"It's Time!" Say the Major Cardiology Organizations Regarding a Change to the Process of Physician Certification Four of the Major Societies Are Calling for a New Method of Certifying Their Members
September 21, 2023 (updated September 26, 2023 with news of Richard Baron's retirement)-- "It's Time!" announces the press release from a new organization, the CVBoard, comprising four of the major
professional cardiology organizations: the American College of Cardiology (ACC), the Heart Failure Society of America (HFSA), the Heart Rhythm Society (HRS), and the Society for Cardiovascular Angiography & Interventions (SCAI).
By "It's Time!" they mean they no longer wish to be subject to certification by the American Board of Internal Medicine (ABIM). By "It's Time!" they are addressing the long-standing complaints of a wide range of cardiologists who claim that the certification requirements of ABIM are not in any way related to their day-to-day practice, are needlessly time-consuming, and are expensive. By "It's Time!" they want a new organization to be in charge of certifying cardiologists.
And by "It's Time!," Dr. Richard Baron, the roundly-criticized CEO of the American Board of Internal Medicine (ABIM) announced today that for him it is indeed "time" and that he is retiring as of Fall 2024. While the push to leave the ABIM isn't new, as noted below, the current controversy was ignited by a segment of the August 5, 2023 #HealthcareUnfiltered podcast, hosted by Dr. Chadi Nabhan, in which Dr. Baron implied that some doctors might become interested in pursuits like photography and become distracted from the level of excellence required for certification. Click on the link to hear his statement and the pointed reaction of UCSD hematologist, Dr. Aaron Goodman.
Just a couple weeks earlier, Dr. Goodman had started a petition to eliminate ABIM's Maintenance of Certification (MOC) requirement, which quickly grew to over 20,000 signatures. On Twitter/X physicians piled on Dr. Baron's comments, citing many "extra-curricular" activities that enrich medical practice rather than detract from it. That, combined with a since-deleted tone-deaf tweet from ABIM, showing a doctor on vacation in a beautiful setting, sitting at a laptop, happily taking her Longitudinal Knowledge Assessment (LKA) exam, definitely amplified the criticisms.
It would not be too much of an exaggeration to opine that social media, in this case Twitter/X, had a hand in today's retirement announcement.
Of course, patients, hospitals, insurers, and regulatory agencies want to make sure that physicians keep up with the current science, studies, and guidelines. But the requirements imposed by the ABIM have been anathema to many practicing physicians. There have been accusations that the significant amount of money garnered from fees has been misspent. And that the testing requirements for continuing certification are pointless.
The ABIM maintains that these multiple choice examinations, similar to the College Board tests, are essential to verifying whether physicians are current with practice. Yet such tests have already been eliminated for college admissions by 80% of four-year colleges!
This controversy isn't new. Eight years ago, a group of influential cardiologists formed The National Board of Physicians and Surgeons (NBPAS). This organization has been certifying cardiologists outside of the ABIM world. And several hospital systems have accepted these certifications. But today's announcement from the CVBoard carries significantly more weight. It is also clearly a recent response to the NBPAS and other criticisms -- the domain name for the CVBoard.org was just created a month ago. And it will be more months before a determination is made as to the validity of this new certification process. And several cardiologists have expressed skepticism as to whether this will address their complaints. One of the most vocal opponents of ABIM, Dr. Westby Fisher, tweeted: "...this move to a 'CV board' is little more than lipstick on a pig."
The reality is that many cardiologists already engage in CME programs. Every year there are multiple meetings at which Late Breaking Clinical Trials are presented, trials that are then communicated via social media like #CardioTwitter, and by many websites, many from the organizations now demanding a new certification method. The hope is that this new configuration will in fact reflect the reality of current practice more accurately, that the demands on the physician to keep current with the science will be based more in reality, and that the financial impact will be minimized.
I leave you with this video, from Dr. Glaucomflecken, portraying his usual brilliant and entertaining distillation of the issues:
This morning's press release from CVBoard follows:
Cardiovascular Organizations Pursue New, Independent Medical Board New Board would recognize evolution of cardiology into distinct medical specialty
September 21, 2023 -- Washington, DC -- Many of the nation’s most prominent cardiovascular organizations, representing tens of thousands of physicians, unite today to pursue the creation of a new Board for cardiovascular medicine. The proposed new Board would be independent of the American Board of Internal Medicine, where the cardiology certification process currently exists. Collectively, the American College of Cardiology (ACC), Heart Failure Society of America (HFSA), Heart Rhythm Society (HRS) and Society for Cardiovascular Angiography & Interventions (SCAI) are working together to submit a new Board application, with potential for additional consortium members to join.
Other cardiovascular organizations, including the American Heart Association (AHA), have applauded the vision and have collaborated in the development of the application. Formal support from AHA is pending, dependent on official review and consideration by AHA’s Board of Directors at its next scheduled meeting.
“It’s time to have a dedicated cardiovascular medicine Board of our own; cardiology is a distinct medical specialty and physicians want—and deserve—a clinical competency and continuous certification program that is meaningful to their practice and patients,” said ACC President B. Hadley Wilson, MD, FACC. “We know that the cardiovascular community is ready for an independent, self-governed entity, and we are proud to develop this new Board with cardiologists and cardiology organizations at the helm.”
Together, the consortium will submit an application to the American Board of Medical Specialties (ABMS), requesting an independent medical Board for cardiovascular medicine to pursue a new competency-based approach to continuous certification—one that harnesses the knowledge, skills and attitudes required to sustain professional excellence and care for cardiovascular patients effectively. ABMS remains the only authority widely recognized by the public, regulators and payers for initial and ongoing physician certification in the U.S. The new Board will replace the “Maintenance of Certification” approach with a pathway to continuous certification and competency, offering diplomates convenience, support, choice and credit for the learning that physicians currently do to keep their knowledge and skills at the highest level.
“The priority of this proposed new Board is to ensure the requirements truly benefit the cardiology community and the patients we serve,” said HFSA President John Teerlink, MD, FHFSA. “The new Board’s focus on competence in the pursuit of continuous certification is a needed paradigm shift for the field, and we look forward to future collaborations with the consortium as we submit the application.”
The field of cardiology has evolved into a complex specialty distinct from internal medicine, and sustaining relevant continuous certification and competency assessments is fundamental to providing high-value health care. The new Board requirements will deemphasize timed, high stakes performance exams in the continuous certification process and instead will focus on learning assessments to identify gaps in current knowledge or skills, with recommendations offered on Continuing Medical Education (CME) learning resources and activities to help close the gaps. Importantly, the new Board will be developed and overseen by physicians dedicated to the field of cardiovascular medicine. Transparency into Board operations will be a key priority.
“SCAI is excited to collaborate with the other cardiovascular societies to bring forth the appropriate standards and transparency necessary for cardiovascular medicine certification requirements,” said SCAI President George Dangas, MD, PhD, MSCAI. “As the premier society representing interventional cardiology, we are committed to ensuring that we create a simplified process that speaks to the evolving trends in continuing education and other rising demands of physicians in our current health care landscape.”
The application approval process is expected to take several months. If approval is granted by ABMS, it will then take several additional months before initial certification and continuous certification and competency programs would begin.
“The field of cardiology, and the subspecialty of cardiac electrophysiology, have evolved dramatically over the last several decades,” said HRS President Jodie L. Hurwitz, MD, FHRS. “The time is now to create a Board of cardiovascular medicine that can offer our U.S. physician members an innovative approach to maintaining specialized certification that measures the true clinical competence of our diplomates and physicians with relevant educational support.”
About The American College of Cardiology
The American College of Cardiology (ACC) is the global leader in transforming cardiovascular care and improving heart health for all. As the preeminent source of professional medical education for the entire cardiovascular care team since 1949, ACC credentials cardiovascular professionals in over 140 countries who meet stringent qualifications and leads in the formation of health policy, standards and guidelines. Through its world-renowned family of JACC Journals, NCDR registries, ACC Accreditation Services, global network of Member Sections, CardioSmart patient resources and more, the College is committed to ensuring a world where science, knowledge and innovation optimize patient care and outcomes. Learn more at www.ACC.org or follow @ACCinTouch.
About the Heart Failure Society of America
The Heart Failure Society of America, Inc. (HFSA) represents the first organized effort by heart failure experts from the Americas to provide a forum for all those interested in heart function, heart failure, and congestive heart failure (CHF) research and patient care. The mission of HFSA is to provide a platform to improve and expand heart failure care through collaboration, education, innovation, research, and advocacy. HFSA members include physicians, scientists, nurses, nurse practitioners, pharmacists, trainees, other healthcare workers and patients. For more information, visit HFSA.org.
About the Heart Rhythm Society
The Heart Rhythm Society is the international leader in science, education, and advocacy for cardiac arrhythmia professionals and patients and the primary information resource on heart rhythm disorders. Its mission is to improve the care of patients by promoting research, education, and optimal healthcare policies and standards. Incorporated in 1979 and based in Washington, D.C., it has a membership of more than 8,200 heart rhythm professionals from 94 countries. For more information, visit HRSonline.org.
About the Society for Cardiovascular Angiography & Interventions
The Society for Cardiovascular Angiography & Interventions (SCAI) is a nonprofit professional association with nearly 4,500 members representing interventional cardiologists and cardiac catheterization teams in the United States. SCAI promotes excellence in interventional cardiovascular medicine for both adults and children through education, representation, and the advancement of quality standards to enhance patient care. Follow @SCAI on Twitter for the latest heart health news.
Reported by Burt Cohen, September 21, 2023 -- updated September 26, 2023
