AOA House: Don’t withdraw certification until all appeals have been exhausted

Concerned that only DOs with unrestricted licenses could take part in osteopathic continuous certification (OCC), per the AOA’s published criteria, the Oklahoma Osteopathic Association proposed a resolution to the AOA House of Delegates to soften this requirement. After debating it for more than an hour on the House floor, delegates today approved the resolution, which directs the AOA not to withdraw the certification of a DO with license restrictions until “all appeals have been exhausted.”

This resolution simply reinforces existing AOA policy. As AOA Trustee Ronald R. Burns, DO, pointed out on the House floor, DOs who are in danger of losing their AOA board certification due to licensing restrictions and other circumstances already can go through a three-step appeal process.

Impetus

The Oklahoma association explained the reasoning behind its resolution during a House reference committee meeting. “A DO who is practicing with a restricted license should not automatically lose his or her board certification and ability to sit for OCC,” said Oklahoma delegate Gabriel M. Pitman, DO. “In Oklahoma, we have more than 60 DOs who are actively practicing under a restricted license. That means there must be thousands nationwide. Many have been ordered into recovery programs and are complying and getting well. Some have a restriction where they cannot prescribe Schedule II narcotics and so forth. Should all of these DOs automatically lose their certification and eligibility to sit for OCC?”

Ronald E. Ayres, DO, who chairs the Bureau of Osteopathic Specialists (BOS), countered that AOA board-certified DOs are not suddenly stripped of their specialty certifications when restrictions are placed on their licenses. The BOS first investigates any such restrictions, he said.

“We understand that many restrictions are minor. But we need the public to know that if a physician has a restriction on his or her license, we’re not turning our back to it and saying we don’t care,” Dr. Ayres said.

Dr. Ayres expressed his concerns about the AOA’s stating in writing that DOs with restricted licenses may continue their certification.

“Please remember that AOA certification is at the level of excellence, not at the level of minimum competence,” added Stephen M. Scheinthal, DO, the vice chairman of the BOS. He noted that the phrase unrestricted license mirrors the language used by the American Board of Medical Specialties in its requirements for maintenance of certification. Lessening the eligibility criteria for OCC could have unintended consequences, he warned.

But Oklahoma delegate Harold Z. DeLaughter, DO, argued that osteopathic physicians with substance abuse problems and other impairments need to know up front that they will not necessarily lose their specialty certification if they seek treatment and end up with license restrictions. “The idea behind this is that we’re trying to encourage physicians to seek help,” he said. “Oklahoma has an excellent record of helping physicians recover. We’ve had quite a few do well. Our concern is that if a physician on probation or with some other sort of restriction cannot participate in OCC, he or she would have to start the certification process all over again after license restrictions are removed.

“If that happens, a lot of physicians will not seek help. What we’re trying to do is create a climate in which they will self-report their problems before their excellence diminishes.”

Timothy J. Kowalski, DO, who serves on the South Carolina Board of Medical Examiners, told the committee that when licensing boards place physicians on probation, they want those physicians to demonstrate their medical knowledge and capability. “Allowing physicians to demonstrate their knowledge through board certification is part of that process,” he said.