I am firing my family medicine board, the American Board of Family Medicine, through which I have held certification for a long time.
First of all, some clarification: board certification is not required for state licensing. Once upon a time it was little more than a nice fancy title one could put after their name: “Diplomate, Board of Specialty Medicine.” It was a status symbol at one time, much like being named in “Who’s Who in America.”
Physician licensure is maintained by the State, and has nothing to do with board certification. All physicians must must renew their licenses yearly and attest that we have achieved a required amount of continuing medical education. Board certification is generally more related to what kind of original medical education a physician received: were they taught to research and study on their own, or just spoon-fed facts and taught to regurgitate them and take multiple choice exams? Can a physician think on their feet and outside the box?
The problem with many board certifications is that someone along the way decided they are schemes to remove physicians from their money.
Over the years, medicine boards have moved from a one-time passage of board exams to requiring reexamination every few years, and these exams are very costly. Many boards have implemented “maintenance of certification” programs with annual fees. Board exams have been made increasingly difficult in order to sell expensive Board Exam Review Courses prior to the exams themselves, and revenue from the study guides goes directly to the boards. Legislation has also been passed making it difficult, and potentially illegal, for physicians who have recently passed the exams to pass useful information to other physicians about to take them. And there is no recourse for addressing grievances.
In short, the board certification process has, in my opinion, become completely untenable. At least for the American Board of Family Medicine.
Back when my employer expected board certification, and when the insurance companies they billed required the same, I spent the money and was reimbursed at least a portion of it. But when I walked away from hospital employment and opened my own practice, I began working for patients. This forces me to look at those dollars quite differently. Is it truly a good investment for my patients to spend their money for my board examinations, or the costly yearly maintenance of certification programs? Sure, I get continuing medical education credit, but how much of what I am learning (i.e., to pass a multiple-choice exam) can be put into practice and actually benefit my patients?
As it turns out, I believe my patients—my employers—receive very little tangible result from my effort in maintaining that board certification. I can obtain just as much education and updates on treatment from far less expensive forums.
So, there you are: that’s why I am firing my family medicine board. The expense does not provide sufficient benefit for my patients. It is a bad investment. The return simply is not there.
I did get certification through the National Board of Physicians and Surgeons https://nbpas.org/. I did this mostly to support this board in hopes that it will be become recognized where board certification is required (primarily through hospitals and insurance programs, which I don’t play with anyway).
I just want everyone to understand that since I now work solely for my members—not a hospital system, not any insurance companies, not any governmental bodies—I have to consider every payment and every obligation, weighing whether it is worthwhile and beneficial for my “employers.” And I’m willing to bet not one of them cares at all whether I have that ongoing American Board of Family Medicine certification or not.
But they DO care whether I would end up having to increase my fees in order to continue to dance to that music.
So, you will no longer see the words “Diplomate, American Board of Family Medicine” below my name on my business cards. I will be taking down the framed paper that states I have re-certified through 2016. And I won’t have to increase membership fees.
I hope that you all, as my employers, agree with my decision