A few weeks ago, I interviewed Jane Orient from the Association of American Physicians and Surgeons (AAPS) regarding a lawsuit the group filed against the American Board of Medical Specialties (ABMS) over the latter's maintenance of certification (MOC) process.
I wanted to give equal time to Lois Margaret Nora, MD, JD, MBA, president and chief executive officer of ABMS, for her perspective on the issue. Nora said she was "happy to speak at any time about the significant value ABMS member board certification brings to patients, their families, and the medical profession."
Is the matter of whether or not a voluntary MOC program should continue one that needs to be decided in a court of law?
Lois Margaret Nora:
ABMS member board certification is voluntary. Patients and members of the medical profession, including physicians who choose to participate in the MOC program as well as hospital and other healthcare decision makers, rely on certification and MOC as benchmarks of quality. The patients who rely on it are in the best position to judge the value of the program. The evidence demonstrates that from the patient’s perspective, "board certification genuinely means something." Board certification and MOC speak to, and are tools which build, "patient trust." Patient trust is crucial in the physician-patient relationship.
Critics charge that board certification has recently begun to replace the "license to practice medicine" as the standard of competence in a way which harms competition.
Board certification and medical licensure are different and I never expect that certification will replace licensure. Board certification is an important way of providing information to a patient, but it is not the only way of establishing that a physician is worthy of patient trust. Board certification is a voluntary program that supplements other means of evaluating quality. The fact that many hospitals rely upon board certification as a standard of excellence speaks favorably of the program’s value.
Can you cite an example where the absence of a system of board certification might negatively affect patient choice?
Yes. Board certification is a system that provides professionals, hospitals, and patients with information about physicians’ qualifications. Without board certification, there would be less information available for decision making. We believe hospitals and patients appreciate the fact that a voluntary system is in place which provides relevant information about a physician’s adherence to the highest standards of excellence.
What about the situation alleged by the AAPS regarding certain highly qualified physicians? I believe the example was a physician who runs a charity clinic caring for thousands of patients, but who lacks the time or resources to devote to maintenance of certification?
I really can’t comment on the specific allegations in the lawsuit. However, what I can say is that ABMS and its member boards work very hard to make board certification both relevant and valuable. Physicians are very busy and need to balance all of the demands of today’s medical practice; we believe that ongoing learning and assessment are important elements of continuous professional development for all physicians, even in our very complex practice environments.
Editor's Note: ABMS Maintenance of Certification is a registered trademark.