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Posts published in “Day: May 11, 2023”


I have only had one occasion to file a complaint against a colleague with the Idaho State Board of Medicine. They rebuffed me with a dismissive, “This is a local standard of care issue, handle it in your community.” My community colleagues had no backbone to address the poor care. I left the community. A year later the person practicing medicine was finally sanctioned for another incident by the Board.

I offer this preface because you need to know, the Idaho BOM and I don’t always see eye to eye. Prior experience tells me this complaint will not be welcome either.

I hereby file a complaint with the Idaho BOM against the Idaho legislature, and our governor, while we’re at it, for the crime of practicing medicine without a license.

It takes quite a bit to get me riled up. I don’t always approve of choices my colleagues make when they provide care, but I can accept that what we do is a “practice”, and the variations within that practice, when studied, can guide us toward best practice.

Indeed, the Idaho Medical Practice Act defines the “practice” of Medicine:

The investigation, diagnosis, treatment, correction, or prevention of or prescription for any human disease, ailment, injury, infirmity, deformity or other condition, physical or mental, by any means or instrumentality that involves the application of principles or techniques of medical science…

Patients come to doctors for many reasons. I do my best to understand their complaints and provide care.

I remember a young woman who came to me with what I thought a trivial complaint. She was young, attractive, but had very coarse and prominent body hair. It darkly covered her forearms. She had a dark mustache she plucked. She said it afflicted all the women in her family, but she had researched an antiandrogenic treatment and asked me to prescribe it. I told her I would study it and get back to her. I did.

The drug blocked the effects of androgens, male sex hormones. It had been developed for the treatment of prostate cancer. But I found studies where it had been used for this young woman’s condition with significant benefit. After a week of study and contemplation, I called her to come back so we could consider this treatment.

I tell you this so you can consider what the Idaho legislature and our governor have just done. They have, by the heavy hand of the law, forbade me from considering a treatment for my patient.

No treatment, other than counseling, for a young person under the age of 18 who suffers from their gender may now be prescribed by a medical practitioner under the penalty of law.

The Idaho legislature and our governor have decided how medicine should be practiced in this state. The Idaho BOM should take heed.

I don’t know the best treatment for gender dysphoria. I have seen patients who struggle with this condition. I do my best to treat them with respect, knowledge, and wisdom. But now, I must also treat them with the consideration of prosecution. Is this the Idaho I love? Is this the community that cares for each other?

There are many issues the struggling youth must address. There are issues their communities must address. But passing laws about what treatments are available doesn’t seem a healthy way to proceed.

The Idaho legislature and our governor have proclaimed they know the best way to practice medicine. The Idaho Board of Medicine needs to assert their authority. Statutes clearly describe the penalties for practicing medicine without a license. Drop that complaint in the Attorney General’s lap. We all know where that would go.

Just because you know the enforcing authority won’t act doesn’t mean you shouldn’t voice your complaint.