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The certification controversy

February 2009

I recently received an e-mailed press release from the American Board of Physician Specialties (ABPS) with this message: “Dear Dr. DeLue: As a leading hospitalist, I thought you’d find the attached info about the American Board of Hospital Medicine of interest.” Well, two thoughts came to mind. Any organization that refers to me as a “leading hospitalist” can’t be all bad. But then I recalled my favorite Groucho Marx quote, “I don’t care to belong to a club that accepts people like me as members.”

In all seriousness, the recent spate of advertisements by the ABPS for hospitalist certification and SHM’s pointed response raise this question: Should hospitalists consider obtaining their certification from the ABPS? From what I can tell, this organization has been around for a long time. It was founded in 1950, and it is the third largest physician certifying organization (there are more than one? who knew?). They even have their own Wikipedia page.

As for the newly minted hospital medicine certification, at least one prominent Canadian physician, Dr. Rashad Dindo, has taken a liking to the concept. In the ABPS press release attached to the e-mail I was sent, he writes, “I encourage, without reservation, all Canadian Hospitalists to contact the ABHM for more information about this cutting-edge board.”

I responded to this e-mail, seeking more information about this “cutting-edge” recognition. My queries included:

– Why is the board unaffiliated with SHM?
– What hospitals and insurance companies will recognize this certification?
– Who wrote the tests and what are the expected pass rates?

I received a curious response. I was sent another press release, this time from Mark Pastin, PhD, which stated, “As President and CEO of the Health Ethics Trust, the nation’s leading organization addressing ethics and compliance issues in healthcare, I want to congratulate the physician leaders of the [ABPS] for their founding of the [ABHM].”

Hmm, “the leading organization addressing ethics”–now this is quite a claim. Regardless, I am not sure how this response answered any of my questions in the first place.

So, I can’t say that the reasons for applying for this certification are piling up unless, that is, one is planning to move to Canada. That isn’t a likely move for me, save for Congress demanding a recount of the recent presidential election leading the Supreme Court to vote for a third term for George Bush.

As for the American Board of Internal Medicine (ABIM), part of the much more widely recognized American Board of Medical Specialties (ABMS), I believe hospitalist board certification is a long time coming.

It is evident that SHM is working diligently to make this dream a reality. I suspect many cogent arguments have been made as to why we merit our own certification. However, I have no doubt that one of the most persuasive reasons to establish a certification program–for any of these boards–is financial. After all, 20,000 hospitalists times $1,500 in certification fees adds up to $30 million. While this amount pales in comparison to the recently proposed $1 trillion government bailout, it is certainly a sum large enough to alter my spending habits. Clearly, certifying physicians is big business.

My understanding is that the ABIM’s recognition of focused practice in hospital medicine will be available in 2010, according to the recent e-mail from SHM president Dr. Pat Cawley. We certainly deserve it–and if ABMS recognition finally does come to fruition, then kudos are due to the SHM leadership. I eagerly await the upcoming national meeting for the definitive answer to the status of our own certification.

In the meantime, I have a solution for those of you who are still undecided about what to do at present. Can’t wait for the ABIM to offer focused recognition? Believe, as I do, that we are eventually due our own ABMS separate board certification, no different from that of cardiology or neurology? Not sure if the ABPS version is worth it even if you can apply today?

Problem solved. Why not become “DeLue Certified” in hospitalist medicine? For just three easy payments of $19.99 each, you will receive a handsome color plaque bestowing upon you the “DeLue Certification in Hospitalist Medicine.” Of course you will have to pass a test first, but I’m not picky. How about you just provide me a sample of hospitalist-relevant questions–more than 10, less than 20–with your answers, and please also include an answer key.

This is the perfect bridge between now and when the ABMS ponies up, and at a fraction of the cost of the current leading competitor. Really, how can you afford NOT to become certified by a “leading hospitalist”? Plus, if you ACT NOW, I will throw in a second board certification ABSOLUTELY FREE (shipping and handling not included). Operators are standing by, and supplies are not limited!