"Grandfathered" Board Certification? Fair or Unfair? Legal or Illegal?
Is it fair that the older board certified physicians do NOT have to undergo MOC (maintenance of cerfitication) or re-certificaton because they have been 'grandfathered' in?
Is it legal to do this? Is it ethical to do this? The intent of MOC and re-certification is to maintain or increase the quality of healthcare, but if you exempt a large number or percentage of physicians from the process, are you really doing the public any good? I feel that if a specialty organization requires its members to participate in the MOC or to re-certify, then all of its members should have to participate in the process. Elitism has no place in modern medicine and older physicians should undergo the same oversight and evaluation as younger physicians. ****************************************************************************
The certificate that was at one time a mark of special distinction is now required to make a living. The ABMS has actively fostered this trend, and as a result is now in the position to charge whatever they want for something you have to have. One of the wisest senior clinicians I ever knew told me (in a different context) "Beware of those who create the need for themselves". The unfortunate recertifiers have a lifetime of ever-increasing fees to look forward to, the proceeds of which will be used to create more and more hoops that they have to jump through. I refuse to apologize for not having to participate in this rat race. I would urge those that are required to recertify to consider banding together and boycotting the whole process. It needs to be torn down and reconstructed.
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Okay. I'm an old guy; I don't have to take the recertification exams.
But what's wrong with you youngsters? First, no one has ever proven that recertification does, indeed, improve the quality of health care. It's a speculation. Possibly a valid one. But not proven. Second, why is it that you youngsters put up with it? Certification and recertification has created a multi-million dollar industry whose major goal isn't improvement of health care: the goal is to continue the growth and profitability of this multi-million dollar industry! Do they have to justify the enormous costs of the examinations? No. Do they have to justify the physicians' travel costs, lodging and meals? No. Do they have to justify the length of time these recertification exams take away from patient care? No. While the medical boards cannot quantify just how much recertification exams improve health care, they can quantify how they arrive at the costs of the examinations. Will they do that? Of course not. In my estimation, a recertification examination should cost no more than $50 or $100. That medical boards should be able to design effective examinations that a doctor can take at leisure in his home in front of his computer screen. As each question is answered, the system should easily be able to tell the doctor if the chosen answer is right or wrong, and it should be able to supply educational facts and reasons for the correct answer, along with educational facts and reasons about any selected wrong answer. For no cost beyond that initial $50 to $100, the doctor should be able to re-take the examination again and again until he passes. But, again, the agenda of the medical boards is not education and improvement of health care. The agenda is to maximize the income the boards receive from those examinations. So why do you youngsters so blithely plunk down your money and proceed down the recertification path? ****************************************************
One malpractice study indicated that board certification has a high loss ratio than fully trained non-certifide physicians.
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I absolutely agree - the whole concept of this self-created for-profit "board certification body" and those of it's ilk - like JCAHO - are all about the MONEY - and nothing to do with anything else, except stripping away more of our autonomy and control over medicine and medical decisions and practice. Why we put up with it I don't know. Perhaps it's something to do with the fact that it's being crammed down every residents throat as another "prize of recognition", who's very nature is that of a competitive being. I for one, after two residencies and two fellowships have had enough of these damn expensive, prove-nothing "board exams" and will not take another! We DO need to organize and educate the young residents that it's NOT LEGALLY necessary to practice medicine - unless they all do it - then it will become so. SPREAD THE WORD BROTHERS & SISTERS! NO MORE BOARDS !!! 20 years of training and other LEGAL exams should be enough!
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One malpractice study indicated that board certification has a high loss ratio than fully trained non-certifide physicians.
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