ABFM: Lipstick on a Pig


The AAFP points out on their site that the ABFM is busy “fine-tuning the continuing certification process to best meet family physicians’ professional development and lifelong learning needs continues.”  Is this a joke?  All family docs want the recertification process dropped!  It goes on:

  • As ABFM President and CEO James Puffer, M.D., said during a recent AAFP visit to the board’s headquarters in Lexington, Ky.: “We have a lot of exciting things going on that we think will benefit your members.”
  • For starters, the term “MC-FP” is going by the wayside; it’s the Family Medicine Certification process now.
  • And although the four core elements that make up the certification process — Professionalism, Self-Assessment & Lifelong Learning, Cognitive Expertise, and Performance Improvement — remain with some modifications, other terms have changed, as well, to more accurately describe what they are.
  • And it’s not just the terminology that’s changing. Perhaps the most substantive change to Family Medicine Certification was based on ABFM diplomates’ feedback regarding the SAMs. Namely, that the clinical simulation portion of these activities was not as useful as the knowledge assessment portion in helping to enhance clinical practice.


Wow, big news. In other words, as the the Talking Heads would say, same as it ever was.  But don’t forget:

  • Finally, the ABFM is simplifying how diplomates pay for certification, shifting from the current methodology — which amortized the total cost of certification (including the cost of the next examination) based on whether the physician was following the seven- or 10 year certification cycle option — to simply paying the same amount annually regardless of certification pathway. The annual payment will still include the cost of the next examination.

That is critical.  The ABFM keeps getting paid and they get paid a lot.  The first comment on the site was from a doctor who said,”This is pure rubbish – putting lipstick on a pig, as the saying goes.”  Exactly.  So why doesn’t the AAFP do something instead of promoting the ABFM information on their website?  Is there some connection financially that I am unaware of?

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  4 comments for “ABFM: Lipstick on a Pig

  1. Bridget Reidy
    August 7, 2016 at 6:30 pm

    My letter to ABFM explaining why I won’t go along with their barely changed process will explain that expertise comes from doing, and since clearly none of them practice medicine anymore they have no concept of how to evaluate me.

  2. hawgguy
    August 3, 2016 at 12:39 am

    I just received an email from the ABFM today warning me that, after 27 years of certificaton & recertification, if I don’t jump through the next set of hoops I will be listed as “not board certified”. I think they should have a new category, “Formally Board Certified” or some such, to differentiate those that don’t want to jump through the hoops from those that never took the test. Not sure yet what I’m going to do. I’ll probably play along for another couple of years, but I’m an edge case for now.

    • Kurt
      August 3, 2016 at 1:04 pm

      Same thing. Was told I have one more part 4 thing. They make 62 million dollars a year off of us and Puffer gets $745,000 according to Doug. I can’t wait to be able to walk away. Same thing here.
      After 27 years of recertifying. The ABFM wants to give “senior” practitioners a break on recert cost.
      Safe for them to say because most of the “seniors” are leaving to retire as soon as they can.

  3. Randy
    August 2, 2016 at 11:31 am

    I just got the 8 page mailer the ABFM sent out on this last week. Note to the ABFM: if it takes you 8 pages to explain how you made things simpler, you haven’t made them simpler.

    What they did essentially is give new names to the same useless components they require to maintain certification, and require yearly payments. They did make the clinical simulations optional, but to make up for it you have to complete an additional and equally worthless component.

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