Opportunities for Continued Collaboration Between Licensing and Certifying Boards

1. Opportunities for Continued Collaboration Between Licensing and Certifying Boards Starting a Dialogue National Alliance of Physician Competency January 15-16, 2007

2. Context For Dialogue • NAPC provides an opportunity and a forum for collaboration and dialogue among licensing and certifying boards • It is within each group’s collective will and interest to make improvements to these interfaces • Significant progress already achieved • e.g., Disciplinary Alert Notification service made available to certifying boards in 2005

3. Preparation to Start the Dialogue • Informal telephone interviews conducted with several certifying and licensing boards • American Board of Internal Medicine, American Board of Surgery, American Board of Pediatrics • North Carolina Medical Board, Michigan Board of Medicine, FSMB Executive Advisory Council • Discussion focused on understanding current interface and what each thought could be improved

4. Findings: Certifying Boards • Through DANS, certifying boards have greater access to licensure sanctions than ever before.(This is the primary interface between licensing and certifying boards.) • Greater access has highlighted variation among licensing boards in regards to: • Availability of data about suspensions/revocations on licensing boards’ websites • Coding and terminology for causes and actions taken • Time it takes to update a record – change a license status

5. Findings: Certifying Boards • In some instances, rulings by licensing boards are perceived by certifying boards not to match the actions of the physician (rulings appear too heavy or too light) • Experts in the field could enhance the licensing boards’ investigations • Certifying boards could provide highly competent, unbiased experts • No central database to find out if someone has a valid license • Some states require certification before a license can be reinstated, but certifying boards require an unrestricted license to be eligible for certification

6. Findings: Certifying Boards (looking inward) • Requirements for licensure during training seem to vary and certifying boards need to set reasonable requirements for recent trainees. • Some boards do not accept voluntary restriction within licensure (i.e. ABFM does not accept family physicians who have voluntarily forfeited their OB-GYN licensure privilege.) • Certifying Boards must have a part 4 pathway for clinically inactive physicians. Can the definition and repercussions of clinically inactive designations be uniform?

7. Findings: Medical Boards • Medical boards utilize board certification data differently • North Carolina • Accepts as evidence of meeting 10 year rule. (Note: current certification is not necessary as long as the physician was certified or recertified within previous 10 years) • Accepts in lieu of PGT requirements for IMGs • Michigan does not utilize certifying information at all • Neither board requires certification for licensure renewal/re-registration • Some discussion about distinction between “restricted license” and unrestricted license granted with conditions

8. Findings: Medical Boards • Expressed interest in greater access to expert witnesses • Medical boards find differences in terminology, basis for actions, etc., confusing too • Processes used by most boards based in statute or administrative rules and regulations