Phlebology as a Recognized Subspecialty A Perspective On the Road Map to ABMS Certification

by Dr. Ben Munger

What is Certification?
Certification in medicine is a two-part system where an independent body, using public criteria, grants authority
to a certifying board or boards to issue-a certificate attesting to the fact that an individual physician has met a
set of clearly defined requirements. At the heart of these requirements is training in an accredited graduate medical education program. The criteria for certification normally consist of a defined period of accredited residency or post residency training and a successful completion of a certification examination meeting national quality standards. The second major component of a certification system is an independent accreditation process that oversees the quality of the graduate medical programs providing the training component of the requirements. The certification and accreditation processes can be overseen by two separate organizations or housed within one.

What is ABMS?
The American Board of Medical Specialties is an organization composed of 24 primary specialty boards. It is
the primary organization providing overseeing certification for physicians in the United States. Most major credentialing agencies and third party payers accept certification by an ABMS member board. As a general statement the ABMS regulates the designation of board certification in the United States through its process of approving primary and subspecialty certification.

Why ABMS Certification?
Defines a SpecialtyIn a broad sense, approval of a certificate by ABMS is the ultimate confirmation that a discipline is a specialty. Without an approved certificate and accredited training programs, a discipline is simply a collection of individualswho have similar interests. They come from a wide variety of training experiences and often exhibit a greater or lesser degree of commitment to the discipline. Accredited training programs followed by a formal examination support the development of common and articulated set of standards. This foundation supports the development of all the other elements of the specialty.

An important but less discussed advantage of ABMS certification is program funding. All training institutions
in the United States involved in graduate medical training receive federal funding through the centers for Medicare
and Medicaid Services (cMS) and are subject to caps on the number of funded training slots they may offer. ABMS
recognition offers access to that pool of funded slots although all decisions are made at the local institutional level and are subject to whatever limitations exist in each institution. Not all subspecialty training slots are funded through cMS. There are other sources of internal and external funding particularly if the program produces physicians that offer important and needed services to the institution or other outside agencies. These sources are also more interested in funding training slots when there is an ABMS certificate available to the fellows.

Acceptance by Other Agencies
Hospitals and insurance companies normally rely on standards set by independent agencies such as ABMS when making decisions to credential physicians at the local level or to include providers in third party insurance plans. Board certification, simply stated, conveys significant credibility.

About the Author
Dr. Munger has extensive experience with the management of large projects and the development of complex
organizations involving multiple and diverse organizations. From 1976-1980, Dr. Munger was a senior executive with the American college of Emergency Physicians (AcEP) and was responsible for the achieving recognition for
Emergency Medicine as a primary medical specialty. In addition to the primary specialty of Emergency Medicine,
Dr. Munger was directly involved in the development of numerous subspecialties involving other specialties. These subspecialties included Pediatric/Emergency Medicine, Sports Medicine, Hyperbaric Medicine and Medical Toxicology. Dr. Munger is currently the Director of the clinical Informatics Fellowship program at the University of Arizona, college of Medicine.

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