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To certify or not to certify, that is the question. There is no evidence that it improves patient care. And yet, the question often comes up in my discussions with colleagues: Should we recertify?
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Dr. Melissa Young
To certify or not to certify, that is the question. There has been much discussion about board certification. It is expensive and time consuming. There is no evidence that it improves patient care. Changes have been made and more are to come, I’m sure. And yet, the question often comes up in my discussions with colleagues. Should we recertify? Should we get additional certifications?
There was a time I would have said yes on both counts. Of course, back then, someone else (my employer) was footing the bill for the necessary CME credits and the fees. Now that I am in private practice, I have to decide whether the expense will translate into better reimbursement and better patient care.
For now, I am still planning on recertifying in endocrinology. While I do not believe it improves patient care, I think it still matters to payors and patients if I am officially board-certified. I just wish that my state-required 50 hours a year of CME credits would suffice as proof that I am up-to-date in medical education. I have not yet fully decided if I am taking the 10-year assessment or the every two-year assessment, although I am leaning towards the latter.
I have recently decided to no longer recertify in ECNU. The cost of the required CME and the cost of maintaining the equipment coupled with the decrease in reimbursement is making performing ultrasounds in-house a financial losing matter. In addition, the approved CME lectures are often far away, are repetitious and would require me to cancel office hours. There are no online CME opportunities. There is actually a thyroid cancer conference in Boston that I may be able to attend, but it is not ECNU approved. At the moment, only one of my payors requires ECNU certification, and it also requires AIUM certification which I do not have. As such, I have not been performing ultrasounds on those patients, unless they are willing to pay out of pocket. Some are, because it actually costs them more to have it done in radiology. So my current plan is to allow my certification to expire and to continue to perform ultrasounds on patients whose insurance will allow it and on those who are willing to pay out of pocket. As one colleague put it, I was doing ultrasounds for 10 years before ECNU was even a thing. That experience is not enhanced by taking a test and paying a fee.
One colleague recently posed the question of whether it is worth it to get certified in obesity management if she is going to do that part-time. Personally, I don’t see the benefit. One can always attend the conference and get the necessary education, but unless you intend to use that certification to gain more patients, I don’t see the utility of taking another test or paying more fees. But then again, my patient panel is full, so there is little benefit to me.
So, for me, at least, the plan is to cave to ABIMs requirements and recertify in endocrinology (I am letting my certification in internal medicine expire), to allow my ECNU certification to expire and to avoid getting tangled up in any additional specific-CME-requiring, exam-necessitating, time-consuming certifications. I’ve got patients to see.
ABOUT THE AUTHOR
Dr. Young is an endocrinologist in Freehold, N.J.