Doctors Say New Recertification Rules May Worsen Physician Shortage!

To maintain specialty certifications, physicians of all ages must now complete a complex set of requirements every two to three years. Certification boards contend the new process will ensure doctors are up to date on the latest medical advances. The American Board of Medical Specialties indicates that this is important since medical knowledge doubles every 8 years.  More than 16,000 doctors have signed an online petition urging medical specialty boards to do away with the new requirements. 

By Roni Caryn Rabin , Kaiser Health News.

doctor icon imagesMany specialists are balking at what they say are onerous new rules to get recertified, warning the demands will force some physicians out of practice at a time when the nation faces a shortage.

Doctors say the new requirements have made maintaining specialty certifications a never-ending process. Younger doctors already retake an arduous exam every seven to 10 years to keep their credentials, long considered the gold standard of expertise, but physicians of all ages must now complete a complex set of requirements every two to three years.

Certification boards contend the new process will ensure doctors are up to date on the latest medical advances, but many physicians dismiss this as meaningless, expensive and a waste of time. Certification is voluntary, rather than a condition of licensing, but doctors view the credential as increasingly important at a time when consumers, employers and insurers are demanding measures of quality.

More than 16,000 doctors have signed an online petition urging medical specialty boards to do away with the new requirements. Some older physicians — once board certified for life and exempted from the periodic exams — say they may simply retire.

“I’m at an age where, if anybody does anything to force me to participate, I’d say, ‘Adios.’ I’d retire,” said Dr. Marc Frager, 65, of Boca Raton, Fla., who is board certified in internal medicine, nuclear medicine and endocrinology and cares for elderly patients, most of whom are on Medicare. “It should be a concern to the health care system. Who’s going to take care of the patients?”

Lisa Mancuso, a board-certified anesthesiologist in Hartsville, S.C., says the new rules will make it even harder to attract physicians to rural areas, especially if hospitals and insurers require the certifications.

“They have a hard enough time bringing younger, well-qualified physicians to these rural areas, and if they tie maintenance of certification to hospital privileges, it will exacerbate the problem of not being able to attract specialists,” she said.

The biggest pushback has come from the Association of American Physicians and Surgeons, which last year sued the American Board of Medical Specialties, and accused the organization of restraint of trade.

It cited the case of John Eck, a 64-year-old family practice physician in New Jersey who lost his hospital privileges three years ago because he had not kept up his board certification in family medicine.

The conflict comes at a time when the credential is increasingly relied upon as a quality indicator. Many consumers check a physician’s board status before making appointments, and some medical centers and insurers require maintenance of certification for doctors seeking hospital privileges or entree to networks.

“Right now, for better or for worse, board certification is one of the best quality indicators we have,” said Leah Binder, president and CEO of Leapfrog Group, an employer-based coalition that advocates for greater health care quality and safety.

Until the 1980s, most medical specialties granted certification for life; physicians took the exams only once after completing their training.

Over time, most of the 24 specialty boards started requiring recertification every 7 or 10 years. This year, the standards became even tougher for internal medicine and many other specialties and require nearly continuous activities. This is in addition to fulfilling state licensing boards’ requirements for continuing medical education credits.

“Medical knowledge doubles every eight years, and having a process where a physician does something once in their professional lifetime or every 10 years just doesn’t seem to cover what physicians need to know to take care of their patients,” said Dr. Mira Irons, senior vice president for academic affairs at the American Board of Medical Specialties, the group that owns the certification program.

While the exams test knowledge, the new requirements are geared to ensuring that doctors integrate that knowledge into their practices.

Physicians may be asked to review patient charts to see how many of their diabetic patients are getting recommended eye exams, or how many female patients had a mammogram recently. Or they may be required to survey fellow physicians.

Some doctors say the process has not been shown to improve practice, however.

“From the day you enter medical school, they put certification up on a pedestal like it’s a holy grail,” said Dr. Jonathan Weiss, 52, a physician in upstate New York who is board certified in three areas. “Now all of a sudden, doctors like me who have just done this without questioning it are saying, ‘Wait a second … None of this makes me a better doctor.’ ”

Kaiser Health News is an editorially independent program of the Kaiser Family Foundation.

We know that there are many doctors who are not familiar with Ehlers Danlos Syndrome. If continuing medical education is reduced, will there will be fewer opportunities for them to learn about EDS?

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