Should I Maintain My Board Certification for as Long as I Practice?

My answer for myself is: Yes, I would always maintain my board certification for as long as I see patients. I would not practice with lapsed board certification. Here I present my reason – yes, I have only one reason to remain board certified. This medical-legal reason is relevant to and resonates with me. It may or may not be relevant or resonate with you, but I think it’s good for you to at least be aware of it as a factor in your decision to remain a board-certified physician.

First, it must be said that letting your certification lapse may not be a viable possibility in your medical specialty. For example, hospital credentialing bodies may require active board certification to be eligible for staff membership and hospital privileges. But in other specialties and among physicians who have strictly office-based or direct pay practices, board certification may be optional, although it certainly narrows one’s job prospects.

Some physicians opt out of re-certifying or maintaining continuous certification because of the financial expense or the large number of educational (and paperwork) activities required to maintain certification. For others, opting out of certification is a case of defying what they regard as an exploitative and unjust system of control.

Why It Is Important to Be a Board-Certified Physician

My sole reason for maintaining board certification is that I believe that letting my certification lapse would have negative implications for me if I’m ever named in a malpractice suit. By age 65 years, 75% of physicians in low-risk specialties and 99% in high-risk specialties are named in a medical malpractice suit.

I’m not an attorney and I don’t know details about how medical malpractice cases go down in all medical specialties. I present my reason to bring it to your attention. I then recommend you speak with colleagues in your specialty and with your medical malpractice insurer. An undervalued resource for physicians is their medical malpractice insurer. It’s in the insurer’s interest to avoid/minimize claims made in general and successful ones, in particular.

To explain, let me unfold the following scenario: One fine day, the nearly inevitable occurs: a medical malpractice claim is filed against you. Your heart sinks and your stomach even more so. Unless you or your medical malpractice insurance company immediately settles the claim against you, you will almost always face the plaintiff’s attorney, in a deposition and/or in front of the court.

The plaintiff’s attorney’s job is to get you 1) to say something that incriminates you in the case being argued, that is, that supports the claim that your negligent care resulted in harm, and 2) to make you look like a ‘bad’ person. Especially, in cases that are presented to a jury – these are often the high-dollar amount cases – the plaintiff’s attorney wants the jury to dislike and distrust you. This forms a ground of negative emotions in the jury members about you within which they evaluate the facts of the case. If jury members have concluded you’re an uncaring jerk, then it’s easy for them to conclude you engaged in and are liable for negligent care. After all, uncaring jerks do uncaring jerky things.

The approach of making you look bad can be done by making you look argumentative, angry, petty, uncaring, haughty, dishonest, and untrustworthy in any other way. Attorneys can do this in several ways: they keep asking you the same question over and over until you lose your cool or you start looking bored and disengaged. The first response makes you look hot-headed and easily triggered. The second response makes you look uncaring. The message, spoken or unspoken, is “Doctor, your patient was grievously harmed by your actions. Can I ask you to at least pay attention to our important inquiry here?”

So how does this relate to letting your certification lapse? Letting it lapse is a gift to the plaintiff’s attorney because it can show the court that the possibly negligent care you’re being accused of is just one part of a long-standing pattern of behavior and of a mindset of not caring about patients while you practice medicine.

Ask yourself this: if you let your certification lapse, what reasons can you give for it? Because it is an unnecessary expense? Because it is time-consuming? Because the board certification process is a hassle? Because you’re upset by your board’s approach, an approach that makes the life of physicians like you harder?

What reason can you give that will NOT make you sound self-absorbed and entitled? The attorney will keep probing and trying to trigger you to make your lapsed board certification a sign of moral turpitude.

I can just hear an attorney suggesting something like this: “So, Dr. Jack, are you telling us you were just too busy to keep up with the educational activities required by your board? How many weeks of vacation did you take last year? And where did you and your family travel to? Europe and the Caribbean. Hmmm. All in one year. Must be nice. By the way, what is your home address? Oh, that’s a really nice suburb. I also notice you drive a Lexus; is that right? So, let me get this straight Dr. Jack, you don’t believe that keeping up with the educational requirements is something you can afford to spend the time on. Do you think keeping up educationally in your specialty is important? You do? But that’s not what your actions say. So, your patient Mrs. Smith was harmed by your failure to do XYZ and she will now be left with a lifetime of pain, all because you were too busy going on international vacations to even take the necessary minimum steps of maintaining your certification?”

So, this is my reason. This may resonate with you or not. I will maintain my certification because it is one large brick in my wall of protection against malpractice suits. It allows me to sleep better at night. It is worth those hassles to me. Let me know what you think.

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