Ideally, physicians, patients, and others should be able to evaluate specialty-certifying boards on the extent to which they demonstrate adherence to the following guiding principles:
A) Transparency at multiple levels of governance and finance.
B) Relevance of board certification to professional practice.
C) Defined opportunities for representation of family physician interests.
D) Certification procedures are not burdensome to physicians.
E) Board certification status encouraged to be used appropriately.
A) Transparency at multiple levels of governance and finance
1. Strong conflict-of-interest protections
a) Qualifying knowledge-certifying activities should not be produced solely by the certifying board.
2. Transparent policies and procedures regarding membership,governance, and finances
a) Members and governance should reflect the makeup of the group they certify (i.e., a group of peers).
b) A governance structure composed substantially of physician members.
3. Nonprofit organizational structure
a) Conforms to community standards of finances and reserves.
b) Public and proactive reporting processes to diplomates and the public including sharing an annual, certified audit of all entities associated with the certifying entity.
B) Relevance of board certification to professional practice
1. Evaluation processes are based on accepted professional standards
a) Relevant to a variety of provider settings and practices within the scope of family medicine.
2. Processes ensure that assessments are based on evidence
a) Knowledge assessments are based on current evidence.
b) Process in place to ensure timely review of all materials to correct inaccurate information.
c) Assessments include a self-evaluative process for the physician
d) A robust quality-control process is in place that ensures the accuracy and validity of all assessments.
e) Ability to accommodate a variety of different assessment methods (i.e., no over-reliance on high-stakes testing).
3. Board certification as a quality indicator
a) Ongoing process of physician engagement in and quality improvement to the evaluation processes.
b) Board clearly and legitimately differentiates to the public a distinct value of board certification.
c) Board demonstrates that certification reflects physicians who deliver quality health care.
C) Defined opportunities for representation of family physician interests
1. Family physicians have significant input to board decisions
a) There should be appropriate family physician membership on the certifying board.
b) The certifying board should regularly survey its diplomates in an anonymous and confidential manner to secure frequent feedback for how the certification process can be improved. Such surveys should not be part of the completion of elements of the certification process.
D) Certification procedures are not burdensome to physicians
1. Process of certification as non-burdensome as possible in cost and time.
a) Not excessively costly to members at any stage of their careers.
b) Processes are not internally or externally redundant.
c) Processes are not irrelevant to majority of physicians.
2. Includes an appeals process that provides members with an opportunity to review their evaluations for accuracy and affords the opportunity for reconsideration.
E) Board certification status must be used appropriately.
1. Board certification is promoted as voluntary and must not be used inappropriately as an absolute or sole criterion for purposes of credentialing, privileging, licensing, payment, or employment.
2) Certification standards of professionalism should not include conduct prior to starting medical training.
3) Certification standards of professionalism should focus only on conduct that is illegal or professionally unethical.