Over the next several months, officials at the American Board of Internal Medicine will be developing requirements for enhanced certification in comprehensive internal medicine.
The new optional certification would be called Recognition of Focused Practice, a designation that ABIM officials have been developing in order to recognize the special skills gained during practice, said Dr. Richard J. Baron, chair-elect of the ABIM Board of Directors. The added certification would be an optional part of the regular maintenance of certification process.
ABIM is developing a similar Recognition of Focused Practice certification pathway for hospital medicine (INTERNAL MEDICINE NEWS, June 15, 2007, p. 1). Before either of the two certification options can go forward, however, the Recognition of Focused Practice pathway must be approved by the American Board of Medical Specialties. Those discussions are ongoing, Dr. Baron said.
“It's very much a work in progress,” he said.
In the meantime, the ABIM Board of Directors has endorsed the idea that comprehensive internal medicine is a form of practice that is different from what is recognized by the underlying general internal medicine certificate. The board also recently asked a committee to develop requirements for such recognition. That group will report back to ABIM in February 2008.
Officials at the American College of Physicians are supportive of the concept of an added optional certification for the comprehensive internist.
“It's a healthy proposal to acknowledge that there are different ways doctors tend to spend their time or focus their practice,” said Dr. David C. Dale, ACP president.
The idea also complements the concept of the advanced medical home, which ACP and other primary care organizations have been advancing in Congress and throughout organized medicine.
Recertifying as a “comprehensive” internist would be a good fit for an internist working in the advanced medical home, because it would recognize the special skills of the internist who oversees patients with complicated illnesses across various care settings, Dr. Dale said.
The decision by ABIM to move forward with designing the requirements for a comprehensive internal medicine certification comes after a number of months of discussions held by an ABIM work group.
Led by Dr. Baron, the work group convened a series of roundtable discussions with a variety of health care practitioners and other stakeholders, including physicians, insurers, purchasers, and members of the health care team, including nurse practitioners and pharmacists. Members of the work group also consulted with chronic care patients.
What came out of those discussions was a “remarkably consistent vision” of what people wanted from a comprehensive internist, Dr. Baron said.
For example, there was strong consensus among the discussion participants that the comprehensive internist should communicate with patients efficiently and provide access not just for visits but also for questions and for follow-up between visits.
The groups also agreed that the comprehensive internist should have a deep knowledge of medicine and of the patient, Dr. Baron said.
If ABIM officials are successful in establishing a Recognition of Focused Practice certification in comprehensive internal medicine, it would be optional for physicians, he said.
The process could be valuable for internists because payers may see the added value of the services provided by a comprehensive internist and could choose to pay more to physicians with such certification, he said.