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Does specialty board certification influence clinical outcomes?

Eric N Grosch1

  • 1United Urgent Care Clinic, Fort Myers, FL 33901, USA. eric.grosh@gmail.com

Journal of Evaluation in Clinical Practice
|September 22, 2006
PubMed
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Specialty board certification lacks evidence linking it to improved clinical quality or patient outcomes. Current evaluations are insufficient for assessing physician expertise in complex medical fields.

Area of Science:

  • Medical quality assessment
  • Physician credentialing
  • Epidemiologic criteria

Background:

  • Public demand for a simple quality index in clinical medicine.
  • American Board of Medical Specialties (ABMS) efforts to provide such an index.
  • Concerns about the validity and public relations nature of these efforts.

Purpose of the Study:

  • To examine the evidence supporting specialty board certification as an indicator of clinical quality.
  • To evaluate the claims made by ABMS and associated studies regarding board certification's relevance.

Main Methods:

  • Application of Hill's causal epidemiologic criteria.
  • Analysis of published data and a review article by Sharp et al. concerning board certification and outcomes.
  • Logical and statistical inference to assess the evidence.

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Main Results:

  • No credible evidence was found linking specialty board certification to clinical outcomes or quality of care.
  • The reviewed data failed to establish a connection between board certification and improved patient care.
  • Sharp et al. presented unjustified conclusions despite the lack of supporting evidence.

Conclusions:

  • Specialty board certification is not supported by evidence as a measure of clinical benefit or physician expertise.
  • Current examination methods are inadequate for evaluating specialists in medicine and surgery.
  • Board certification serves as a surrogate, unsubstantiated standard for physician quality.