ANN ARBOR, Mich. — As hospitals face pressure to distinguish themselves from peers through better patient care and outcomes, an increasing number of health care providers are requiring pediatricians to become board certified before gaining hospital privileges.
Between 2005 and 2010, the number of hospitals requiring their pediatricians be board certified before attaining hospital privileges increased from 67 to 80 percent, according to a University of Michigan Health System study published in the Journal of Hospital Medicine.
Gary L. Freed, M.D., M.P.H., professor of pediatrics and child health policy and Director of the Child Health Evaluation and Research (CHEAR) Unit at the University of Michigan's C.S. Mott Children's Hospital and lead author of the study, says the uptick in certification requirements represents a trend by hospitals to use external measures of quality to better maintain trust with the public.
“More and more, hospitals need a way to differentiate themselves from their peers and competitors and to ensure the public’s trust in the quality of their care,” says Freed, who is also a professor of health management and policy at the U-M School of Public Health. “What we’re seeing is that more hospitals are requiring their pediatricians to be board certified in an effort to maintain and promote the care they offer.”
The researchers first surveyed pediatrician certification rates in 2005, but were interested to see how the numbers changed as the landscape of physician and healthcare quality assessment shifted. Freed says in the time between 2005 and 2010, an increased emphasis on quality-of-care assessment tools and the American Board of Pediatrics’ decision to implement the Maintenance of Certification program, or MOC, likely triggered more hospitals to mandate board certification.
The MOC is an ongoing process of lifelong learning and self-assessment to continuously improve knowledge and clinical performance. Freed says more hospitals might be requiring their pediatricians to be board certified in an effort to engage these physicians to participate in the MOC program.
“It’s worthwhile for physicians to be involved in the MOC program, especially as regulatory agencies pay more attention to it,” Freed says. “For example, the Centers for Medicare and Medicaid rewards physicians with additional incentive payment for participating in the MOC program.”
While the number of hospitals requiring pediatrician certification did increase in the five-year span, the researchers also found that more hospitals were also making exceptions to this policy. Exceptions could include grandfathering physicians who had hospital privileges prior to the change or giving recent graduates time to obtain board certification.
Freed says more research is needed to fully assess the effect of the MOC program on hospital policies and ultimately on quality of care. Because the program was introduced at the beginning of the year in 2010, Freed says the survey results might show a lag in uptake of policy change. Either way, policies such as mandatory board certification for pediatricians will continue to be a part of the public discussion about health care quality.
“As the healthcare policy in the U.S. remains a national focus, the demands of the public for increasingly comprehensive assessments of healthcare quality will continue into the future,” Freed says.
Authors: Kelly M. Dunham, MPP; Acham Gebremariam, MS
Disclosure: None to report
Funding: American Board of Pediatrics Foundation
Citation: “Changes in Hospitals’ Credentialing Requirements for Board Certification From 2005 to 2010,” Journal of Hospital Medicine (2013)