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Most family physicians seek recertification
The rate of family physicians never attempting recertification remained less than 7% from 1980 to 2000, according to findings recently published in Annals of Family Medicine.
“Board certification has been linked to improved clinical knowledge, higher quality care and less disciplinary action,” Winston Liaw, MD, MPH, medical director at the Robert Graham Center in Washington, D.C., told Healio Family Medicine. “It's important for us to monitor trends in those leaving the certification process.”
Liaw and colleagues classified all family physicians residing in the United States first certified between 1980 and 2000 as either successfully recertifying or not trying for recertification as of Dec. 31, 2015. The researchers also recorded the number of first certification examination failures, doctors’ ages at first certification, region in which they lived, and sex. In addition, doctors of medicine were set apart from doctors of osteopathy and international medical graduates from U.S medical graduates. In total, data from 51,678 family physicians across three initial certification years and four different age groups were analyzed.
Researchers found that the rate of family physicians not attempting recertification was 6.6% for 1980 to 1989. The rate dropped to 4.9% for 1990 to 1995, then rose to 5.7% for 1996 to 2000. Receiving first certification at age 30 years or older, an international medical graduate and a man were linked with being less likely to attempt recertification.
“There are several potential explanations [for these results],” Liaw said in the interview. “The requirements for certification have increased over time, leading some to weigh the costs of certification. There may be some physicians who perceive that the costs outweigh the benefits. Others leave the specialty and pursue another residency. Finally, some leave medicine altogether.”
Liaw explained that research into family medicine certification rates will likely continue.
“We would like to examine the extent to which burnout is playing a role in attrition and look at those physicians who are leaving family medicine for other specialties,” he said.
The American Board of Family Medicine, which oversees the recertification process told Healio Family Medicine that current data show that the attrition rate remained “relatively low and stable” through 2017.
“The [American Board of Family Medicine] has made a major commitment to collecting and utilizing data in order to better understand current physician practice (eg, workforce, scope and burden) in order to make data-driven decisions that will help family physicians,” Robert Phillips, MD, MSPH, vice president of research and policy, American Board of Family Medicine said.
"These data are helping clarify that an absolute primary care shortage remains a problem, but that the greater risk is continued erosion of robust primary care models which are shown to reduce costs and improve outcomes. This erosion is largely explained by increasing employment of physicians by health systems that do not understand or support valuable primary care functions including long-term relationships, care across settings (including hospitals) and delivering babies,” he continued.
Elizabeth Baxley, MD, American Board of Family Medicine board chair as well as professor of family medicine and senior associate dean for academic affairs at East Carolina University, said that initiatives like the Continuous Knowledge Self-Assessment, which assists family physicians in determining knowledge gaps, and the development of the Prime Registry, which takes information from electronic health records and uses it to, among other things, observe and follow patient care quality are “working to ensure that ongoing, adaptive learning methods are seamlessly integrated into a physician’s work day in order to help maintain a high retention rate.”
These two tools were developed with physician feedback, she added. – by Janel Miller
For more information : The Continuous Knowledge Self-Assessment can be accessed through Google Play, iTunes, and www.theabfm.org. The Prime Registry is available through www.primeregistry.org.
Disclosure: Liaw reports no relevant disclosures. Baxley and Phillips work for the American Board of Family Medicine. Please see the study for a full list of the other authors’ relevant financial disclosures.