Recognized focused practice: Does sub-specialty designation offer value to the neurosurgeon?

Maya A Babu,Linda M Liau,Fredric B Meyer,Zachary A Smith

doi:10.1371/journal.pone.0189105

Abstract

Vehicles for life-long assessment such as Maintenance of Certification tend to focus on generalist neurosurgical knowledge. However, as neurosurgeons advance in their careers, they tend to narrow their practice and increase volumes in certain specific types of operations. Failing to test the type of procedures most relevant to the practitioner is a lost opportunity to improve the knowledge and practice of the individual neurosurgeon. In this study, we assess the neurosurgical community’s appetite for designations of board-recognized Recognized Focused Practice (RFP). We administered a validated, online, confidential survey to 4,899 neurosurgeons (2,435 American Board of Neurological Surgery (ABNS) Diplomates participating in MOC, 1,440 Diplomates certified prior to 1999 (grandfathered), and 1,024 retired Diplomates). We received 1,449 responses overall (30% response rate). A plurality of respondents were in practice 11–15 years (18.5%), in private practice (40%) and participate in MOC (61%). 49% of respondents felt that a RFP designation would not be helpful. For the 30% who felt that RFP would be helpful, 61.3% felt that it would support recognition by their hospital or practice, it would motivate them to stay current on medical knowledge (53.4%), or it would help attract patients (46.4%;). The most popular suggestions for RFP were Spine (56.2%), Cerebrovascular (62.9%), Pediatrics (64.1%), and Functional/Stereotactic (52%). A plurality of neurosurgeons (35.7%) felt that RFP should recognize neurosurgeons with accredited and non-accredited fellowship experience and sub-specialty experience. Ultimately, Recognized Focused Practice may provide value to individual neurosurgeons, but the neurosurgical community shows tepid interest for pursuing this designation.

Highlights

The lay press and the public have been more attentive in recent years to continuing medical education for practicing surgeons and the safeguards that exist to ensure that practitioners are delivering high-quality care throughout their career
Recognized focused practice neurosurgery following competing interests: Linda Liau serves on the Board of the American Board of Neurologic Surgery; Fredric Meyer is the Executive Director of the American Board of Neurologic Surgery
Practitioners must actively participate in Maintenance of Certification (MOC) to receive recognized focused practice certification

Summary

Introduction

The lay press and the public have been more attentive in recent years to continuing medical education for practicing surgeons and the safeguards that exist to ensure that practitioners are delivering high-quality care throughout their career. Random audits of the attestation process via communication with the selected officer of the hospital, and enrollment in the process is the agreement to this audit process” In this program, practitioners must actively participate in MOC to receive recognized focused practice certification. The American Board of Neurologic Surgery has contemplated whether to offer a recognized focused practice designation in several or all of the sub-specialties (e.g., spine, skull base, etc). Before such a program could be launched, the appetite from Diplomates needed to be gauged.

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Conclusion