Boards

The neurology boards are coming up on March 24. I have to take those every ten years. They test me to make sure that I'm a competent neurologist.
Hyperkalemic Periodic Paralysis is a channelopathy in which there is a problem with sodium channels whereas Hypokalemic Periodic Paralyis has a potassium channel defect. Thomsen's disease (Paramyotonia Congenita) has a chloride channel problem. The other one is something something with myokimia. It is a calcium channel disorder.
I can bet my house that I will never see any of these diseases. I can bet my car that there will be at least one question asking one of those facts. So I've memorized it. I have to read twenty books that are between two hundred and three hundred pages and memorize most of them for this very annoying test. About 30% of it will be about these types of things. The other 70% will be about things like Stroke, Epilepsy, Neuropathy, Parkinson's and other things we actually see in practice.
The people who become very prominent academicians do research most of the time. They spend their entire lives researching something like Periodic Paralysis. So they find it kind of hard to imagine that someone exists who doesn't know the details of it. It's hard to ask them not to write any questions about it.
It's annoying to study for this test though.
One thing that no one wants to accept is this: it's pretty much impossible to figure out which doctors are good or not. You can "board certify" us. But that really only means that I'm pretty good at memorizing these twenty books. It doesn't mean anything about how good I am at what I do. You can measure patient satisfaction. It's been shown that this is a valid measurement. But that doesn't tell you anything about diagnostic accuracy. You can measure if people follow guidelines or not. But guidelines have been studied and shown to not necessarily reflect best medicine. (Guidelines don't take into account patients, which may have multiple conditions). I guess there is some degree of satisfaction that there is some minimal degree of competence if a person passes a test. But the problem is that people don't really know how well the test reflects the quality of care someone can provide.
How are we supposed to know if our doctors are any good? It's a really vexing question. As "consumers" (patients) we're really not in a very good position to evaluation this because we can't judge the fund of knowledge required. There isn't a consumers report either.