News from the AOA's Blog

As a planned discussion and vote on board certification nears, a prominent optometrist sent an e-mail to AOA members explaining how residencies alone can’t help optometrists ensure they are prepared for expected changes in health care and U.S. representatives heard a health care leader describe how board certification is an intrinsic element in value-driven health care. The AOA House of Delegates will take up board certification the morning of Friday, June 26 at Optometry’s Meeting®.

“One of the aspects of the discussion that has ‘clouded’ the discourse is the idea that residency training has a role in this process,” noted J. James Thimons, O.D., in a letter to AOA members May 14. “While residency training is critical to the long-term growth of the profession and serves a key role in the identification and development of future educators and clinicians, it is an obscuration of the discussion on board certification.”

He noted that in the 30 years since residency training has been available, the schools and colleges of optometry, in cooperation with clinics at the Department of Veterans Affairs, referral centers, community health centers, and other sponsors, have developed approximately 300 Accreditation Council on Optometric Education-accredited positions at 150 locations. This is about 20 percent of the current graduating class. …Logistically, to create a universal mandate for residency training would require another 1,500 slots be developed. At the current rate of development this would create universal residency training in the year 2159!”

In his letter, Dr. Thimons explained, “While the ‘dream’ of universal residency training for the profession is one that I and probably many residency-trained colleagues would endorse, it is a concept that has decades and decades of work ahead of it and would need millions and millions of dollars to underwrite its development. Clearly this removes it from the palette of available options as to how we as a profession address the issue of board certification/continued clinical competence. It also does nothing to help the practicing optometrists (90 percent of whom are not residency trained) who want to have the option of getting board certified and demonstrating maintenance of that certification.”

In another development related to board certification and maintenance of certification, Christine Cassel, M.D., president and chief executive officer of the American Board of Internal Medicine (ABIM) testified before the U.S. House Committee on Energy and Commerce, Sub-Committee on Health, April 2, 2009.

“Board certification programs demonstrate and hold physicians accountable for the very skills that innovative care delivery models need to achieve the ultimate sweet spot of enhancing quality and value,” she testified in a hearing on “Making Health Care Work for American Families: Saving Money, Saving Lives.”

Dr. Cassel told U.S. representatives that “we are increasingly able to demonstrate through research that higher standards for physicians mean better quality care for patients. Consequently, we believe that our standards should continue to be incorporated into and aligned with the accountability frameworks of both public and private payers.”

She noted that board certification and maintenance of that certification through regular, formal skills testing, practice monitoring, and self-evaluation, offer ways to enhance the skills of physicians – both those who are in the midst of their training and those who are in practice – and to ensure that physicians can manage complex patients.

According to her testimony, “leading health plans have recognized this critical benchmarking and have put a premium on physicians who are involved in ongoing re-certification or maintenance of certification (MOC) in their reward and recognition programs.” She noted that the certifying boards have also been involved in discussions with Senate staff to recognize MOC as a pathway within the Medicare PQRI program and “we would ask the House leadership to give this idea the same consideration.”

For information about the issue of board certification, visit http://certification.aoa.org.