Patients Should Avoid “Re-Certified” Physicians


Although he supports board certification, which signifies successful completion of a rigorous training program, board-certified plastic surgeon Kenneth D. Christman, M.D., writes that demands for periodic re-certification or “Maintenance of Certification” are harmful to patients.

The very expensive re-certification processes and examinations are doing nothing to improve the quality of patient care, he writes in the spring issue of the Journal of American Physicians and Surgeons. Rather, they are enriching the Federation of State Medical Boards (FSMB), the American Board of Medical Specialties (ABMS) and their 24 specialty medical boards, and other constituents of this private nongovernmental regulatory industry, which is not subjected to any oversight or regulation itself.

The largest specialty board, the American Board of Internal Medicine (ABIM), grossed more than $49 million in 2011 from its certification and re-certification business. ABIM and other boards, along with their “stakeholders,” intend to define “quality,” Christman points out.

“As a patient I insist on defining ‘quality’ healthcare for myself… Under my definition of quality, there are only two stakeholders: 1) myself as patient, 2) my doctor,” he writes. Other stakeholders in the “quality” industry include nonprofit foundations, such as the Robert Wood Johnson Foundation and its “collaboratives”; insurers; business councils; and government agencies, including Medicaid. “Over-utilization” is one of their key concerns.

“As a pawn on the [healthcare reform] chessboard, I am soon to be considered an expense item, along with virtually all other citizens and non-citizens. The potential for rapidly escalating costs is so alarming that systems must be built to curtail expenditures while simultaneously using the label of ‘quality,'” Christman explains.

The interface between electronic medical records and specialty board certification will be the method used to enforce rationing, Christman states. The EMR will be used to monitor patients and doctors for “quality assurance purposes,” and doctors will risk losing their ability to work if they deviate from the plan laid out by their specialty medical boards and other “stakeholders.”

The elite who are imposing onerous Maintenance of Certification requirements on other physicians frequently opt out of recertification themselves, Christman observes.

The regulators are engaged in “lifelong larceny, not lifelong learning,” Christman states. Their process for developing care pathways and guidelines is not to be trusted, he observed.

“We should insist that physicians who care for us are those who possess the courage to ‘just say no’ to the board re-certification cartel,” he concludes.

The Journal is the official, peer-reviewed publication of the Association of American Physicians and Surgeons (AAPS), a national organization representing physicians in all specialties, founded in 1943 to preserve private medicine and the patient-physician relationship.

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