Should Doctors Explain Their Board Certification to Patients?

Cheryl Clark, for HealthLeaders Media , April 19, 2010

Legislation, such as the Hayashi bill, would at least inform patients if, for example, a doctor proposing to do surgery was not board certified in surgery, or perhaps was board certified in another field, such as radiology.

The idea would be that the patient may start to think twice about whether the doctor had the appropriate qualifications for the procedure under discussion.

Bruner says the requirement may help educate patients who don't know the difference between a physician and other practitioners who have entirely different types of training.

In a recent survey of patients, he discovered that "72% believe a podiatrist is a doctor." Similarly, patients largely believe optometrists and chiropractors are medical doctors as well, he says.

A study in this month's journal, Plastic and Reconstructive Surgery, nine surgeons from Loma Linda, CA, discovered that "a majority (94%) of those providing invasive cosmetic procedures in Southern California have some type of surgical training background, [but] it is disconcerting to see that approximately 40% of the liposuction practitioners in Southern California had no surgical training in liposuction before entering practice."

Lead author Matthew Camp, MD, summed up, "We must question the expanding scope of services that those untrained in surgery are gaining the confidence to offer. The chance of surgical misadventure is high, and the practitioner may find himself or herself in a situation from which extrication [for both physician and patient] to safety may not be possible."

Bruner and Camp say the problem of improperly trained surgeons performing cosmetic surgery is increasing because many non-surgeons—distressed by their declining payments from traditional sources, such as insurance payers or Medicare—are looking to the field to increase revenue.

"These factors are causing an understandable migration into the cosmetic marketplace," Camp wrote. They start out performing procedures that don't require surgical skill, such as injectable fillers, but then "develop the confidence to offer more than just injections and topical treatments.

"Liposuction is one of the most popular aesthetic treatments and has been the focus of much discussion regarding the very real possibility of patient morbidity or mortality when carried out in an inexpert fashion," Camp wrote. "We feel that the provision of such a potentially hazardous treatment by physicians with no training in surgery poses a genuine threat to the safety of patients."

Cheryl Clark is senior quality editor and California correspondent for HealthLeaders Media. She is a member of the Association of Health Care Journalists.

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