Introduction

Reviews

Checking a Doctor's Credentials, Part 2

Timothy B. McCall, M.D.

Last week we discussed the importance of where the doctor went to medical school. Let’s continue by covering such topics as board-certification, hospital affiliations and disciplinary actions against a doctor.

Board Certification

About 400,000 of the more than 600,000 physicians in the United States are board certified. In order to receive board certification in a specialty, a doctor must complete a training program in it and pass a rigorous examination. Board certification means that a doctor has sufficient knowledge to pass the exam or at least had the knowledge at the time the exam was taken. Since medical knowledge is constantly growing, a doctor who was last certified in 1970 may be 25 years out of date. Some specialty boards require that doctors be regularly recertified but mandatory recertification is not yet universal.

Some older doctors may have trained before board certification was common but these days board certification is becoming a minimal standard to expect from physicians. Almost all doctors desire board certification but many don’t attain it because they haven’t had the required training or haven’t passed the exam. If your doctor isn’t board certified, ask why not.

Many doctors who list themselves as specialists in the yellow pages, aren’t really specialists, they’ve just decided to call themselves one. Many of them have neither completed the required training or passed the rigorous certifying examination. The phone company makes no effort to verify the credentials of the doctors they list. In fact, a study from the New England Journal of Medicine found that two thirds of doctors who called themselves specialists in Allergies in the Yellow Pages weren’t board certified. Ditto for 30 percent of doctors who said they were family practitioners. Of note, with the exceptions of plastic surgery and colorectal surgery, surgeons listing themselves as specialists were more likely to be certified than medical doctors.

Some doctors list themselves as being “board-eligible” implying that they’ve completed the required training for specialty certification but have not yet taken or not yet passed the certifying examination. This is legitimate for a doctor who has just completed training but the term board eligible is abused indefinitely by some doctors who never are able to pass the exam.

You can check on an M.D.’s board certification by consulting the Directory of Medical Specialists in your public library. The easiest way to find out if a doctor is certified is to call the toll-free number of the American Board of Medical Specialties, (800) 776-CERT. They’ll ask a few questions then tell you what specialties a doctor is certified in and the year of certification.

Hospital Affiliation

In order to receive the right to admit patients to a hospital, a doctor must be granted admitting privileges. In order to clear a doctor, the hospital must consult a national data bank on physicians—unfortunately currently inaccessible to patients—which summarizes any disciplinary action against the doctor as well as the doctor’s history of malpractice problems.

What the hospital does with the information is up to them. More prestigious hospitals may refuse admitting privileges to doctors with bad records. Doctors, though, are cash cows for hospitals. Hospitals need to fill their beds to be profitable and it is doctors who direct patients into these beds. Hospitals have a strong incentive to grant admitting privileges to a doctor with a large practice whose patronage could mean hundreds of thousands of dollars in business per year.

Membership in the Local Medical Society

At one time, membership in the local medical society was considered an important indication of a doctor’s standing in the community. In today’s world, it means next to nothing. It is sometimes possible to call the local medical society to check on a doctor’s credentials but they are not good sources of information on the quality of different doctors. Some medical societies will simply read the information the doctors provided, without making any effort to verify its accuracy.

The National Practitioner Data Bank

Since 1990, the National Practitioner Data Bank has collected information on all physicians in the United States. Any malpractice payments, any disciplinary actions by State Licensing Boards or Medical Societies or any revocation or limitation of a doctor’s privileges by a hospital or clinic must be reported. One of the goals of the Data Bank is to prevent physicians who are disciplined in one state from relocating to another state to avoid penalties. In the past, doctors who had their licenses revoked in one state would simply move across the state line and open a practice, their past problems hidden from their patients and from the authorities in the new state.

Due in part to the strong objections of the America Medical Association, the information in the National Practitioner Data Bank is not accessible to consumers. In fact, the AMA favors eliminating the Data Bank entirely, rather than see the information it contains get into the public’s hands. In lieu of the information in the Data Bank, the best source of information on disciplinary actions by state medical boards or the federal government against physicians is published by the Public Citizen Health Research Group. Their address is 1600 20th Street NW, Washington, DC, 20009. Their telephone number is (202) 588-1000.

Checking Up on Massachusetts Doctors

This past November, Massachusetts became the first state to make public the records of malpractice claims and disciplinary actions against doctors, as well as criminal records. Other states, such as Florida, California, Wisconsin, and New York are considering similar disclosure laws but haven’t enacted them yet. Anyone who wants information on a doctor's history, can call Registration in Medicine's Toll Free line and receive up to ten profiles mailed or faxed to them free. The listings will also offer practical information, such as whether the doctor is accepting new patients, the hospitals where they practice, and what insurance plans they accept. The number is 1-800-377-0550.

Next: Are Specialists Better?

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