Most patients assume that if a license to practice medicine is hanging on the wall of a doctor's office, the doctor is qualified to treat them. But that may not be the case.
For example, I have a license to practice medicine in the states of New York and New Jersey, and that means I have carte blanche to practice any kind of medicine and do any kind of surgery in my office. Although I am totally untrained to practice ophthalmologic surgery, there is nothing to stop me from doing it because no state law forbids my doing so. The type of medicine I practice is not the state's concern. All the state is acknowledging by granting me a license is that I have had four years of medical school plus a year of training as an intern. I can be an OB-GYN, as I am, but I can if I wish also do brain surgery or foot surgery or liposuction, treat your stomach ulcer or take care of your child. Am I qualified to do these things? Of course not.
What a patient needs to look for, after seeing the state license to practice medicine on the wall of a doctor's office, is a second document testifying to Board-certification in the doctor's specialty. Indeed, even more to the point is to ascertain whether the doctor is Board-certified when you call initially to make an appointment. If you are not entirely certain, you can go online to select the appropriate specialty Board website to ask for information.
The reason I stress Board-certification is because doctors can call themselves infertility specialists or perinatologists or anything else they please. They are not compelled to undergo further training in a specialty in order to practice it. Only Board-certification confirms that they have had the training. A doctor, when asked, may answer, "I'm Board-eligible," or "I'm Board-active," but anything other than the term Board-certified means that the doctor is not a qualified specialist, unless they are just out of residency and are in the process of becoming Board-certified.
For over two decades, the American Board of Medical Specialties has not only required that a physician become Board-certified, but also that he or she maintain that certification with regular examinations and clinical testing of their current knowledge, known as re-certification or maintenance of certification. Many physicians older than 55 years of age who received their initial Board-certification in the early years of their practice have never been re-certified because they have been "grandfathered" into the ranks of the Board-certified. They can do this because it is still a voluntary process. Although I am Board-certified for life, I have chosen to take the examination each year to maintain my Board-certification annually. Some older physicians, many of them celebrities that we know and love, have chosen not to annually maintain their certification and just keep their initial year of certification, which may have been over 25 years ago.
Other than Board-certification, a patient should ask her physician whether or not their practice is affiliated with a teaching hospital and medical school, such as Columbia or Mount Sinai. Private practice sounds wonderful, but if your doctor just goes to his or her office each day and never teaches anyone, i.e., a medical student or resident, then their skills and knowledge are usually arrested at the stage when they left residency and they never will know current trends unless they go to a weekend course or three-day seminar; which usually doesn't happen because their patients generate revenue and conferences do not. It's great for a physician to have experience in a certain area, but if he or she is not current, then the experience may have become obsolete. Another attribute of a good physician is if he or she has recently published any medical reports or studies in their respective medical journals, thus contributing to the knowledge so vital in managing patients.
Knowledge, experience, compassion and availability are ideal traits a patient should seek in a physician -- and in a pinch you can do without the compassion. But never settle for compassion in the absence of the knowledge and experience because you only have one body.
Yvonne S. Thornton, M. D., M. P. H., Sc. D. (hon), FACOG, FACS
Note: The above opinions are my own and do not necessarily reflect the policies or practices of my affiliated medical school or medical center.
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