Opinion
As new certifications appear, they raise practical and legal issues
LETTER — Posted April 16, 2007
Regarding "New board certifications beg question: What's an IM physician qualified to do?" (Letters, Feb. 26): In his short, insightful letter, Peter T. Smyth, MD, of Glencoe, Minn., questions whether primary care doctors are being made to feel incompetent by the onslaught of board certifications that include hypertension, geriatric medicine, sleep medicine and palliative care. I agree with him.
It's hard to find fault with educational programs that are supposed to make us better doctors, but are they really necessary and do the organizations promoting them really understand the practical and legal ramifications of adding new certifications?
With every new certification added, there is a risk that some HMO or other insurance organization might consider a physician who does not hold a certificate in, say hypertension, not as qualified to treat the disease as one who is certified.
There is also a medicolegal component. What if a physician is sued on the basis that because he didn't have a certificate in palliative care, he didn't treat the patient appropriately?
The list goes on and on.
How can the organizations responsible for these changes be so short-sighted? We talk about the dangers of fragmenting patient care, yet we are guilty of adding to that fragmentation ourselves.
Even worse, we fragment ourselves at a time when solidarity and unity are so essential.
Investigating this issue should be given top priority by organized medicine. I certainly will bring it up at our state medical society's house of delegates meeting.
Edward J. Volpintesta, MD, Bethel, Conn.
Note: This item originally appeared at http://www.ama-assn.org/amednews/2007/04/16/edlt0416.htm.
