Should U.S. Physicians be Forced to Continuously Renew Board Certifications?

By Dr. Brian Dixon

|Apr 22, 2019

Board certifications used to last a lifetime. But medical boards argue it’s better for patients to require doctors to renew certifications every decade.

Doctors are worried that pricey professional board certification testing costs will continue to skyrocket, worsening our physician shortage and endangering healthcare in America (in addition to also causing a major headache for everyone).

Why revise an already-high standard?

Board certification used to signify that physicians had not only successfully completed residency (intense on-the-job training) but could "sit" and take a national test to show that their knowledge was equal to every physician in that specialty across the country.

The label "board certified" demonstrated to patients and physicians alike that the doctor in question was qualified in that specialty.

In the era of hospital and doctor online reviews, the public has more ways than ever to assess the quality of their physician's care. Unfortunately, the medical profession hasn't kept up. At a time when organizations should bring increased clarity to the medical profession, they choose obfuscation.

The rising cost of board certification

The ABMS (American Board of Medical Specialties) is the non-profit company governing other specialty-specific non-profit companies who control the tests that physicians take to become board certified. Here's the issue: costs for these tests have been going up for years without reason.

Physicians are generally a docile bunch when it comes to politics. But when the ABMS decided to double dip, all hell broke loose.

The initial board exam was costly and high-pressure. The ABMS — in conjunction with hospitals, med schools, legislatures, and insurance companies across the country — held initial board certification as the standard for hiring and paying a physician. We all fell in line because we had to. Tests cost thousands of dollars to take and require thousands more to study for.

But once you passed the test, you were set for life.

In steps the new problem

Then the ABMS created maintenance of certification: MOC.

Overnight, they nullified our initial board certifications saying that we have to retest every 10 years in addition to a whole bunch of random things that don't actually improve patient care. Worse, they "grandfathered" older docs, saying that they can keep their initial board certification for life.

Requiring physicians to renew board certifications every 7 to 10 years:

  • Costs already-qualified physicians thousands in additional expenses ($$$)
  • Threatens physicians’ ability to work
  • Jeopardizes academic positions
  • Hinders physicians from being paid by insurance companies

Physician autonomy is worth the fight

Now, doctors are fighting back. I vocally refuse to participate in MOC and will continue to state that I am board certified because I put in the time, money, energy, and effort to become board certified for life.

Recently, my board, the American Board of Psychiatry and Neurology, has been named in a lawsuit arguing that they are essentially creating a monopoly that should be considered illegal. Fortunately, as a direct-pay practice, I'm not being pressured by insurance companies to pay for MOC.

Time for a new, smarter standard

Right now, our battle is against MOC. But at the end of the day, the long-term answer isn’t just reverting back to the old model. U.S. healthcare finance is all out of whack, from how patients pay for care to the hoops physicians have to jump through just to do their job.

How do we begin to create sensible physician governance with high educational and medical standards that doesn’t exploit medical professionals for money?

As Dr. Wes Fisher, the physician who started a GoFundMe to support legal action against the maintaining MOC, says,

“It is critical working physicians see the legal battle against MOC® for what it is: not a campaign against continuing medical education, but rather a campaign against the massive runaway train of economic exploitation, self-enrichment, and micro-management of our professional lives that are now the hallmark of ABMS and its member boards.”

Please, let doctors be doctors. This situation just adds further evidence to the case for rethinking U.S. healthcare finance. Get involved and join the movement.

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About the author

Dr. Brian J. Dixon

With accolades spanning my career as a child psychiatrist, entrepreneur, writer, and public speaker, I advocate for a more sensible U.S. healthcare solution that appeals across all party lines. I am a Texan, born and raised. My psychiatry practice, Progressive Psychiatry, is based in Fort Worth.

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