Today I finished the last part of my Internal Medicine recertification. I can't say I was pleased by the process. Although I understand the need for some kind of certification process to guarantee physician competency, I think the American Board of Internal Medicine is going about this in all the wrong way.
To complete the boards recertification, I had to sit for an 8-hour examination (fine), and then do 100 hours of learning modules (not so fine). It's one thing to have to sit for a test every 10 years to prove you know what you are doing. But for the Board, taking an exam wasn't enough. I also had to complete 100 credit hours of personal study modules in addition to the exam. And it is those study modules that I want to complain about.
First of all, it's not as if I just sat for the test. Far from it. I studied for months to prepare for that exam. But studying for, taking, and passing a fairly difficult exam wasn't enough for the Ol' Board. They had to lay some lard on that there butter. So they added a whole additional array of requirements for recertification. Just a bunch of stuff I could knock out in my free time. On top of maintaining a legal medical license. And practicing medicine every day. And fulfilling the 20 hours of medical education I have to complete (and document that I have completed) annually to stay licensed in the state of Mississippi.
The truth is, I learned little or nothing from these modules, and my time would have been much better spent studying areas in medicine directly related to my practice, rather than doing a series of learning modules that really didn't apply to the type of medicine that I do.
My cynical self finds it easy to believe that the Board added all this additional material simply so they could charge me more money for board certification. It's easier to justify charging several thousand dollars for a test when you throw in a whole lot of busywork as lagniappe. And busywork is just what I found it to be. The Board tries to emphasize evidence-based medicine, and yet, there isn't a whit of evidence that 100 hours of board learning modules will improve the medical care my patients get. In fact, I can assure you it won't.
It's too many hoops to jump through. I already have to devote a large amount of my energies as a physician to maintaining compliance with the many, many, many federal rules that are now imposed upon the practice of medicine. I have to deal with insurance issues, documentation issues, and hospital demands in my routine practice. In the last few years I have seen regulations explode in every area of medicine, while the amount of time that I have to comply with them all remains fixed.
(And for you Obamahaters, don't blame this on Obamacare. These regulations have been gradually set in place over many years. They have more to do with insurance companies saving money than with the most recent flavor of health care reform.)
The American Board of Internal Medicine is supposedly composed of physicians. You would think that a group of physicians would look for the least time-consuming method to ensure physician competency, especially knowing as they should all the other bureaucratic problems we face in routine medical care.
Understand that I'm not suggesting that no regulation is needed. Only that the burden of regulation should be kept at a level that is proven to benefit patients, and not at the level the Board of Internal Medicine would like it to be in their dream world. No matter what, the number of rules I have to comply with to keep that diploma on my wall should not rest solely on the judgment of people whose job security depends on more and more regulations rather than fewer and fewer.