ABIM/ABMS Double-Dealing Leaves No Choice: Join National Board of Physicians & Surgeons

What is publicly announced by organizations frequently does NOT reveal the real purpose. The American College of Physicians (ACP) was founded in 1915 with the stated mission, “to enhance the quality and effectiveness of health care by fostering excellence and professionalism in the practice of medicine”. However, the real mission was to distinguish its members from the lesser trained general practitioners that were most prevalent at that time to justify higher fees. The ACP in 1998 merged with the American Society of Internal Medicine (ASIM), which had been formed in 1956 to further the financial well-being of internists. From 1998 to 2008 the combined organization was called the ACP-ASIM, then renamed itself back to just the ACP in 2008 (Ref.1). To help justify their higher practice fees the ACP, along with the American Medical Association founded the American Board of Internal Medicine (ABIM) in 1936 to develop testing to prove internists’ extensive knowledge; it has grown to develop tests for the existing 24 internal medicine subspecialties (Ref.2). The ABIM makes it clear that it is NOT a membership organization but rather an independent non-profit, accountable to the profession and to the public (Ref.3). Such a vague statement makes it clear that the ABIM is responsible to no-one, including the hundreds of thousands of physicians who put in the effort to pass their initial board exam.  
    The ABIM is the largest certifying board of the other 23 medical and surgical certifying boards that make up the American Board of Medical Specialties (ABMS).  In 1989 the ABMS led by the ABIM decided that there was a fortune to be made by no longer certifying for life, but rather furnishing time limited certification requiring costly retesting, called maintenance of certification (Ref.4). Complicating this situation was hospitals and insurance companies claiming to offer the best care, wanted proof of physician board certification. This put the ABMS in a powerful position to demand physicians maintain their certification (MOC). 
    This obvious over-reach by the ABMS has led to physician push-back. Dr. Wesley Fisher (no relation) led an unsuccessful legal battle against the ABIM but was able to demonstrate massive income growth and inappropriate expenditures by the ABIM (Ref.5,6). However, many other attempts to nullify this financial grab by the ABIM and other boards have been successful. Several states have passed legislation forbidding hospitals and insurance companies from withholding privileges and payments because of loss of certification due to non-participation in MOC (Ref.7,8). But, perhaps the most exciting accomplishment to allow boarded physicians to avoid MOC is the recent announcement of the National Board of Physicians and Surgeons (NBPAS), that it is now certified for all insurances (Ref.9,10). The requirements for NBPAS certification are proof of initial board certification, continuing medical education (CME) and minimal fees. 
    Specialization in medicine has proven to be extremely beneficial. There is no doubt that when finishing extensive training in a chosen area, passing a rigorous test on that knowledge base is mandatory. But, with the need of CME to maintain licensure in every state and the physicians’ knowledge development while practicing, a general recertification exam is superfluous and onerous. It is now time for ALL physicians to join the NBPAS, forcing the ABMS member organizations to return to sanity. With insurance verification hospitals should readily accept NBPAS board certification.

1. https://www.bing.com/search?q=the%20founding%20of%20the%20American%20college%20of%20Physicians&pc=0YMS&ptag=C5N100AED911BEECF&form=CONBDF&conlogo=CT3210127  (accessed November 12, 2021)
2. The American Board of Internal Medicine, The British Medical Journal, Aug. 29, 1936, available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2457310/pdf/brmedj06855-0027b.pdf(accessed November 15, 2021)
3. About ABIM – Mission, Certification by the American Board of Internal Medicine, 2021, available at: https://www.abim.org/about/mission/ (accessed November 15, 2021)
4. American Board of Dermatology, MOC Overview, available at: https://www.abderm.org/about-moc/moc-overview-and-history.aspx (accessed November 18, 2021)
5. Dr. Wes., The Courts Speak: Internists to Be Boarded to Death, March 1, 2021, available at: http://drwes.blogspot.com/ (accessed November 10, 2021)
6. Joyce Frieden, Maintenance of Certification at Issue in Appeals Court: Critics Fight to Dump MOC, Medpage Today, October 22, 2020, available at: https://www.medpagetoday.com/practicemanagement/practicemanagement/89279 (accessed November 16, 2021)
7. Jessica Schaeffer-Helmeecki, “Anti- Maintenance of Certification” Laws, Legislative Research, October 23, 2019, available at: https://www.cga.ct.gov/2019/rpt/pdf/2019-R-0222.pdf (accessed November 14, 2021)
8. MSMS, Maintenance of Certification Bills Pass the Michigan House of Representatives, December 5, 2018, available at: https://www.msms.org/About-MSMS/News-Media/maintenance-of-certification-bills-pass-the-michigan-house-of-representatives (accessed November 14, 2021)
9. NBPAS, NBPAS Meets All National Accreditation Standards for Health Plans, available at: https://nbpas.org/ncqa-update/?fbclid=IwAR2qLWxK59DEDrFU1EX_aqIEvOvMLQNptWWhYC2snfZgtpeonrBQKRb0yH4 (accessed November 15, 2021)
10. NBPAS, Providing Physicians A Choice In Maintaining Board Certification, available at: https://nbpas.org/ (accessed November 12, 2021)