Business <\/p>\n
Leaders of a group convened to establish a new, independent board for cardiology are reviewing options after the American Board of Medical Specialties (ABMS) rejected their application to establish the American Board of Cardiovascular Medicine and invoked a 2-year wait time to reapply.<\/p>\n
The ABMS rejected the application on February 26, just over a year after five societies \u2014 the American College of Cardiology (ACC), the American Heart Association (AHA), the Heart Failure Society of America (HFSA), the Heart Rhythm Society (HRS), and the Society for Cardiovascular Angiography and Interventions (SCAI) \u2014 submitted a formal application for a new board of cardiovascular medicine, which would be governed by cardiologists, operating under the ABMS.<\/p>\n
\u201cWe are deeply disappointed,\u201d American Board of Cardiovascular Medicine President Jeffrey Kuvin, MD, chair of cardiology at Northwell Health in New York, said in a statement<\/a>. \u201cThe decision ignores the evolution of cardiovascular medicine into its own distinct medical specialty, separate from the field of internal medicine, requiring its own set of knowledge, skills, and competencies to sustain professional excellence and effectively care for cardiovascular patients.\u201d<\/p>\n \u201cWe are not done with this fight,\u201d he explained in an interview. \u201cThe profession needs to be governed by cardiologists. Clinician competency, in all of our estimation, [should] not [be] based on a timed examination [when] you\u2019ve been practicing for 30 years.\u201d<\/p>\n Some of the reasons for the denial stated in the ABMS letter focused on \u201cthe financial feasibility of a new board,\u201d Kuvin pointed out.<\/p>\n \u201cWe put forth many analyses pro forma to suggest that if we are awarded an independent board of cardiovascular medicine, we believe wholeheartedly that this would be a financially feasible new board. We knew that this would be a controversial step because it would take the existing certification from the ABIM [American Board of Internal Medicine] and move it to a new board,\u201d he said. The roadblock came when the ABMS said \u201cthere was a possibility they would allow a competing board.\u201d In other words, there would be a board from the ABIM and a competing board called the American Board of Cardiovascular Medicine.<\/p>\n They fought that, Kuvin said, because \u201cfirst, there should be one certifying body. Second, if one has a competing board, that poses a tremendous amount of confusion for the diplomates or physicians, or the hospitals employing the physicians, and the patients.\u201d He explained that the ABMS \u201chas not admitted a new board in over 30 years.\u201d<\/p>\n Although replacing the ABIM as the certifying board was financially feasible, the American Board of Cardiovascular Medicine stated that competing with it would not be. \u201cIt would not be feasible for any start-up board to compete with any organization, such as the ABIM, which has deep pockets and could easily lower the cost,\u201d Kuvin said.<\/p>\n \u201cWhen we were handed the decision, they suggested to us that because we told them that a competitive board would not be feasible for a start-up board, they denied our application. They put us in a position where we couldn\u2019t counter it,\u201d Kuvin said.<\/p>\n The ABMS felt that the board of cardiovascular medicine did not meet some of their standards for ensuring that a cardiologist is continuously certified. \u201cWe felt very strongly that we met all of the criteria,\u201d he added.<\/p>\n The board of cardiovascular medicine partners echoed Kuvin\u2019s disappointment. \u201cOur quest for the creation of this new, independent board, in collaboration with the AHA, HFSA, HRS, and SCAI, has been several years in the making and in direct response to repeated calls from members for a new approach to assessment and maintenance of competency,\u201d ACC President Cathleen Biga, MSN, and Vice President Christopher M. Kramer, MD, said in the statement. \u201cWe recognize and share in the deep disappointment this decision brings. While it is a setback,\u201d they added, \u201cthis important work remains at the heart of ACC\u2019s Strategic Plan.\u201d<\/p>\n Cardiology has been part of the ABIM since 1941. The current effort by the American Board of Cardiovascular Medicine is not the first time physicians have diverged from the ABIM. In 2015, criticism of ABIM requirements drove a group of physicians, led by cardiologist Paul Teirstein, MD, chief of cardiology at the Scripps Clinic in La Jolla, California, to form the National Board of Physicians and Surgeons<\/a>, which now provides a path to certification for \u201call of the broadly recognized\u201d specialties, its website states.<\/p>\n At the beginning of the board of cardiovascular medicine application process, Teirstein said that he welcomed the proposal \u2014 and the competition in general \u2014 as a solution to the ABIM monopoly<\/a>. The National Board of Physicians and Surgeons mission statement includes its dedication to provide competition and choice in continuing certification. \u201cThe fact that the ACC, SCAI, AHA, HRS, and HFS have come together to form a new cardiovascular board indicates just how fed up cardiologists and cardiology leadership is with the ABIM,\u201d he explained.<\/p>\n Although the board of physicians and surgeons offers another choice, \u201cit is not recognized by a majority of payers and\/or hospitals,\u201d Kuvin noted. A board formed under the ABMS would already have the acceptance of all payers and hospitals, he pointed out, which is why cardiovascular medicine chose that route.<\/p>\n The ABMS does not comment on the specifics of individual applications, a spokesperson explained, and the Policy on Admission of New Medical Specialty Boards to Membership in ABMS<\/a>, which is available publicly, governs membership applications.<\/p>\n In its rejection letter, the ABMS stated that \u201cthey felt we didn\u2019t have broad enough professional support across the medical field,\u201d Kuvin explained.<\/p>\n \u201cI can\u2019t imagine broader support than having the five leading cardiologist [societies] that represent almost every single cardiologist in this country behind this application process and financially supporting it,\u201d he said.<\/p>\nBusiness Financial Feasibility Questioned<\/strong><\/h2>\n
Business Precedent for Dissent<\/strong><\/h2>\n