Leading the Charge Toward Maintenance of Certification Changes

Leading the Charge Toward Maintenance of Certification Changes Posted By:
...

The rationale and justification behind certification examinations has always been explained to me as it must be guaranteed to patients that anyone practicing medicine should have minimum core competencies. In other words, certification examinations—and recertification examinations—protect the public.

Upon graduation, PAs have to take a certification examination, the PANCE (Physician Assistant National Certifying Exam)—commonly called our boards—to practice. Years ago, this was a written generalist examination called a core exam. Plus, PAs had to pass at least one of two extended core written exams: on primary care or surgery. One needed to pass the core generalist exam plus either of the two extended core exams to be able to practice. Many years ago, the core exam was expanded and the two extended core exams eliminated. The exam also was moved to a computer-based testing.

For maintenance of certification (MOC), regardless of the specialty of practice, PAs have been obligated to take the Physician Assistant National Recertifying Exam (PANRE), a general knowledge written exam. That was originally done every six years and only recently has that been changed to every 10 years.

PAs have complained bitterly for many years about the high-stakes PANRE, in part because one might be practicing in a super-subspecialty area yet be required to take this generalist exam. It can be argued that the oncology gynecological PA has little to no need to memorize the pediatric immunization schedule. There is a paucity to no data supporting recertification examinations being linked to enhanced quality of care delivered. Some felt this was being used almost exclusively to generate fees. Partially in response to these longstanding objections, the National Commission on Certification of Physician Assistants has developed a new pilot examination which is taken online, over an extended period of time, with 25 questions every three months. This new testing began in January 2019.

Not surprisingly, many physicians have been complaining of their high-stakes MOC with strangely similar arguments. This has escalated to the point of a class action lawsuit against the American Board of Internal Medicine. And just this month an independent commission established in 2017 by the American Board of Medical Specialties (ABMS) issued a 96-page report entitled Vision for the Future Commission. This report opines that the ABMS MOC process is so inappropriate that even the term "maintenance of certification" should be abandoned. In surveying approximately 34,000 physicians, the report found that just 1 in 10 (12%) said they valued MOC, whereas 41% said they did not value the program, and 41% had mixed feelings. The report remains open for public comment and the final report is anticipated in February 2019. With that said, the ABMS is likely years away from changing their MOC process.

It is interesting that once again PAs appear to be on the forefront in adapting to a recertification process that may do what is needed: protecting patients while maintaining the skills and knowledge within the scope of practice of their healthcare providers without bludgeoning people in the process.

Reference

Share

Filed under: Practice Management/Career

Related
Autonomy and Motivation for the Healthcare Workforce

Autonomy and Motivation for the Healthcare Workfor ...

I recently discovered the New England Journal of Medicine podcast Not Otherwise Specified. In full t ...

Filed under: Health Policy and Trends, Miscellaneous, Practice Management/Career, NPs & PAs


Continue Reading
Implicit vs Explicit Bias in Healthcare: A Crash Course

Implicit vs Explicit Bias in Healthcare: A Crash C ...

We all have it—bias, that is. It affects how we interact with others and our relationships, includ ...

Filed under: Miscellaneous, Practice Management/Career, NPs & PAs


Continue Reading
Honest and Confident Patient-Provider Relationships

Honest and Confident Patient-Provider Relationship ...

Continuing Adelaide's case example from post 1 and post 2.

Two months later, Adelaid ...

Filed under: NPs & PAs, Practice Management/Career


Continue Reading
Hope Tempered With Reality

Hope Tempered With Reality

"We don't want to lose hope or let Mom think we don't believe she'll get better." For palliative car ...

Filed under: Miscellaneous, Practice Management/Career


Continue Reading
Why Palliative Care?

Why Palliative Care?

Palliative and serious illness care can be thought of as a "newer" specialty in medicine. The specia ...

Filed under: Practice Management/Career


Continue Reading
Toxic Culture and Driving Meaningful Change

Toxic Culture and Driving Meaningful Change

I have recently taken an increased interest in podcasts. One of my favorites is Brené Brown's Dar ...

Filed under: Miscellaneous, Practice Management/Career


Continue Reading