I’m responding to the argument that doctors should be forced BY LAW to provide OCPs, or coumadin, or appendectomies, or any specific service. As I’ve already stated many times, there is NOTHING in the state medical codes that require this,

Technically, you are correct. However, if you set yourself up as an OB/GYN and then refuse to provide one of the basic services for which women go to OB/GYNs you will find yourself in difficulty very quickly. First, you’ll lose patients very quickly. I wouldn’t go to an OB who wouldn’t provide OCP even though I don’t use them for birth control. There are other indications for the use of OCP such as…well, can you name a few? If you’re past the first year you should be able to. Second, you’re going to get sued for failing to provide care that meets the standard of care for gynecology in the US. Unless you can justify your decisions through citations in the peer reviewed literature that indicate that, for example, condoms are a better choice of birth control for, again as an example, a 20 year old woman in a monogomous relationship with a family history of ovarian cancer seeking highly effective birth control. Technically, you could send her to another OB who is willing to prescribe OCP, but then you’re losing patients again. Finally, you’re betraying your patients and your profession by refusing to do what is right for your patients. In the end, if you’re any kind of decent doctor at all, the good of your patients must come first. Not your religion, not your social conscience, not your profit margin, not your paper count. If you can’t put your patients’ interests before all that, then go into another field.

It works on a state by state basis, but there are several states where you apply for medical licensure immediately out of med school.

Which ones? And are you talking about a permanent license or a resident’s license? I’m prepared to believe that there are states that don’t require the USMLE, but I find the idea that some states don’t require an MD (or DO) highly unlikely. Hence, a med student would not have applied for his or her license yet.

Wow. You really are headed for a major malpractice suit someday, aren’t you?

Your examples have nothing to do with what I’m talking about. I’m responding to the argument that doctors should be forced BY LAW to provide OCPs, or coumadin, or appendectomies, or any specific service. As I’ve already stated many times, there is NOTHING in the state medical codes that require this, and there is no parallel for this precedent in any other licensed profession.

So my orthopedic surgeon could spend his days doing pelvic exams rather than knee surgery because nothing in his license requires him to practice the area of medicine that he’s trained and skilled in? That’s pretty scary.

Yes, he could. State medical licenses give you an unrestricted scope of practice. Theoretically, a FP could start doing brain surgery. There’s nothing in the state medical codes that prohibits that. However, a myriad of other protections keep it from happening. One, a FP could never get operating privileges at a hospital to do brain surgery. Two, his insurance company would drop him if they found him working outside his scope. Three, every neurosurgeon in the state would raise a ruckus and he would be publicly shunned/humiliated. Four, the obvious medical malpractice case would rise against him.

BTW, every person who graduates med school is well qualified to do pelvic exams. Its a pretty simple procedure. Hell, even associates degree nurses do them nowadays and they do a fine job. If your example of the orthopedic surgeon is supposed to show that he’s not qualified to do pelvics, you are mistaken. If your example was supposed to show that the ortho doing pelvics means he’s sexually assaulting women for no medical reason, then thats where medical malpractice and criminal law come into play. But its ridiculous to write a law stating that orthopods cant do pelvics, or REQUIRE them to do knee replacements.

I guess that’s why you’re only supposed to go to board-certified physicians, because doctors like you are convinced that they not only don’t have to fulfill the basic requirements of their jobs, they can do any other doctor’s job without having to have the actual training or certification to do it.

WTF are you talking about? You obviously dont understand what “board certified” means. It regulates intra-disciplinary, not inter-disciplinary competencies. You’re just making up BS now. I never said I was qualified to do whatever I wanted with no training/certs.

Or are you under the impression that the Basic Certification of Obstetricians and Gynecologists exam includes a section about family planning and contraception on the assumption that it’s a topic that will never come up in the course of a doctor’s normal practice?

Again, its the difference between requiring basic competency in a subject vs FORCING you to provide a particular service, two entirely different things. I’ve got no problem with the oral boards failing an ob/gyn who doesnt know enough about OCPs to script them properly. If the oral boards cover the subject of IVF and an applicant cant pass that subject, then by all means fail them. But board certification in any field DOES NOT require you to offer all of the services under that umbrella.

You are obviously out of the loop. It works on a state by state basis, but there are several states where you apply for medical licensure immediately out of med school.

You obviously didnt read this thread. I never said anything about medical malpractice suits. Thats an ENTIRELY DIFFERENT ANIMAL than government regulations FORCING docs to script certain drugs or do certain procedures. Its the difference between a doc getting sued for medical malpractice for failing to intubate a patient in respiratory failure VS state law which says all doctors must do intubations. Surely you can see the distinction. Medical malpractice suits are a fine instrument which teases out the particulars of individual patient scenarios. Laws forcing docs to provide OCPs, or IVF, or intubations are extremely blunt instruments with no place in society.

Unless things have changed drastically since I was a medical student, med students are not required to pass state licensure. Indeed, they generally can’t be licensed until they’ve graduated and passed the USMLE. Methinks that there’s something odd about “med student”…

Forcing ob/gyns to prescribe is in no way analogous to the regulations guiding other professions.

So by your rationale:

Psychiatrists do not have to prescribe anti-depressants or anti-psychotics to mentally ill patients whose lifestyles they disapprove of, even if those drugs are medically indicated.

Cardiologists do not have to prescribe anti-clotting drugs to heart patients whose lifestyles they disapprove of, even if those drugs are medically indicated.

Internists do not have to prescribe antibiotics to infection patients whose lifestyles they disapprove of, even if those drugs are medically indicated.

Surgeons do not have to remove the burst appendixes of patients whose lifestyles they disapprove of, even if removing that appendix is medically indicated.

Wow. You really are headed for a major malpractice suit someday, aren’t you?

Have you read the medical licensing statutes? I have and I was tested on them. There is NOTHING in those statutes requiring doctors to script certain classes of drugs, or offer particular procedures.

So my orthopedic surgeon could spend his days doing pelvic exams rather than knee surgery because nothing in his license requires him to practice the area of medicine that he’s trained and skilled in? That’s pretty scary. I guess that’s why you’re only supposed to go to board-certified physicians, because doctors like you are convinced that they not only don’t have to fulfill the basic requirements of their jobs, they can do any other doctor’s job without having to have the actual training or certification to do it.

Or are you under the impression that the Basic Certification of Obstetricians and Gynecologists exam includes a section about family planning and contraception on the assumption that it’s a topic that will never come up in the course of a doctor’s normal practice?

You obviously dont understand what I posted. Go back and read it again. The FAA says IF you choose to fly a certain plane, you have to meet certain requirements. It does NOT say that every pilot must operate a certain kind of aircraft. Requiring all doctors, or all OB/GYNs, to script a particular class of drug is analogous to the FAA declaring that ALL pilots must fly a certain type of plane. Lets use drivers licenses for example. If you want to be a truck driver, then you are required by law to get a CDL. But it does NOT require you to get a regular DL, motorcycle DL, etc. In other words, you have the choice to decide which kind of service you are going to offer. Forcing ob/gyns to prescribe is in no way analogous to the regulations guiding other professions.

Seriously, the more you chatter, the less you seem to understand about how the world actually works. You’re going to get yourself into deep trouble with a licensing board someday if you don’t educate yourself about this stuff.

WTF do you know about medical licensing boards? Did you pass the medico-legal jurisprudence exams? Did you successfully apply for state licensure? I have, and I’ll put my knowledge and experience of medical licensing boards up against yours any day of the week.

Have you read the medical licensing statutes? I have and I was tested on them. There is NOTHING in those statutes requiring doctors to script certain classes of drugs, or offer particular procedures. Thats left to the discretion of the individual physician. Thats the way pilots, accountants, lawyers, social workers, truck drivers, and every other licensed professional operates and thats the way it should be. What some of you are describing is a fantastical fascist state where the government dictates all facets of practice. Thank god we dont live in that world.