The American Board of Internal Medicine is up to something

---but at this point it’s hard to know just what. Given my concern and skepticism about the way the American College of Physicians (ACP) and the American Board of Internal Medicine (ABIM) are redefining internal medicine, this post by Retired Doc naturally caught my eye. He writes:

The American Board of Internal Medicine (ABIM) is proposing still another piece of sanctified paper for internists to strive for and jump through hoops to obtain.

According to a news article in the July 1, 2007 issue of Internal Medicine News, ABIM's Board of Directors has approved the concept and is moving forward awaiting the report of a committee, due in Feb. 2008, charged with the development of requirements.This certification is to be optional and is called a Recognition of Focused Practice.

The Internal Medicine News article is linked here. As much pleasure as I’d probably derive from shooting the proposal down I can’t, really, because the article is so vague. Whether this piece of obfuscation is the work of Internal Medicine News or of ABIM is difficult to say, but it makes little sense.

While the concept of focused practice could take several forms a major area for “focus” is, oxymoronically, “comprehensive internal medicine.” Aside from the obvious contradiction in these terms, what about the existing certification exam? Isn’t it supposed to be comprehensive? What’s different, then, about the special recognition? The ABIM seems to think there’s a difference but they don’t tell us what it is:

In the meantime, the ABIM Board of Directors has endorsed the idea that comprehensive internal medicine is a form of practice that is different from what is recognized by the underlying general internal medicine certificate.

It sounds pretty nebulous to me. There’s nothing new in the tradition of internal medicine about comprehensive care. It’s part of what general internal medicine has always been about.

Stay tuned. I’ll be here to comment further once the ABIM spells out what hoops are to be jumped through and what it all means.