The FSMB is an elite, highly influential, secretive private organization. We also believe that it is thoroughly corrupt. ANH Action Alert!
Each of the fifty states, as well as the District of Columbia and the US territories, has laws that define the practice of medicine; each one delegates the authority to enforce those laws to a state medical board. State medical boards also adopt policies and create guidelines related to the practice of medicine. They have the power to revoke physician licenses for violating the state’s laws of the practice of medicine—subject to the boards’ interpretation of the law, which can be highly arbitrary.
The Federation of State Medical Boards (FSMB) is a private 501(c)(6) trade association that purports to represent the seventy state medical and osteopathic boards of the US and its territories, and cosponsors the United States Medical Licensing Examination. It is tremendously powerful: whatever it suggests in terms of medical care policies are often adopted by the state medical boards. A private trade association with no public funding, transparency, or accountability arguably has the power to interpret state medical law and grant or revoke medical licenses! Ever wonder why it’s so hard to find a doctor who will prescribe bioidentical hormones or administer chelation therapy? We believe it’s because the FSMB has made it such a career risk for the doctor to use his own independent judgment.
So far as we can tell, it seems that the FSMB was infiltrated in the late 1990s by the so-called “quackbuster” contingent—people openly hostile to complementary and alternative medicine. At the 1996 annual meeting of the FSMB in Chicago, there was a radical shift from a focus on health fraud as defined by the federal government (overbilling, un-bundling, and kickbacks) to another definition of health fraud: alternative medical care. It seems a concerted effort to label innovation in health care—and especially any natural treatment that competes with an emphasis on drugs and surgery as the ideal for modern medicine—as mere “quackery.” (In fact, at just one session of that meeting, Dr. William Fleming—a member of the FSMB’s board of directors, and chair of its Ad Hoc Committee on Health Care Fraud—used the word “quack” or “quackery” 139 times.)
Since then, the FSMB has challenged integrative medicine as being outside the “standard of care,” defining the term to suit its own purposes; in this, the organization mirrors and amplifies the American Medical Association’s antipathy toward integrative medicine. Because practicing outside the standard of care is grounds for a state medical board to revoke a doctor’s license, the attempt to exclude CAM therapies from the standard of care is a major threat to consumers’ access to integrative doctors. For years we have seen integrative doctors being harassed and charged by their state medical boards for practicing outside this bogus standard of care when what they have really done is posed a competitive threat to conventional medicine, at a time when conventional medicine is doing a great deal of harm and really needs competition. You may also recall our story last month in which the FSMB participated in a biased anti-chelation event, attempting to define chelation therapy as health fraud.
The Milwaukee Journal Sentinel and MedPage Today recently reported that the FSMB asked for $100,000 from Big Pharma to help create and distribute the organization’s new policy on pain medication to their 700,000 practicing doctors. The federation won’t say how much money it received from industry, but estimated that it will cost $3.1 million for its campaign.
And what is this campaign? To get the word out about “safe” use of opioid analgesics in the treatment of chronic pain! That’s right, FSMB’s new policy favors the use of opioids for long-term pain management, despite an epidemic of painkiller abuse and addiction (not to mention the terrible crime rates that accompany it)—and a lack of scientific support for this use of the drugs.
If you think drug manufacturers might be pleased to contribute to such a campaign, you would be right. The University of Wisconsin, with funding from Purdue Pharma, the maker of OxyContin, developed a continuing education course for doctors based on the FSMB’s manual. This is the drug company that in 2007 paid $600 million in fines in settlement of a guilty plea for having misled doctors and patients when it claimed that the drug was less likely to be abused than traditional narcotics.
So if we used to be puzzled about the FSMB’s motives in attacking integrative medicine, this latest move has made it clear that a good part of it may just be about the money.
Last Tuesday, the Senate Finance Committee launched an investigation into the close ties between pharmaceutical companies, the FSMB, and “nonprofit pain groups” like the American Pain Foundation. The Foundation received 90 percent of its $5 million in funding in 2010 from the drug and medical device industry, and its guides for patients, journalists, and policymakers downplay the risks associated with opioid painkillers while exaggerating the benefits from the drugs.
Tuesday morning, two senators from the Finance Committee sent letters to the American Pain Foundation and four other pain nonprofits, three drug companies, and the FSMB, expressing concern about their relationship with each other. Tuesday evening, the Foundation announced that it would “cease to exist, effective immediately.” Coincidence?
The senators also asked about any influence the drug companies had on a 2004 guide for doctors about pain that was distributed by the FSMB, based on guidelines by the American Pain Society and on the American Pain Foundation’s Military/Veterans Pain Initiative.
The US Centers for Disease Control and Prevention report that opioids were involved in 14,800 overdose deaths in 2008, more than cocaine and heroin combined. So much for “safe use.”
How much money does the FSMB take in total from industry? How does it use it? Who really runs the FSMB? What exactly is its relationship with the American Medical Association? With the so-called Quackbusters? With state medical boards? These are all questions that need answers. In the meantime, ANH-USA will continue to monitor the state medical boards that seem to have been heavily influenced and turned against natural medicine by this rogue organization.
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