A little over a year ago I decided that I wasn’t going to renew my ABMS Family Medicine board certification. I was worried whether I could land a job as a physician without that certification. Fortunately, I haven’t had any trouble at all after switching from ABMS to NBPAS. In fact, it’s one of the best things I did for my wallet and sanity.

The ABMS is a bloated organization that doesn’t do shit for me. They have been hustling hard to make changes because physicians are leaving ABMS for NBPAS for their board certification needs.

This post is my 1-year NBPAS board certification update. I’m still alive, still have my medical license (well…), and I’m still earning fat dough despite the lack of ABMS board certification.

NBPAS Board Certification Update

I signed up with them online in Aril 2017 and paid my dues which was less than $200. It was incredibly painless.

I haven’t been bombarded with emails like I was from ABMS. No warm, fuzzy letters from Puffer.

With ABMS there was always a test to take, some data to enter in some horribly designed website. And there was always a fee to pay. Nothing made sense.

They lobby hard for medical groups to require you to have an ABMS board certification. Kaiser Permanente is such an organization and they suck, so good riddance.

Other medical groups in town and most telemedicine companies haven’t cared which entity I’m board certified with. As long as I have a specialty board certification, they are content.

The NBAS recently launched a new website where all physicians can interact with each other by posting medical questions. How is that for self-governance!

They offer the physicians CME points for posting and replying to questions. It’s a logical way for information to be disseminated among clinicians.

I won’t be asking any questions on there nor sharing any case stories since I don’t want to have that linked back to me in a lawsuit but I like the idea. Let physicians take charge of their own knowledge and earn CME credits for doing it.

Cost Savings with NBPAS vs ABMS

The dollar numbers saved are nothing compared to the time savings and emotional peace of mind.

I dreaded having to log onto ABMS for my Family Medicine board certification. As an urgent care doctor I had no fucking idea why they wanted me to enter data on my continuity of care patients.

Then there were those SAM’s. How many was I supposed to complete? How much did they cost? $300 each or $300 for each 2-year time chunk? Was I paid up? What was I missing? Section IV? Section V? Why the fucking roman numerals?!

The idea of retaking my Family Medicine board certification exam again was constantly on my mind. I didn’t care to retake that test. And after having taken the SAM’s, I knew that there would be very little clinical relevance. How we practice medicine in the real world is still different from what we are tested on.

Foreseeing Future Problems

I won’t be returning to a mainstream medical career in the future. I don’t care to be a full-time employee for a large medical group. Those days are behind me.

If a medical group insists I have an AMBS board certification then I won’t apply to them because there are enough alternative medical groups which accept NBPAS.

I can’t imagine a scenario when I’ll need ABMS but it’s not like I can never return to ABMS. I will perpetually remain board eligible.

As for lawsuits, I can’t think of a scenario where an ABMS board certification would protect me more than an NBPAS board certification.

My Reasons for Switching

For the sake of transparency, my motivation to make the switch was because I didn’t want to retake the ABMS board exam which is every 10 years for family medicine physicians.

This got me online in search of an alternative, which is how I came across NBPAS. It would have been fine if I didn’t have any specialty designation at all, but it was nice to have so I signed up for it.

I enjoyed taking the SAM’s – there was always something to be learned but it was a tedious process.

It would have been much smarter for ABMS to send a weekly or even daily quiz to your inbox so that you can stay up to date. That could be nearly 300 questions for the year.

NEJM Knowledge+ sends you a free weekly question from their board review question bank. This has been a good way for me to stay on top of my facts and it includes explanations for each answer.

ABMS is Shady

A recent article published in Annals of Internal Medicine points to ABMS board certified physicians having better patient outcomes than their matched peers who aren’t board certified.

The differences were abysmally small. Even then, they used HEDIS measures, the joke of medicine.

But the embarrassment really comes from the article’s disclosures. Several authors are employed by the American Board of Internal Medicine. Do we really need such biased studies? Imagine how much the data had to be massaged and manipulated in order to come up with a mere 2% difference.

The HEDIS adherence were pathetic in both groups, ~70%. A 2% difference between the board certified and non-board certified is hardly worth pointing out especially when your prized group had an adherence of <80%.

Shouldn’t these brilliant board certified physicians have much higher HEDIS adherence? I’m being facetious, HEDIS has nothing to do with physician competency.

Medicine and Oversight

What’s the point of that rigorous application process to get into medical school, into residency, and eventually into an attending position when we’re always assumed to be criminals?

What I mean by criminals is the way we are treated by medical boards, lawyers, supervisors, QA committee members, and angry patients.

I’m sure mechanics and financial advisors deal with similar shit. They have to go through the process of gaining the customer’s trust first which can take a while due to poor historical precedence.

I’m a physician who works his ass off to help patients. I don’t have evil secondary intentions. Nor do I care to be treated as though I do regardless of what others have done before me.

Some oversight is necessary but it doesn’t need to get militant. Let the medical boards and lawyers hound us. Shit, even the patients can doubt us and harass us but do we need the ABMS to put even more pressure on us? Can our astonishing physician burnout rate handle it?

Taxis in the US got destroyed by Uber and Lyft. Taxi companies were scrupulous and everyone disliked dealing with them. The ABMS has gone the same way and much like the taxi companies, they don’t care to service those whom they collect fees from.

I’m not fooled by the ABMS’s heartfelt letters they write every damn month. Get the fuck out of here with that. Your words mean navel lint to me, show me what you’re doing. It’s a free market economy and I will vote with my money, even when it comes to my medical board certification.