Roiled About Recertification
The troublesome issue of recertification has been lingering for many years (Bulletin cover story, Summer 2001). Now pressure has been put upon associations to put in place some kind of recertification. One of the main problems with this issue is that between 30 and 35 percent of practicing neurosurgeons in this country were never certified to begin with. How can you subject the people who have already passed their boards to undergo another gruesome exam while the other 35 percent don’t give a damn what you or anybody else says? Are you going to recommend that the state board revokes their licenses?
The second major problem with recertification is that the public and the legal profession correlate certification with competence. This is totally erroneous. In my 30 years of practice I have seen many certified neurosurgeons who are incompetent and I have seen many who are not certified who are pretty good. I am saying this because I have observed these people perform surgery. Nothing can determine the competence of a neurosurgeon more than watching him during surgery. The individual might be pretty good in his didactic examination but be a lousy surgeon. Does that mean he is competent and meets the requirements? Exactly how will you determine that without a lawsuit?
Speaking of lawsuits, I also read the medicolegal update (“Status of Unprofessional Conduct Complaints,” Summer 2001), and the problem is more widespread than the 15 complaints received by the AANS. During the past 30 years I have been on a peer review committee. Some of the cases I saw were completely outrageous. Some of these individuals do this on a full-time basis. They are for the plaintiff because that is where the money is.
I am pleased the AANS is taking action against these people even though I know that the Professional Conduct Committee is quite lenient and only takes disciplinary action in the most serious cases. The AANS should not be afraid of frivolous lawsuits that will be eventually thrown out of court.
– David A. Yazdan, MD, FACS, Brick, N.J.
EDITOR’S NOTE: Eighty-six percent of respondents to the AANS’ practice survey in 1995 said they were board certified.
At Risk
In the Fall 2001 AANS Bulletin, “A Profession at Risk-The Medical Liability Crisis,” John Popp, MD, brought forth a momentous issue for neurosurgeons. Indeed, neurosurgery has been a profession at risk for quite some time, and many neurosurgeons are quitting rather early, rather than becoming grist for the trial lawyer’s mill. This medical liability problem is number one for neurosurgeons and the AANS, yet it’s not so at all for the umbrella organization, the AMA, which politically claims to represent all physicians.
– Miguel A. Faria, Jr., MD, Macon, Ga. He is editor-in-chief of the Medical Sentinel of the Association of Physicians and Surgeons.