Physician board certification in hospice and palliative medicine.
The American Board of Hospice and Palliative Medicine (ABHPM) was formed in 1995 to establish and implement standards for certification of physicians practicing hospice and palliative medicine and, ultimately, accreditation of physician training in this discipline. The ABHPM has created a certification process that parallels other member boards of the American Board of Medical Specialties (ABMS). After 3(1/2) years and the administration of seven examinations, 623 physicians have achieved board certification in hospice and palliative medicine. Those with ABMS primary board certifications have been certified by anesthesiology, 4%; family practice, 23%; internal medicine, 55%; pediatrics, 1%; radiation oncology, 2%; and surgery, 2%. The majority describe their practice location as urban. Sixty-nine percent report more than 5 years of clinical experience in hospice/palliative medicine and 75% report an association with a hospice as medical director or hospice physician. Sixty-seven percent belong to the American Academy of Hospice and Palliative Medicine. Applicants were drawn from 48 states, Canada, and 3 foreign countries. The available data indicate only 20% were less than 40 years of age and that two-thirds were men. There is significant physician interest in seeking professional recognition of expertise in caring for terminally ill persons and their families through creation of a specialty in hospice and palliative medicine. Certification of physicians and accreditation of training programs are key elements in this process. This process will encourage more physicians to enter this field and provide needed expertise in the management of patients with progressive disease for whom the prognosis is limited, and the focus of care is quality of life.