Reexamination/recertification: measurement of professional competence and relation to quality of medical care.
Over the past half decade, there has been an increment in forces moving the profession toward recertification and a decrement in the restraining forces. The whole process will be catalyzed by available funding through grants to implement continuing medical education, development of performance-, and competency-based assessment measures and recertification. Specialty boards serving relatively small numbers of candidates have serious difficulty funding certification, to say nothing of recertification. An adequate mechanism to implement recertification can emerge only from the profession itself, working through the American Board of Medical Specialties and specialty boards. The means to discharge this responsibility should, at the outset, come from public and private sources. Eventually the system may become self-supporting through evaluation and certification fees. The public interest will be best served when there are adequate mechanisms to assess continuing competence of all physicians. As a minimum, there must be a system to guard against incompetence through obsolescence of any of the practicing professionals.