Internal medicine organizations survey internists on maintenance of certification

Internists say most important reasons to recertify are to improve professional image and update knowledge

PHILADELPHIA -- (Jan. 3, 2006) A survey of internists--physicians practicing internal medicine--whose board certification was up for renewal in December 2002 found that the most common reasons for participating in recertification or Maintenance of Certification (MOC) were to maintain professional image and update knowledge.

The survey findings report that 59 percent of general internists and 60 percent of subspecialists participated to maintain their professional image. Additionally, 51 percent of general internists and 60 percent of subspecialists participated to update their medical knowledge.

The survey results are summarized in an article, "Who is Maintaining Certification in Internal Medicine -- and Why? A National Survey 10 Years after Initial Certification," published in the Jan. 3, 2006, issue of Annals of Internal Medicine and available at http://www.annals.org/cgi/content/full/144/1/29.

The survey was conducted by the American Board of Internal Medicine and the American College of Physicians to identify factors that influence participation in MOC and explore how diplomates (physicians board-certified in internal medicine and its subspecialties) perceive the value of the program.

The impetus for this study was that ABIM estimated that about 77 percent of internal medicine generalist physicians and 86 percent of internal medicine subspecialty physicians with time-limited certificates participate in MOC.

Specifically, ABIM estimated that 23 percent of general internists and 40 percent of internal medicine subspecialists were not renewing their internal medicine certificates, and 14 percent of subspecialists were not renewing their subspecialty certificates.

Board certification is not mandatory but is required by many employers to gain privileges to practice.

ABIM and ACP sampled a group of 3,500 diplomates with a response rate of 51 percent. While about half the respondents reported that at least one employer required board certification, only about one third gave employer requirements as a reason to participate in the recertification program.

Of those who did not participate or chose not to renew their certificates, the most common reason was that recertification takes too much time.

"ABIM's MOC program has evolved to address the concerns that many internists have about participating in a recertification program," said Christine K. Cassel, MD, ABIM president and chief executive officer. "We want to make this program effective for our diplomates by reducing redundancy and encourage participation by communicating how maintaining one's certificate can improve the quality of care delivered."

"ACP believes in lifelong learning and professional accountability through recertification," said Steven E. Weinberger, MD, ACP senior vice president for medical knowledge and education. "The survey shows that internists who recertify do so not only to improve knowledge but also to improve the quality of patient care."

While 91 percent of the internists surveyed were still working in internal medicine or its subspecialties, the proportion was lower among generalists (79 percent) than subspecialists (96 percent). The survey did not ask why these doctors left internal medicine.

"We will try to determine this in our next survey, as well as track the attitudes and impact of the new enhancements to MOC for our diplomates," said Rebecca Lipner, PhD, ABIM vice president of psychometrics.

Several survey questions assessed internists' attitudes toward MOC. These found that 69 percent of general internists felt that internists working in direct patient care should be certified, and that peers and patients perceive board-certified physicians to be more competent than non-certified physicians.

Among internal medicine subspecialists, 72 percent felt that allowing their certification to expire would adversely affect their careers, that internists working in direct patient care should be certified, and that peers perceive board-certified physicians to be more competent than non-certified physicians.

ABIM's MOC program is designed to evaluate both medical knowledge and practice performance in addition to a secure exam. To ease the burden on physicians, ABIM has collaborated with groups such as ACP and other medical organizations to offer credit for modules developed outside of ABIM.

Such collaborations reduce the time needed to complete MOC and allow physicians to gain CME credit through society affiliation. ABIM and ACP will continue collaborative efforts to provide periodic surveys assessing the impact of continuous MOC enhancements for diplomates.

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The American Board of Internal Medicine (ABIM) is an independent, not-for-profit organization that grants board certification a marker of physician quality in the United States and internationally -- to internists and subspecialists. Certification is a rigorous, comprehensive program for evaluating physician knowledge, skills and attitudes to assure both patients and payers that a physician has achieved competence for practice in a given field. Individual physician certification results may be found at www.abim.org.

The American College of Physicians is the largest medical-specialty organization and second-largest physician group in the United States. Membership includes internists, related subspecialists, and medical students. Internists specialize in the prevention, detection and treatment of illnesses in adults. ACP, publisher of Annals of Internal Medicine, provides educational programs and products to help enhance the quality and effectiveness of health care.

NOTES TO EDITOR:
Because of the holiday hiatus (ACP and Annals of Internal Medicine are closed the week of Dec. 26), please use this contact information:

Dec. 19-23, Lynda Teer, ACP
215-351-2655 or 1-800-523-1546, ext. 2655

Dec. 19-30, Veronica Jones, ABIM
215-606-4120 or 1-800-441-2246, ext. 4120

An embargoed PDF of the article, "Who is Maintaining Certification in Internal Medicine -- and Why? A National Survey 10 Years after Initial Certification," and interviews can be obtained by calling contact numbers above


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