Education  |   October 2018
Association between Performance in a Maintenance of Certification Program and Disciplinary Actions against the Medical Licenses of Anesthesiologists
Author Notes
  • From the American Board of Anesthesiology, Raleigh, North Carolina (Y.Z., H.S., A.M., M.T.K., A.J.P., T.W., A.E.H., D.O.W.); Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, California (A.M.); Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota (M.T.K., D.O.W.); Department of Anesthesiology, University of Nebraska Medical Center, Omaha, Nebraska (A.J.P.); Department of Anesthesia and Critical Care, The University of Chicago, Chicago, Illinois (M.M.M.).
  • Corresponding article on page 631.
    Corresponding article on page 631.×
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    Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are available in both the HTML and PDF versions of this article. Links to the digital files are provided in the HTML text of this article on the Journal’s Web site (www.anesthesiology.org).×
  • Submitted for publication November 14, 2017. Accepted for publication May 10, 2018.
    Submitted for publication November 14, 2017. Accepted for publication May 10, 2018.×
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Article Information
Education / Original Investigations in Education / Education / CPD / Patient Safety / Quality Improvement
Education   |   October 2018
Association between Performance in a Maintenance of Certification Program and Disciplinary Actions against the Medical Licenses of Anesthesiologists
Anesthesiology 10 2018, Vol.129, 812-820. doi:10.1097/ALN.0000000000002326
Anesthesiology 10 2018, Vol.129, 812-820. doi:10.1097/ALN.0000000000002326
Abstract

Editor’s Perspective:

What We Already Know about This Topic:

  • Anesthesiology board certification is now time-limited, requiring participation in a program to maintain certification

  • It is unknown how physician performance is associated with participation and performance in this program

What This Article Tells Us That Is New:

  • The introduction in 2000 of certificates that require participation in a program to maintain certification was not associated with a significant change in the incidence of disciplinary license actions

  • Completing maintenance of certification program requirements in a timely fashion was associated with a lower incidence of license actions

Background: In 2000, the American Board of Anesthesiology (Raleigh, North Carolina) began issuing time-limited certificates requiring renewal every 10 yr through a maintenance of certification program. This study investigated the association between performance in this program and disciplinary actions against medical licenses.

Methods: The incidence of postcertification prejudicial license actions was compared (1) between anesthesiologists certified between 1994 and 1999 (non–time-limited certificates not requiring maintenance of certification) and those certified between 2000 and 2005 (time-limited certificates requiring maintenance of certification); (2) within the non–time-limited cohort, between those who did and did not voluntarily participate in maintenance of certification; and (3) within the time-limited cohort, between those who did and did not complete maintenance of certification requirements within 10 yr.

Results: The cumulative incidence of license actions was 3.8% (587 of 15,486). The incidence did not significantly differ after time-limited certificates were introduced (hazard ratio = 1.15; 95% CI, 0.95 to 1.39; for non–time-limited cohort compared with time-limited cohort). In the non–time-limited cohort, 10% (n = 953) voluntarily participated in maintenance of certification. Maintenance of certification participation was associated with a lower incidence of license actions (hazard ratio = 0.60; 95% CI, 0.38 to 0.94). In the time-limited cohort, 90% (n = 5,329) completed maintenance of certification requirements within 10 yr of certificate issuance. Not completing maintenance of certification requirements (n = 588) was associated with a higher incidence of license actions (hazard ratio = 4.61; 95% CI, 3.27 to 6.51).

Conclusions: These findings suggest that meeting maintenance of certification requirements is associated with a lower likelihood of being disciplined by a state licensing agency. The introduction of time-limited certificates in 2000 was not associated with a significant change in the rate of license actions.