Doctors are additionally concerned about new transparency policies that reveal to the public which doctors meet interval requirements, and which ones don't. "There's an insinuation that good doctors pass their boards, and bad doctors don't," Fleming says.
General guidelines for the new certification are now required by the American Board of Medical Specialties for all 24 boards, each of which tailors specific certification requirements for its group of specialty practitioners.
For internists, the largest group, board certification comes from the American Board of Internal Medicine, which certifies 200,000 internists or one in four physicians in the United States.
But it is the way the ABIM has interpreted its mandate from the ABMS, and tailored its own rules, that has internists fired up. "The ABIM's requirements are as rigorous or more rigorous than many other certification boards," Fleming says.
For example, the new rules require doctors to survey patients' charts, to assure that certain services have been provided, such as foot exams for all patients with diabetes. The effort may involve hiring more staff.
"We're not saying they shouldn't have to do this, but the problem is the way it's being rolled out, with very tight expectations that are burdensome for many practices. We don't think it should be part of the recertification process," Fleming says.