I have been researching this topic for some time. I am currently board certified in Family Medicine – yes, mother, I am a specialist!! My recertification exam is coming up next year, 2018. As of this writing in 2018, I have decided against retaking my family medicine boards. Which means, I won’t be paying $1,300 for the test. And yet, I will still remain board certified – lemme ‘splain.
Practicing medicine in the USA
To practice medicine in the US you must be licensed. Which means, you must have an acceptable medical school education followed by a residency year. This is often a 1-year internship, at which point you would be considered a general practitioner, a GP.
Internists and family docs aren’t GP’s, even though we refer to them as that.
Each State can set their own minimum number of years of internship/residency before allowing you to be licensed. Connecticut, Kentucky, Michigan, Montana and a few others, for example, requires 2 years of residency before licensing a physician in their territory.
It’s estimated that 20% of US physicians aren’t board certified.
Employment without Renewing Family Medicine Boards
So the biggest concern for doctors is that they won’t get a job if they aren’t board certified. Ironically, these same doctors earned extra income in residency through moonlighting – when they weren’t board certified!
So, if my dumbass as a resident was able to earn a decent income moonlighting then I certainly will have job availabilities as an attending who once was board certified.
Admittedly, it’s a little easier to have at least finished a residency to become board eligible (BE). And having had a status of board certification once in the past will make it much easier to skip future board certification – keep reading and I’ll expand on this.
Why Be Board Certified in Family Medicine?
Well, according to American Board of Medical Specialties (ABMS) – the officially recognized umbrella group in charge of all the other medical specialties – if a patient sees a physician who isn’t board certified then they are putting their health at risk. I’m not making this up.
My buddy Dr. S only completed 1 year of residency and he works beside me in the urgent care as a per diem and I would say he is a better clinician than myself. Not only is he not board certified in family medicine but he will never never have to worry about renewing a family medicine board certification.
My medical group won’t hire him part-time or full-time because he needs to be BE/BC in order to qualify for that position.
Then again, the ABMS also recommends that you interview your physician with the following questions when you meet them for the first time. None of which measure the competency of the clinician.
The most obvious issue is that when you don’t have a board certification (BC) then you potentially may not be able to bill in your particular medical group. This is the case with Kaiser Permanente, if I wanted a part-time or full-time gig with them.
Most other insurance groups also prefer or even mandate board certification in order for you to be part of their network of physicians.
In some circumstances, the insurance company can decrease the payout if a provider without a family medicine board certification is doing the billing.
Most carriers will insure GP’s the same as specialists. But there is a good number who will either charge more or not insure such clinicians at all.
This becomes a problem because if you are seeking employment somewhere, they could legally deny you a job because you aren’t accepted by their malpractice carrier.
If a case goes to court then you will most likely have to accept expert testimony against you from a board certified clinician. This, of course, is an opportunity for the plaintiff to claim that you don’t have the minimum expertise needed to handle their particular case.
Most States lean towards having expert witnesses be in the same specialty as the defendant physician. However, exceptions are made and if the non-specialized doctor was practicing in an urgent care where most doctors are family medicine or emergency medicine board certified then that expert witness will be the gold standard by which the defendant will be judged by the jury.
If you have issues with malpractice in the past then renewing your family medicine certification makes sense. Maybe.
My Family Medicine Board Certification Process
If I knew that I was going to not give a fuck about recertifying before my next deadline then I wouldn’t have bothered taking those damn SAM’s all these years or go through the headache of dealing with the fuckfest of ABFM.
The ABFM’s incomprehensible website has come a long way. It was a nightmare dealing with them when it came to the various recertification steps because I wasn’t practicing traditional family medicine, I was only doing urgent care.
Someone can chime in below. But the image above states that I only owe $250 to take the recertification exam – the ABFM website states I have to pay $1,400 – so, are they just being shady or am I too stupid to figure this out?
The above screenshot is the enigma which I need to deal with in order to qualify to sit for my 10-year anniversary family medicine board examination.
Ways around ABMS certification
There is a monopoly on the board certification process in the US, the ABMS holds that monopoly. There is oversight over this entity but the ABMS are the ones who mandate maintenance of certifications (MOC) and the need to take and pay for self-assessment modules (SAM’s).
Their legislative arm pushes hard to get MOC’s included in the bylaw wording of various institutions including malpractice insurance, health insurance, and hospital appointment.
MOC’s = $$$’s.
NBPAS vs. ABMS
The National Board of Physicians and Surgeons (NBPAS) came on the scene not too long ago to simplify the specialty certification process. They are a separate group from the ABMS and claim that they will a provide board certification document to qualifying physicians.
Their process is simple, it’s on you to do your 50 CME’s every 2 years and there is a fee of $169 for a 2-year certification process. No SAM’s. No MOC’s. No board examination.
The caveat is that you must have been previously board certified by the ABMS and you can’t be in poor standing and of course, you must meet other basic criteria.
Is NBPAS Recognized?
For the record, the NBPAS is referred to by medical professionals as the “fake” board certification. Sadly, our own colleagues are as brainwashed as our patients.
This won’t stop the NBPAS’s cause. They are petitioning aggressively to get recognized by various organizations.
Insurance companies and most malpractice groups will accept this board certification designation, from my research.
Your employer will be another issue. I recommend reviewing their bylaws. I just flipped through a massive document of Kaiser Permanente’s bylaws to look for the requirement of ABMS designation and couldn’t find anything that specified it.
What specialties are offered?
NBPAS offers all the board certification that ABMS offers. You can view a complete list on their site here.
And no, if you were never board certified in Orthopedic surgery then you can’t just get a mock certificate saying you are board certified in it. The process for NBPAS is legit and you’ll need to submit all the proper documents.
Do I endorse The NBPAS?
I am not mentioning NBPAS because I think they are a valid organization. I just found them on the first page of Google. Some research showed that they might be a great alternative to renewing my family medicine board certification.
Then again, I don’t think I am a better physician because I am board certified despite what the ABMS claims on their propaganda websites.
The reason I don’t want to continue with ABMS is because I don’t want to pay their high fees nor have to take a 1-day exam for board certification.
Why do I need to report to a brick and mortar facility to take my test, anyway? Why can’t I refer to my peripheral brain resources? Why do I have to pay another entity to certify me? Will they protect me in court? Will they gimme a hug after a patient finishes chewing me out?
The application process
I went on their application website and uploaded my CME’s, entered my medical license number and my NPI number and paid the $169 fee. That’s it.
Hilarious. It reminds me of the way taxis work and the way Uber works.
Taxi: call them, be on hold, get a rude person on the phone, request a cab, wait forever, have a rude person show up, have them get pissed that I didn’t tip well, leave the cab smelling like shit.
Uber: open the app, enter my destination, set my location, get in and get out.
They state that it takes 6 weeks to get the certificate made out to you. I am updating this post because it’s been 2 weeks now and the board certificate has been emailed to me.
In the future, I’ll let the readers know how this certificate holds up to various job applications. I am quite curious myself. The process was incredibly easy and I am very glad I went with this option.
2021 Update on Family Medicine Board Recertification with ABFM
I decided to retake my family medicine boards with the ABFM. There are many reasons why which I’ll share in future articles. Here is a podcast episode I recorded explaining it.
The advantage is that I am now eligible for some telemedicine gigs which I couldn’t even apply for because of how strict the board certification requirement has gotten.
I wouldn’t go as far as to say it’s necessary to be board certified. But renewing my family medicine boards means that I have even more time until my own business ideas take off.
I maintain my NBPAS board certification (the link goes to my active certificate). And here is my ABFM active certification. For the time being, it’s worth it to have both because it’ll give me a lot more options.