Opportunities for Continued Collaboration Between Licensing and Certifying Boards Starting a Dialogue National Alliance of Physician Competency January 15-16, 2007

Context For Dialogue NAPC provides an opportunity and a forum for collaboration and dialogue among licensing and certifying boards It is within each group’s collective will and interest to make improvements to these interfaces Significant progress already achieved –e.g., Disciplinary Alert Notification service made available to certifying boards in 2005

Preparation to Start the Dialogue Informal telephone interviews conducted with several certifying and licensing boards  American Board of Internal Medicine, American Board of Surgery, American Board of Pediatrics  North Carolina Medical Board, Michigan Board of Medicine, FSMB Executive Advisory Council Discussion focused on understanding current interface and what each thought could be improved

Findings: Certifying Boards Through DANS, certifying boards have greater access to licensure sanctions than ever before. (This is the primary interface between licensing and certifying boards.) Greater access has highlighted variation among licensing boards in regards to:  Availability of data about suspensions/revocations on licensing boards’ websites  Coding and terminology for causes and actions taken  Time it takes to update a record – change a license status

Findings: Certifying Boards In some instances, rulings by licensing boards are perceived by certifying boards not to match the actions of the physician (rulings appear too heavy or too light)  Experts in the field could enhance the licensing boards’ investigations  Certifying boards could provide highly competent, unbiased experts No central database to find out if someone has a valid license Some states require certification before a license can be reinstated, but certifying boards require an unrestricted license to be eligible for certification

Findings: Certifying Boards (looking inward ) Requirements for licensure during training seem to vary and certifying boards need to set reasonable requirements for recent trainees. Some boards do not accept voluntary restriction within licensure (i.e. ABFM does not accept family physicians who have voluntarily forfeited their OB-GYN licensure privilege.) Certifying Boards must have a part 4 pathway for clinically inactive physicians. Can the definition and repercussions of clinically inactive designations be uniform?

Findings: Medical Boards Medical boards utilize board certification data differently –North Carolina Accepts as evidence of meeting 10 year rule. (Note: current certification is not necessary as long as the physician was certified or recertified within previous 10 years) Accepts in lieu of PGT requirements for IMGs –Michigan does not utilize certifying information at all Neither board requires certification for licensure renewal/re-registration Some discussion about distinction between “restricted license” and unrestricted license granted with conditions

Findings: Medical Boards Expressed interest in greater access to expert witnesses Medical boards find differences in terminology, basis for actions, etc., confusing too Processes used by most boards based in statute or administrative rules and regulations