The reason, he says, is medical licensure, hospital regulations, and insurance regulations are in three separate titles of law in Oklahoma. The bill was written in the licensure title of law, but specifically named hospitals and insurance companies. However, the hospitals and insurance companies didn't think the law was applicable to them.
Rather than go through a legal battle with hospitals and insurance companies, the Oklahoma Medical Society, and the bill's sponsor, Rep. Mike Ritzke, MD, rewrote it to prevent any loopholes. As such, the two entities drew out the hospital and insurance lobbies against the bill and Beller says it hit a brick wall. Currently, the Oklahoma Legislature is working on a budget shortfall that has to get squared away before other issues — such as MOC — get worked out.
Beller says he doesn't have a problem with physicians on staff at a hospital deciding whether or not MOC should be required for re-certification, just administrators. Yet this stance, in Oklahoma and in many other communities, has pitted the physicians against the hospital, in an odd battle of provider interests.
A prominent example of this contrast between physicians and hospitals is in Oklahoma's neighbor to the south, Texas. The Texas Medical Association and the Texas Hospital Association were active voices on different sides of the debate over Texas Senate Bill 1148. The bill would prevent hospitals and healthcare facilities from requiring MOC as a way to credential, hire or fire physicians, with the exception of academic medical centers and comprehensive cancer centers.
In the proverbial battle between hospitals and physicians, there was a definitive winner. The bill was passed and signed into law by Texas Governor Greg Abbott in June, and will go into effect at the beginning of next year. Like in Oklahoma, Texas' bill was sponsored by two physicians, Sen. Dawn Buckingham, MD, an ophthalmologist in Austin, and Rep. Greg Bonnen, MD, a neurosurgeon in Friendswood, Texas. Carlos Cardenas, MD, president of the Texas Medical Association, says the law will empower medical staffs at the affected healthcare providers.
"It stops the discrimination against physicians who elect to skip the process and it more specifically prohibits the state from using [MOC] as a requirement for licensing or renewal. It brings back autonomy for medical staffs to make a decision about whether or not to use [MOC]," he says.
Those who have been following the various state-wide efforts, such as Fisher, say it's the strongest law passed against MOC thus far. In Michigan, Edison says the results in Texas are exciting and inspiring for other states trying to get legislation passed. Kim Monday, the outspoken advocate who testified on behalf of the bill in front of the Texas Legislature, offers advice to others looking to follow in their path.