J Am Board Fam Med
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Addressing professionalism is a key role of Certification Boards, but how best to do this is not clear. This article describes a 360° approach to monitoring and enhancing professionalism taken by the American Board of Urology (ABU). ⋯ As a part of its 10-year cycle, the Board requires peer evaluations from other urologists in the community. Finally, and most importantly, ABU uses a portfolio practice log to evaluate the candidates' use of procedures appropriate to their stated subspecialty area of expertise, evaluation of potential overuse or inappropriate use of procedures and a narrative that details any major complications associated with their procedures.
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Traditionally the role of certifying boards has been to hold physicians accountable for demonstrating standards of competence. In recent years, the authority of continuing board certification has been challenged, due to multiple factors that have shifted the dynamics. The breadth and depth of new information, combined with the pressures of system barriers and administrative burdens, can make it challenging for clinicians stay current and maintain their own competency. Absent feedback about their performance, physicians presume they're practicing effectively. The resulting gap between confidence and competence can also lead physicians to make errors of which they may be unaware. In this environment, assessment and accountability are more important than ever. ⋯ Boards have a critical role in professional self-regulation. They should not compromise on their primary responsibility to set and evolve standards for competence and to conduct rigorous assessments of physicians. The methods boards use for assessments should evolve to meet the changing needs of physicians. Collaboration between educators and assessors provides more educational choice, relieves burdens, and supports physicians' commitment to lifelong learning. By working together with physicians, educators and assessors advance their shared goal of supporting physicians to work at the top of their capability and ultimately, optimize patient care.
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The quality of care for children and adults in the United States is variable and often suboptimal. Approaches that improve the systems of care for entire patient populations are needed. ⋯ The American Board of Pediatrics has catalyzed collaborative improvement networks, resulting in improved health outcomes for children, fostered partnerships with patients and families, and brought together key stakeholders to advocate for network improvement efforts for sickle cell disease as one action to address health disparities. Similar concerted efforts by certifying boards in collaboration with physicians and patients can improve the quality of care and lead to better patient outcomes.
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The history of the American Board of Family Medicine (ABFM) is briefly recounted by focusing on 4 major touchstones that can be considered instrumental in shaping its development as the third largest specialty board in the United States. These include the board's founding, its implementation of maintenance of certification, the creation of its research enterprise, and its culture. The importance of each of these touchstones to the unique contributions that the ABFM has made to the specialty board community is explored.