The man behind MOC defends the program against critics
Board certification has always been a standard that is higher than licensure, and people who hold it are proud to hold it because it’s higher than licensure. They could have gone out after one year of training in most states to independent practice, and most of them didn’t, because they wanted to learn more and be able to say they had acquired a set of skills.
It used to be that lifetime certification was a great way to do that. But with knowledge changing as fast as it does, it becomes pretty important to know who’s staying current.
ME: What about the cutoff date? That’s not going to change at all under this announcement you made today?
RB: When a certificate is issued, we make commitments that we keep. So when we issued certificates before 1989 we said those would be lifetime certificates, and they are.
When we issued certificates after 1990 we said they would not be lifetime certificates, and they’re not. Part of what we started to do in 2014—and this was also something we heard a lot from younger doctors—was, ‘Wait a minute, how can anyone tell the difference between me, with this time-limited certificate, and this person who got a certificate in 1980, and for all you now hasn’t done anything?’
So we still report those people as certified, but we report separately whether they are participating in the maintenance of certification program, and we do that for precisely that reason. A number of so-called grandfathered doctors have signed up for the maintenance of certification program, because they want to have a way of saying to their patients, ‘I’m staying current. I’m at the top of my game, I’m practicing today’s medicine.’ We don’t make them do that to still report them as certified, so that’s not changing.
ME: Is there any evidence that certification, or lack of certification matters to patients?
RB: Absolutely. I think patients are desperate for high-quality information about doctors and who they’re seeing. Lots of doctors say to me, ‘no patient has ever asked me whether I’m board-certified.’ Well first of all, lots of patients I talk to say ‘I go on the internet or I look at the directory, and if that doctor’s not board-certified I don’t go.’ Lots of people tell me that. They’re not asking the doctor because they already know before they came.
So yeah, I think patients do care about it. I think patients don’t look too deeply the way doctors do at what’s behind the credential. But I think they respect it a lot more deeply than they do Yelp reviews.
ME: It kind of makes you wonder how the 20% of doctors who aren’t certified are staying in business?
RB: Well as I say, I think it’s very market-dependent, And there are places where people are practicing and situations where people are practicing where they are filling a need. And someone says ‘I may not be as pushy here as I otherwise might have been.’