Proponents of the American Board of Surgery's maintenance of certification initiative gave the program a spirited defense during a town hall meeting titled “Maintenance of Certification: Is It Really Worth It?” held Wednesday morning at the American College of Surgeons' annual clinical congress going on in Chicago.
With maintenance of certification
, the American Board of Medical Specialities—of which the American Board of Surgery is one of 24 members—is replacing recertification exams that physicians take every few years with a process promoting “continuous professional development and assessment.”
The congress program guide's description for the 7 a.m. session set the tone for what could have been a confrontational affair.
“Today, the new rules for Maintenance of Certification (MoC) are time-consuming and costly,” the program guide stated. “Many surgeons are asking for a cost benefit analysis to explain the need for such a program. … As expendable income continues to fall, fellows will make critical decisions about where they are going to spend their hard-earned dollars.”
In his opening remarks, session panelist Dr. Tyler Hughes, a surgeon from rural McPherson, Kan., let attendees know where he stood.
“You're not making decisions for thousands of surgeons,” Hughes said of his role as an ABS board member. “You're making decisions for millions of patients.”
Dr. Danny Robinette from Fairbanks, Alaska, was another panelist, and he said that “a lot of my colleagues have much angst about” the MoC program, but he hadn't found it too time consuming. That said, Robinette added that he would like the ABS to be more open in what to expect regarding MoC and for individual surgeons to have some input into how the program evolves.
Dr. Mark Malangoni, ABS associate executive director, noted that board certification and maintenance of certification are voluntary and that the board is seeking to align its requirements with state medical boards and other regulatory agencies to eliminate duplication of efforts. “Our job is to make it as least burdensome as possible, that's the philosophy,” he said. “Hopefully, it will get easier over time.”
He added that the ABS MoC fees were lower than any of the other 23 boards, which was not entirely correct. The ABS charges $1,250 and that covers up to five attempts at the exam. The American Board of Pediatrics charges $1,125. But that covers only one attempt at its test. The American Board of Neurological Surgery is the most expensive at $5,550.
When asked if the program was cost-effective, Hughes replied that he didn't know, but also said that he knew doing nothing was not. He added that surgeons who know the right thing and then do the right thing at the right time would not have patients spending eight weeks in the intensive-care unit recovering from a surgical error.