founder of the Breen Foundation, was the featured speaker at the FSMB Foundation’s luncheon in New Orleans. The FSMB continues its work, with the assistance of FSMB Past Chair Art Hengerer, MD, with the NAM and its Action Collaborative on Clinician Well-being and Resilience.
In 2022, the Research Department explored ways to leverage insight from FSMB’s comprehensive database on physicians and physician assistants by creating interactive graphics to make physician workforce data more accessible on FSMB’s website. The department has collaborated with regulatory partner organizations to streamline NPBD’s coding process, provided medical boards with customized licensing and disciplinary statistics and explored how continuing medical education (CME) affects physician recidivism.
It should be noted that that we are still in a pandemic (currently facing a highly transmissible variant known as XBB.1.5) and that we continue to follow guidance from federal and state public health officials to be able to deliver our services from Euless, TX, and Washington, DC, and other parts of the country. We are grateful to our approximately 160 full-time employees who are committed to supporting our member boards in any way that we can. We have made significant improvements to many of our services, from Federation Credentials Verification Service (FCVS) to the Physician Data Center (PDC), to the United States Medical Licensing Examination (USMLE) and Uniform Application (UA).
Through the PDC, FSMB supports our member boards in their mission to license physicians by providing secure and accurate physician information. Through the end of November 2022, medical boards queried the PDC 225,229 times and received 15,452 disciplinary alerts; 6,858 physicians have used the FSMB’s Practitioner Direct service to send PDC profiles reports directly to medical boards. FSMB also supports physicians navigating the licensing process by providing services for USMLE Step 3 registration, as well as verified credentials via the FCVS and the UA for physicians and physician assistants applying for licensure.
The past year has also led to many important changes to USMLE processes, including a return to in-person meetings, strong contributions from USMLE advisory groups (such as the USMLE State Advisory Panel and the USMLE Medical Student and Resident Advisory Panel), and, in January, implementation of a new policy of pass/fail score reporting for Step 1. Additionally, pilot work related to assessment of clinical skills (CS) in the remaining portions of the USMLE following discontinuation of Step 2 CS moves forward with staff exploring new item formats around communication skills and clinical reasoning.
In late January 2023, we will co-host, alongside Administrators in Medicine, an in-person meeting in Euless, TX, of the executive directors (or their designee) of the nation’s state medical and osteopathic boards. We are also moving forward with drafting strategic goals and priorities for the FSMB with our Strategic Planning Committee, established by FSMB Chair Sarvam TerKonda, MD, to make sure the lessons learned from the pandemic are applied in a way that we remain helpful and supportive of our member boards.
Finally, I am very grateful to FSMB Chair Dr. Sarvam TerKonda, who has worked tirelessly in his role this year to champion the role of state medical boards and support activities, including actions and services that directly and indirectly benefit our member boards and the public they protect. It has been an honor to work alongside him and our energetic and diverse board of directors, who bring an incredible amount of energy, insight, and wisdom to the FSMB, which this year celebrated its 110th year of service to our member boards.