Board certification is a credential that is granted to doctors who have demonstrated a high level of skill and expertise in a specific field of medicine. A doctor who is board-certified has completed additional education, training, and testing beyond what is required for a medical degree. This process ensures that the doctor has the knowledge and expertise necessary to provide high-quality care to patients in their respective fields. To be blunt, the only reason a doctor does a residency in an accredited medical specialty is to become board certified.
First of all, many doctors and most laypersons are unaware that there are only 24 approved medical specialty boards that offer certification. These boards are recognized by the American Board of Medical Specialties (ABMS), which is the governing body for board certification in the US. The American Board of Medical Specialties (ABMS) was created to assist these 24 medical specialty boards in the development and use of standards in the ongoing evaluation and certification of physicians. ABMS is recognized as the “gold standard” in certification and believes that better trained physicians means better care for patients. To become board-certified, doctors must meet the specific requirements of their respective specialty boards. This typically includes completing additional education and training, passing written and oral exams, and demonstrating a high level of clinical competence.
Board certification is important for several reasons. First, it provides patients with assurance that the doctor they are seeing has a high level of knowledge and expertise in their field. Board-certified doctors are more skilled at diagnosing and treating complex medical conditions, and have better patient outcomes than doctors who are not board-certified.
Additionally, board certification is important for doctors who want to advance their careers. Most hospitals and healthcare organizations require board certification for physicians who want to practice in certain areas, such as surgery or cardiology. Board certification can also lead to higher salaries and greater career opportunities.
There are many doctors who falsely advertise that they are board certified or claim that they are certified in a recognized medical specialty. It is simple to ascertain the truth by looking on the ABMS website.
I want to give an example to highlight what I am describing. First, let’s look at the medical specialty called phlebology. Phlebologists are specialists that deal with the diagnosis, therapy, and rehabilitation of diseases of the veins. Unfortunately, phlebology is not one of the 24 recognized medical specialties and there are no formal university-based training programs in existence today. The American Board of Phlebology was formed in 2007. In 2013, the Board of Directors approved a new name for the organization, The American Board of Venous and Lymphatic Medicine. The website states that “This change was approved so that our name more clearly conveys the purpose of our organization and the focus of our diplomates. We believe this will help improve communication and reduce confusion when engaging with the lay public, other physicians, health plans, and a variety of governmental and non-governmental agencies. The ABVLM is an independent non-profit organization organized under the laws of the state of Illinois for scientific and educational purposes. No part of its net earnings shall inure to the benefit of any director, officer, or other individual.” The American Board of Venous and Lymphatic Medicine is not a member board of the American Board of Medical Specialties (ABMS).
I read the different ways to achieve “board certification” in phlebology. Most of the 24 recognized specialties are medical in nature and not surgical. Only surgical specialities learn how do an operation. I think it is naïve and irresponsible to believe that phlebology can be performed by any doctor who can provide the correct documentation and pass a written test. The harsh reality is that board certification in phlebology is not “real” and should not convey to the public this means the physician has had proper training.
The three surgical specialties that include formal training in the operative management and the medical care of patients with diseases of the blood vessels are general surgery, vascular surgery, and cardiothoracic surgery. It is taught early on in training that a surgeon should not be performing a procedure if they are incapable of providing complete post-operative care including being able to deal with any potential complication that might have occurred as a direct result of the procedure performed. These three surgical disciplines are the only specialties that train the residents to master the technical aspects required to deal with vascular/venous problems. It should make complete sense to both physicians and those with no medical background that no other specialty has the qualifications to treat these sometimes complex and often misunderstood diseases of the venous system. Clearly a neurosurgeon, who is one of the most highly trained surgical specialists and deals with some of most critically ill patients, does not practice phlebology. Any physician, however, who has performed a residency in any one of the recognized specialties can call himself or herself a phlebologist and say they are board certified if they pass a written test and have additional documentation of having some experience dealing with venous disease? The notion that training in any specialty can lead to a physician becoming a board certified phlebologist is asinine.
Furthermore, the American Board of Venous and Lymphatic Medicine states “ it is not the purpose of the Board to define requirements for membership on hospital staffs, to gain special recognition or privileges for its diplomates in the practice of phlebology or to define the scope of venous and lymphatic medicine practice. The Board does not define who may or may not practice venous and lymphatic medicine. It is neither a source of censure nor an entity for the resolution of ethical or medico-legal issues.” After a critical reading in layman’s terms, this basically says the Board is not responsible for who does what, what their training is in, or where they do it at. In contrast, The American Board of Thoracic Surgery maintains the standards and provides certification to only those cardiothoracic surgeons who have gone through a rigorous training program. It is only after successful completion of the training program that one can be accepted for the written board examination and if successful, sit for a very difficult oral examination. Only then can they call themselves board certified in thoracic surgery.
In summary, board certification is a mark of excellence in medicine, indicating that a doctor has undergone rigorous training and assessment in a specific field. For patients, board certification provides assurance of a doctor's knowledge and competence, while for doctors, it can lead to greater career opportunities and better patient outcomes.
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An interesting and necessary Substack. Thanks.
Dr Richman has become a part of our family, his advocacy has saved our daughter's life and ours. We love you Michael