Board certificaiton: Is it tearing optometry apart?

Optometric Management, Apr 2000 by Bowling, Ernest L

If optometry perceives the lack of board certification to be a barrier to insurance panel inclusion, then shouldn't we ask insurers if board certification would make a difference in O.D. acceptance?

I posed this question to Tommy Hudson, D.D.S., senior vice president for Ancillary Products for Blue Cross and Blue Shield of Georgia. His responsibility includes credentialing all optometrists in the Georgia Blue Cross network. He was very frank in his comments:

"An HMO environment seeking accreditation from the National Committee for Quality Assurance (NCQA) places importance on physicians being board certified. No organization could require a credential that isn't in existence. Even if optometric board certification were in place, it wouldn't help or hurt you from a managed care standpoint. Certification isn't necessary to be on our panel. But, if this credential is put in place, it will play into recruiting and certification."

Dr. Hudson pointed out that his organization also credentials dentists, and board certification for general dentists has never been an issue.

"Voluntary" participation would become involuntary

One thing is certain. If ABOP becomes a reality, then the concerns voiced by the State University of New York's (SUNY) optometry school President, Alden Haffner about "commercial houses" embracing board certification would be only one of our potential problems.

You can bet managed care organizations, private insurers, credentialing organizations, employers, the government, the military, academia and everyone else will flock to this new credential like ticks to a dog. So the "voluntary" participation ABOP has envisioned will quickly fall by the wayside.

We'll all be forced to participate for economic survival. Or, as Tom Cheezum, O.D., of Chesapeake, Va., and a member of the Virginia Board of Optometry wrote in a recent letter:

"I'll probably take this sham certification test . . . only to protect myself. The insurance companies will likely think we need board certification to be providers, and some O.D.s will advertise themselves as `superior' if they're certified."

Or as the NBEO stated, `the original potential problem of not being able to check the box will then be a real problem - a selffulfilling prophecy."'

Initiating board certification

The proposed mechanism for initial ABOP certification calls for 10 hours of "board certified continuing education" with certification attained after successful completion of a monitored 100question exam. According to Kevin Alexander, O.D., Ph.D., and current AOA trustee, the initial certification process was "done in this way to be credible, yet doable for everyone."

Dr. McCall added, "What ABOP is doing to initiate board certification is the same as every board certification program has done in its respective beginnings. There has to be some way to bring existing practitioners into the program."

Yet the certification process is not without its detractors. The NBEO maintains that "the ABOP standards for initial certification will be quite different and considerably lower than those of any other healthcare profession."