Rand Paul has another problem

In 2010 Rand Paul explained that he formed the board in 1997 along with 200 young ophthalmologists to protest a decision by the American Board of Ophthalmologists to grandfather those who were certified by 1992, but to limit certification for a ten year period for those first certified after that date. Rand Paul fell within the latter group. He found that decision “discriminatory” and unfair so he set up the NOB along with his wife and father-in-law to certify himself. Despite calling itself “national,” it appears to have operated purely in Kentucky. The board remained in operation until 2000, when it was dissolved. It was reinstated in 2005. Since the certification story broke, the NOB again dissolved in 2011.

In the spring of 2010 stories first swirled around Sen. Rand Paul’s certification as an ophthalmologist by an outfit called the “National Ophthalmology Board,” an entity he founded. This week I discovered that while he continues to present himself as “board certified” the NOB has been out of business since 2011, and in any event, does not under Kentucky law permit him to advertise as “board certified.”

However, it is not clear how that entity would have comported within Kentucky law. Michael S. Rodman, executive director of the Kentucky Board of Medical Licensure tells Right Turn, “The Kentucky Board of Medical Licensure does not  license physicians based on their specialty board certification nor is it a requirement for licensure. ” However, he explained that “Board does address specialty board certification  through our regulation on physician advertising.” Rodman confirmed that if a board is not on the list, then a Kentucky specialist is prohibited from advertising himself as board certified.  That list does not include the National Ophthalmology Board.

A physician in Kentucky and elsewhere can still practice without certification, but since the 1990′s the certification has become increasingly important in the medical field. Beth Ann Comber of the American Board of Ophthalmology tells me, “Board certification, and especially MOC [Maintenance of Certification] participation, by an ABMS-recognized board helps patients make more informed choices regarding their medical care. Today, the internet connects patients with a wealth of physician information, but it’s often difficult for patients to determine where the information on those sites comes from, how the ratings are determined, and where paid advertising stops and unbiased information begins. . . .Certification is voluntary, so physicians who make the choice to participate in continuous learning and quality improvement activities are doing so out of a personal commitment to high standards for their patients and their practice.” Moreover, “there are many hospitals, private practice groups, insurers, etc. that require board certification for staff privileges or leadership positions. Some medical specialty societies also require board certification for membership or offer a special class of membership for board certified physicians.”

Rand Paul continues to perform eye “surgery in his home state, often getting favorable media attention for performing free eye procedures. His profile on the website of the Tri-Star Greenview Regional Hospital, where Paul has privileges, includes the notation “Specialty Board Certifications: Ophathalmology.” Likewise on the Healthgrades  Web site where patients can locate physicians his entry reads: “Ophthalmology, Board Certified.”

Since 2005 Rand Paul has not been certified by any board recognized by the state of Kentucky, and since 2011 has had no certification since the NOB was dissolved. I asked Rand Paul’s staff a series of questions, trying to determine why he still held himself out as a “certified” ophthalmologist:

Did the National Board of Ophthalmology have examinations and/or continuing education requirements? If so, what were they?
How many doctors claimed certification through the NBO? Did they continue to do so or did they obtain American Board of Ophthalmology certification?
When it dissolved, did Dr. Rand stop presenting himself as “board certified”?
The Kentucky Board of Licensure’s list of approved accreditation boards does not appear to include the NBO so why did Dr. Rand believe he had the right under Kentucky law to advertise as board certified? Did he receive an exemption or opinion of some sort from the state licensure board?
Is he continuing to hold himself out as “board certified”?
Has he taken any continuing education since he was originally certified? Since 1997?

I got back a nonresponsive answer that recited his medical school and residency record. As to the certification issue, a Rand Paul spokeswoman would only say:

In 1997, Dr. Paul led a nationwide protest against the American Board of Ophthalmology’s decision to require recertification for younger ophthalmologists, but not for older ophthalmologists. Over 200 young ophthalmologists co-signed a letter with Dr. Paul to protest the policy. When ABO refused to extend their recertification policy to all ophthalmologists, the group formed a competing board certification group called the National Board of Ophthalmology.  The group administered its own certification exam for about a decade, but is no longer active.
NBO is a nonprofit corporation and all who took part were volunteers without salary. Dr. Paul has not profited in any way from this group.
The decade-long battle against a policy that the ABO did not make binding on all members is just another example of Dr. Paul’s willingness to fight against any law or rule that doesn’t include equal protection for everyone.

In refusing to answer the direct questions Rand Paul will prompt further inquiry as to whether he skated around Kentucky law, received appropriate continuing education and represented himself forthrightly to his patients, paid or otherwise. It is noteworthy that he says 200 people signed the letter; he does not confirm that any of them relied on the NBO certification.

Rand Paul is already under fire for plagiarism charges, and has reacted angrily to that story. (“It annoys the hell out of me. I feel like if I could just go to detention after school for a couple days, then everything would be okay. But do I have to be in detention for the rest of my career?”)  His reaction doesn’t bode well for presidential campaign-level scrutiny. At one point he told the New York Times, “To tell you the truth, people can think what they want, I can go back to being a doctor anytime, if they’re tired of me. I’ll go back to being a doctor, and I’ll be perfectly content.” If he does, he would be smart to get certified by the American Board of Ophthalmologists to be fully compliant with state law and give patients the reassurance he’s current on the latest developments in his field.

So long as he is a U.S. senator with presidential aspirations, however, he will need to respond calmly and honestly with controversies about his own actions and record. By providing so little information he guarantees continued scrutiny.