What is Board Certification?

A friend recently recommended a doctor, and as he talked about some of the doc’s methods, alarm bells started ringing in my head.  As gently and politely as possible, I suggested that my friend might want to dig a little deeper into the qualifications of this “doctor.”  Where did he go to school?  Where did he do his residency?  What type of credentials does he hold?  Is he board certified?

That information should be readily available, and when someone won’t tell, it should make you stop and ask what they’re trying to hide.  I started digging, trying to see what I could learn to help my friend.

My friend wasn’t even sure what board certification means.  It means that someone who graduated from either an allopathic or osteopathic medical school served a residency (and perhaps an additional fellowship) to obtain extra training in one particular medical specialty.  For instance, since this blog deals mostly with autoimmunity, for someone to become a rheumatologist, that person would need:

  • 4 years to earn a bachelor’s degree
  • 4 years to earn a medical degree
  • 3 years residency in either internal medicine or pediatrics (or 4 year med/peds residency)
  • 2-3 year fellowship in rheumatology

After demonstrating competency during the residency, the physician takes a test to prove knowledge of that particular specialty.  Passing the test earns the doctor board certification.  For sub-specialities (such as rheum), an additional test is required.

The history of board certification is interesting.  In 1908, some MDs were sitting around brainstorming, and decided that patients could be confident in the quality of a doctor’s training and qualifications if there were standards that the doctor had to meet to be deemed competent. Actually, it was much more formal than that:  the president of the American Academy of Ophthalmology and Otolaryngology suggested in a speech that it would be important to define and credential medical specialties.  Patients could rest assured that someone hadn’t gone off the deep end claiming to have special training in a non-existent field.  He proposed creating credentialing boards to certify that doctors had met high standards in that particular specialty and were qualified to practice that type of medicine.

Then, as now, doctors didn’t want to rush into adopting radical new ideas, so it took a while.

  • Nine years after the initial recommendation took place, the board of ophthalmology was incorporated.
  • It took seven more years before the otolaryngology board formed.
  • Six additional years later (a total of 22 years), the ob/gyn board came into being.
  • Doctors practicing dermatology and syphilology* only took two more years to form their own board.

The following year (twenty-five years after Dr. Vail first proposed the idea), those four specialty boards and a whole host of medical organizations** created an Advisory Board of Medical Specialties.*** Since that time, twenty more specialty boards have joined the ABMS, creating a total of 149 specialties and subspecialties in which a physician (MD or DO) can be board certified.

Six years after creation of the ABMS, in 1939, osteopaths created their own credentialing body.  This eventually came to be known as the American Osteopathic Association’s Bureau of Osteopathic Specialists. Today, the BOS lists eighteen specialty boards, with many specialties and subspecialties in which a DO can be board certified.

When doctors are board certified through ABMS or BOS, it’s easy to verify.  Both organizations have everything online.  It’s quick, simple, and free.  Check certification through ABMS here, and the OAO’s BOS here.  On both sites, search for the doctor’s name, then when a list comes up, select the specific doctor whose credentials you want to verify and a new screen will display information about that doctor’s board certification.

To throw a little confusion into the mix, although the American Osteopathic Association was responsible for the creation of what is now the AOA’s Bureau of Specialists, in 1950, the American Association of Osteopathic Physicians created another credentialing organization, which lead to what is today known as the American Board of Physician Specialists.  According to their website, the ABPS has twelve member specialty boards and oversees eighteen specialties; however, the American Association of Physician Specialists (for whom ABPS oversees credentials) claims seventeen specialty boards, so it’s hard to know which (if either) claim is accurate.  It isn’t exactly clear to me what the point of this third credentialing board was (and is).

ABPS’s certifications aren’t easy to confirm, either.  There’s an official form to be completed, and the form must be submitted along with an official letter of request, a $50 fee, and a release from the physician.  I really don’t want to know badly enough that I’d do all that; I’d just find a doctor whose board certification can be verified online in less than a minute! 

***

A quick search revealed that the doctor my friend was considering going to see is not board certified through either the ABMS or the OAO’s BOS.  He contacted the office and was told that the “doctor” is a “Board Certified NMD, DNM, ND, PhD, LCHC, CNHP, DIP, PHC.” What

That’s not a doctor!  The person handling inquiries was highly offended when my friend asked where the naturopath had studied and, in fact, refused to provide any details that would allow someone to verify any of the guy’s claims.

Don’t be confused into thinking that a string of letters after someone’s name means that the person is a qualified medical doctor.

_________________________________

*The American Academy of Dermatology & Syphilology held its first annual meeting in November of 1938.  In 1955 the name was changed to American Board of Dermatology.

**Those organizations involved in creating the first ABMS included (but were not limited to) the AHA, AAMCFSMB,  AMA, NBME

***In 1970, the Advisory Board of Medical Specialties was reorganized and renamed the American Board of Medical Specialties.

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4 thoughts on “What is Board Certification?

  1. As always, a great wealth of information. If your friend’s “doctor” does, in fact, have a PhD, then his title is truly “Doctor X.” However, that doesn’t make him a medical doctor or necessarily capable of prescribing treatment plans (depending on what his PhD is in). Treatment plans, both medical and natural, are scary enough in the hands of well-trainted, competent professionals. They are potentially much, much worse when administered by snake-oil salesmen. This is a good warning for all of us when we seek new health professionals.

  2. My friend has been on hospice for longer than the six months that was expected, so it’s hard to define what will “help” him. Money stayed in his pocket instead of being wasted on snake oil, but maybe he would have preferred to have the hope that CAM offers.

    I know that PhD is a doctoral degree, so technically the person is entitled to be called “doctor” if he does indeed hold a PhD. He’s definitely not a medical doctor, though, and that’s the impression he was trying to convey to my friend. When pressed, the guy wouldn’t say where he went to school or what his doctorate is in. Sounds shady.

    Naturopaths claim to be doctors, too, but people don’t always realize that’s not a different type of medical doctor; it’s not the practice of medicine at all. The guy shouldn’t be presenting himself as if he is. I got taken in by a naturopath once, so I’m extra touchy about this ;)

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