The Hijacking of Board Certification

Board certification is used across multiple career disciplines as a measure of quality and expertise. Even a superficial computer search of the topic reveals the problems caused by the sale of "bogus" certifications in the educational and financial services arenas.

Nowhere is this of greater issue than in medicine. The profusion of board certifications in varying subspecialties has led to a dilution in the meaning and purpose of certification.

Board certification is not required to practice medicine here in Tennessee. It may be unethical, but it is not illegal to hang a shingle claiming to be a specialist in any field regardless of one's training. Board certification implies that the physician has had specialty post graduate training and has been appropriately tested and retested over time. Board certification indicates that the physician has committed to continuing education and review by one's peers to maintain certification. Board certification goes beyond participation in fellowship training programs and membership in professional societies. However, this process can be easily derailed resulting in unwary patients and clients being harmed.

A well known politician recently involved in a campaign for higher office allowed his board certification in ophthalmology to expire. Instead of committing to the recertification process put forth by the American Board of Medical Specialties (ABMS), he created his own “Board” with a similar name to the genuine board and certified himself. Not candid – not ethical – but not illegal.

Connecticut's Attorney General announced an investigation into the sale of phony certifications in April of 2009. He issued a warning to both Doctors and consumers that these schemes both deceive and mislead potential patients. He noted that "Bogus medical certifications – are dangerous and a disservice to the entire medical profession".

What do we do? Become educated! Develop a zero tolerance to purposefully confusing media hype. The ABMS – our national accrediting agency - issues 25 different specialty board certifications. They also offer subspecialty certification to 113 subspecialties after primary specialty certification. The ABMS was established in 1933 to oversee the certification of physician specialists in the United States. In the 1990’s because of the explosion in medical knowledge "Certificates of Added Qualification" were added to identify subspecialty areas of expertise. These "CAQ’s" are granted only after as rigorous a testing process as primary certification.

In my case, for example, I am currently Board Certified in Plastic Surgery, and have a "CAQ" in Hand Surgery. After I completed my general surgery training in 1993, I also Board Certified in "general" Surgery, but I allowed that certification to lapse since I no longer practice general surgery. Although a large portion of my practice is dedicated to cosmetic surgery and breast reconstruction, there are no Board Certifications or CAQ’s offered by the ABMS for either of these two subspecialties of plastic surgery. If there were, I certainly would commit to obtaining these credentials.  

Unfortunately, nothing short of legislation will halt the deluge of bogus board claims that have now become a staple in the medical advertising marketplace. Ask your Doctor about his or her certifications. Those of us with the real thing don't mind talking about it at all. Then, visit the ABMS website. It is designed to be patient friendly. As President Reagan said, "Trust, but verify".