National Board of Physicians and Surgeons (NBPAS)

[DrMetal]

This is pretty huge news, NBPAS is gaining more acceptance. NBPAS is an alternative BC, that requires iBC (initial BC via ABMS), then rigid CME. No 'MOC', no further testing. It's quickly picking up steam. Would encourage all to look into it (I have no official affiliation, am only a member).

NBPAS - Providing a Pathway for Continuous Certification​

The Monthly Dose​

News and Announcements​

Major Momentum: UnitedHealthcare and HCSC Accept NBPAS Certification​

We’re excited to announce two major developments that advance physician choice and modernize credentialing standards.

UnitedHealthcare, one of the nation’s largest insurers, has formally confirmed that its credentialing policies do not require participation in costly Maintenance of Certification (MOC) programs. In a recent letter, UnitedHealthcare emphasized that physician competency is best demonstrated through initial board certification, active clinical practice, and ongoing learning—not burdensome testing. The organization also affirmed that NBPAS certification is accepted as part of its credentialing process, reinforcing the shift toward fair, evidence-based standards.

Additionally, Health Care Service Corporation (HCSC), which operates Blue Cross Blue Shield plans in Illinois, Montana, New Mexico, Oklahoma, and Texas, now accepts NBPAS board certification. As the largest customer-owned health insurer in the country, HCSC’s acceptance is a powerful endorsement and a major milestone in our mission to expand recognition nationwide.

We extend our sincere thanks to Monica Berner, MD, Senior Vice President of Markets and Chief Clinical Officer at HCSC, and an NBPAS-certified family physician, for her leadership in helping make this possible at HCSC.

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Members don't see this ad.

 

[MD46]

Thanks for sharing, I was thinking to ask our credentialing department this to see what they say about hospital and clinic privilege's based on NBPAS certification alone. I am in the in Mid West for reference.

 

[DrMetal]

Thanks for sharing, I was thinking to ask our credentialing department this to see what they say about hospital and clinic privilege's based on NBPAS certification alone. I am in the in Mid West for reference.

It seems to be catching on. If you want to get more involved, you can contact NBPAS, and they can do the leg work with your credentialing office, if they're interested.

Still a long ways to go, I wouldn't give up your ABMS certs. But it would be nice to one day have options?!

 

[chessknt]

How did they get UHC to accept them though? That company hates doctors. The paranoid part of me thinks there was some sort of backroom deal that helps UHC significantly and if that is the case it isn't worth the cost.

 

[DrMetal]

How did they get UHC to accept them though? That company hates doctors. The paranoid part of me thinks there was some sort of backroom deal that helps UHC significantly and if that is the case it isn't worth the cost.

I don't know the details. I suspect if NBPAS keeps more doctors in the game, maybe UHC financially benefits.

There's a decently sized community of doctors over 60 years old who want to continue practicing but are absolutely done with any further testing or MOC. If MOC was forcing their hand into retirement, this might be a great solution.

I'd rather have a 65yo FP, BCd via NBPAS, as my primary, than a 28yo NP with some crackerjack degree.

 

[chessknt]

I don't know the details. I suspect if NBPAS keeps more doctors in the game, maybe UHC financially benefits.

There's a decently sized community of doctors over 60 years old who want to continue practicing but are absolutely done with any further testing or MOC. If MOC was forcing their hand into retirement, this might be a great solution.

I'd rather have a 65yo FP, BCd via NBPAS, as my primary, than a 28yo NP with some crackerjack degree.

Ok but why is UHC playing along though?

 

[DrMetal]

Ok but why is UHC playing along though?

I dunno, maybe a change of heart since Luigi took out their CEO . . . maybe they've become more physician-friendly!

NBPAS isn't quite big or powerful enough, nor do they have enough money or clout . . . to work out any "drug deals", so I don't think that's the case here.

 

[VA Hopeful Dr]

I dunno, maybe a change of heart since Luigi took out their CEO . . . maybe they've become more physician-friendly!

NBPAS isn't quite big or powerful enough, nor do they have enough money or clout . . . to work out any "drug deals", so I don't think that's the case here.

I'd bet it will count as board certified but get a lower fee schedule compared to ABMS board certification. So they don't lose the doctors but can pay them less.

 

[chessknt]

I'd bet it will count as board certified but get a lower fee schedule compared to ABMS board certification. So they don't lose the doctors but can pay them less.

Or I am thinking the board promised to be a supportive voice behind reimbursement cuts or coding change in their favor to make it seem like doctors are happy with the insurance company ****ing them in the dingus.

 

[dgdg]

I'm sure there is a lot of effort behind the scenes. I wish there were more obvious ways we could support them.
The hard part is hospital system acceptance.

I took what I hope to be my last 10 yr MOC exam in 2023. After that expires, I'll do the LKA for another five but NBPAS would be an attractive option.

 

[DrMetal]

I'd bet it will count as board certified but get a lower fee schedule compared to ABMS board certification. So they don't lose the doctors but can pay them less.

I seriously doubt that. This wouldn't fly.

 

[DrMetal]

I'm sure there is a lot of effort behind the scenes. I wish there were more obvious ways we could support them.
The hard part is hospital system acceptance.

I took what I hope to be my last 10 yr MOC exam in 2023. After that expires, I'll do the LKA for another five but NBPAS would be an attractive option.

How many times have you taken it? Can I ask roughly how old you are?

 

[VA Hopeful Dr]

I seriously doubt that. This wouldn't fly.

Maybe. But we've seen this before. You can get jobs as a GP but the pay is almost always less than what someone who is board certified will make.

 

[VA Hopeful Dr]

Somewhat unrelated, but I think NBPAS needs to update their hospitals accepting this as board certification. One of the ones that they listed for South Carolina no longer exists.

 

[dgdg]

How many times have you taken it? Can I ask roughly how old you are?

I've taken the 10 year MOC twice.
Likely will do LKA next time to eek out a bit more.

 

[DrMetal]

I've taken the 10 year MOC twice.
Likely will do LKA next time to eek out a bit more.

So you've taken the test 3 times (iBC + 2 x MOC). I assume you're in your 50s or even 60s.

Its absolutely shameful that you have to go through this. It would make great sense for ABIM to make a rule, that if you've passed this test 3 times, you can be grandfathered in and be considered permanently BC'd.

But no, such a policy doesn't line their pockets.

 

[VA Hopeful Dr]

So you've taken the test 3 times (iBC + 2 x MOC). I assume you're in your 50s or even 60s.

Its absolutely shameful that you have to go through this. It would make great sense for ABIM to make a rule, that if you've passed this test 3 times, you can be grandfathered in and be considered permanently BC'd.

But no, such a policy doesn't line their pockets.

Not defending the ABIM here but a big reason that we have to recertify is because medical knowledge is constantly advancing.

You can argue whether MOC is the way to measure whether or not everyone is keeping up, but it's the entire point of it.

 

[DrMetal]

Not defending the ABIM here but a big reason that we have to recertify is because medical knowledge is constantly advancing.

You can argue whether MOC is the way to measure whether or not everyone is keeping up, but it's the entire point of it.

No one would argue the need to maintain medical knowledge, to read, to continuously study your kraft. If you care about your practice, your patients . . . or at least, if you care about not getting sued or not getting disciplined by your credentialing/privileging bodies, then you'll study and keep up to date.

It's offensive that some organization out there feels the need to constantly "test" and "probe" you. As if to say, you're not trustworthy enough, you're still a student and we have to keep you in check.

Newsflash: we're not students. We're professionals. Some of us, like @dgdg , have been in practice for decades.

No more testing! No more questions! I don't want to do 25 questions per quarter, I don't want to do 400 questions per decade.

Let me practice and judge me on that result.

 

[dgdg]

So you've taken the test 3 times (iBC + 2 x MOC). I assume you're in your 50s or even 60s.

Its absolutely shameful that you have to go through this. It would make great sense for ABIM to make a rule, that if you've passed this test 3 times, you can be grandfathered in and be considered permanently BC'd.

But no, such a policy doesn't line their pockets.

I'm still 29 and stickin' to it! Hee hee.

I learned a lot this MOC go around (big thank you to everyone here), starting my study prep about 16 months out. I became an esoterica test taking machine again. Much of that esoterica I don't see often enough to retain, so I need to look those items up anyway to ensure I'm practicing evidence based guideline medicine. And those 16 months of studying, and 10 hours of questions don't comprise everything I see in general medicine anyway. You have to learn that too. There is always more and that is the professionally exciting part.

Regardless of MOC prep for those brief times in my life which we all bemoan, I'm constantly reading both medical and other things.
UpToDate was relatively new when I was an intern, and it was a dream come true. Frequently, I still read up on things I don't see often, or things I often see but the recommendations may have since changed.
For hospice education to my clinical team members, I will pull practical journal articles or NEJM Journal Updates to present. I feel that I learn more than everyone else on the team for the sheer volume of material I sort through.

Learning, whatever it may be, should be lifelong enrichment to our career, our patients, and oneself. I feel like I could go back to college now and start a whole new major just to enjoy learning and applying the knowledge.

Be curious.
Be a positive force to our society.

 

[VA Hopeful Dr]

No one would argue the need to maintain medical knowledge, to read, to continuously study your kraft. If you care about your practice, your patients . . . or at least, if you care about not getting sued or not getting disciplined by your credentialing/privileging bodies, then you'll study and keep up to date.

It's offensive that some organization out there feels the need to constantly "test" and "probe" you. As if to say, you're not trustworthy enough, you're still a student and we have to keep you in check.

Newsflash: we're not students. We're professionals. Some of us, like @dgdg , have been in practice for decades.

No more testing! No more questions! I don't want to do 25 questions per quarter, I don't want to do 400 questions per decade.

Let me practice and judge me on that result.

I've seen (and I'm sure we all have) plenty of doctors who don't keep up at all but because they have good bedside rapport with their patients never get sued.

There's a now retired OBGYN that used to be part of my father-in-law's call group. On average, in a given year he probably cut between 5 and 10 ureters while doing hysterectomies. The urologists despised him, but his patients loved him so he was never sued.

The doctor I took over for when he retired a number of years ago was still a prescribing quinine to his patients with statin myalgias.

Not saying that maintenance of certification would necessarily fix any of this, but this is definitely a problem that we don't have a solution of any kind for.

 

[DrMetal]

A good podcast if further interest:

Episode Description​

We need to make sure our physicians are qualified, but there’s always room for ensuring that the certification process honors the needs and realities of today’s medical and healthcare landscape.

This week, Tim Fischer speaks with Karen Schatten, Associate Director of the National Board of Physician and Surgeons. Karen brings a sincere passion for addressing physician burnout, dissatisfaction with traditional certification pathways, and supporting the goal of lifelong learning among all healthcare professionals. She delves into how patients across the country are affected by a status quo that too often fails to keep physicians focused on their patients—or fails to keep them in the medical field altogether.

Join us as we discuss:

• The origin story for the National Board of Physicians and Surgeons
• Why it’s vital for credentialing bodies and hospital administrations recognize and accept varied certification pathways
• The problem with valuing the dollar over the data
• How to ensure that administrative processes and requirements are adding true value

 

[Splenda88]

I am just hoping I won't have to deal with ABIM by the time I am re-certifying in 2031.

NBPAS should be more aggressive in advertising themselves to healthcare organizations.

 

[VA Hopeful Dr]

I am just hoping I won't have to deal with ABIM by the time I am re-certifying in 2031.

NBPAS should be more aggressive in advertising themselves to healthcare organizations.

I'd be surprised if that's the issue.

The bigger problem is going to be two-fold.

First, what's in it for the hospital? They have a system that works well that most physicians use. Why change?

Second, you and I both know it's more complicated than this, but the way the NBPAS operates can appear to say "I'm too lazy to stay current with the regular BC process". And while that's certainly not universally true, we also both know that it's true sometimes.

 

[gutonc]

I'd be surprised if that's the issue.

The bigger problem is going to be two-fold.

First, what's in it for the hospital? They have a system that works well that most physicians use. Why change?

Second, you and I both know it's more complicated than this, but the way the NBPAS operates can appear to say "I'm too lazy to stay current with the regular BC process". And while that's certainly not universally true, we also both know that it's true sometimes.

I've seen a couple of credentialing applications held up when people apply only with NBPAS and expired ABMS cert. In each case, the discussion at Credentialing Committee was "what are they hiding and why don't they want to stay current on medical knowledge?". This is true in a non-zero number of cases unfortunately (I'm personally familiar with 2), and that small number taints the general population and overall feelings about NBPAS.

 

[DrMetal]

First, what's in it for the hospital? They have a system that works well that most physicians use. Why change?

And there lies the problem. Most physicians and their governing institutions (which physicians usually run) don't want to change, even if said change is something positive that helps the plight of the physician. We like the "suck" , it's just inherently part of our culture (since we were pre-meds), and so we perpetuate it!

As far as the "lazy" perceptions goes: I think NBPAS evaluates every applicant to deem whether or not they're still credentialed and actively practicing somewhere (in some capacity). If you're an FP seeing 25 patients per day, x 5 days per week, and spending some of your weekend time finishing notes . . . I'd never call you lazy! Maybe you just don't want to be hassled by a high-stakes test every quarter, or every decade.

This is true in a non-zero number of cases unfortunately (I'm personally familiar with 2), and that small number taints the general population and overall feelings about NBPAS.

True now. That's why most (including me) are keeping their ABMS certs. If NBPAS gains more acceptance, hopefully that tide will change.

 

[VA Hopeful Dr]

And there lies the problem. Most physicians and their governing institutions (which physicians usually run) don't want to change, even if said change is something positive that helps the plight of the physician. We like the "suck" , it's just inherently part of our culture (since we were pre-meds), and so we perpetuate it!

As far as the "lazy" perceptions goes: I think NBPAS evaluates every applicant to deem whether or not they're still credentialed and actively practicing somewhere (in some capacity). If you're an FP seeing 25 patients per day, x 5 days per week, and spending some of your weekend time finishing notes . . . I'd never call you lazy! Maybe you just don't want to be hassled by a high-stakes test every quarter, or every decade.



True now. That's why most (including me) are keeping their ABMS certs. If NBPAS gains more acceptance, hopefully that tide will change.

I don't think any of us like MOC. But, its a fairly minor annoyance at most (and at present y'all have a much easier time of it than us FPs). Honestly I hate the required opioid CME every 2 years with my license way more than MOC.

If you're an FP with that schedule doing work over the weekend I'm going to call you inefficient. But just because you work hard in one area doesn't mean you work hard in other aspects. I work my tail off at work, but I'm pretty lazy at home.

 

[DrMetal]

I work my tail off at work, but I'm pretty lazy at home.

You're supposed to be lazy at home!

 

[gutonc]

You're supposed to be lazy at home!

That's not what my partner says.

 

[Splenda88]

That's not what my partner says.

Leave your partner then.

 

[gutonc]

Leave your partner then.

 

[Splenda88]

I was being tongue in cheek.

 

[AlbinoHawk DO]

Just as an FYI. You can become board certified through the Osteopathic pathway as an MD. The board certification actually holds every privilege that the ABIM has, except for program director. I think it's a much better alternative to trying to push this new board, NBPAS

 

[gutonc]

Just as an FYI. You can become board certified through the Osteopathic pathway as an MD. The board certification actually holds every privilege that the ABIM has, except for program director. I think it's a much better alternative to trying to push this new board, NBPAS

But it comes with the same issues that @DrMetal hates about ABIM, namely MOC (OCC for AOBIM) and recertification.

 

[AlbinoHawk DO]

But it comes with the same issues that @DrMetal hates about ABIM, namely MOC (OCC for AOBIM) and recertification.

You don't need to re-certify for the osteopathic board for primary IM. They are currently transitioning all subspecialty to be the same way. However, you do have to do MOC

 

[gutonc]

You don't need to re-certify for the osteopathic board for primary IM. They are currently transitioning all subspecialty to be the same way. However, you do have to do MOC

Which is literally the thing that @DrMetal rails against the most.

 

[DrMetal]

Which is literally the thing that @DrMetal rails against the most.

True. There should be no 'maintenance' of anything. You certify once, you should be good for life. As is the case with your licensure (we don't make you take the USMLE Steps 1-3 every 10 years). Thereon after, judge the physician by her practice.

Now, if MOC is redefined to be just high-quality CME (no high-stakes testing involved), I might be ok with that. That's what NBPAS is, essentially.

The fact that we have now 3 different potential BCing bodies (ABIM, AOBIIM, NBPAS) demonstrates how silly all of BC is. 'Board Certification' is a fictitious credential, it really need not exist. Who's country club do you want to belong to?

Medical school + (ACGME-accredited) residency +/- fellowship == Enough!

 

[AlbinoHawk DO]

Which is literally the thing that @DrMetal rails against the most.

Well, it's only one thing, and if the board is open to changes, then it makes more sense to work with them than try to bring an entirely new board from the ground up, but hey, I'm not complaining if you do your own thing. Maybe if NBPAS is one day better than ABIM or AOA, I'll transfer over