Use of Board Certification and Recertification of Pediatricians in Health Plan Credentialing Policies

Abstract

These findings, although specific to pediatrics, likely apply to other primary care disciplines and raise questions regarding the ability of plans to ensure initial or continued competence of their credentialed physicians. Growing public concern regarding patient safety, as well as demonstrated patient preferences for certified physicians, will likely result in greater emphasis on quality assessments in physician credentialing.

Health Plan Use of Board Certification and Recertification of Surgeons and Nonsurgical Subspecialists in Contracting Policies

“…This finding was similar to previous findings that pertain to health plan board certification requirements for pediatricians and pediatric subspecialists. 13 However, our findings on certification requirements for surgeons and nonsurgical subspecialists indicate that a smaller proportion of health plans require certification compared with hospitals, although published findings have been limited to the pediatric specialties. Previous research indicated that 70% of hospitals require pediatricians to obtain board certification at some point.…”

Motivation for Participation in the American Board of Family Medicine Certification Program

“…7 A companion study of health plans in 2009 found that 90% did not require general pediatricians to be board certified at initial credentialing; 41% required general pediatricians to be certified at some point in their association with the plan; and 84% had never revoked or not renewed credentialing status for not recertifying. 8 For surgeons, only 5% of hospitals surveyed required certification at initial privileging; 12% restricted the privileges of nonboard-certified surgeons; and 82% allowed surgeons to retain privileges after their certification had expired. 9 Given this information, we wished to examine family physicians' motivation for continuing ABFM certification and to identify physician and practice characteristics associated with doing so.…”

The Role of Gender in the Experience and Impact of Recertification Exam Preparation: A Qualitative Study of Primary Care Physicians

“…Employers are increasingly requiring physicians to be and remain board certified, but may not provide protected time to study. [37][38][39][40][41] Organizations that employ physicians or reimburse for their services, especially those that require board certification, could formalize supports for physicians who need to prepare for a board examination, with appropriate attention to gender-specific needs and challenges. 42 Providing physicians with protected time or other supports or incentives for studying could allow them to take the time to prepare in ways best suited to their learning style, which could, in turn, help reduce unnecessary stress and minimize detrimental personal and practice-related impacts of examination preparation.…”

“…Employers are increasingly requiring physicians to be and remain board certified, but may not provide protected time to study. 37 –41 Organizations that employ physicians or reimburse for their services, especially those that require board certification, could formalize supports for physicians who need to prepare for a board examination, with appropriate attention to gender-specific needs and challenges. 42…”