Use of board certification in ambulatory surgery center credentialing: a pilot study

Ambulatory surgical centers (ASCs) play a considerable role in providing surgical care in the United States. However, compared to hospitals, ASCs may have less oversight and less-well-developed policies for credentialing and privileging. Specialty board certification is one metric for measuring physician competence. What proportion of ASCs currently requires board certification for privileging is unknown. This article examines the relationship between board certification and privileging policies at ASCs in the United States. A telephone survey of privileging personnel among a convenience sample of 139 freestanding ASCs with two or more specialty services was conducted between February and May 2007. Fifty out of 81 eligible ASCs completed the survey, resulting in a cooperation rate of 62 percent. More than half of ASCs surveyed require that surgical specialists (54 percent, N=27), nonsurgical specialists (56 percent, N=22), and non-American Board of Medical Specialties (ABMS) specialists (56 percent, N=24) be board certified at some point during their tenure. Among ASCs that call for board certification during physician tenure, 11 percent (N=3) require surgical specialists, 5 percent (N=1) require nonsurgical specialists, and 12 percent (N=3) require non-ABMS specialists to hold current board certification at the point of initial privileging. Twenty-nine ASCs (59 percent) allow physicians to retain their privileges after certification expires. Ensuring safe medical care necessitates coordination across healthcare organizations and regulatory agencies. Nevertheless, our results indicate that almost half of multispecialty ASCs are not using this measure of physician competence issued by specialty boards as part of their privileging process.