When four physician certification boards founded the American Board of Medical Specialties (ABMS) in 1933, those forward thinking organizations—and their professional society sponsors—launched a national movement toward ever increasing physician accountability. Back then, quackery was rampant, so “board certification” meant a lot to patients. The ABMS has since grown to 24 member boards, all ostensibly dedicated to serving “the public and the medical profession by improving the quality of health care through setting professional standards for lifetime certification.”
Because information and technology now advance so rapidly, those one-time lifetime certificates from years ago may no longer be enough. A doctor who passed a test in 1990 isn’t necessarily competent today. The boards have thus changed their approach to certification; for newly minted physicians, time-limited (e.g., 10 year) endorsements now replace the lifetime ones granted to their predecessors. Initially contingent on additional examinations each certification cycle, these newer time-limited endorsements now additionally require ongoing participation in Maintenance of Certification (MOC®) programs.
Humans are aspirational by nature.
The integration of behavioral health into the primary care setting has resulted in a number of benefits. Traditionally, behavioral health and medical health operated separately, but in recent years, the integration of these two systems has improved access to care, ensured continuity of care, reduced stigma associated with seeking care and allowed for earlier detection and treatment of mental health and substance abuse issues. By bringing behavioral health specialists into primary care facilities, healthcare systems have streamlined care and brought down costs, working collaboratively and reducing the number of appointments and hospital visits.
Austin Frakt and Aaron Carroll recently approached me about a 
Our day-to-day interactions with technology are changing expectations and aspirations for almost every touch point in modern life. We want instant feedback and action at the push of a button, from the digital shopping cart to the doctor’s office. That is part of why there is a constant stream of new apps and tech services being released across every industry, including wellness. But the barrage of options can be a problem of its own nature.
Last week, the Senate Health, Education, Labor and Pensions Committee wrapped up hearings focused on stabilizing the individual insurance market leaving unresolved an issue that separates Dem’s and Rep’s on the committee: just how much freedom states should have in managing their insurance markets. At issue are the Section 1332 waivers which allow states to reduce essential benefits in health insurance policies, thus allowing insurers to sell policies that cover less with lower premiums.
