A curious idea came into my head the other day. A concept,
really, as it furnished itself into a full blown thesis. You might ask what the
thesis was about. That…
Man is meant to fly!
Looking at those creatures that take flight under their own
power, the answer would be no. Man therefore was not meant to fly. That then is the original antithesis.
Yet when I look at the airplanes, man has learnt to utilize
material to allow himself to fly through the air. True that! And recently the
Jetmen who flew over Dubai, suggests that man is coming closer to the original
hypothesis of man is meant to fly. This then is the new synthesis.
The dialectic proceeds and furthers our notion that we as
humans go boldly “there” wherever “there” is because it is there. The original
thesis continues to be reframed by the antithesis. The mind forces
the world and brings it to its knees. Space and time are forced through the
dialectic of a mind into substance and causality. And eventually the antithesis
reforms the original thesis; “Man is meant to fly but with an assist!” This
might change in the future, since there are antithetical arguments already in
place to re-synthesize the newly reformed thesis.
The universal paradigm of giving birth to a thesis also leaves a
constant trail of evocative pebbles in its wake. Not every concept takes flight after all. Each pebble a “run in with the
antithetical monster,” is a constant reminder of how the world is shaped. Each
pebble an outcast, lost in the whirlwind of the antithetical argument, never to
realize its goal. In golf there is a truism about putting, “Not up, not in.”
That is true for the discarded pebbles in the trail of a shaped reality. One such fresh pebble lies behind our last footstep, forced by the antithetical force of
truth and finds itself heaped in the basket of ruined thought.
This thesis that lies bleeding, by a thousand cuts, is
the Maintenance of Certification (MOC) requirement for physicians. Here the
thesis propounds some fallible arguments pitched only by the conflicted souls of
the organization. The originators of the MOC, ABIM/ABMS, claim there is a need for MOC and the importance of MOC is
for the benefits of the patient care; public good is implied. Hidden, but
recently revealed, is that there is no benefit to either the patient or the
physician from MOC compliance, except only to the agency (the ABIM/ABMS), that
collects millions of dollars in fees pays the officers handsomely in 7-figures and then plows the remainder into the ABIM Foundation.
The only correlate that I can find to the MOC phenomenon is
a malignant leukemic cell that thrives in its micro-environment where it is fed
by supporting cast of other like-minded cells to prosper and proliferate at the
detriment of the host. Sad but true. That is the Yin and Yang of life. To kill the beast or perish under its weight.
The antithetical argument to MOC seems to have found its stride. MOC
was never meant to be helpful to the patients and their physicians - this much is well established. The
original tenet was faulty! The antithesis is robust. Hence no synthesis is
possible. A human response antidote is needed. The dialectic is fractured. The
vein of fiction is ruptured and the vessel exsanguinated. There is no life to
support here. The EKG is flat lined! No breath, no pulse, nothing! The thesis
is dead!
Move on!
But, “No,” say the enriched tarnished brass pining for the
polish to shine, “The MOC is dead. Long live the MOC.” Apparently the new/old
thesis has not been fully realized by the players yet. The old verified and
validated thesis being, “CME is still king.” NBPAS (National Board of
Physicians and Surgeons) seems to understand that very well and so do most 97% of the physicians (based on a SERMO survey).
“Move On!”
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