Physicians who have proudly hung their specialty board certificates planning not to give them another thought for at least seven years should think again. The American Board of Medical Specialties is formulating a plan for boards to continually scrutinize their diplomates and assess their actual performance rather than just test their knowledge base. The move to up the ante for maintaining a board certificate comes amid increased public demand for proof of doctors' competence and a simmering turf struggle between the boards and the AMA's accreditation program. Whether accountability or competition is the prime impetus for the move, many board leaders see broader and more timely assessment of certified doctors' competence as critical to the boards' continued relevance. But something will replace it if the boards don't improve the processes after that point.
People expect more from their physicians than just knowledge.
We need to be more accountable than we are now. The current process, required recertification, is proving outmoded before it even really gets off the ground. Time-limited certificates, only now coming due for the first time among a majority of the 24 ABMS member boards, are guaranteed for seven to 10 years. That time lag and heavy reliance on cognitive exams makes recertification inadequate for ensuring competence in today's health care environment, according to some critics. Work groups are weighing various assessment methods and debating how patient outcomes, quality improvement initiatives and physicians' lifelong learning could be incorporated into the certification process.