All Entries Tagged With: "board certification"
Poll question: Reimbursing for practitioner certifications
The American Board of Medical Specialties approved a new medical specialty for treating child abuse last month. This move highlights the importance practitioners place on regulating their work through certification programs. Medical staffs also value certifications and sometimes make them a privileging requirement.
In this week’s poll question we want to know if your organization helps pay for these certifications. Take the poll below and see how your facility compares to others.
More talk of board certification
Yes, folks, the conversation regarding board certification as a measure of physician competency is till rolling. More of your colleagues have written in to share their opinions. Here’s what they have to say:
“Board certification is obviously one item of many that should be considered in the evaluation of a physician, either at initial appointment or at re-appointment. However, that is not its only purpose. More important in this discussion is whether a hospital medical staff should require board certification, independent of any use for credentialing. Requiring board certification makes a statement to the medical staff, to the board, and to the public that the hospital is trying to be the best that it can be. That institutional attitude counts for a lot.
“Our own healthcare system is going to be visited soon by the investigation team for the Baldridge Award. Why should we try for such an award? Just the effort needed to apply for the award makes a statement about the institutional attitude, whether or not we receive the award. Cultivate that attitude, build and expand on it, and let that attitude be expressed in everything we do. The plaque on the wall, the congratulatory letter in the doctor’s file, the monthly newsletter announcement that one of our doctors recently was re-certified: all of these help to tell the world who we are and what we stand for. Just as important is that they tell us who we are.”
~Van Swan, MD
Presbyterian Medical Group
“Rather than the idea that medical staffs and boards do not consider that certification is a reflection of physician competence, I believe they are reluctant to enforce the regulation for other reasons. I have seen these groups not enforce the decision at the time of appointment or reappointment because the physician was needed or has been a loyal colleague. For the most part, the regulations began with grandfathering of the current medical staff membership, which may make some believe an unfairness exists. I believe that the few hospitals that enforce this requirement have an higher quality medical staff. Even though I was in an administrative position in 2000 at the age of 70, I re-certified in internal medicine. This did require the appropriate time commitment, something that busy practitioners may find difficult to do.
“I also have noticed that committees or boards sometimes opt to extend deadlines for individual medical staff members to pass their boards. We had a bylaw that indicated the requirement to have board certification or the equivalent. The equivalent was hard to define and carry out. A member of our bylaws committee suggested a procedure that he had seen in the orthopedic association that required a review of office records. This did not work out.”
~Francis M. Wilson MD, FACP
Retired Chief Medical Officer
St. John Health
You can find more food for thought about board certification here.
Board certification conversation still going!
The conversation regarding the relationship between board certification and physician competence continues! I’ve received several more e-mails, so I thought I’d share what your colleagues have to say.
“I believe that expiration of board certification occurs for various reasons not related to competency. It seems ludicrous to assume that a practitioner’s competence diminishes if he/she does not recertify. The measure of true competence should not be confined to board certification, and in fact that runs contrary to CMS conditions of participation.”
~Jill Jourden, CPMSM
Medical Staff Administration
Saint Francis Memorial Hospital
“My hospital established a board certification requirement in 2002. It requires all physicians to obtain board certification within five years of completing their residency or fellowship. All members, with few exceptions, are required to maintain board certification. When the bylaws amendment was created, a grandfather clause was included for those physicians who did not qualify for board certification. Most of those physicians have retired from staff by now. We’ve had a few physicians challenge the bylaws. One physician went as far of the state supreme court. We’ve had physicians who left the medical staff because they failed their board exams, allowed their certifications to lapse, or chose not to recertify at the end of their careers. All of these issues have been dealt with thoughtfully by the medical executive committee. At times, enforcement of the bylaws can be difficult, but consistency is the key.”
~Anonymous
“Board certification, within itself, does not prove physician competence. It is simply one measure, one tool if you will, to determine whether or not a physician is qualified to perform in a particular specialty. Other considerations such as training, experience, teaching, and continuing medical education should also be considered when evaluating a physician’s competence. Our medical group believes that board certification provides a unique and widely accepted measurable objective upon which to base decisions. We have mirrored our internal policy to that of surrounding hospital and insurance carrier partners.“
~Sheri Wahl
Manager, provider credentialing and enrollment
UT Medical Group, Inc.
I’d love to hear your thoughts! Keep the comments coming in!
Join the conversation: Board certification and competency
Little did I know how many responses I would get when I included a news bite in this week’s issue of Medical Staff Leader Connection regarding a new study that explores the relationship between board certification and privileging!
A study in the Archives of Surgery suggests that hospitals do not consistently require physicians to be board certified to receive privileges. Out of the 109 hospitals that were surveyed, only 5% required surgeons to be board certified when they received initial privileges. In addition, 82% of all hospitals surveyed allowed surgeons ad non-surgical subspecialists to retain privileges after their board certification expired.
Here are some of the comments you had to share:
Sales of fake medical certifications under investigation
The Connecticut Attorney General is investigating complaints from the American Board of Internal Medicine and others about the illegal sale of fake medical certifications, according to an April 8 ModernHealthcare.com article. The certifications are allegedly being sold by Keith Alan Lasko who targets foreign-trained physicians unfamiliar with authentic certification organizations.
The certifications come from false organizations such as the American Board of Geriatric Medicine and the United States Medical Specialists Federation.
ABMS sets new standards for life long learning
The American Board of Medical Specialties (ABMS) is putting increased focus on life-long learning for physicians. It has created a new set of standards for its maintenance of certification (MOC) program, which will be implemented over the next three years, according to a March 26 ABMS press release. These standards raise the bar for CME activities and require physicians to better document those activities.
“The ability to respond to the needs of the public while keeping pace with the growing field of physician performance measurement requires a dynamic continuous certification process,” said Kevin B. Weiss, MD, president and CEO of the ABMS, in the press release.
On one hand, I can see some physicians rolling their eyes as they think “Great, something else I have to document and be measured against.” But on the other hand, doesn’t it make sense that in the rapidly evolving medical field, we make life-long learning a requirement? The key may be to ensure that whatever the ABMS and other certifying bodies require of physicians coincides with or complements Joint Commission and medical staff requirements.
Check out the conversation about board certification on the Hospitalist Leadership blog.
Battle of the boards – are all created equal? (cont’d)
The American Board of Internal Medicine (ABIM) recently took a stance on what it views as “phony” certification boards, stating that it is concerned about the welfare of patients who may be misled by physicians who display their board certification as being equivalent to the American Board of Medical Specialty certification programs. Although the American Board of Hospital Medicine (ABHM) was not identified specifically, the ABIM mentioned “hospital medicine” as one of the certification groups that may be “fraudulent”.
New board for hospitalists, part II: Things aren’t always what they seem
Our January 15 blog post highlighted a news release from the American Board of Physician Specialties revealing the new American Board of Hospital Medicine. But things aren’t always what they seem.
After that initial press release, Society of Hospital Medicine (SHM)’s President Pat Cawley, MD, sent an email notification to its members two days later, stating SHM has no ties to ABPS: “The Society of Hospital Medicine is in no way affiliated with the American Board of Physician Specialties and was not involved with the creation of the so-called American Board of Hospital Medicine,” said Crawley in the press release.
Board certification sets the bar
Many hospitals have medical staff membership criteria that require board certification believing that such a requirement sets the bar for public acceptance of quality clinical care. I’ve seen medical staff bylaws that (1) identify which boards are acceptable, (2) set the time frame for obtaining board certification, and (3) require maintenance of board certification in the primary clinical practice area. All in all, pretty straight forward.
As with anything else in the creative world of credentialing and privileging, criteria does not all answer all the questions nor is it constant. For example, my last post was about a new certification program for Hospitalists. I’m fairly certain that we will not find any medical staff bylaws that address that particular board nor will many even mention “hospitalist” as a recognized specialty. Most likely there will be a medical staff (or credentialing) policy that addresses how new privileges, new specialties, and new certification programs will be handled. That seems manageable.
Recently I learned that the American Board of Sleep Medicine has suspended the administration of a sleep medicine examination (actually ceased after the 2006 exams). Instead, a number of American Board of Medical Specialties certification programs began offering exams in sleep medicine (American Board of Internal Medicine, American Board of Psychiatry and Neurology, American Board of Pediatrics, American Board of Otolaryngology, and American Board of Family Medicine).
This may be an appropriate time to check your medical staff bylaws, policies and procedures, and review medical staff membership criteria to see if any changes or modifications are necessary.
MSPs know that keeping up with an ever-changing environment is critical to success. It’s nice to know we have information available to us to help ups along this path.
Carole La Pine, MSA, CPMSM, CPCS