While most physicians are genuinely dedicated to constantly improving their skills, increasingly costly bureaucratic demands for recertification may cause many to say “Enough!” just as baby boomers retire and a physician shortage looms.
In the past, board certification was for life, after years of intensive training. For younger physicians, however, the certificate comes with an expiration date. Self-appointed expert committees of specialty organizations are now prescribing more and more requirements that force physicians to spend thousands of dollars and take big chunks of time away from their families and their practices.
In the era of “evidence-based medicine,” these exercises are exempt from any requirement to show that they improve medical care in any way.
Orthopaedic surgeon Lee Hieb, M.D., current president of the Association of American Physicians and Surgeons (AAPS), writes that she had to spend time studying theory of joint replacements, which she never does, instead of focusing on spine surgery, her specialty. Then she needed to hire a lawyer because bureaucrats were refusing to allow her to sit for the examination—for lack of a signature sheet on her application.
“Recertification has become a cottage industry of bureaucrats and testing agencies, dragging with them a few university physicians,” she writes, in the summer 2011 issue of the Journal of American Physicians and Surgeons. www.jpands.org/vol16no2/hieb.pdf
While hospitals all over the country can’t find orthopaedic surgeons to take trauma call, the time of practicing surgeons is being wasted. “Growing numbers of physicians are planning to choose retirement a year or two early rather than recertify,” Hieb observes.
In the same issue of the Journal, Martin Dubravec, M.D., calls board certification/recertification/maintenance of certification “a malignant growth.” www.jpands.org/vol16no2/dubravec.pdf
It has become a multi-million dollar industry with no proven benefit to patients. The clinical relevance of the tests is questionable.
Many physicians are choosing not to recertify. According to the American Board of Internal Medicine, 23 percent of general internists and 40 percent of subspecialists are not renewing their internal medicine certification. “This number will most likely increase as these processes become more expensive and more time-consuming, and continue not to reflect clinical practice,” Dubravec writes.
Some of these bureaucratic agencies are working toward the goal of forcing physicians to recertify to maintain their medical licenses.
A 2009 survey of AAPS members http://www.jpands.org/vol14no1/orient.pdf showed that only 30 percent thought the process of recertification had improved their performance as physicians, and only 22 percent would voluntarily do it again.
“We cannot afford to drive our most seasoned, experienced physicians into early retirement,” stated AAPS executive director Jane M. Orient, M.D. “They simply cannot be replaced.”