The subject of Sen. Rand Paul (R-KY) among my colleagues is probably tempered by the same force, which has produced the above oddities. Ophthalmologists, in my personal experiences, don’t approve of him mostly because of his rough history with the American Board of Ophthalmology (ABO), the only certification organization for ophthalmologists in the United States.
In short, Sen. Paul disagreed with the ABO’s 1992 decision to exempt pre-1992 certificate holders from the need to re-certify every 10 years. He felt it was an “injustice” and that “the establishment” needed to hear a “clear message” that they would lose members, and their dues, if they did not treat all of their members equally.
Sen. Paul established the National Board of Ophthalmology (NBO) as an alternative to allow agreeing ophthalmologists to send this “clear message” and to make what he felt is a more rational process for attestation.2
This is not the first time a national, certifying organization has been confronted with organized opposition.
As recently as this year, the American Board of Internal Medicine (ABIM)—an organization that continues to certify about 200,000 physicians4—has received a great deal of push back from San Diego cardiologist, Paul Teirstein, MD. Met with the demands and inconsistencies of Maintenance of Certification (MOC), Dr. Teirstein contacted his group of interconnected cardiologists and asked his interventional cardiology fellows to organize a petition to change the way the certification process is mediated.
Among Dr. Teirstein’s complaints are the price of MOC, its clinical relevance, and the general manner in which the ABIM could not mount a sufficient response to what he saw as an obvious issue. In other forums, he points out the dearth of evidence supporting the measures in place to certify physicians and notes that there is a significant financial conflict of interest in maintaining the offices of certifying organizations.5
Dr. Teirstein raised significant support, garnering more than 10,000 signatures within a short period and has started a conversation loud enough that the ABIM has responded.
Less than a month ago Richard Baron, MD, president of ABIM, contacted his diplomats to inform them they would make some changes to MOC and planned other unspecified changes. This was not satisfactory to Dr. Teirstein, who had already established and named himself president of the National Board of Physicians and Surgeons (NBPS). He has already implemented policies with NBPS and described in popular print the “Paulian” ethos of monopoly, freedom, etc.