Do Board Certifications Really Matter?

A friend recently asked me whether it matters if a physician is board certified in his or her specialty. For those of you who don’t know, the medical profession is governed by both a national and state medical board. In order to practice medicine, physicians must have a state license and a national certificate showing they have passed all the three steps of the United States Medical Licensing Examination. Once they are fully licensed general physicians, they typically obtain board certification in their specialty. Their specialty may be something broad, such as general family practice, internal medicine, or general surgery, or they may go on for further training to get subspecialty certification, such as in plastic surgery or cardiology. Essentially, at every step of their training, physicians need to pass an exam that says that they are competent according to national standards in that field. Board certification exists to ensure that there is a minimum standard practice among physicians in a specialty.

There are many physicians who do not have board certification in their specialty. This does not mean that they cannot practice medicine or their specialization. It may mean that they will have a difficult time gaining privileges at hospitals. It may also mean that the discerning patient may choose to go to someone who is more qualified. But, typically, it only matters if there is a complication or the patient is not satisfied with his or her outcome. If there is a lawsuit, it is likely that someone who practices a certain specialty without having the appropriate certification would be more exposed than someone who does have all the certifications.

One example of this is the notorious plastic surgeon on Dr. 90210, Dr. Robert Rey. I cannot confirm this, but I have read several articles that indicate he is not board certified, and he has been quoted as saying that he simply was too busy to get board certified. It does not surprise me that patients continue to flock to Dr. Rey for this services. Given his notoriety and fame from television, patients seeking a doctor to the stars will happily pay for his services.

From an economic point-of-view, this illustrates something very powerful in medicine – that reputation and business-savvy can trump qualifications. You do not have to be the best doctor or care provider in order to have a busy practice. It is well known in the medical community that, if you really want to find out whether a doctor or surgeon is good, you need to ask the key personnel who work with many doctors. For example, surgical scrub technicians know which surgeons have the best hands and the best intra-operative judgment. The average person watching Dr. 90210 does not know whether Dr. Rey is good or bad at what he does. He gains his reputation from the patients shown on television, his good looks, and the fact that he has his own TV show.

It makes me wonder why we have board certifications, after all, if the general public does not care much about it. Physicians in medicine seem to be chasing their tails getting more and more qualified, but perhaps this is all a futile endeavor.

5 comments to Do Board Certifications Really Matter?

  • So not true! Board certification does matter! I am the physician owner of a local locums company ( a company that supplies “fill in” physicians to busy practices) and I will not even consider anyone that is not board certified and has a minimum 3 year experience post residency. Why? Because the practices we work with demand it! Furthermore, the practices we work are very particular about WHICH board certification they want–e.g. Family Practice vs. Internal Medicine. I think you are really off base here; physicians and practices are very invested in providing the best care, and that goes along with being board certified. Please feel free to contact me if you have more questions, and PLEASE do not use a television physician as an example!

  • EconoMD

    I think board certification is a farce. Any doc who was board certified prior to 1990 doesn’t have to re-cert. As fast as medicine changes, the older docs are precisely the ones that should have to re-certify to prove their familiarly with new protocols, drugs and guidelines. Taking the boards while in private practice is very expensive as you have to stop seeing patients to allow time for studying, board reviews, etc and the fees for the exams can be upwards to $2,000.00. This can be very costly for the physician in solo practice once you factor in the lost income while away at conferences, etc.

    A better solution would be similar to what many malpractice companies offer: take a course that provides 5-10 hours of education about how to avoid malpractice. In turn you get a discounted rate on your insurance (similar to taking a defensive driving course). If doctors were required to have X amount of CME a year pertaining to their field of practice you would see a lot less crappy care. Just like the elderly should have their driving skills/vision tested more frequently, so should the older doctors have to keep up with their field of medicine. As long as there are physicians who have been board certified “indefinitely” I do not believe the board certifications mean anything especially when you consider all the board review courses that are out there designed exclusively for passing the obscure questions that are asked on the boards but are never actually encountered in real world medicine.

    We all know the reality is that good medical care is often not provided secondary to insurance formularies, financial limitations and, of course, the ego of the physician who is in over their head but unwilling to refer to a specialist.

  • mamtaifyjailk

    Nothing seems to be easier than seeing someone whom you can help but not helping.
    I suggest we start giving it a try. Give love to the ones that need it.
    God will appreciate it.

  • DocD

    At least in psychiatry, being board certified is not equivalent to a ‘best psychiatrist’. The board exam consists of having memorized brain anatomy, peripheral nerves of the arm and neck, statistics and historical facts about who came up with what theory.
    There is little to nothing on the exam about how to talk to a person, or understanding underlying emotional processes, which is what makes a good psychiatrist face to face with a person.
    I cannot speak to the value of board certification in other specialties.

  • david

    Of course board certification matters. Otherwise how do you know you know enough to take care of your patients? If you have spent enough time in the medical profession, you will easily tell whether a doctor is board certified or not, based on their clinical reasoning and management practices.
    There are certain things you never study except for board certification.
    How many of you will hire a lawyer who has not passed the bar exams? Will you knowingly allow a pilot who has not passed the prescribed tests to fly you cross country? So why subject yourself to noncertified doctors.
    While I must admit that board certification is not the be all, it still matters. Alot.

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