Faced with contentious maintenance of certification requirements, fewer family physicians are keeping their board certification, according to a new study.
Some 5.6% of family physicians who achieved initial certification with the American Board of Family Medicine from 1980 to 2000 never attempted recertification, according to the study published in the Annals of Family Medicine.
The rate of doctors who did not try to recertify with the board increased from 4.9% for those initially certified between 1990 and 1995 to 5.7% from 1996 to 2000. Factors associated with the failure to recertify their board credentials were being male, having an international medical graduate or being 30 years of age or older at initial recertification.
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The study, which included 51,678 family physicians, was done by researchers from the Robert Graham Center in the District of Columbia, the American Board of Family Medicine and the Oregon Health and Science University in Portland who wanted to determine the rates and predictors of attrition from certification, which is associated with higher quality care.
The American Board of Family Medicine put in place a maintenance of certification (MOC) program in 2003 that allows so-called diplomates to extend their original seven-year board certification by three years. As of 2011, certification depends on meeting specific requirements every three years and passing an examination at least every 10 years.
However, there is the perception among some doctors that MOC is too costly, time-consuming and unnecessary if not required by healthcare organizations and payers.
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Of the diplomates who certified or recertified in 2003, 23% did not maintain certification. Reasons included not completing MOC, failing the examination and retirement.
The study authors said the findings have implications in light of projected shortages in primary care doctors and increasing burnout.
“We hypothesize that certification attrition is a transitional step between burnout and leaving the primary care workforce although future studies should elucidate the relationship,” they wrote.
In addition, MOC requirements have provoked fears of physician attrition, they said. Although doctors are leaving certification at higher rates, the absolute numbers are small, they said.
Both hospital credentialing and insurance network membership is often tied to MOC, which proponents say keeps doctors up-to-date and protects patients. However, grassroots doctor organizations have sprung up to press state legislations to adopt laws that ease or eliminate those MOC requirements.