Authored by Jeff Morris via RealClearDefense,

According to the Association of the U.S. Army, the crisis of doctor shortages has been increasing for years, which negatively affects military readiness. Their own report cited the inability of the Army, Navy, and Air Force to recruit and retain enough doctors. As the number of military physicians has consistently decreased, the armed services have been forced to close some hospitals, to lower other hospitals to clinic status, and to use nurses and technicians as “physician extenders.”

More recently, leading U.S. physicians have spoken out about the largest healthcare monopoly in the country that we have ever seen, which also involves our medical residency programs. This too affects military readiness.

A renowned doctor recently wrote an OpEd in the Wall Street Journal scratching the surface on this crisis. He described how the private American Board of Medical Specialties (ABMS) acts like a regulator, hamstringing physicians with endless fees, paperwork, and testing.

Not only doctors are sounding the alarm. Adam Candeub, leading antitrust attorney and current General Counsel to the FCC, stated in his white paper titled The American Board of Medical Specialties: Certification and The Need for Antitrust Enforcement, that “board certification serves as medicine’s gatekeeper.” He went on to say that “competition among organizations providing these certification services drives innovation and lowers healthcare costs. The domination of the American Board of Medical Specialists (ABMS) over certification is dramatically raising certification costs and indirectly accreditation costs throughout medicine, decreasing access to physicians, increasing already exploding medical budgets, and reducing healthcare innovation.”

The urgent issue is this self proclaimed “Gold Standard and Gatekeeper” has created the largest monopoly in physician care that we’ve ever seen. All the while contributing to our current and growing physician shortages. It is important to note that testing is a key component that ensures physicians meet the very standards needed for higher quality care for all Americans. 

The ABMS has long been working with the Accreditation Council on Graduate Medical Education (ACGME) to corner the market on physician board certification. Their collusive relationship, which began when ABMS co-founded the ACGME, can be considered one of the root causes of physician shortages throughout the country, the military, and within key specialties. The impact can be seen in every aspect of our health care system, greatly contributing to shortages in specialties within primary care, especially access to much-needed specialties for 21st-century medicine throughout rural America. These include emergency and integrative medicine as well as family medicine obstetrics.

In March, the Republican leadership of the House Judiciary Committee’s antitrust panel launched a probe into the nation’s medical residency system. The ACGME was one of the organizations asked to provide documents to the Committee along with the AMA and major universities. U.S. Representative Scott Fitzgerald (R-WI), said “for years, resident wages have remained stagnant while doctor shortages have increased, which harms medical students and hospital patients, and forces us to rely on foreign talent to fill the gap.”

With the Trump Administration’s mandate to end bureaucracies and monopolies within our healthcare system, Congress and HHS need to act now. The collusive activities of the ABMS and the ACGME have suppressed innovation and restricted access across the country. In addition, their bureaucratic control has gone beyond that of federal agencies such as HHS, as they now hold the Defense Health Agency under regulatory capture. This resulted in limiting our military’s ability to access much needed physician care. This drastically impacts not just military personnel, but global readiness. 

Many have spoken on the impact on maternal care, as pregnant servicewomen and military spouses often have to travel hours away or even back to mainland U.S. for months at a time to have their baby alone.

Now more than ever we need Congress and HHS to investigate the root causes of doctor shortages which in turn helps strengthen our military. 

Jeff Morris, JD is CEO of American Board of Physician Specialties.