MEDICAL BOARD CERTIFICATION IMPLIES A DISTINCTION OF EXCELLENCE
Continuous Monitoring Assures High Standards for Medical Board Certification
In this blog, Hugh Greeley discusses the qualifications of medical board certification. The nature of being certified by a medical board would naturally imply that the person has been vetted and meets the prescribed standards of excellence.
There are 24 member boards as part of the American Board of Medical Specialties that certify physicians in the respective specialties. Medical board certification confirms a mastery of the skills necessary to demonstrate competence in the specialty in which the physician holds board certification. In some health care organizations, board certification is required in order to receive privileges.
Beyond the additional training and assessment for competency pertaining to the specialty and subspecialty, what considerations are given to the physician’s moral and ethical standards demonstrated by past and current behaviors?
To sustain medical board certification, physicians are required to participate in continuing education and assessment to stay abreast of the latest innovations in their specialty.
While ongoing education and competency monitoring are actively assessed, monitoring for OIG exclusion, disciplinary actions, criminal behavior, and fraud would assure that the standards of excellence cover skills and knowledge as well as adherence to a level of moral conduct expected of health care providers.
By Hugh Greeley, author of Hugh’s Credentialing Digest
EXAMINING MEDICAL BOARD CERTIFICATION
I often receive questions about the meaning of medical board certification, so I’ve chosen that subject for this blog.
Generally speaking, “medical board certification” connotes distinction, accomplishment, capability, trustworthiness, and competence. Some may suggest that the meaning is limited to confirmation of successful completion of an approved residency and passage of a rigorous two-part examination process, without reference to competence.
LICENSE STATUS AND CRIMINAL BEHAVIOR
Should a physician maintain board certification status if his or her license has been limited or restricted by a state board of medical licensure?
Should one maintain certification status if convicted of a crime? Or if he or she has been subject to successful corrective action by a recognized peer review entity? Or if the physician has been found guilty of deceiving the Federal Government and has been excluded from the Medicare program?
ACCORDING TO THE AMERICAN BOARD OF INTERNAL MEDICINE
The answer appears (in part) to be, “Yes,” according to the American Board of Internal Medicine (ABIM). The organization’s published policies state that it may, at its discretion…revoke or suspend certification or participation in the certification process if:
- The physician fails to maintain moral, ethical, or professional behavior satisfactory to ABIM, or engages in misconduct that adversely affects professional competence or integrity;
- The physician made any material misstatement of fact or omission of fact to ABIM in connection with the application, or to any third party concerning the physician’s certification status; or
- The physician’s license to practice medicine has been revoked, suspended, restricted, or surrendered in any jurisdiction.
REQUIREMENTS OF THE AMERICAN BOARD OF MEDICAL SPECIALITIES
Similarly, according to the American Board of Medical Specialties (ABMS), the question of license status has been answered. The ABMS requirements include the following:
- Licensure and Professional Standing – Holding a valid, unrestricted medical license in at least one U.S. state, territory, or in Canada.
- Lifelong Learning and Self-Assessment – Participating in continual educational and self-assessment programs that meet specialty-specific standards set by the Member Boards. This can include everything from rigorous take-home tests to continuing medical education to providing specific information about new treatments and standards of care.
- Cognitive Expertise – Proving medical and practice-related knowledge through regular, formal examination.
- Practice Performance Assessment – Being continually evaluated to assess care compared to peers and national standards, and then improving care based on findings and recommendations. This can be achieved through peer and patient surveys, patient chart reviews by objective sources, etc.
A SHORT CASE STUDY ON PRACTICING MEDICINE WITH A RESTRICTED LICENSE
All components of organized medicine do not agree that physicians must hold an unrestricted license in order to maintain board certification status. The American Osteopathic Association (AOA) House of Delegates recently approved a resolution, which directs the AOA not to withdraw the certification of a Doctor of Osteopathy (DO) with license restrictions until “all appeals have been exhausted.”
This resolution, which was introduced by the Oklahoma Osteopathic Association, was premised on the contention by the State Association that Oklahoma has more than 60 DO’s who are actively practicing under a restricted license. That means there must be thousands nationwide, and that revoking their certification would adversely affect self-reporting of potential health and other practice problems.
Ronald E. Ayres, DO, former chair of the Bureau of Osteopathic Specialists (BOS) countered that certification is not automatically revoked, but that each situation is investigated carefully. “We understand that many restrictions are minor. But we need the public to know that, if a physician has a restriction on his or her license, we’re not turning our back to it and saying we don’t care.”
Stephen M. Scheinthal, DO, former vice-chairman of the BOS, also suggested, “AOA certification is at the level of excellence, not at the level of minimum competence.” He noted that the phrase, “unrestricted license”, mirrors the language used by the American Board of Medical Specialties in its requirements for maintenance of certification. Lessening the eligibility criteria for Osteopathic Continuous Certification (OCC) could have unintended consequences, he warned.
Presumably, the Bureau of Osteopathic Specialists continues to discuss this issue in order to assist the AOA in determining an optimal position on the issue. In the meantime, medical staff professionals and credential committee chairpersons might take a moment to review their actual practices and their medical staff bylaws. If, for example, the bylaws call for appointees to hold a state-issued license (restricted or not) and board certification, you should determine now how the staff would react if a practitioner were to lose certification as a result of restrictions placed upon a license.
If, as the Oklahoma Association suggests, there are thousands of osteopaths with restricted licenses nationwide, and presumably thousands of medical doctors as well, what actions or changes to policies and procedures should be taken by organized medical staffs?
CONTINUOUS MONITORING IS THE KEY TO ASSURING PROVIDER QUALITY
Unfortunately, the state of the art in many hospitals is such that, unless a practitioner reports that his or her license has been restricted, this fact will not be known until reappointment. Such a situation should not be allowed to continue. All medical staff offices must determine how they will continuously monitor the licensure status of physicians and others on their staffs. If a restricted license could easily slip through the cracks, so too could a revoked license, thus clearly placing both the patient and the reputation of the hospital at risk.
Suggested action: Check your bylaws, policies, and procedures and discuss this potential situation with your credentials chair or VPMA. Determine how best to monitor the license status of your staff with the state medical board continuously.
WHERE AND HOW TO FIND REAL-TIME PRIMARY SOURCE DATA
Verisys Connect® is Verisys’ self-service data search portal that provides real-time data solutions to check current and historical national license status, as well as disciplinary actions, exclusions, debarments, sanctions, and other critical primary source data such as criminal or abuse records.
CheckMedic® is the enterprise-wide, turn-key solution to screening, credentials verification, and continuous monitoring against more than 3,500 primary sources including FACIS®. CheckMedic® issues a MedPass® to each provider and employee as a comprehensive digital credentialing profile for all data, credentials, peer reviews, board certifications, license status and history, and other relevant data. The MedPass® is a secure, portable digital credentials profile and has custom alerts for expirations, CEU requirements, and actionable adverse actions.
Data Insights for Health Care Best Practice is a downloadable whitepaper outlining data sources and how including a larger net of data insights can help protect a health care organization from reputational damage.
Also, the e-book, “Closing the Five Critical Gaps in Health Care Screening, Verification and Monitoring for Credentialing” reveals the data solutions that close the data gaps so often missed and that contribute to organizational risk.
|Written by Hugh Greeley|
Credentialing and Healthcare Industry Expert
HG Healthcare Consultant
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