BY CINDY BORGMEYER
One of the most contentious issues considered by this year's AAFP Congress of Delegates in New Orleans received neither a thumbs-up nor a thumbs-down from delegates. The issue: the American Board of Family Practice's new Maintenance of Certification for Family Physicians program, or MC-FP. The decision: Refer the whole matter to the AAFP Board of Directors, with a report back to the 2004 Congress.
For specifics on the new program, visit the ABFP Web site at http://www.abfp.org and click on "Maint of Cert for FPs" in the menu to the left.
 American Board of Family Practice Executive Director James Puffer, M.D., responds to AAFP members' concerns about the board's new maintenance of certification process. |
Academy members had plenty of opportunities to voice their concerns about the new process, starting with a jam-packed town hall meeting Sept. 29.
ABFP Executive Director James Puffer, M.D., and ABFP President Ronald Christensen, M.D., of Anchorage, Alaska, addressed the more than 300 people who showed up with questions about the new program.
During that meeting, some common themes emerged, among them the timetable for implementation.
Why now?
"One of the questions we've been asked is, 'Why are you doing this now? With all the other problems besieging family physicians in the trenches, this is the worst possible time you could do this,'" Puffer said.
Strictly speaking, Puffer said, the ABFP had little choice in the matter. The directive to develop and implement specialty-specific maintenance of certification processes came from the American Board of Medical Specialties, which oversees the ABFP and the other 23 medical specialty boards.
ABMS acted in response to increasing concerns about patient safety and physician accountability -- concerns first expressed in the landmark Institute of Medicine report, To Err Is Human: Building a Safer Health System.
As for the timing of implementation -- that, too, is according to the ABMS schedule, Puffer said. "The ABFP is probably on track with the other large specialty boards in rolling out this maintenance of certification process."
The prospects of added cost and added burden were also sticking points for members who attended the Sept. 29 meeting, as well as for those who testified about three resolutions on the topic in an Oct. 1 reference committee hearing.
Puffer sought to quell the financial concerns at the town hall meeting, saying the ABFP has estimated the cumulative cost of the complete MC-FP cycle -- that is, the cost in 2010 -- as roughly equivalent to that for recertification under the current system. Diplomates would have the option of either paying up front for the entire seven-year cycle or paying incrementally, he said.
As for the time needed to complete the program, Puffer said, "Let me reassure you: Mainte-nance of certification as currently envisioned will not take any more time than the current recertification process."
Communication breakdown
 Oregon alternate delegate John Saultz, M.D., of Portland testifies about the need to educate family physicians about the ABFP's role. |
Perhaps one of the most galling issues for some members grappling with MC-FP was the ABFP's failure to consult its Diplomates, who see themselves as major stakeholders in the venture, as it developed.
Puffer replied that the ABFP's role is to ensure the quality of the nation's family physicians. "Each of the 24 medical specialty boards has a sacred covenant with the American public," he stated. "The American Board of Family Practice does not serve you; it serves the American people."
Nevertheless, insisted Arkansas delegate Joseph Stallings Jr., M.D., of Jonesboro, "We are stakeholders. We represent the people who take care of the majority of people from New Mexico to New York."
South Carolina delegate Audrey Boyd, M.D., of Columbia said she would be among the first group to enter the new process. "I would have liked to have been given the opportunity to give input on why and how (this program) should be implemented," she said.
To be continued ...
The AAFP and ABFP executive committees have met twice since early summer, when the Academy first learned about MC-FP. (Then) AAFP President James Martin, M.D., of San Antonio told attendees at the town hall session those meetings had proven fruitful in helping define the Academy's participation in the new process. However, there clearly remains much yet to be accomplished by the two organizations, he said.
To reach writer Cindy Borgmeyer, e-mail
cborgmey@aafp.org.
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