National Board of Physicians and Surgeons - Board ...



DATE \@ "MMMM d, yyyy" March 1, 2018Dear?XXX,I am contacting XXX to advocate for XXX acceptance of an alternative continuing board certification pathway. Most contracts between payers and provider groups require adherence to the payer's credentialing standards. XXX credentialing standards require board certification by an ABMS or AOA member board. ABMS board certification requires two parts, initial certification and maintenance of certification (MOC). There is controversy surrounding the requirements for MOC. Many physicians believe current MOC requirements are onerous, time-wasting, not meaningful and unnecessarily expensive. In response to this discontent, an alternative board, the National Board of Physicians and Surgeons (NBPAS) was formed. NBPAS provides an alternative pathway for the maintenance phase of certification. I am writing to request XXX credentialing requirements accept NBPAS certification as an alternative to ABMS certification. Importantly, many published studies have found no association between MOC or recertification and improved patient outcomes (see references below). Most physicians participating in MOC activities find they learn very little from the experience. Most of the time spent studying for the computer modules and exam is spent studying aspects of medicine that are irrelevant to their practice. In fact, in response to criticism from NBPAS, various medical societies and other organizations, many ABMS member boards are now starting to change their MOC processes, thereby validating NBPAS criticism. The American Board of Anesthesiology has discontinued the 10 year re-certification exam and the American Board of Internal Medicine's own task force has recommended the same. Important points for consideration:1) Endorsing an alternative certifying organization like NBPAS will not open the door to numerous competing "fly by night" boards. NBPAS requires initial ABMS certification, therefore NBPAS actually supports ABMS and requires a rigorous secure initial certifying test.2) There is no evidence, or even common belief that the ABMS member board MOC process protects the public from bad doctors. In fact, most, if not all of the recent scandals in medicine involved ABMS board certified physicians. 3) CMS, the nation's largest payer does NOT require board certification/recertification or MOC.4) The role of payers in this controversy is central. Currently, many hospitals are resisting acceptance of NBPAS certification for hospital privileging due to concerns regarding contractual obligations with payers. The NBPAS criteria for board certification are listed below.Candidates must have been previously certified by an American Board of Medical Specialties or AOA member board.Candidates must have a valid, unrestricted license to practice medicine in at least one US state. Candidates who only hold a license outside of the U.S. must provide evidence of an unrestricted license from a valid non-U.S. licensing body.Candidates must have completed a minimum of 50 hours of continuing medical education (CME) within the past 24 months, provided by a recognized provider of the Accreditation Council for Continuing Medical Education (ACCME). CME must be related to one or more of the specialties in which the candidate is applying. Re-entry for physicians with lapsed certification requires 100 hours of CME with the past 24 months. Fellows-in-training are exempt.For some specialties (ie interventional cardiology, electrophysiology, surgical specialties), candidates must have active privileges to practice that specialty in at least one US hospital or outpatient facility licensed by a nationally recognized credentialing organization with deeming authority from CMS (ie Joint Commission, HFAP, DNV).A candidate who has had their medical staff appointment/membership or clinical privileges in the specialty for which they are seeking certification involuntarily revoked and not reinstated, must have subsequently maintained medical staff appointment/membership or clinical privileges for at least 24 months in another US hospital licensed by a nationally recognized credentialing organization with deeming authority from CMS (ie Joint Commission, HFAP, DNV).NBPAS believes in the value of Continuing Medical Education (CME) for life-long learning. Organizations providing recognized CME programs are regulated by a rigorous accreditation body (ACCME) requiring each CME offering provide an educational gap analysis, “needs assessment,” speaker conflict of interest, course evaluations and many other performance standards. CME can provide education in both established knowledge and also future directions that keep the physician on the “cutting edge.” CME offerings are highly competitive and provide choice. Therefore, using CME to fulfill life-long learning requirements provides efficiency and minimizes redundant activitiesTo view recent research studies examining the impact of MOC on patient outcomes see articles and links below from Circulation and JAMA: Association of Physician Certification in Interventional Cardiology With In-Hospital Outcomes of Percutaneous Coronary InterventionPaul N. Fiorilli, MD et. al. Circulation. 2015; 132: 1816-1824 Between Physician Time-Unlimited vs Time-Limited Internal Medicine Board Certification and Ambulatory Patient Care QualityJohn Hayes, MD JAMA. 2014;312(22):2358-2363. doi:10.1001/jama.2014.13992. Between Imposition of a Maintenance of Certification Requirement and Ambulatory Care–Sensitive Hospitalizations and Health Care Costs Bradley M. Gray, PhD JAMA. 2014;312(22):2348-2357. doi:10.1001/jama.2014.12716 a more complete discussion of the board certification controversy please use the links below to recent NEJM publications.BOARDED TO DEATH — WHY MAINTENANCE OF CERTIFICATION IS BAD FOR DOCTORS AND PATIENTS OF CERTIFICATION 2.0 — STRONG START, CONTINUED EVOLUTION Board Members:The NBPAS Advisory Board Members are high profile, physician thought leaders who value patient care, research, and lifelong learning. Board members (all unpaid) believe continuous medical education is the most meaningful means for staying current in medicine.Paul Teirstein, M.D., President NBPAS, Chief of Cardiology, Scripps ClinicJohn Anderson, M.D., Past President, Medicine and Science, American Diabetes Association, Frist Clinic, Nashville, TNDavid F. Dies, M.D., MBA, Medical Director of Liver Transplantation, John C. McDonald Regional Transplant CenterDavid John Driscoll, M.D., Professor of Pediatrics, Mayo Clinic College of MedicineDaniel Einhorn, M.D., Immediate-Past President, American College of Endocrinology; Past President, American Association of Clinical EndocrinologistsBernard Gersh, M.D., Professor of Medicine, Mayo Clinic College of MedicineC. Michael Gibson, M.D., Professor of Medicine, Harvard Medical SchoolMichael R. Jaff, D.O., Massachusetts General Hospital, Professor of Medicine, Harvard Medical SchoolPaul G. Mathew, M.D., FAHS, Director of Continuing Medical Education, Brigham & Women’s Hospital/Harvard Medical School, Department of NeurologyJordan Metcalf, M.D., Professor and Research Director, Pulm. & Crit. Care, ?Oklahoma University Health Sciences CenterDan Morhaim, M.D., Sinai Hospital Baltimore, MD; Maryland State Legislator – House of DelegatesJeffrey W. Moses, M.D., Professor of Medicine at Columbia University Medical Center, New York, NYJ. Marc Pipas, M.D., Professor of Medicine, Dartmouth Medical SchoolJeffrey Popma, M.D., Professor of Medicine, Harvard Medical SchoolHarry E. Sarles Jr., M.D., FACG, Immediate Past President for the American College of GastroenterologyHal Scherz, M.D., Chief of Urology- Scottish Rite Children’s Hospital, Assoc Clinical Professor of Urology Emory UniversityKaren S. Sibert, M.D., Associate Clinical Professor: UCLA Health; President-Elect: California Society of AnesthesiologistsGregg W. Stone, M.D., Professor of Medicine, Columbia University College of Physicians and SurgeonsEric Topol, M.D., Chief Academic Officer, Scripps Health; Director, Scripps Translational Science InstituteBonnie Weiner, M.D., Professor of Medicine, University of Massachusetts Medical SchoolMathew Williams, M.D., Chief, Division of Adult Cardiac Surgery, New York University Medical CenterList of hospitals where credentials committees, Medical Executive committee and/or hospital board have voted to accept NBPAS as an alternative to ABMS certification:*Advanced Surgical Hospital: Washington, PAArctic Surgery Center: Anchorage, AKArkansas Heart Hospital: Little Rock, ARBaptist Health Lexington: Lexington, KYBaptist Medical Center Princeton: Birmingham, ALBayhealth Medical Center: Dover, DEBaylor St. Luke’s Medical Center/Texas Heart Institute: Houston, TXBozeman Health Deaconess Hospital: Bozeman, MTBrandon Regional Hospital: Brandon, FLCapital Region Medical Center: Jefferson City, MO – (affiliated w/ Univ. of Missouri)Centennial Medical Center: Nashville, TNCHI St. Vincent: Hot Springs, ARChristus Highland Medical Center: Shreveport, LAClinton Memorial Hospital: Wilmington, OHColumbia Basin Hospital: Ephrata, WACommunity First Medical Center: Chicago, ILCommunity Memorial Hospital: Ventura, CACuyuna Regional Medical Center: Crosby, MNEisenhower Medical Center: Rancho Mirage, CAEmory Healthcare: Atlanta, GAFlorida Hospital Heartland Division: Sebring, FLFlorida Memorial Hospital: Daytona Beach, FLFrederick Memorial Hospital: Frederick, MDHabersham Medical Center: Demorest, GAHalifax Medical Center: Daytona Beach, FLHoag Hospital: Newport, CAHolmes Regional Medical Center: Melbourne, FLHuntington Hospital: Pasadena, CAIntegris Baptist Medical Center: Oklahoma City, OKLawrence & Memorial Hospital: New London, CTMcAllen Medical Center: McAllen, TXMemorial Hospitals and Healthcare Systems: ,Mendocino Coast District Hospital: Fort Bragg, CAMercy Health – St. Elizabeth Boardman Hospital: Fort Bragg, CAMercy Health – St. Elizabeth Youngstown Hospital: Youngstown, OHMercy Medical Center: Cedar Rapids, IAMiller County Hospital: Colquitt, GAMission Hospital: Mission Viejo, CAMonarch Healthcare: Irvine, CA – IPA, subsidiary of Optum/UnitedNorman Regional Hospital: Norman, OKOklahoma Heart Hospital: Oklahoma City, OKPalm Bay Hospital: Palm Bay, FLParrish Medical Center: Titusville, FLPennsylvania Medical Society: , PAPhoenix St. Luke’s Hospital: Phoenix, AZPlaza Park Hospital: Houston, TXPresbyterian Hospital: Albuquerque, NMProvidence Little Company of Mary: Torrance, CASaddleback Memorial Hospital: Laguna Hills, CASentara Halifax Regional Hospital: South Boston, VAShawnee Mission Medical Center: Kansas City, MOSibley Memorial Hospital – Johns Hopkins Medical System: Washington, DC.Southeast Missouri Hospital: Cape Girardeau, MOSouthern New Hampshire Medical Center: Nashua, NHSouthern Tennessee Regional Health Systems: Lawrenceburg, TNSt Luke’s Hospital: Cedar Rapids, IASt. Jude Medical Center: Fullerton, CASt. Mary Medical Center: Langhorne, PASurgery Center of Oklahoma: Norman, OKTexas Health Presbyterian: Rockwall, TXTexas Neurological Society: Austin, TXTidelands Georgetown Memorial Hospital: Georgetown, SCTidelands Waccamaw Community Hospital: Murrels Inlet, SCUniversity of Pittsburgh Medical Center Hamot: Erie, PAVirginia Gay Hospital: Vinton, IAWillis Knighton Health System: Bossier City, LAWorld Trade Center Health Program: New York, NYWuesthoff Hospital: Melbourne, FLYavapai Regional Medical Center: Prescott, AZYukon-Kuskokwim Health Corporation: Bethel, AK*Note: Some of the above hospitals have changed their bylaws to allow alternatives to ABMS certification that include NBPAS without specifically naming NBPAS.The Washington State Medical Association has recognized NBPAS as an alternative pathway for board recertification. To view the official announcement, click on the link below: has now been selected as the certifying body for over 6,000 physicians. NBPAS offers certification in all ABMS specialties. Physicians across the country are crying out for change and asking for endorsement of NBPAS. Acceptance of NBPAS by XXX will be extremely helpful to physicians throughout the country. Conversely, rejection by XXX will be very harmful. We ask XXX to change its credentialing requirements to either specifically endorse NBPAS for continuing certification or limit its certification requirements to initial certification.Thank you for your consideration.Sincerely yours,XXX XXX, M.D. ................
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