American Board of Internal Medicine

Last updated
American Board of Internal Medicine
AbbreviationABIM
Founded1936;88 years ago (1936) [1]
Founders American Medical Association, American College of Physicians
39-0866228 [2]
Legal status 501(c)(3) nonprofit organization [2]
PurposeTo enhance the quality of health care by certifying internists and subspecialists who demonstrate the knowledge, skills and attitudes essential for excellent patient care. [3]
Headquarters510 Walnut Street, Suite 1700,
Philadelphia, Pennsylvania 19106, U.S.
Coordinates 39°56′51″N75°09′02″W / 39.947509°N 75.150470°W / 39.947509; -75.150470
Rajeev Jain, MD, FACP, FASGE, AGAF [4]
Chair, ABIM Council
Laura E. Evans, MD, MSc [5]
Furman S. McDonald, MD, MPH [6]
Subsidiaries ABIM Foundation 501(c)(3) [3]
Revenue$55,571,566 [3] (in 2016)
Expenses$62,512,167 [3] (in 2016)
Employees268 [3] (in 2015)
Website www.abim.org

The American Board of Internal Medicine (ABIM) is a 501(c)(3) nonprofit, self-appointed physician-evaluation organization that certifies physicians practicing internal medicine and its subspecialties. The American Board of Internal Medicine is not a membership society, educational institution, or licensing body.

Contents

History

The American Board of Internal Medicine was established on February 28, 1936, by the American Medical Association and the American College of Physicians to issue certification to physicians. [1] In 1989, ABIM began requiring maintenance of certification (MOC) examinations every 10 years for continued board certification. [7]

ABIM is the largest of 24 member certifying boards of the American Board of Medical Specialties. [8] The American Board of Internal Medicine categorizes physicians into one or more of its 20 subspecialties based on training and the passing of a standardized exam, namely:

The certification exams' "blueprints" for each of these specialties can be found at their website.

The current president and chief executive officer of the American Board of Internal Medicine is Furman S. McDonald, MD, MPH.

The American Board of Internal Medicine adopted a governance structure that consists of three entities, namely a Board of Directors, ABIM Council, Specialty Boards and Advisory Committees, and Approval Committees.

Certification

American Board of Internal Medicine Board Certification demonstrates that physicians have completed a residency in a specified medical specialty and have passed a rigorous knowledge assessment exam. Additionally, certification encompasses the six general competencies [9] established by the Accreditation Council on Graduate Medical Education (ACGME). Following regulations established by the American Board of Medical Specialties, in order to be certified, a physician must:

Physicians may become board certified when they have successfully completed residency or fellowship training and by passing a secure examination. Unlike licensure, board certification is not a requirement to practice medicine. Many hospitals require internists to be board certified in order to have admitting privileges, and many health plans require certification for contracting or eligibility for select networks.

The American Board of Internal Medicine asserts that there is a growing body of research that suggests:

The validity of the studies that the American Board of Internal Medicine cites to support these arguments has been questioned, because the authors of these studies are individuals who are employed by, or have previously been employed by, the American Board of Medical Specialties or its related bodies (see Hawkins, Richard E.). [17] In addition, there appears to be a tightly knit, self-credentialed "patient safety/medical quality" industry developing in the United States, from which the authors of many of the studies supporting maintenance of certification have emerged. [18]

The American Board of Internal Medicine is an organization that attempts to assess physicians through proprietary testing and completion of required modules. The American Board of Internal Medicine has issued more than 425,000 initial certificates in internal medicine and its subspecialties in the United States and its territories since its founding. [19] From 2001 to 2013, American Board of Internal Medicine certified 91,024 physicians in general internal medicine. [19] From 2001 to 2013, the American Board of Internal Medicine certified more than 10,000 cardiologists and more than 6,400 medical oncologists. [20] More than 140,000 physicians – including more than 8,000 physicians holding certifications that hold certifications which are valid indefinitely — are currently enrolled in the American Board of Internal Medicine's Maintenance of Certification program.

Maintenance of Certification (MOC)

The American Board of Internal Medicine asserts that research shows that physician knowledge deteriorates and practice habits and patterns fail to change, over time, in response to medical advances[ citation needed ]. Every 10 years, some internists and subspecialists certified in or after 1990 renew their certifications through the American Board of Internal Medicine's Maintenance of Certification program.

The American Board of Internal Medicine's Maintenance of Certification program changed in January 2014. The program now requires physicians to:

  • Some Maintenance of Certification activity every two years
  • 100 Maintenance of Certification points every five years

Criticism of Maintenance of Certification Program

The Maintenance of Certification program has been criticized for taking time away from patient care, not being proven to improve patient care, and costing more in time and expense than it can justify. [21] [22]

On February 3, 2015, the American Board of Internal Medicine announced more changes to the Maintenance of Certification program. In a press release, the American Board of Internal Medicine apologized that it had "clearly got it wrong", and it admitted that the program changes in January 2014 were instituted prematurely. [23] The American Board of Internal Medicine has suspended the Patient Survey and Patient Safety components for at least two years, and it will make changes to the secure exam to make it more reflective of medical practice among others. The final form of Maintenance of Certification remains to be seen.

On March 10, 2015, an article written by Kurt Eichenwald for Newsweek raised skepticism of the ABIM Foundation and its merit. [24]

And there is another organization called the ABIM Foundation that does ... well, it's not quite clear what it does. Its website reads like a lot of mumbo-jumbo. The Foundation conducts surveys on how "organizational leaders have advanced professionalism among practicing physicians." And it is very proud of its "Choosing Wisely" program, an initiative "to help providers and patients engage in conversations to reduce overuse of tests and procedures," with pamphlets, videos and other means.

Doesn't sound like much, until you crack open the 990s. This organization is loaded. In the tax year ended 2013, it brought in $20 million—not from contributions, not from selling a product, not for providing a service. No, the foundation earned $20 million on the $74 million in assets it holds.

The foundation racked up $5.2 million in expenses, which—other than $245,000 it gave to the ABIM—was divided into two categories: compensation and "other." Who is getting all this compensation? The very same people who are top earners at the ABIM. Deep in the filings, it says the foundation spends $1.9 million in "program and project expenses," with no explanation what the programs and projects are.

There are some expenditures, though, that are easy to understand: The foundation spends $153,439 a year on at least one condominium. And it picks up the tab so the spouse of the top-officer can fly along on business trips for free.

—  Kurt Eichenwald

In July 2015, the Annals of Internal Medicine published an independent cost-analysis of the American Board of Internal Medicine's Maintenance of Certification program. [25] Using simulation modeling of the entire American Board of Internal Medicine-certified workforce of US physicians, researchers from the University of California San Francisco and Stanford University estimated that the Feb 2015 version of American Board of Internal Medicine Maintenance of Certification would cost $5.7 billion over ten years, including $561 million in American Board of Internal Medicine's fees and $5.1 billion in time costs (arising from 32.7 million physician hours spent completing Maintenance of Certification requirements). Internists will incur an average of $23,607 (95% CI, $5,380 to $66,383) in Maintenance of Certification costs over 10 years, ranging from $16,725 for general internists to $40,495 for hematologists-oncologists. The authors concluded that "A rigorous evaluation of its effect on clinical and economic outcomes is warranted to balance potential gains in health care quality and efficiency against the high costs identified in this study." [25]

For the first time, the American Board of Internal Medicine faces competition in the certification business from another entity, the National Board of Physicians and Surgeons (nbpas.org). Much of the controversy about the recent behavior of the American Board of Internal Medicine is detailed on their new competitor's website, including a debate between the rival parties. In a survey on Sermo, a physician-only website, 97% of physicians favored the elimination of Maintenance of Certification.

See also

Related Research Articles

<span class="mw-page-title-main">Neurology</span> Medical specialty dealing with disorders of the nervous system

Neurology is the branch of medicine dealing with the diagnosis and treatment of all categories of conditions and disease involving the nervous system, which comprises the brain, the spinal cord and the peripheral nerves. Neurological practice relies heavily on the field of neuroscience, the scientific study of the nervous system.

<span class="mw-page-title-main">Physician</span> Professional who practices medicine

A physician, medical practitioner, medical doctor, or simply doctor is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through the study, diagnosis, prognosis and treatment of disease, injury, and other physical and mental impairments. Physicians may focus their practice on certain disease categories, types of patients, and methods of treatment—known as specialities—or they may assume responsibility for the provision of continuing and comprehensive medical care to individuals, families, and communities—known as general practice. Medical practice properly requires both a detailed knowledge of the academic disciplines, such as anatomy and physiology, underlying diseases, and their treatment, which is the science of medicine, and a decent competence in its applied practice, which is the art or craft of the profession.

A psychiatrist is a physician who specializes in psychiatry. Psychiatrists are physicians who evaluate patients to determine whether their symptoms are the result of a physical illness, a combination of physical and mental ailments or strictly mental issues. Sometimes a psychiatrist works within a multi-disciplinary team, which may comprise clinical psychologists, social workers, occupational therapists, and nursing staff. Psychiatrists have broad training in a biopsychosocial approach to the assessment and management of mental illness.

Obstetrics and gynaecology is the medical specialty that encompasses the two subspecialties of obstetrics and gynaecology. The specialization is an important part of care for women's health.

Internal medicine, also known as general internal medicine in Commonwealth nations, is a medical specialty for medical doctors focused on the prevention, diagnosis, and treatment of internal diseases in adults. Medical practitioners of internal medicine are referred to as internists, or physicians in Commonwealth nations. Internists possess specialized skills in managing patients with undifferentiated or multi-system disease processes. They provide care to both hospitalized (inpatient) and ambulatory (outpatient) patients and often contribute significantly to teaching and research. Internists are qualified physicians who have undergone postgraduate training in internal medicine, and should not be confused with "interns", a term commonly used for a medical doctor who has obtained a medical degree but does not yet have a license to practice medicine unsupervised.

Hospital medicine is a medical specialty that exists in some countries as a branch of family medicine or internal medicine, dealing with the care of acutely ill hospitalized patients. Physicians whose primary professional focus is caring for hospitalized patients only while they are in the hospital are called hospitalists. Originating in the United States, this type of medical practice has extended into Australia and Canada. The vast majority of physicians who refer to themselves as hospitalists focus their practice upon hospitalized patients. Hospitalists are not necessarily required to have separate board certification in hospital medicine.

Internal medicine-pediatrics, or med-peds, is a medical specialty in which doctors train to be board certified in both internal medicine and pediatrics. A residency program in med-peds is four years in length, contrasted with three years for internal medicine or pediatrics alone. Upon completion of a med-peds residency, a doctor can practice in the areas of internal medicine, pediatrics or can complete a fellowship program to further specialize in an internal medicine or pediatrics sub-field.

An allergist is a physician specially trained to manage and treat allergies, asthma and the other allergic diseases. They may also be called immunologists.

Christine K. Cassel is a leading expert in geriatric medicine, medical ethics and quality of care. She is planning dean of the new Kaiser Permanente School of Medicine. Until March 2016, she was president and CEO of the National Quality Forum. Previously, Cassel served as president and CEO of the American Board of Internal Medicine and the ABIM Foundation.

Maintenance of Certification (MOC) is a recently implemented and controversial process of physician certification maintenance through one of the 24 approved medical specialty boards of the American Board of Medical Specialties (ABMS) and the 18 approved medical specialty boards of the American Osteopathic Association (AOA). The MOC process is controversial within the medical community, with proponents claiming that it is a voluntary program that improves physician knowledge and demonstrates a commitment to lifelong learning. Critics claim that MOC is an expensive, burdensome, involuntary and clinically irrelevant process that has been created primarily as a money-making scheme for the ABMS and the AOA.

The American Board of Nuclear Medicine (ABNM) certifies physicians as specialists in the practice of nuclear medicine. Diplomates of the ABNM are called nuclear medicine physicians. The ABNM is one of the 24 member boards of the American Board of Medical Specialties (ABMS).

The American Board of Dermatology (ABD), located in Newton, Massachusetts, United States, certifies physicians in dermatology, dermatopathology, and pediatric dermatology. Board-certified physicians are known as diplomates. Since its inception in 1932, the ABD has certified over 15,000 physicians. The ABD was one of the original four sponsoring organizations of the American Board of Medical Specialties (ABMS). Dermatologists possess expertise in all aspects of healthy and diseased skin through basic scientific research and clinical care. In addition to the wide range of medical diseases, dermatologists have practices devoted to skin surgery, care of children with skin disease, immunologic diseases of the skin and pathology of the skin. Dermatologists play an important role in the maintenance of the general public health in educating people about sun avoidance, sun protection and the signs of skin cancer.

The American Board of Emergency Medicine (ABEM) is one of 24 medical specialty certification boards recognized by the American Board of Medical Specialties. ABEM is a physician-led, non-profit independent organization that certifies residency trained emergency medicine physicians who pass both written and certifying examinations and maintain their certification on a five year cycle. It was originally funded by the American College of Emergency Physicians (ACEP) in 1968 and received specialty board approval in 1979 to become the 23rd medical specialty. 

In 2006, hospice and palliative medicine was officially recognized by the American Board of Medical Specialties, and is co-sponsored by the American Boards of

<span class="mw-page-title-main">American Osteopathic Board of Internal Medicine</span> American organization

The American Osteopathic Board of Internal Medicine (AOBIM) is an organization that provides board certification to qualified Doctors of Osteopathic Medicine (D.O.) who specialize in the prevention, diagnosis, and treatment of disease in adults (internists). The board is one of 18 medical specialty certifying boards of the American Osteopathic Association Bureau of Osteopathic Specialists approved by the American Osteopathic Association (AOA), and was established in 1942. As of December 2011, 3,072 osteopathic internal medical physicians held active certification with the AOBIM.

<span class="mw-page-title-main">American Osteopathic Board of Anesthesiology</span>

The American Osteopathic Board of Anesthesiology (AOBA) is an organization that provides board certification to qualified Doctors of Osteopathic Medicine (D.O.) and non-osteopathic physicians who specialize in the administration of anesthetic agents and perioperative medicine (anesthesiologists). The board is one of 16 medical specialty certifying boards of the American Osteopathic Association Bureau of Osteopathic Specialists approved by the American Osteopathic Association (AOA), and was established in 1956.

Richard J. Baron is the president and CEO of the American Board of Internal Medicine (ABIM) and ABIM Foundation. Baron was chair of the American Board of Internal Medicine's board of directors in 2008–09, a trustee of the ABIM Foundation 2008–13 and a Master of the American College of Physicians.

The American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM) is a medical society for the medical subspecialty of neuromuscular and electrodiagnostic medicine based in the United States. Members are primarily neurologists and physiatrists—as well as allied health professionals and PhD researchers.

The American Board of Pathology (ABPath) is one of 24 member boards of the American Board of Medical Specialties. This organization was assembled in May 1936, under the approval of the Advisory Board for Medical Specialties (ABMS) and the American Medical Association (AMA) Council on Medical Education and Hospitals. It is the duty of the ABPath to grant certification in Anatomic Pathology, Clinical Pathology and/or Anatomic/Neuropathology to qualified Doctors of Medicine and Doctors of Osteopathic Medicine (M.D./D.O.).

The American Board of Obstetrics and Gynecology is a non-profit organization that provides board certification for practicing obstetricians and gynecologists in the United States and Canada. It was founded in 1927, incorporated in 1930, and is based in Dallas, Texas. It is one of 24 medical boards recognized by the American Board of Medical Specialties. ABOG's mission is to define the standards, certify obstetricians and gynecologists, and facilitate continuous learning to advance knowledge, practice, and professionalism in women's health.

References

  1. 1 2 "The American Board of Internal Medicine". British Medical Journal. 2 (3947): 439–40. 29 August 1936. doi:10.1136/bmj.2.3947.439-a. PMC   2457310 . PMID   20780075.
  2. 1 2 "American Board of Internal Medicine". Tax Exempt Organization Search. Internal Revenue Service. Retrieved October 15, 2018.
  3. 1 2 3 4 5 "Form 990: Return of Organization Exempt from Income Tax". American Board of Internal Medicine. Guidetsar. June 30, 2016.
  4. ↑ "Board of Directors". American Board of Internal Medicine. Retrieved October 18, 2024.
  5. ↑ "ABIM Council". American Board of Internal Medicine. Retrieved October 18, 2024.
  6. ↑ "". American Board of Internal Medicine. Retrieved October 18, 2024.
  7. ↑ McDonald, FS; Duhigg, LM; Arnold, GK; Hafer, RM; Lipner, RS (August 2018). "The American Board of Internal Medicine Maintenance of Certification Examination and State Medical Board Disciplinary Actions: a Population Cohort Study". Journal of General Internal Medicine. 33 (8): 1292–1298. doi: 10.1007/s11606-018-4376-z . PMC   6082195 . PMID   29516388.
  8. ↑ Baron, RJ; Johnson, D (5 August 2014). "The American Board of Internal Medicine: evolving professional self-regulation". Annals of Internal Medicine. 161 (3): 221–3. doi:10.7326/M13-2478. PMID   24821363. S2CID   19874060.
  9. ↑ "Policies". American Board of Internal Medicine. Retrieved 16 January 2019.
  10. ↑ Meyer AD, Payne VL, Meeks DW, Rao R, Singh H (2013). "Physicians' Diagnostic Accuracy, Confidence, and Resource Requests: A Vignette Study". JAMA Intern. Med. 173 (21): 1952–58. doi: 10.1001/jamainternmed.2013.10081 . PMID   23979070.
  11. ↑ Davis DA, Mazmanian PE, Fordis M, Van Harrison R, Thorpe KE, Perrier L (2006). "Accuracy of physician self-assessment compared with observed measures of competence: A systematic review". JAMA. 296 (9): 1094–1102. doi:10.1001/jama.296.9.1094. PMID   16954489.
  12. ↑ Zevin B (2012). "Self Versus External Assessment for Technical Tasks in Surgery: A Narrative Review". Journal of Graduate Medical Education. 4 (4): 417–424. doi:10.4300/JGME-D-11-00277.1. PMC   3546569 . PMID   24294416.
  13. ↑ Eva KW, Regehr G (2008). "I'll never play professional football" and other fallacies of self-assessment". J Contin Educ Health Prof. 28 (1): 14–19. doi:10.1002/chp.150. PMID   18366120.
  14. ↑ Choudhry NK, Fletcher RH, Soumerai SB (2005). "Systematic review: The relationship between clinical experience and quality of health care". Ann Intern Med. 142 (4): 260–273. doi: 10.7326/0003-4819-142-4-200502150-00008 . PMID   15710959.
  15. ↑ Audet AM, Doty MM, Shamasdin J, Schoenbaum SC (2005). "Measure, learn, and improve: Physicians' involvement in quality improvement". Health Aff (Millwood). 24 (3): 843–853. doi: 10.1377/hlthaff.24.3.843 . PMID   15886180.
  16. ↑ Hawkins RE, Lipner RS, Ham HP, Wagner R, Holmboe ES (2013). "American Board of Medical Specialties maintenance of certification: Theory and evidence regarding the current framework". J Contin Educ Health Prof. 33 (S1): S7–S19. doi:10.1002/chp.21201. PMID   24347156. S2CID   23906005.
  17. ↑ "Archived copy" (PDF). Archived from the original (PDF) on 2015-02-11. Retrieved 2015-02-11.{{cite web}}: CS1 maint: archived copy as title (link)
  18. ↑ "NGO Pushes for Centralized Power, Control over Physician Licensure — HOLBROOKS WORDSMITHING". Archived from the original on 2015-02-15. Retrieved 2015-02-20.
  19. 1 2 ABIM. Number of candidates certified. Feb. 11, 2014. http://www.abim.org/pdf/data-candidates-certified/Number-Certified-Annually.pdf Archived 2014-04-19 at the Wayback Machine
  20. ↑ ABIM. Number of candidates certified. Feb. 11, 2014. http://www.abim.org/pdf/data-candidates-certified/Number-Certified-Annually.pdf Archived 2014-04-19 at the Wayback Machine
  21. ↑ Teirstein, Paul S. (8 January 2015). "Boarded to Death — Why Maintenance of Certification Is Bad for Doctors and Patients". New England Journal of Medicine. 372 (2): 106–108. doi:10.1056/NEJMp1407422. PMID   25564895.
  22. ↑ Ofri, Danielle (15 December 2014). "Opinion - Board-Certification Has Gone Too Far". The New York Times– via NYTimes.com.
  23. ↑ "ABIM Announces Immediate Changes to MOC Program". ABIM.org. 2015-02-03. Archived from the original on 2019-08-25. Retrieved 2019-06-16.
  24. ↑ Eichenwald, Kurt (10 March 2015). "The Ugly Civil War in American Medicine". Newsweek. Retrieved 9 April 2015.
  25. 1 2 Sandhu, Alexander T.; Dudley, R. Adams; Kazi, Dhruv S. (15 September 2015). "A Cost Analysis of the American Board of Internal Medicine's Maintenance-of-Certification Program". Annals of Internal Medicine. 163 (6): 401–8. doi:10.7326/M15-1011. PMID   26216046. S2CID   24204390.
This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.