Physicians could face increased requirements when renewing their state medical licenses under a draft model policy currently being evaluated by the Federation of State Medical Boards.
Under the draft policy, relicensure would become more comprehensive and require that physicians demonstrate continuing skills and knowledge in their area of practice.
The maintenance of licensure process would closely mirror the requirements that the American Board of Medical Specialties has in place for maintenance of certification.
The draft policy is a model that individual state medical boards could use, but the states would determine whether or how it would be implemented.
Over the last 5 years, the Federation of State Medical Boards (FSMB) has been considering just how state medical boards could change these policies to ensure that physician licensees are competent.
“There is general agreement that current licensing requirements involve mainly activities associated with passive learning,” said Dr. Audrey Uknis, professor of medicine at Temple University, Philadelphia, and chair of the continuous professional development committee for the American College of Rheumatology.
But while current relicensure requirements may fall short of demonstrating physician competence to the public, they can still be onerous in terms of their demands on physician time, she said. As a result, if states were to move ahead with increased requirements for relicensure there could be some initial pushback from rheumatologists.
The proposed plan to allow physicians involved in maintenance of certification to use that process to satisfy any new state licensing requirements would help some rheumatologists, Dr. Uknis said. However, there are many rheumatologists who are not engaged in maintenance of certification because of the time and expense involved, or because they hold a lifetime certification from the American Board of Internal Medicine. Roughly half of the 5,000 rheumatologists who are board certified have lifetime certification, she said.
If even a fraction of those physicians who have lifetime certification chose to retire because of increased licensing requirements, it would have a significant impact on the rheumatology workforce, Dr. Uknis said.
But Dr. Uknis said officials at the ACR will continue to work to ensure that even rheumatologists who aren't participating in maintenance of certification have a reasonable pathway to relicensure and tools that can help them meet those requirements.
Earlier this year, the organization's House of Delegates approved guiding principles for developing maintenance of licensure and called for additional research on the impact that the new requirements would have on state medical boards and licensed physicians.
Once that research is complete, the draft maintenance of licensure policy would likely be considered by the FSMB House of Delegates at their meeting next May, said Carol Clothier, vice president of strategic planning and physician competency initiatives for the FSMB.
“Nobody wants to create more work for physicians,” she said.
The idea is to try to take advantage of activities physicians already are doing to and use those to satisfy state licensure requirements, she said.
For their part, state medical boards are feeling pressure from the public in light of rapidly changing science and technology.
And the current requirements, which vary but generally include some continuing medical education, don't match up with public expectations, she said.
If the maintenance of licensure policy is accepted by the FSMB House of Delegates, it still would be a model policy only, Ms. Clothier said.
It would be up to individual states and territories to decide if they wanted to adopt, revise, or ignore the model policy. And that decision and its timing is likely to vary widely based on the politics involved in each state, she added.
This Month's Talk Back Question
If this maintenance of certification issue affects you, will you recertify? Why or why not?