From the
President
BRUCE A. SCOTT, MD
GLMS President | [email protected]
DO YOU HEAR THE DRUMBEAT?
IT’S GETTING LOUDER EVERY DAY . . .
A
bout 20 years ago I heard a similar
but less sinister cadence as hospital
medical staffs one by one amended
their bylaws to require board certification.
This mandate was theoretically in response
to “public demand” – presumably patient
demand. Back then some physicians pointed
out that there was no evidence to prove
that performance on a written standardized
exam equated to high-quality patient care.
Established physicians already on the medical staff were “grandfathered” so there was
little resistance to the amendments to “protect our patients” and “ensure quality care.”
Many physicians in the past have supported board certification as an indication
of expertise within a specialty, but as the 24
member boards of the American Board of
Medical Specialties (ABMS) have over time
greatly expanded their requirements for recertification physicians are complaining that
the process, now known as Maintenance of
Certification (MOC), has become intrusive,
difficult to comply with and financially burdensome. Physicians particularly object to
the requirement for a secure standardized
written examination. Although, there continues to be no compelling evidence that
ABMS Certified physicians who enroll in
MOC provide better patient care, this expanded certification is said to ensure quality
- all of this again, in response to that “public
demand.” Personally, I have not heard the
public outcry. In my experience many patients remain confused about board certification, and I have never had a patient ask
if I participate in MOC or have recertified.
Now we learn that the Federation of State
Medical Licensure Boards is encouraging
state medical licensing boards to mandate
“Maintenance of Certification” as a condition of “Maintenance of Licensure” (MOL).
The self-regulated ABMS strongly supports
this requirement. Of course, this is the same
group that profits from the standardized
tests and required reporting that are the
basis of MOC.
The concern many physicians have expressed is whether the MOC process and
the reliance upon a standardized written
examination truly measures the quality of
physician-provided patient care. It seems
hypocritical that the ABMS which certifies the credentials of physicians remains
unable or unwilling to scientifically validate the MOC process, much less written examinations, which they recommend
mandating for physicians. Cynics suggest
that the ABMS is motivated by the greatly
expanded revenues generated by the MOC
requirements.
The Kentucky Board of Medical Licensure
(KBML) already requires that physicians
participate in CME to maintain their license.
I don’t necessarily agree with some of the
specific CME courses required by random
legislative actions over the last number of
years, but I believe it is our professional
responsibility to keep our knowledge base
current and strive for continuous improvement in the quality of care we provide our
patients. Hearing the drum beat, the KBML
is considering adding MOC to our licensure
requirements. Given the physician shortage
in Kentucky, which has led to expansion
of the scope of non-physician providers,
perhap