David A. Johnson, Humayun J. Chaudhry Lanham, MD: Lexington Books. 2012.. 357 p.$80.00 hardcover; $36.00 paperback; $30.00 Kindle edition.ISBN: 978-07391- 7438-8.
Email: gro.htlaehecneserp@xeurt.ronaele, Medical Library, Presence Saint Joseph Hospital-Lakeshore, Chicago, IL
Copyright : © 2014, Authors.David A. Johnson and Humayun J. Chaudhry's surprisingly engaging Medical Licensing and Discipline in America: A History of the Federation of State Medical Boards was published to commemorate the centennial celebration of the Federation of State Medical Boards (FSMB). It opens with the infamous John Brinkley, known for transplanting live goat testicles into men in order to “cure” impotence, and segues neatly into demonstrating how vital licensure and discipline continue to be for the medical profession and the general public. The authors pepper the book with many other such examples, making the dry remote process of licensure absorbing and pertinent to the reader. The thesis is laid out quite clearly in the introductory chapter: “[to] focus on the evolution of medical practice, education and regulation in North America from the 1600s to the 1800s, [with the remainder of the book] focusing on the formation, evolution and growth of the Federation and its continuing role on behalf of the nation's seventy state and territorial boards” (p. 2).
Readers may not have considered that the current conventional process to become a doctor was anything but business as usual in medicine until fairly recent times. Instead, each element presented a struggle for the medical profession and reflected the struggles that the United States had as a young nation. History, politics, culture, and human nature pervade this book, taking a potentially dull subject and rendering it fascinating, at least to this reader. The book also covers issues still relevant today, such as impaired physicians, immigrant medical graduates, the shifting physician-patient dynamic, maintenance of licensure, appropriate methodology to evaluate candidates, and transparency to name just a few of the issues explored here.
By shifting from state- to federal-level developments, the authors make each phase of the FSMB's growth in scope and authority clear. The book is laid out chronologically, with mostly clear, concise writing that does become pedantic at times. Medicine touches every aspect of the human condition, so it is not surprising that state and federal law, politics, geography, and even culture play into this narrative, creating sections that can be intimidating to absorb.
This book takes the broad and long view of medical licensure and its governing bodies, despite its deployment of anecdotes to liven the narrative. It is not a topic written about frequently in book form. Ruth Horowitz's In the Public Interest: Medical Licensure and the Disciplinary Process (Rutgers University Press; 2012; ISBN: 978-0-8135-5426-6) would be the best basis for comparison. In the Public Interest presents a more personal experience as the author is a member of two state boards, critiques the structure of the FSMB and its member bodies, and provides strategies to change the federation in the name of the public good. These two books actually complement each other, with Johnson and Chaudhry's providing background and history and In the Public Interest providing an insider's perspective.
Each of the eight chapters contains an extensive bibliography. There are several appendixes featuring an acronym list, the original constitution and bylaws of the FSMB, its original charter members and charter fellows, a list of past presidents and executive committee members, a list of current fellows of the FSMB, and finally, sample board questions from the Missouri State Licensing exam from 1906 (which is fascinating in itself).
The licensing of medical practitioners is a complex and, at times, unwieldy process. Much the same could be said of this book. It is a dense, rich source for any medical library and not solely because it fills a reference gap. The active clinician is not going to have an urgent need for this resource, but any hospital that has a residency program or an active and engaged continuing medical education program would benefit from adding this comprehensive book to its collection.
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