Are all Doctors Board Certified?

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A Surgeon

Subject: Uncertified

I am not Board Certified and never will be. I went through a residency, then fellowship, and have been pleased to have both institutions offer me jobs on graduation but moved on to my own practice. I am a subspecialty surgeon. I passed the written portion of my board exam. I will never pass the oral exam.

Usually passing the written and not the oral exam means one is not a fluent English speaker, but in my case it is due to the form of abuse that spanned the entirety of my young life. Sitting down in a confrontational oral cross-examination by figures of authority is a problem for me. I have no other part of my life in which I have not been able to conquer my past. I don't melt under pressure. I did hundreds of hours of mock oral exams, but the real exam got worse every year I took it. It is doubly embarrassing because there are a lot of questions that are repeated from year to year and the examiners were mostly the same people.

Before my final permitted attempt I swallowed my pride, explained my situation to my examining board, and asked if accommodations could be made for an oral exam. I was told NO accommodation could be made. Written exams have policies for accommodations such as extended time for dyslexic doctors, or large print for doctors that have poor vision that glasses cannot correct. Perhaps it is because I am insufficiently disabled. I have no obvious effects other than speech pattern changes and loss of access to most of my adult memory. I look and sound calm, though my pulse runs about 180.

Not being board certified means I will be dropped from one of the hospitals I work at this year and the other is likely to follow next year. By itself, that isn't a problem because I do almost exclusively outpatient surgery. Ambulatory surgery centers require hospital privileges within a certain distance, however, so I will quickly be dropped from them as well. A surgeon without an OR cannot work. If I want to stay in medicine I will have to go back and do a residency in one of the specialties that does not have an oral exam. It will be hard because the federal dollars that are paid to residency programs cannot be used twice for the same person, making me a very unattractive candidate. I may have to quit medicine altogether.

It frustrates me that after all the passed tests, failing this final one will destroy my ability to practice. I have lower than average complication rates, higher than average satisfaction scores, and am trusted enough that other doctors send their children to me for treatment. I've taught fellows, was chief resident of my program, lecture to standing-room-only groups of ancillary practitioners, and mentor medical students. For my abusive parent to be able to take this all away, so many years after I escaped... is hard to accept. I hate the idea of having to explain my past to every single insurer, hospital, surgery center, and potential employer. Perhaps I should consider myself lucky that I won't have to, because "policy" makes me ineligible even before I would get the chance to speak.

jason

Subject: uncertified

Hello, I happened to come across your post while looking for an internal medicine doctor, or an appropriate doctor to help me with Adhesive Arachnoiditis in my lumbar spine. If you have heard of this disease, it literally affects every aspect of your physical and mental functions, as well as being in the very top of the most painful diseases there is. I had to respond to your statement about board certified. I have seen probably 100 doctors of every kind over the past 10 years and I am 42. I've seen the most recognized specialists, down to a regular family practitioner. The supposed best doctors, the M.D's ect, have not helped me near as much as someone who is willing to listen and caring. In fact, it's because of a great neurosurgeon that I have gotten this disease in the 1st place. There is no cure, and it's devastating. I can relate to frustration, and just wanted to share my thoughts with you on overcoming things. Like I said, this disease is very hard to deal with, and having doctors knock me down, and minimize the complications and pain I'm in has gotten me to a point where I don't have much respect for the doctors who are supposed to be the best, with letters after their names, and very high self esteem, or pride, whichever it is. What helps me as a person on the other side of your situation is Jesus. Overcoming every minute is a challenge for me, and without him it would be impossible. I've realized that some things in life require power we do not have in ourselves to overcome. But I know for a fact that God has got more power to overcome anything on this earth for people who follow him. And also praying is the most powerful thing that there is. You sound very dedicated, and honest. God will help you if you ask him to, and you'll end up in a better place than you even planned on to begin with. There's a prayer going out for you right now, and I am praying for you to be shown God's grace and love. I hope you can take hold of this free gift from him, and realize that NOTHING is impossible when you are on God's side. :)
Jason

L. Nichols Cook

Subject: Clarification of Board Certification

I am an Eye Surgeon who has been in practice over 22 years. I see a lot of things written about Board Certification, and much of it is false. For example, the idea that Board Certification proves that the doctor has undergone continuing education is misleading. ALL physicians must undergo continuing education as part of their state licensing requirements. They can choose the CME that most relates to their practice and which they would feel to be most beneficial to their patients. They cannot stay in practice if they do not get continuing education.

Almost half of all physicians who are "Board Certified" received lifetime certificates. They may have taken their test 30 years ago. More recent graduates are being required to re-take the tests every so many years. I have taken the test twice, but refuse to take it again on the grounds that it is bogus, so in a few months I will no longer be certified, yet those docs who last took the test 25 years ago will still be certified!

Here is the dirty little secret about Board exams: the tests are NOT at all like being in a practice situation, and they DON'T test actual practical clinical ability, especially surgical skill, or bedside manner in any way! The Board Test is meaningless when it comes to determining if a physician (and especially surgeon) is one with whom a patient would be happy. I personally will always choose the physician who hasn't taken a certification exam in decades, but is highly skilled and whose patients do well, over the recently-recertified doc whose patients have a high complication rate or who has poor people skills. The actual characteristics of what makes an individual physician "good" or "bad" are almost completely independent of conventional closed-book tests such as a Board exam.

I have been in practice for decades, yet I have NEVER had a patient ask me if I was Board certified. What I AM asked is how many of these surgeries I have done! THAT, at least, is a question worth asking!

As an aside, more and more care is being given by people who are not even MD's at all. They did not go to medical school, let alone do a residency in a specialty that has Board Exams. So while the Board companies (whose only business is selling exams) are arguing that the public "demands" Board certification, the truth is that people don't even "demand" actual doctors! Try it yourself - go find out if you actually see an MD when you make an appointment with your "doctor"! Chances are you will see a nurse practitioner.

The Board Certification exams are onerous, expensive, and meaningless. They should be done away with completely, and replaced with evaluations by the patients who actually receive care by the docs, and those evaluations should be made public knowledge. Oh, wait! The online rating services already do that!

rgbuesa

Subject: Board certification vs non-Board certification

It all depends on the physican. Certification is a great honor to attain but it does not make you a better individual. A great physician is one that listens and examines his patients and has excellent bedside manner. He should be objective but very honest and of high integrity. Internal medicine physicians should always carry these qualities after they get accepted into medical school. In my opinion, it does not matter if my physician is Board certified or non-Board certified. The physician will have to earn the trust from his patients. Board certification is the easy way to be given that honor.

Barbara Casteel

Subject: Non-Board Certified Physician at VA

Could I please ask a question? My "doctor" at the VA in Tulsa, OK, is not board certified, nor is she licensed in the state of Oklahoma. Does the VA have the right to have non-state licensed doctors in their facilities? This doctor scares us, she is uncertain of what she is even doing! Is there anything we can do to get her out of there?

Shawn Parker

Subject: Licensure

Barbara, for Federal Govt positions- such as VA, Indian Health facilities, and Dept. of Defense, any state license can work these- it doesn't have to be specific to the state in which the position is, because it's technically a federal position. So your doctor would be licensed in at least 1 state- just not necessarily in the state the facility is located in. As to their competency, I cannot of course speak to that.

Dr. Gregory Pernoud, D.D.S.

Subject: American Board Certification

American Board Certification verifies that the Physicians have been tested by their piers. Pure and simple. In order to qualify to take the test, a doctor must satisfactory complete a residency training program in that field, which has been approved by a governing body for that specialty. The Physician then becomes "Board Eligible". The Doctor does not become Certified until he has taken the American Board of Examiners test. These tests are usually very intense, and may take several days just to complete the test. The preparation for this test may take a year of your personal time, outside, or after the residency program. Some of the more difficult Board Exams may fail up to 50% of those to take it or more. A doctor may take it again, usually in a year, and may, in some cases, may only attempt to take it three times. Many hospitals and insurance companies require American Board Certification for appointments to medical staff, or as a qualifier for insurance.
Those who claim they are "Board Eligible" are the physicians who did not complete an approved residency satisfactorily, or at all, or they took the test and failed it.

Patty S

Subject: Board Eligible VS Board Certification

I'm actually extonished by your definitions of Board Eligible VS Board Certified....the U.S.AirForce actually had the FBI come and interview my spouse to be President Ronald Reagens' personal physician due to his High Security as a Captain with the Air-Force as an Emergency Dept. Physician... He has never been Board Certified but yet has been one of the Best Ever ED Physician.

Kind of Funny; I was in a pedestrian accident. Back over by a car in a cross walk at Lowes. The Board Certified Physician (ER Physician) missed my closed head injury, one herniated disc in my cervical spine and three ruptured disc in my lumbar....
Looks as if your definition of Board Cerified Physician doesn't add up...hmmm?

Brittany Paris
Brittany Paris

Subject: Board Eligible Vs. Board Certification

You’re correct, Patty. Being board certified does not guarantee someone is a better doctor than one who is not certified. Some very fine physicians elect to not get board certified; however, certification gives patients peace of mind by proving the doctor has undergone continued education in their speciality. 

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I second the original question (still unanswered). Speaking as someone who logged in today to try to find an attorney, I see this category as one that's exactly what I have my Angie's List membership for:

1. It's important that I find a good one
2. I'm not an expert enough to know myself who is a good one
3. The industry is full of advertisements and misinformation
4. I wish I knew what experiences other people have had


?
I don't care about lawns--I planted mine in clover and don't have to mow it. When I do need to mow I use a rotary Fiskars mower, which is great--or a scythe. That's right--a scythe (the European type, which is smaller, and it's very good exercise). Gas-powered mowers, chemical fertilizers and weed killers--all nasty stuff that gets into everyone's air, soil, and water. I'm sure my neighbor doesn't like my wildflowers, semi-wild pockets of fruit bushes, and unmown areas and yes, dandelions (I have 10 acres) but that's too bad. It's better habitat for wildlife, especially the pollinators on which our food supply depends. I think this obsession with the Great American Lawn is a waste of time and resources. Plant some food instead.


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I'm not sure Angie et. al. want you to have a complete answer to this question. By re-subscribing at the Indiana State Fair in 2012, I think I paid $20.00 per year for a multi- year subscription. Maybe even less. At the other extreme--and I hope my memory isn't faulty about this--I think the price, for my area, for ONE year was an outrageous $70.00. And they debited me automatically without warning. I had to opt out of that automatic charge. I like Angie's List, but if some of the companies they monitor behaved the way they do in this respect, they'd be on some sort of Pages of Unhappiness. I'll be interested to see if this comment gets published or censored out of existence.
?

That's very difficult to answer without seeing the house. As one poster said, the prep is the most important part. On newer homes that don't have a lot of peeling paint, the prep can be very minimal even as low as a couple or a few hundred dollars for the prep labor.

On a 100 year old home with 12 coats of peeling paint on it, then the prep costs can be very high and can easily exceed 50% of the job's labor cost.

A 2100 sq ft two story home could easily cost $1000 just for the labor to prep for the paint job. That number could climb too. Throw in lots of caullking  or window glazing, and you could be talking a couple or a few hundred dollars more for labor.

Painting that home with one coat of paint and a different color on the trim could run roughly $1000 or more just for labor. Add a second coat  and that could cost close to another $1000 for labor.

For paint, you may need 20 gallons of paint. You can pay from $30-$70 for a gallon of good quality exterior paint. The manufacturer of the paint should be specified in any painting contract. Otherwise, the contractor could bid at a Sherwin-Williams $60 per gallon paint and then paint the house with $35 Valspar and pocket the difference. $25 dollars per gallon times 20 gallons? That's a pretty penny too.

That was the long answer to your question. The short answer is $2000 to $4000 and up, depending upon the amount of prep, the number of coats, the amount of trim, and the paint used.