Table 1 Revised functions of national medical Boards in a market-based regulatory system

Recognition of the validity of training or experience represented by degrees or qualifications conferred locally or elsewhere

Prevention of well-qualified candidates accepting job offers agreeable to informed local medical employers and insurers

Maintaining a national register of qualified practitioners, who pay a nominal initial fee (only) for that service

Charging practitioners high annual fees solely in return for official permission to continue practising

Investigation of complaints involving professional misconduct, with the power to suspend or disqualify a practitioner from registered status if guilt is proven beyond reasonable doubt

Blocking registration for well-qualified practitioners with no track record of proven misconduct, for no reason other than that a filed complaint has not yet been evaluated by another Board

Developing mechanisms to ensure that practitioners do not over-service the patient community to an extent that is cost-ineffective, e.g. by making unfounded claims or otherwise creating excess demand

Making continued professional practice contingent upon costly and time-consuming compliance with prescribed educational activities of assumed but unproven relation to medical competence or public safety

Building transparent bridges with international regulatory partners by developing accessible online databases of complaints and disciplinary procedural outcomes

Invoking notions of privacy and confidentiality, in any setting, as a means of maintaining opacity and non-accountability, whether to the profession itself or to the public