Medical license and board certification: What's the difference?
Anna Bright of Milwaukie, Ore., says the lackadaisical attitude of her back surgeon left her unsatisfied and frustrated. Only after the procedure did she learn the doctor isn't board certified, a process that requires physicians to periodically refresh their skills.
"I'll definitely check credentials next time," Bright says. "A co-worker referred me, but I didn't check him out any further."
Patient advocate Trisha Torrey says a lot of people don't research their doctor beforehand. "They don't understand the importance," Torrey says. "I think many believe all doctors are board certified, just like most believe all doctors are licensed. Neither is the case."
It seems patients need the equivalent of a medical degree to figure out what all the acronyms on the diplomas on their physician's walls mean as far as credentials and competency. Understanding the difference between a medical license and board certification is an important place to start.
A doctor must have a license to legally practice medicine. To get licensed, a physician must graduate medical school, fulfill residency requirements and be approved by the state's medical board.
A board-certified doctor has met those same requirements, plus training and tests beyond what's required for a license. Board certification is a voluntary process and, unlike licensure, specialty specific.
"Board certification is important because it keeps that speciality current," says Dr. Michael Eisenfeld, a board-certified pediatrician at All Children's Hospital in St. Petersburg, Fla. "I wouldn't expect a doctor to become a pediatrician, or any other specialty, and not get board certified."
Two major umbrella not-for-profits regulate the majority of doctor certifications. The American Board of Medical Specialities oversees 24 member boards. Nearly 85 percent of the 700,000 licensed U.S. physicians are certified by an ABMS member board.
"A patient who selects a board-certified physician knows that doctor has taken an extra step to provide quality care through a commitment to lifelong learning," ABMS President Dr. Kevin Weiss says.
The American Osteopathic Association is the other major player in certification, supervising 18 specialty boards. Approximately 38 percent of the 54,700 osteopathic doctors actively practicing in the U.S. are AOA certified.
Member boards of both groups offer certifications in many of the same specialities, such as emergency medicine and pediatrics. In order to keep pace with advances in medicine, each requires recertification every six to 10 years, depending on the specialty.
Board certification applies to dentists as well, although their credentials can be tougher to verify. The American Dental Association recognizes nine specialty member boards. Five of those allow patients to check certifications online for free. The rest charge $25 for the information. One board even requires the patient to enter the dentist's social security number.
Many young doctors aren't yet board certified because some specialties require up to four years of additional residency training before they can apply. Some doctors simply choose not to seek board certification, yet others use the term "board eligible" for years with no intention of getting certified.
The ABMS and AOA recommend contacting the relevant board to find a physician's actual status. "In the cases of some general practitioners, it may be OK to never do it," Torrey says. "However, the more specialized the need, common sense tells us the more expertise a doctor needs."
While board certification represents a standard of quality, the ABMS and AOA agree it isn't the be-all and end-all when searching for the right doctor. Both say it's possible to receive quality care from doctors who aren't board certified. "It doesn't mean they're not competent," Weiss says.