Family medicine gets jump on certification program
■ Some family physicians say changes will make the maintenance-of-certification process more flexible.
By Damon Adams — Posted June 12, 2006
The American Board of Family Medicine has gotten an early start on changes to its maintenance-of-certification program, which offers a seven-year or 10-year certification cycle. In response to requests from diplomates, the ABFM on May 18 began instituting its enhancements -- months earlier than the January 2007 start it had planned.
Board officials say the changes make the process more user-friendly for family physicians seeking to maintain board certification. "People wanted it, and we obviously want to encourage participation in maintenance of certification," said James Puffer, MD, ABFM president and CEO.
In the seven-year program, diplomates complete six self-assessment modules (SAMs) and one performance-practice module (or complete a METRIC module created by the American Academy of Family Physicians) before taking the recertification exam in the sixth or seventh year.
Under the 10-year plan, physicians do two SAMs and one performance-in-practice or one METRIC module in three separate three-year stages. The recertification exam is in the 10th year.
The seven-year plan requires the completion of one module per calendar year. The new 10-year program allows doctors to complete their required modules at any time during each three-year stage. Board officials say the shift relieves the pressure of the annual requirements and year-end rush to finish modules.
"During the three-year stage, they can do [modules] whenever they want," Dr. Puffer said.
Getting an early start
Because only one module could be completed a year, some diplomates did extra modules to receive credit for continuing medical education. Now diplomates already taking part in the maintenance-of-certification program will be able to apply those credits toward their first three-year stage of the program.
In addition to that change, the board also is eliminating late fees for 2006. The board had announced it would stop late fees in 2007, but it decided to wipe out the fees earlier to keep with the shift from annual requirements to three-year stages.
Indianapolis family physician Richard Feldman, MD, likes the changes.
"It's a positive thing. If you really want to do the 10-year cycle, you're able to start now," said Dr. Feldman, former president of the Indiana Academy of Family Physicians. He previously spoke against the MOC process to AAFP leaders.
No longer a one-time deal
Physicians used to be board-certified only once during their career spans. But after the American Board of Family Practice (now the ABFM) was founded in 1969, it started issuing time-limited certificates and requiring physician recertification every seven years.
In 2000, medical specialty boards agreed to a transition from recertification to maintenance-of-certification programs, which focus on lifelong learning.
Most boards view MOC as a continuous process and encourage diplomates to spread learning throughout the years instead of bunching modules at the end of the cycle.
Most hospitals and health plans require board certification, and failing to get certified can mean losing managed care contracts.
American Medical Association policy states the AMA will continue to monitor the progress of MOC of all member boards of the American Board of Medical Specialties (which includes ABFM) and its impact on the practice community.
In 2004, family physicians voiced frustrations to AAFP leaders about the MOC process of the ABFM and wanted SAMs suspended until technical and content problems were resolved. Through reviews of its program and physician feedback, the ABFM made more than two dozen changes to the process.
Last year, those changes included allowing physicians to download and print questions for work off the computer and providing critiques for all knowledge assessment items.
"We think the [early start changes] increase flexibility, which is good," said Norman Kahn, MD, AAFP vice president of science and education. "We consider this a continuation of the responsiveness of the [board] after a rocky start."