June 15, 2018 / 9:21 PM / in 9 months

Internists who maintain board certification may provide better care

(Reuters Health) - Physicians who maintain board certification by regularly passing exams on current clinical guidelines may provide higher quality care than their colleagues who don’t, a U.S. study suggests.

Researchers examined health data for 85,931 Medicare patients treated between 2009 and 2012 by 1,260 general internists who were initially certified by the American Board of Internal Medicine in 1991. Overall, 786 doctors, or 61 percent, maintained their board certification from 1991 to 2012.

To assess the quality of primary care, researchers looked at how often patients got several recommended screenings: mammograms to check for breast cancer; cholesterol tests for people with heart disease; and blood sugar tests, cholesterol checks, and eye exams for patients with diabetes.

In every case, doctors who maintained board certification did these things more often than physicians who let their certification lapse, researchers report in the Annals of Internal Medicine.

“The latest research shows that doctors who maintain certification are more likely to meet important quality metrics throughout their career,” said Richard Baron, president and chief executive officer of the American Board of Internal Medicine (ABIM), which employs or has other financial ties to the study’s authors.

“This information is important for patients who may be selecting doctors and may consider choosing a doctor who is actively maintaining their certification versus one who is not,” Baron said by email.

Seventy-two percent of women got mammograms every other year when they saw doctors who maintained board certification, compared with 68 percent of those who saw other physicians.

For patients with heart disease, 79 percent got annual cholesterol checks when they saw doctors who maintained board certification, compared with 77 percent with other physicians.

Doctors who maintained board certification also had more of their diabetic patients get twice-a-year measurements of their glycated hemoglobin levels, which is a marker of blood sugar control: 58 percent compared with 54 percent for other physicians.

While all of these differences are statistically meaningful, the differences were only slightly better for doctors who kept up their certification, according to the author of an editorial published with the study.

Dr. Lee Goldman, dean of health sciences and medicine at the Vagelos College of Physicians and Surgeons at Columbia University in New York City writes in the editorial, “If maintenance of certification simply takes my doctor from a low F to a slightly higher F, or even from D+ to C-, on metrics that may or may not be worth grading, then I don’t find it helpful at all.”

In order to become board certified in internal medicine, doctors must complete medical school, followed by a three-year training program in this specialty and, in some cases, additional years of fellowship training in subspecialties. After this, doctors must pass an exam to be board certified, which Baron said typically costs about $1,400, plus about $2,200 to $2,900 for any separate subspecialty exams.

To maintain certification, doctors must keep their medical license and participate in ongoing education and take a brief exam every two years or a longer exam every 10 years, Baron said. Over ten years, this costs about $2,000 to $2,500, though it can vary based on the number of subspecialties doctors have.

SOURCE: bit.ly/2t97fu8 and bit.ly/2yf9iTj Annals of Internal Medicine, online June 12, 2018.

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