Boards sponsor certification in end-of-life care

Family physicians, internists and doctors in eight other specialties can be board certified in hospice and palliative medicine starting in 2008.

Medical leaders said the subspecialty certificate would ensure that more doctors provide quality care to patients with chronic progressive diseases and those near the end of life.

"This is an area that is very important to all of the specialties involved," said Stephen H. Miller, MD, MPH, president and CEO of the American Board of Medical Specialties.

This is the first time 10 ABMS member boards have collaborated to offer certification in one area, according to board leaders. Co-sponsoring the new certification are certifying boards in family medicine, internal medicine, emergency medicine, obstetrics and gynecology, pediatrics, physical medicine and rehabilitation, anesthesiology, psychiatry and neurology, radiology and surgery.

"Each of the co-sponsoring boards recognizes the growing importance of this area of medicine," said James C. Puffer, MD, president and CEO of the American Board of Family Medicine.

Hospice and palliative medicine groups asked several boards to consider developing the subspecialty certification. The ABMS approved the certification in September 2006. The new certificate will be offered to physicians who hold specialty or subspecialty certification by one of the 10 sponsoring boards, the ABMS said.

The American Academy of Hospice and Palliative Medicine said it was pleased that hospice and palliative care would be recognized as an ABMS subspecialty.

Participating boards will develop core requirements and an exam for the certificate. Each board will announce when the certification will be available, Dr. Puffer said, and will publish criteria to sit for the board exam. The certificate will be renewable every 10 years, depending on completion of education, training and exam requirements. The first exam likely will be offered in 2008.

Exploring other emerging areas

The American Board of Family Medicine also wants to create certification in sleep medicine and is working with other boards on the effort. Family medicine board officials said the field of sleep medicine had grown in the last 15 years, and an Institute of Medicine report in 2006 showed how common sleep disorders are.

An estimated 50 million to 70 million Americans have sleep disorders, says the ABFM. Board officials said some health problems family physicians treat are impacted by sleep disorders, including chronic pain syndromes and cardiovascular disease.

The board sees the need for primary care physicians to enter sleep medicine, Dr. Puffer said. He said offering certification in the subspecialty would create more family physicians equipped to treat sleep disorders.

Dr. Puffer said his board wants to co-sponsor the sleep certification with the boards of internal medicine, pediatrics, psychiatry and neurology and otolaryngology. The plan will be submitted to the ABMS for approval early this year, he said.

Meanwhile, the American Board of Internal Medicine is developing a focused recognition for hospital medicine as part of its maintenance-of-certification process. That would give hospitalists a formal credential recognizing hospital medicine as a distinct field in internal medicine, officials said. The ABIM is working on criteria for the certificate, which may be offered by 2009.

The Society of Hospital Medicine, which represents about 6,000 hospitalists, applauded the plan and said it was the culmination of efforts by the society and certifying boards to create a process to formally credential hospital medicine.