Welcome to my blog, a place to explore and learn about the experience of running a psychiatric practice. I post about things that I find useful to know or think about. So, enjoy, and let me know what you think.

Wednesday, February 18, 2015

Another Board

I'm still so appalled by the whole MOC experience, that I applied for Board Certification in Psychiatry through the National Board of Physicians and Surgeons. I can't remember if I wrote this in a past post or not, but when I checked out their site previously, it didn't look like they offered certification in general psychiatry-just subspecialties. But that seemed weird, so I went back and looked again, and cemented my belief in good design. I know that seems like a non-sequitur. But see what I mean:

This is a segment of the list-there are more subspecialties, as well as other specialities. None of the phrases is a hyperlink. So it looked to me like "Psychiatry and Neurology" was just the heading. But it's not, and they do offer it.

They require your medical license number and registration expiration date, a single pdf that includes certificates for 50 CME credits in the last 24 months, and a fee of $169, or $29 if you're within two years of your training, that covers two years of certification. And for an extra $18, you can get a paper certificate "with gold seal suitable for framing". Turnaround time for certification is six weeks or less.

They also provide two sample letters, one to "Credentials Committee, MEC, Chief of Staff, administrators, or insurers", and the other to colleagues, as well as a general summary "to educate your hospital’s Medical Executive Committee, administrators, colleagues, and patients, about why NBPAS certification is important", explaining the controversy over board certification, their requirements for certification, and with some references.

Their position is as follows:

There is controversy surrounding the requirements for continued certification in a medical specialty. Many physicians believe recent changes requiring physicians engage in various medical knowledge, practice-assessment, and patient-safety activities as well as recertification exams do not provide optimal use of physician’s time. Furthermore, no high quality data exist to justify these labor intensive and expensive activities.

Some of their more important FAQs:

They're a grass roots organization trying hard to gain acceptance by hospitals and payers.

The application fee goes to the cost of maintaining the organization, and to ultimately spreading the word and lobbying hospitals, payers, and politicians to accept this certification. They hope to lower application fees, going forward. Also, thus far, physician management has not taken any salary.

There's a bit about the FSMB's proposed Interstate Compact, and whether it will require ABMS MOC. NBPAS's take on this is that the FSMB claims this is a myth, but that they're not so sure, so better to get cracking and be accepted by the FSMB as an alternative board, before that happens.

I don't know much about the Interstate Compact, but here's a link to an overview, and another to their list of myths.

This was a bit of an impulse buy for me. I was reminded of the NBPAS by an anonymous comment on my post, I Really Should Be Studying..., with links to their site, as well as the AAPS page with information about the Interstate Compact. My thanks to anonymous.

I don't know exactly what this certification is worth-I'm basically paying $187 for a piece of paper-or if it's any better or worse than the ABMS. But I do think the ABMS needs some good old market competition, at least to keep down fees. And since I really don't plan on taking another MOC exam 10 years from now, when the blintzes hit the fan, I don't want to be standing around without at least SOME certificate to cover me.


  1. What does it mean to a patient point of view if you are certified by one as opposed to the other?

    1. Really good question. I don't know the answer. I'm not sure certification by either board means much with respect to patient care. My feeling about it is that how much effort a doctor puts into lifelong learning is on an honor system, just as what one does with patients is on an honor system. No piece of paper can compensate.