ABMS

March 24, 2010APDR: ABR Update

SPECIALTY BOARDSEstablished to assure the public that the physician has specific qualifications

– American Board of Ophthalmology 1917

– American Board of Otolaryngology 1924

– American Board of Obstetrics 1930

– American Board of Dermatology 1932

Advisory Board for Medical Specialties (forerunner of ABMS) established 1933

–The 4 Boards

–Associate Member organizations

ABMS 24 Member BoardsThe American Boards of:The American Boards of:Allergy and ImmunologyAllergy and ImmunologyAnesthesiologyAnesthesiologyColon and Rectal SurgeryColon and Rectal SurgeryDermatologyDermatologyEmergency MedicineEmergency MedicineFamily MedicineFamily MedicineInternal MedicineInternal MedicineMedical GeneticsMedical GeneticsNeurological SurgeryNeurological SurgeryNuclear MedicineNuclear MedicineObstetrics and GynecologyObstetrics and GynecologyOphthalmologyOphthalmologyOrthopaedic SurgeryOrthopaedic Surgery

OtolaryngologyOtolaryngologyPathologyPathologyPediatricsPediatricsPhysical Medicine and Physical Medicine and RehabilitationRehabilitationPlastic SurgeryPlastic SurgeryPreventive MedicinePreventive MedicinePsychiatry and NeurologyPsychiatry and NeurologyRadiologySurgerySurgeryThoracic SurgeryThoracic SurgeryUrologyUrology

37 primary, 111 subspecialty certificates

AMERICAN BOARD OF RADIOLOGYEstablished 1934Established 1934

Today: 3 Primary Certificates (DR, RO, RP)Today: 3 Primary Certificates (DR, RO, RP)

SubspecialtiesSubspecialtiesNeuroradiologyVascular & Interventional RadiologyPediatric RadiologyNuclear RadiologyHospice and Palliative Medicine

Maintenance of Certification: All disciplinesMaintenance of Certification: All disciplines

Founding BoardsDermatologyOB/GynOphthalmologyOtolaryngologyOrthopedic SurgeryPediatricsPsychiatry & NeurologyRadiologyUrologyInternal MedicinePathologySurgeryNeurological SurgeryAnesthesiologyPlastic Surgery

Physical Medicine & Rehab 1947

Colon & Rectal Surgery

Preventive Medicine

Family Medicine

Allergy & Immunology

Nuclear Medicine

Thoracic Surgery

Emergency Medicine

Medical Genetics

1935

1936

19371940

1936

1949

1969

1971

1979

1991

Year Joined ABMS

1933

ABMS Member Boards General Certificates Issued

BOARD 2000-2008 CUMULATIVE

Internal Med 62,953 227,387

Family Med 28,418 97,818

Pediatrics 24,603 93,720

Psych / Neuro14,977 62,376

Radiology 11,389 53,915

Surgery 10,188 58,103

Radiology ranks 6th by size of budget

ABMS THROUGH THE YEARS

• Advises the Member Boards• Approves certificates (new, modified)

• Specialization/subspecialization

• Recertification (time-limited certification)

• Maintenance of Certification (MOC)

• Engages healthcare stakeholders

• Defends/promotes/advances the specialty board movement

Medical Specialty Board Movement

Standards for knowledge, skill

Professional self-regulation

Fulfills social contract as a professional

Voluntary

Over and above licensure (compulsory) Today: >85% of U.S. physicians have earned

>1 ABMS Specialty Board certificate

Board Certification=Gold Standard

August 2003 Gallup Poll:When asked:

“When given the choice between a board certified physician and a physician who was not board certified but was recommended by a trusted friend or family member…”

75% opted for a board certified physician

23% opted for the physician recommended by a friend or family member

Board Certification=Gold Standard

May 2008 Opinion Research Corp. Telephone Poll

When asked:

“Key factors when choosing a doctor…”95% bedside manner; communication skills

91% board certification

82% friend or family member recommendation

78% doctor’s hospital affiliation

75% doctor’s office location

60% hospital or school where doctor trained

Pressures Resulting in Subspecialization and Time-Limited Certification

New technologyPace of discovery

Pressure to limit scope

Lifelong learning, periodic re-examination1

Time-limited certification– ABFM (1969)

– ABEM (1976)

Subspecialization

ABR– Radiation Oncology (since 1995)

– Diagnostic Radiology, Radiologic Physics (since 2002)

– Peds, VIR (’94), Neuro (’95), Nucl (’99), Hosp & Palliative Med (’08)

August 2003 Gallup Poll:When asked:

“If you knew your doctor’s board certification had expired, would you change doctors?”

54% Very Likely

27% Somewhat Likely

9% Not Too Likely

8% Not at All Likely

Public values maintenance of board certification

81%5

Demonstrate to the public that physicians certified by Member Boards of ABMS —including the ABR-- maintain the necessary competencies to provide quality patient care, and thereby:

Improve the quality & safety of U.S. healthcare

Purpose of MOC (in a nutshell)

CURRENT ABMS INITIATIVES

• MOL: FSMB-NBME-ABMS• Grass roots defense of

ABMS Member Board certification

• “Board Eligible”

• Alternate Pathways

• ABMS-PCPI collaborative measures development

• Institutional recognition of MOC

• Stakeholder engagement on physician performance measures & improvement through NQF

• MOC-PQRI

• Innovation Pathways in MOC: Focused Practice Recognition

• ABMS-BC/BS collaboration?

• MU-HIT

• ABMS Journal

“Certification Matters”