Blog Readers Argue About Board Certification: Is It Fair Or Another Way To Discriminate?

When I think about subjects that cause controversy, my last blog topic, “Making Interprofessional Education a Priority to Improve Podiatric Parity,” (https://tinyurl.com/cuefzz5 ) would not be at the top of my list. However, for some readers, it met the qualifications for controversy and they started a verbal parry over what I had said.

I had called for a new accreditation requirement for the colleges of podiatric medicine, namely Interprofessional Education, a common requirement for medical, nursing, pharmacy and other healthcare related colleges. In this new educational forum between all members of the healthcare team, there is an opportunity to break down barriers between the allopathic/osteopathic worlds and our podiatric one.

I always write my blogs independently but this month, I thought I would include some comments by readers to this blog because each side brought up valid comments. The conversation started with some “fightin’ words.”

Doctor A wrote: “Can we complain about professional discrimination when our own boards divide the profession?”

Now there was some controversy and it did not take long to hook a response from Doctor B, a podiatry thought leader and a specialist in children’s podiatric pathology.

“Our colleagues run the boards. The boards aren't dividing us. We are dividing us. This isn't a criticism whatsoever. It's the reality we are dealing with right now.

“The bylaws of ACFAOM require ABPOPPM Qualification/Certification to apply for membership, much like the surgical counterpart with ACFAS requiring ABPS status.”

He explained that if you didn’t participate in qualifying residency programs, “then you are not eligible to sit for the ABPOPPM board examination. Simple as that.”

Dr. B is right in his concept if not in the semantics. A doctor applies for fellowship status after completing a qualifying residency program and passing the ABPOPPM qualifying and certifying exams. Membership is available to podiatric physicians who meet qualifying case requirements and pay a fee for that status. (Visit www.acfaom.org for more information.)

Is There Exclusion From Within The Podiatric Profession?

Doctor A asked a reasonable question from his perspective: “Why would ABPOPPM exclude any licensed podiatrist? Make the exam hard but do not make absurd rules. The states respect our education and experience more than our boards.”

“Why would a primary podiatric board not accept all podiatrists? How do they benefit from this?

“I think if they are unfair to podiatrists, the APMA and CPME should not endorse them ... I can practice podiatric medicine in any state but cannot ever be board certified in it. Thanks a lot, ABPOPPM!”

“How about a little basic fairness to fellow podiatrists before dreaming about parity with MDs?”

Dr. B challenged his correspondent to do some research: “I think that you should look into why these boards/colleges were initiated and how the various residencies came about.

“Every profession is in constant evolution. Things that were valid 20 years ago may not be so anymore for a variety of reasons.

“We already have a body that represents all podiatrists (whether they are members or not) in the APMA. Why exactly should the ABPOPPM represent all podiatrists? Or the ABPS? The reason is for standardization. What is today's standard vs. what it was 20 years ago?

However, when you feel that you have been unfairly shut out, it brings out responses like those from Dr. A.

“Why would a primary podiatric board not accept all podiatrists? How do they benefit from this?

“I think if they are unfair to podiatrists, APMA and CPME should not endorse them.”

What About Public Perception Of ‘Board-Certified’?

I’m sorry, Dr. A. I cannot agree with you on that last comment.

Why should the ABPOPPM accept all podiatrists? For that matter, would ABPS ever accept all podiatrists who had surgical experience or those who took a surgical residency or those who do not?

Of course not nor should they. That is not the meaning of a professional board. Becoming board certified is meant to represent something to the public.

I did a very unscientific poll and asked what “board certification” meant to people not affiliated with medicine. I received the following responses:

• An expert
• The best doctors
• Someone extremely well qualified
• Doctors “I can trust to do a good job”

In Conclusion

Those of us in the profession can always identify those people who received board certification — surgical or medical/orthopedic — but who can’t proficiently perform a hammertoe procedure or diagnose a case of necrobiosis lipodica if it came up and bit them.

Gratefully, those are the exceptions and we still have board certification as a way to set apart those who have gone above and beyond.

Are there excellent podiatric physicians and surgeons who do not have board certification? Of course.

Let this be a lesson to those young podiatric surgeons who think that medicine and orthopedic board certification is not what you want and are planning to “hold out” for surgical certification.

While you are able to do so, get ABPOPPM certified. Then when you can do so, become ABPS certified as well and be one of the truly elite — a double-boarded DPM. I have talked with more than a dozen podiatric physicians who planned to become ABPS-certified and were unable to do so as their “time ran out” on their cases and they would be required to re-sit for qualifying exams. If they had their ABPOPPM certification, they would not be excluded from insurance panels or lose hospital rights in most cases.

There are unique benefits to ABPOPPM certification that I will discuss further in my next blog.