Continuing Board Certification: Vision for the Future Initiative – a Q&A with Dr. Thomas L. Schwenk

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Thomas L. Schwenk

University of Nevada, Reno School of Medicine Dean Thomas L. Schwenk, M.D.

In a press release, the Continuing Board Certification: Vision for the Future Initiative announced that University of Nevada, Reno School of Medicine Dean Thomas L. Schwenk, M.D., would be part of a 25-physician Vision Initiative Commission to make recommendations to help optimize systems in place for continuing board certification.

If you are like me, having a board-certified physician is probably important to you. But also like me, you may not really know what it means or why it's important. I had no idea that there's an ongoing debate in the field concerning the current board certification systems.

After the news of his impressive appointment, I posed some questions to Dr. Schwenk to gain a better understanding of this lively national debate assessing patient and physician care:

Ellyn Kirtley: Could you briefly discuss the national debate concerning continuing certification?

Dr. Schwenk: The overarching issue here is whether and how to assess the commitment of physicians to lifelong learning and continuous updating of our skills and knowledge. The field started about 50 years ago with a demanding and high-stakes exam every seven years following residency training that was required if one wanted to proclaim continuing board certification. Different specialties handled this slightly differently, but it became an issue of board certification being required for hospital medical staff membership, an expensive exam and significant negative consequences if a physician failed.

Ellyn Kirtley: Why is this a hot national topic?

Dr. Schwenk: The most immediate threat and crisis is that a few state legislatures are being pressured by physicians to outlaw the need for physicians to remain board certified in order to hold hospital staff or insurance credentialing. This would essentially be the end of the profession's commitment to lifelong learning, would be viewed incredibly negatively by the public and would be embarrassing-not to mention would lead to physicians not staying current with medical knowledge. This comes down to whether continuous certification is a good idea poorly executed or a bad idea. Most physicians think it is the former, and there are ways to do this important work more efficiently and effectively.

Ellyn Kirtley: How do you think the Vision Initiative Commission will impact this discussion and ongoing debate?

Dr. Schwenk: The American Board of Medical Specialties (ABMS) is responsible for setting policies that are passed down to all specialty boards. The recommendations of this commission are said to have a high likelihood of implementation because of the high level national nature of the commission, the fact that many specialties are represented, and the crisis looming in some specialties and states that may "throw the baby out with the bathwater."

Ellyn Kirtley: What does this mean for future physicians?

Dr. Schwenk: I think physicians in general are committed to lifelong learning and to providing the highest quality medical care, but the current system does not take full advantage of new technologies, does not account for the many different ways that physicians are already assessed for the quality and safety of their medical care, and puts too much emphasis on a somewhat outmoded way of evaluating a physician's knowledge.

It will be interesting to see where the Commission takes this heated national debate.  

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The University of Nevada, Reno School of Medicine, Nevada's first public medical school, is a community-based, research-intensive medical school with a statewide vision for a healthy Nevada. Established in 1969, UNR Med is improving the health and well-being of all Nevadans and their communities through excellence in student education, postgraduate training and clinical care, research with local, national and global impact and a culture of diversity and inclusion.