Many people confuse having a medical license with being board certified. These are not the same thing at all.
Often when discussing certification and qualifications, patients are shocked to learn that my medical license is not restrictive. In other words, even though I have trained extensively in plastic and reconstructive surgery, I could open a practice in neurosurgery. Or obstetrics. This illustrates the difference between being legally allowed and ethically appropriate. Although I have rotated in neurosurgery and obstetrics, I do not have the expertise of those who were trained in these disciplines through long hours of study, on-the-job training in residency, and the rigorous process of board certification; therefore, I (and the vast majority of medical providers) do not consider it ethical to practice medicine in these fields.
The governing body of the majority of medical specialty boards is the American Board of Medical Specialties. The ABMS serves as a sort of watchdog over the watchdogs. The boards that are regulated by the ABMS, including the American Board of Plastic Surgery (ABPS) are held to rigorous standards to ensure that certification is awarded to safe, competent physicians that have completed residency, and often additional training, along with written examinations. The ABPS further requires an oral board examination, which is an intense series of examinations given by the leaders of the field. Only if both examinations are passed may one receive certification. Finally, there is a maintenance of certification program (MOC) that requires recertification every 10 years, in order to stay up-to-date and practice safely throughout a surgeon’s career.
“OK, we get it. If you are board certified, you know what you’re doing.” Well, maybe yes and maybe no. Just like I could practice neurosurgery (not necessarily safely, of course), I could also start my own certifying board. I wouldn’t have to even ensure that the certified surgeons knew a scalpel from a salami. I could call it “Jarred’s Board of Awesomeness in Cosmetic Surgery” (JBACS), and the only qualification for admission could be paying me a couple grand for a certificate. Sure, it doesn’t predict safe, ethical care (like ABPS certification), but it would be completely legal for me to form the board, and for (unscrupulous) surgeons to claim board certification.
If all of this is confusing…well, you’re not alone. A good place to start is to check out websites and search the boards that a surgeon belongs to. If the board is not overseen by the ABMS, that may be a warning sign. You may dig a little deeper; how many cases does the surgeon’s board require for certification? Does the surgeon have to demonstrate their own cases at an oral examination to demonstrate safety and competence? Is there a maintenance of certification requirement? Don’t be embarrassed to ask your surgeon these questions as well. After all, it is your health and appearance that is at stake.
Jarred McDaniel, MD
Diplomate, American Board of Plastic Surgery
Founder, President, Secretary, Member, Dictator Emeritus — JBACS 🙂