Special Competence in Critical Care Echocardiography?

[narcotics999]

Stumble upon NBE, found this new exam starting next year. Anyone knows about it? What's the use of it? One can perform TTE, TEE and bill them? Intraoperative TEE competency for cardiac surgery?

Certification is still in developing stage.

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[Twiggidy]

I have a very bias opinion of all these new certifications that show up. I think if you're going to be doing these things everyday and billing for them every day, or at least often then I think it's worthwhile to have a certification behind you. If it's once in a blue moon that you're going to stick a probe on someone's chest or down their esophagus then as a critical care attending or even Joe Anesthesiologist, I think it turns into a waste of money, unless in order to have privileges at you hospital to do these things you need the certification (which most don't).

Just always proceed with cautions when new shiny certifications show up in our field, outside of an actual board certification in a specialty.

 

[AdmiralChz]

I’m not sure what it adds or why they did it (other than $$!) - CCM already has a separate board certification. For cardiac the advanced exam is the de facto board exam. The basic is an option for those wanting to demonstrate competency... but is only offered every 2 years.

One can “bill” for TTE/TEE without these exams, but the certifications/tests help clear credentialling hurdles for sure.

 

[CCM-MD]

It’s primarily for bedside point-of-care TTE but the exam also has lung, abdomen and vascular. I am going to be taking it and many of my colleagues (non-academic intensivists) plan on taking it also. We don’t currently bill for our bedside ultrasounds/echos - we add it on to our critical care billing currently - but may bill for them in the future.

There’s some institutional politics associated with echo in the ICU due to cardiologists and having an echo exam and board certification for intensivists may help things. May help from a legal standpoint also - I am occasionaly making clinical decisions based echo findings and if I am ever put on the stand and asked about certification/formal training, I will have something to show in the future.

 

[psychbender]

I'm taking it this year, and my former PD made it plain that he expects that all of his fellows and staff will take and pass the exam. These exams don't do anything for billing, but may help for credentialing purposes. I do TTE pretty much every day that I'm in the unit, still facing hurdles with the hospital regarding documenting and billing, because our parent hospital isn't interested in streamlining our workflow in Epic.

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[Twiggidy]

I’m not sure what it adds or why they did it (other than $$!) - CCM already has a separate board certification. For cardiac the advanced exam is the de facto board exam. The basic is an option for those wanting to demonstrate competency... but is only offered every 2 years.

One can “bill” for TTE/TEE without these exams, but the certifications/tests help clear credentialling hurdles for sure.

I'll add to this that make sure you do enough to warrant certification for "billing" purposes. The reimbursement may not be worth it unless you do a lot of these exams.

 

[deleted171991]

They are milking the cow. I can't figure out if what's more disgusting, that the NBE is so greedy, or that the ASA, SCA, SCCM etc. are all partners in crime (meaning that they get a cut). I am beginning to not notice any difference between these societies and the lowlifes from the AMA. All they care about is money and power. Shame on all who support them by being their members! They represent YOU.

I have never billed for a bedside focused echo, so they can wait till I pony up $1000 for this crap. That's like asking for certification for using a stethoscope. Let's not mention how useless and valueless some of their examinations are, e.g. the Basic PTE. Biggest waste of money in my life; any idiot could pass it.

 

[GA8314]

They are milking the cow. I can't figure out if what's more disgusting, that the NBE is so greedy, or that the ASA, SCA, SCCM etc. are all partners in crime (meaning that they get a cut). I am beginning to not notice any difference between these societies and the lowlifes from the AMA. All they care about is money and power. Shame on all who support them by being their members! They represent YOU.

I have never billed for a bedside focused echo, so they can wait till I pony up $1000 for this crap. That's like asking for certification for using a stethoscope. Let's not mention how useless and valueless some of their examinations are, e.g. the Basic PTE. Biggest waste of money in my life; any idiot could pass it.

I do sometimes agree that things are going a bit too far. Do you need a "certification" to interpret a PA catheter? How about any of the various goal directed fluid therapy systems (vigileo etc). These are tools. Echo is a tool.

More so, do surgeons get "certified" in the latest surgical technology? Do guys learning robotic surgery late in their career take exams with esoteric questions on how an electric servo motor works and how many Amps each linear motor consumes etc.?

Do OB/GYN's even take a certification to do fetal monitoring scans? They use US all the time.

Why don't we allow the same level of flexibility to develop our skills as pertains to new TOOLS as do other specialties? It's sort of ridiculous that we don't. We put up all of these barriers that limit us in the long run.

I don't know what the solution is but some of it seems a bit much.

 

[Psai]

We put more barriers in front of our own as we let CRNAs run roughshod over our departments. I don't get it.

 

[vaibh]

Agree we keep adding certifications for Physicians and let NOCTORS have easy life !

BTW what resources are you all using for the this test ?

 

[fakin' the funk]

. Let's not mention how useless and valueless some of their examinations are, e.g. the Basic PTE. Biggest waste of money in my life; any idiot could pass it.

Generally agree with you here. Basic PTE exam was very very easy but I don't know if "any idiot" can do it. Certainly, doing and reviewing the exams for the certification was quite useful.

 

[fakin' the funk]

We put more barriers in front of our own as we let CRNAs run roughshod over our departments. I don't get it.

How is it a barrier?

I dunno about your dept but our CRNAs basically don't / can't / won't even touch an ultrasound let alone do POCUS.