Controversy Erupts at AMA over Doctors’ Recertification Treadmill

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At the annual meeting of the American Medical Association, leaders tried to gut or suppress a resolution calling for an end to costly, onerous recertification examinations, but delegates forced consideration on the floor of the House of Delegates, where the resolution passed, reports the Association of American Physicians and Surgeons (AAPS).

“The public needs to understand what this is about,” said AAPS executive director Jane Orient, M.D. “What if you got a time-limited college degree, and 10 years later had to do more homework and pass an expensive and difficult final exam? If you missed a few too many questions, your degree would expire. Then you might suddenly lose your job, and a lot of potential employers would refuse to pay for your work.”

Older doctors who successfully went through advanced specialty training got board certified for life, she explained. But doctors who finished training in the late 1980s or later only got time-limited certification. They are on a Maintenance of Certification treadmill for the rest of their lives. This is claimed to be “voluntary,” but those who decline to participate, or who fail a high-stakes exam may lose hospital privileges or insurance panel membership. Their hospitalized patients lose their trusted doctor, and patients can’t get insurance coverage for that doctor’s care.

“There is no evidence that re-certified doctors are any better than ‘grandfathered’ doctors, or those who didn’t make it over their specialty board’s hurdles,” Dr. Orient said. “But the process generates huge revenues for the testing industry, and assures that doctors are forced to study the treatments that elite ‘guidelines’ committees want them to use.”

The AMA’s Reference Committee attempted to weaken the proposed Resolution, but the one that ultimately passed after strong advocacy by many delegates, especially the Florida and Pennsylvania state medical associations, reads:

“RESOLVED, That our American Medical Association call for the immediate end of any mandatory, secured recertifying examination by the American Board of Medical Specialties (ABMS) or other certifying organizations as part of the recertification process for all those specialties that still require a secure, high-stakes recertification examination.”

The American Board of Medical Specialties (ABMS) immediately fired back, claiming that continuing medical education is not enough. The AMA’s official rejection of the proprietary recertification process “erodes the public’s trust,” said an ABMS memorandum urging reconsideration of the new AMA policy.

“It erodes the bottom line of the self-appointed elites,” Dr. Orient said, “but for doctors who prefer to dedicate their time and energy to their patients, it is incredibly good news.”

The Association of American Physicians and Surgeons (AAPS) is a national organization representing physicians in all specialties, founded in 1943.

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