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AAP News Vol. 30 No. 6 June 2009, p. 1 © 2009 American Academy of Pediatrics
ABP addresses permanent certificate holders concernsAlyson Sulaski WyckoffAssociate Editor With the new, multidimensional requirements for Maintenance of Certification (MOC) in pediatrics, some physicians holding permanent certificates — those awarded before May 1, 1988, — have asked if their certification really is permanent.
"The ABP will continue to honor its commitment of lifetime certification to permanent certificate holders," said H. James Brown, M.D., FAAP, vice president for physician relations of the American Board of Pediatrics (ABP). The ABP, one of the 24 member boards of the American Board of Medical Specialties (ABMS), is the Chapel Hill, N.C.-based organization that develops and administers the process to board-certify pediatricians and pediatric subspecialists. Last fall and in April, the ABP sent letters about MOC to those with permanent certification. Of the 75,000 diplomates (board-certified pediatricians), about 25,000 hold permanent certificates. Still, many of them continue to doubt the permanency of their certification. Discussions on listservs have ramped up lately, and the AAP Oregon Chapter drafted a formal letter of opposition, concerned the ABP plans to change its policy on time-limited certification. Under MOC, certification awarded beginning in 2010 requires pediatricians to fulfill four parts (parts 1, 2 and 4 every five years; part 3, the secure exam, every 10 years). Also beginning in 2010, the ABP will recognize only two categories of diplomates: those who are certified and meeting current MOC requirements and those with permanent certificates. Permanent certificate holders who do not participate in MOC will be listed on the ABP Web site as being certified, but as not meeting the current requirements of MOC. Some pediatricians have complained about the cost ($990), time commitment and what is viewed as the complexity of the MOC process, as well as the switch since 2003 to a "secure" exam. Yet, all 24 boards of the ABMS require the four-part MOC process, including the secure exam. Despite assurances that permanent certificate holders always will retain their lifetime certification, the ABP encourages those "grandfathered in" to participate in MOC. "The value of my permanent certification, which was earned in 1974, does not carry the same significance it once did," said Dr. Brown. "By enrolling in MOC, pediatricians like myself are showing the public their commitment to quality care and lifelong learning." He said people will begin to view meeting the requirements of MOC as the certification standard. The ABP Web site notes: "While you will always be certified by the ABP, it is clear that groups outside the ABP are increasingly less likely to accept a credential awarded 10, 20 or more years ago as evidence of your current ability to provide quality medical care." It has become more common for agencies to require evidence of physicians continuous participation in MOC programs, according to the ABP site. State licensing boards and hospitals, as well as pay-for-performance programs, either have considered or begun requiring evidence that physicians are taking part in ongoing evaluations of professional competence. Allen D. Harlor Jr., M.D., FAAP, keeps up with pediatrics by reading 25 journal articles a month and attending continuing medical education (CME) meetings regularly. Though he once re-certified, Dr. Harlor is of the opinion that board certification should not be necessary for state licensure and hopes this change is not inevitable. "Most states require CME credit to maintain licensure, and that should be sufficient," he said. There are incentives for permanent certificate holders to begin MOC before 2010:
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