Today’s the day that The National Board of Physicians and Surgeons (NBPAS) officially launches. Briefly stated, it’s an alternative certification organization, set up by Dr. Paul Teirstein and a group of physicians, mostly cardiologists, who strongly objected to the Maintenance of Certification assessment track established by the American Board of Internal Medicine (ABIM).
You can read more about it in my post from last week, “Scalpel…Suture…Suction…Pencil?” and in Dr. Teirstein’s New England Journal of Medicine article, titled “Boarded to Death — Why Maintenance of Certification Is Bad for Doctors and Patients.”
I’ll be following the progress of this initiative, but a few recent articles and developments bring up some interesting points. Continue reading
The buzz going around the medical community this week is Dr. Paul Teirstein’s article in today’s New England Journal of Medicine, titled “Boarded to Death — Why Maintenance of Certification Is Bad for Doctors and Patients,” in which he skewers the imposition of the Maintenance of Certification (MOC) requirement put into place a year ago by the American Board of Internal Medicine (ABIM).
The concept of the MOC was to ensure that physicians who had been certified in their specialty kept current with medical practice and the current guidelines. It’s not that concept that Dr. Teirstein objects to, but its heavy-handed implementation by, as he puts it, “people not directly involved in patient care who have lost contact with the realities of day-to-day clinical practice.” Ouch!
And Dr. Teirstein is not alone in his objections. An online petition he created has garnered almost 20,000 signatures. It asks the ABIM to recall the changes in MOC and institute a simple pathway consisting of a recertification test every ten years; a corollary petition, pledging non-compliance (read “boycott”) has over 6,000 signers – a more difficult pledge since many physicians are employed by hospital systems that require the ABIM MOC. And this certification is a monopoly, but more on that later…. Continue reading
Dr. Charles Dotter in LIFE Magazine (1964)
Who is that mad scientist in the 1964 issue of LIFE magazine? Oh, just the man who invented the concept of angioplasty; in fact he’s the man who actually coined the word “angioplasty!” And he’s the doctor who performed the first angioplasties in the leg, in order to save limbs from amputation without resorting to surgery.
Like many innovators, he had a crazy idea: to open blocked arteries from the inside out. No cutting, suturing, or stitching. Less trauma, lower morbidity, quicker recovery. His name was Charles Dotter and he was a radiologist in Portland, Oregon who, 51 years ago next week, performed an angioplasty on the blocked leg artery of an 82-year-old woman. Continue reading