How do you know a good doctor when you see one? The role of board certification

Physicians go through a lot of training: pre-med, medical school, internship, residence and some go on to further specialization in fellowships. It used to be that a physician would finish training and hang up a shingle. Competence was assumed and/or self-proclaimed. As one might imagine, this assumption or assertion might not mesh with reality. 

The idea that the public can discern physician quality is challenging: How do you know a neurosurgeon is good? Maybe you’d know if you are also a neurosurgeon, or if you work alongside the neurosurgeon in question, but that’s unlikely. At some point, the medical establishment devised a set of exams to test competency, the exams specific to the discipline: surgery, orthopedics, internal medicine, family medicine, etc. 

The boards in charge of these exams define a threshold of competency, and those that pass are certified as competent in the field. So “board certified in internal medicine” became a mark of competence.

Listen to my conversation with Dr. Richard Baron the president and CEO of the American Board of Internal Medicine. He describes what we do and do not know about physicians and quality and how we might want to think differently about the way we fund primary care if we are interested in improving health outcomes in the U.S.

Dr. Gordon Moore is senior medical director, Clinical Strategy and Value-based Care for 3M Health Information Systems.