A Word from Our Chair
Is Board Certification Good for Optometry?
The question we usually get asked by individual practitioners is “Why should I become board certified? What will it do for me?” And we each have our reasons. I practiced with two ophthalmologists who were board certified in ophthalmology, so when board certification in optometry became available, it was the logical next step for me. Others have been able to secure positions with large institutions or medical practices who required board certification. There are many of us who enjoy setting large goals for ourselves, and who looked at board certification as a challenge, a way to test ourselves. It is all that and more.
But what about the profession as a whole? Is board certification good for Optometry?
To answer that, let's take a look back at 2009, when the American Board of Optometry was formed. The United States was going through a transition with a new president, who was looking at universal health care, and talking about metrics for assuring quality care. One of those metrics was board certification. Prior to that, leaders in our profession had fought hard for optometrists to have parity with doctors of medicine, and as a result, Medicare and Medicaid payments for eye care services were standardized no matter who provided those services. It was essential that we not lose parity with ophthalmology.
Optometry at the time had a means for advanced certification: Fellowship in the American Academy of Optometry, or in College of Optometrists in Vision Development. But neither of those certifications were recognized by the Centers for Medicare/Medicaid Services or any other insurers.
Many of our colleagues consider themselves “board certified” for having passed National Boards, but in this, National Board of Examiners in Optometry’s position is clear: Passing the NBEO examinations does not award board certification. In fact, the 1998 NBEO Board policy states that “Passing any current National Board examination, including the TMOD examination, or any combination of current National Board examinations, is not equivalent to ‘board certification.’” That remains true today. In 2016, NBEO notified the Council for Affordable Quality Healthcare that an optometrist cannot claim to be board certified by NBEO for CAQH renewal.
Lack of board certification has been one of the primary arguments Ophthalmology has used against scope expansion in Optometry. In this 2010 article https://www.aao.org/about/policies/differences-education-optometrists-ophthalmologists, the authors argue the following as a means of outlining the differences between optometrists and ophthalmologists:
“There is a new national board certification process under development, but beyond state optometric licensure, there is no ongoing national recertification process to assure the public of the competency of optometrists who are already in practice.”
We wanted to retain parity with medicine in the real world of getting paid, and to be able to expand the scope of practice so that ultimately we can all practice as taught, and as we choose. Therefore, board certification, and a standardized maintenance of certification program were essential to the profession.
What about now?
There are nearly 3000 board certified optometrists in the United States. The credential is recognized by CMS as being equivalent to board certification in medicine, which they define on the Physician Compare website as follows: “Board-certified physicians or other clinicians are experts in a specialty. They have to complete extra education and pass a test to become board certified.”
The Gundersen Clinic in Wisconsin requires all practitioners to be board certified. Other large practices are following suit. The state of Washington accepts Maintenance of Certification in lieu of continuing education for license renewal. Our vision is that being board certified would allow an optometrist to practice anywhere s/he wants. It should.
Now there is a new administration in Washington, and the future of the Affordable Care Act is unclear. Changes in Maintenance of Certification programs and recertification testing are underway in most branches of medicine. (And in Optometry as well.) In our view, the only way for us to be prepared for the future is for us to have all processes (board certification, maintenance of certification, continuing education certification) in place, and to be proactive about any potential future requirements.
What is good for Optometry's future is for optometrists to have full participation in health care.
Board Certification enables us to continue to be part of that conversation.
Barbara L. Reiss, OD, FAAO
Diplomate, American Board of Optometry
Chair, American Board of Optometry
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