2. ABMS March 24, 2010 APDR: ABR Update

3. SPECIALTY BOARDS  Established to assure the public that the physician has specific qualifications –American Board of Ophthalmology 1917 –American Board of Otolaryngology 1924 –American Board of Obstetrics 1930 –American Board of Dermatology 1932  Advisory Board for Medical Specialties (forerunner of ABMS) established 1933 –The 4 Boards –Associate Member organizations

4. ABMS 24 Member Boards The American Boards of: Allergy and Immunology Anesthesiology Colon and Rectal Surgery Dermatology Emergency Medicine Family Medicine Internal Medicine Medical Genetics Neurological Surgery Nuclear Medicine Obstetrics and Gynecology Ophthalmology Orthopaedic Surgery OtolaryngologyPathologyPediatrics Physical Medicine and Rehabilitation Plastic Surgery Preventive Medicine Psychiatry and Neurology RadiologySurgery Thoracic Surgery Urology 37 primary, 111 subspecialty certificates

5. AMERICAN BOARD OF RADIOLOGY Established 1934 Today: 3 Primary Certificates (DR, RO, RP) Subspecialties  Neuroradiology  Vascular & Interventional Radiology  Pediatric Radiology  Nuclear Radiology  Hospice and Palliative Medicine Maintenance of Certification: All disciplines

6. Founding Boards Dermatology OB/Gyn Ophthalmology Otolaryngology Orthopedic Surgery Pediatrics Psychiatry & Neurology Radiology Urology Internal Medicine Pathology Surgery Neurological Surgery Anesthesiology Plastic Surgery Physical Medicine & Rehab 1947 Colon & Rectal Surgery Preventive Medicine Family Medicine Allergy & Immunology Nuclear Medicine Thoracic Surgery Emergency Medicine Medical Genetics 1935 1936 1937 1940 1936 1949 1969 1971 1979 1991 Year Joined ABMS 1933

7. ABMS Member Boards General Certificates Issued BOARD 2000-2008 CUMULATIVE  Internal Med62,953 227,387  Family Med28,418 97,818  Pediatrics24,603 93,720  Psych / Neuro14,977 62,376  Radiology11,389 53,915  Surgery10,188 58,103 Radiology ranks 6 th by size of budget

8. ABMS THROUGH THE YEARS Advises the Member Boards Approves certificates (new, modified) Specialization/subspecialization Recertification (time-limited certification) Maintenance of Certification (MOC) Engages healthcare stakeholders Defends/promotes/advances the specialty board movement

9. Medical Specialty Board Movement  Standards for knowledge, skill  Professional self-regulation  Fulfills social contract as a professional  Voluntary  Over and above licensure (compulsory)  Today: >85% of U.S. physicians have earned >1 ABMS Specialty Board certificate

10. Board Certification=Gold Standard August 2003 Gallup Poll: When asked: “When given the choice between a board certified physician and a physician who was not board certified but was recommended by a trusted friend or family member…” 75% opted for a board certified physician 23% opted for the physician recommended by a friend or family member

11. Board Certification=Gold Standard May 2008 Opinion Research Corp. Telephone Poll When asked: “Key factors when choosing a doctor…” 95% bedside manner; communication skills 91% board certification 82% friend or family member recommendation 78% doctor’s hospital affiliation 75% doctor’s office location 60% hospital or school where doctor trained

12. Pressures Resulting in Subspecialization and Time-Limited Certification  New technology  Pace of discovery  Pressure to limit scope Lifelong learning, periodic re-examination 1 Time-limited certification – ABFM (1969) – ABEM (1976) Subspecialization  ABR – Radiation Oncology (since 1995) – Diagnostic Radiology, Radiologic Physics (since 2002) – Peds, VIR (’94), Neuro (’95), Nucl (’99), Hosp & Palliative Med (’08)

13. August 2003 Gallup Poll: When asked: “If you knew your doctor’s board certification had expired, would you change doctors?” 54% Very Likely 27% Somewhat Likely 9% Not Too Likely 8% Not at All Likely Public values maintenance of board certification 81% 5

14.  Demonstrate to the public that physicians certified by Member Boards of ABMS — including the ABR-- maintain the necessary competencies to provide quality patient care, and thereby:  Improve the quality & safety of U.S. healthcare Purpose of MOC (in a nutshell)

15. CURRENT ABMS INITIATIVES MOL: FSMB-NBME-ABMS Grass roots defense of ABMS Member Board certification “Board Eligible” Alternate Pathways ABMS-PCPI collaborative measures development Institutional recognition of MOC Stakeholder engagement on physician performance measures & improvement through NQF MOC-PQRI Innovation Pathways in MOC: Focused Practice Recognition ABMS-BC/BS collaboration? MU-HIT ABMS Journal “Certification Matters”