Dr. Sonny Morton: This is How You Become a Slave

This is an edited version of a Substack essay first posted on Dr. Sonny Morton’s personal Substack, Fuel for the Free Mind. Click here to view the original post in your browser.

What does a revolt look like?

I received an email the other day, a request to e-sign one more bureaucratic form that allows me to keep practicing medicine. It was a routine permission slip, giving permission for one health care bureaucrat to send my information to another bureaucrat. But attached was this statement:

This document has been updated to include attestation to this statement as required by NCQA: I understand that I am attesting to my lack of present illegal drug use.

Now, the question of whether I do drugs is beside the point. I possess state licenses from medical boards that ask the same question, and I answer it. Those boards have a tenuous but real interest in such things, even though there is no evidence that casual drug use makes any difference in the quality of care provided. There are questions NCQA could ask that are much more relevant to my professional competence: how much alcohol I consume, do I engage in theft, do I obey traffic laws and use my seatbelt... Most important of all, how do I treat other people?

So, who is the NCQA (National Committee for Quality Assurance) anyway, and what gives them the right to ask this question? From the NCQA website:

Our Mission: Improve the quality of health care.

Our Vision: Better health care. Better choices. Better health.

NCQA:

Points the way to health care that science says works.

Studies how well health plans and doctors provide scientifically recommended care.

Identifies organizations that are run in ways that make care better.

The NCQA is a 501(c)3 organization founded in 1990 to measure and accredit health plans. After 35 years of mission creep, they now require that I answer personal questions that are irrelevant to the quality of care I provide and none of their business. They get away with this intrusion by abusing their control over the payment system. If I don’t answer, my bills don’t get paid.

I could write an article every week about the indignities involved in dealing with health care bureaucrats. My purpose here is to point out that this is how we become slaves to the bureaucracy. This little example will require a small amount of time and, for some people, a little white lie. But this is not the only example. Our practices are full of examples of the invasion and micromanagement of our lives by forces beyond our control. Other examples:

• Being in arrears on child support is enough to deny a medical license in some states (how does one pay child support if you can’t work?)

• Many of the decisions about what continuing medical education I take are made for me by state legislatures and medical boards that are lobbied by special interest groups. I waste time and money studying things that have no relevance to my practice.

• DEI and other politically motivated indoctrination is shoved down our throats as a requirement to practice

It goes on. Stop and notice how often you are asked to do something that the entity asking has no right to ask. You should be alarmed.

We have lost control of our profession, and this is what it looks like. We need to get cranky about it. But how? This is tough, and I understand that in most cases people cannot afford to take risks with their career. In my situation, I am mostly retired and see patients two or three days a month. I would like to keep doing that for a few years, but what the hell… I will make some suggestions, but the most important thing is to notice what is happening and to begin to think in terms of resisting it.

Is there a professional society that might take up the cause? Can you organize some type of passive resistance within your company or work group? Finally, there is “I will not comply.” All of these carry risks and you must consider this risks. The entire process depends on no one paying attention or taking the time to complain. Notice the infringements and look for situations where you can make a stand. At least, resist the incursion and drag it out, increasing the hassle factor involved in getting compliance from you. Encourage others to do the same. Get cranky!