10/05/2022    Jon Purdy, DPM

AACPM Statement on Board Certification (Bret Ribotsky, DPM)

Board certification, in this day and age, is a
requirement to maintain insurance contracts and
hospital privileges in almost all cases. Unlike
days past, when certification was a badge of honor
and optional, today, not becoming board certified
can mean the end of a physician's practice.

Like any political world, our profession is
intertwined among our state, the APMA and multiple
certification boards. To challenge this,
especially on a state society level, is a
political hot potato. Even individuals appear to
be fearful in using their names in posting
commentary. The APMA, through the HOD, in
conjunction with the CPME, gives the green light
to the boards of their choosing. It then follows
that states will transfer this decision to their
individual licensing boards, and
therefore the acceptance of hospitals and
insurance companies.

Knowing the severity of not becoming certified
should make one question the fairness and
oversight in the administration of such a
certification board. One should know that the
ABFAS (American Board of Foot and Ankle Surgery)
and the ABPM (American Board of Podiatric
Medicine) have "self-certified," and do not
currently have any standardized third party
accreditation or other independent oversight. This
runs contrary to other well know boards such as
the American Board of Orthopaedic Surgery, which
have partnered with the National Center for
Quality Assurance (NCQA) and National Quality
Foundation (NQF).

Many may not be aware of the American Board of
Multiple Specialties in Podiatry (ABMSP). This
board is accredited by the American National
Standards Institute (ANSI) under the ISO
International Standards ANSI/ISO/IEC/17024:2003
for Accreditation for Bodies Operating
Certification of Persons, as well as accredited by
URAC (former Utilization Review Accreditation
Commission). Over the years, the ABMSP has failed
to gain acceptance by the APMA-HOD, even using the
same psychometrically based testing and comparable
certification process as that of the ABFAS. The
American Board of Multiple Specialties in Podiatry
has certification tracks for wound care, diabetic
limb salvage, podiatric medicine, podiatric
orthopedics, and podiatric surgery.

The CPME and the HOD state that numerous boards
are confusing to the public and medical
communities and strive for unification. It follows
that one board certifying in multiple areas would
be preferred, according to this stated mission.
There is no board better qualified nor situated to
fulfill this role than the ABMSP. Yet, they remain
a non-entity in our profession.

In comparison, the ABFAS rules leave podiatrists
terminally ineligible for board certification if
"too much" time has passed in one's career,
effectively ending that individual's career. There
is no such limitation by the ABMSP. If one meets
all criteria to sit for board certification, I
can't for the life of me understand why a
podiatrist would be deemed ineligible secondary to
having "too much" experience.

There are a number of ABFAS "criteria" in becoming
eligible to sit for board certification, that are
far more restrictive than that of even the
American Board of Orthopaedic Surgery. Although
ABMSP does have minimum case numbers needed within
a specific time frame, they do not require “case
diversity” and do not require “site specific”
minimum number of surgeries. This is also true of
the ABOS. These boards do not pose these
requirements, because case diversity and site
specific surgical requirements potentially force
surgeons to operate outside of what works best in
their hands. There is also the potential that
these requirements compel a surgeon to perform
surgeries that are not in the best interest of
their patient population in order to meet
certification requirements.

Currently a podiatrist must join multiple boards,
pay multiple fees, and strain their practice with
multiple burdensome application processes. This
brings to question the current system and
political mechanisms this profession faces.
Although the ABMSP is equipped to solve all of
these extremely important issues and flaws, they
can't seem to beat the system. And to this end,
many of our colleagues will soon face the
inability to continue a viable practice in the
absence of "board
certification."

Jon Purdy, DPM, New Iberia, LA

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