Rand Paul, the Republican candidate for Senate in Kentucky who is an ophthalmologist, has been practicing medicine for the last five years without a nationally recognized certification for his specialty. While this is not illegal, it's certainly unusual. While all physicians are required to graduate from an accredited medical school and pass a state licensing test, specialists normally seek board certifications, essentially an additional training and practice in their chosen field. Once a physician has obtained their certification, they need to renew it every ten years.
Today, Zach Roth reported that Paul created an alternative certification board for his specialty in 1999. More notable, however, is that Paul apparently allowed his own American Board of Ophthalmologists certification to lapse in 2005, which means he's been practicing for the last five years without the nationally recognized credential, an aberration within the profession.
"Over all, about 85 percent of all practicing physicians are board certified," Beth Ann Slembarski, the administrator of the ABO, says. "Ophthalmology has a higher percentage than that, we're upwards of 95 percent. Once someone is board certified, there is about less than five percent of people initially don't re-certify." Slembarksi says that doctors who decline to re-certify usually do so when they stop seeing patients, shift their focus to research, or leave the country.
I also called Lori Boukas, a spokesperson at the American Board of Medical Specialties, the national umbrella organization for certification boards. She said board certification is the "industry standard," explaining that some hospitals make it a policy not to hire specialists who lack certification and that insurance companies will exclude non-certified doctors from their coverage networks. Malpractice-insurance costs are also lower for doctors whose certification is up-to-date.
"We say to the public that board certification is something that you want to look at to make sure that they're keeping updated in their specialty, because technology and practices change," Boukas told me. The ABMS allows the public to learn if their doctor is certified on its website. Paul's father, Republican Congressman and former Libertarian presidential candidate Ron Paul, is also a physician and maintains an active certification from the ABMS-recognized American Board of Obstetrics & Gynecology.
Most ophthalmologists become certified through the American Board of Ophthalmologists, a national professional organization that is recognized by the American Medical Association and the ABMS. As Roth chronicles, Paul apparently set up an alternative certification organization in response to a change in rules at the ABO that forced younger doctors to recertify every 10 years, while older doctors were grandfathered in with lifetime credentials. (A variety of certification boards adopted time-limited certification in the late 1980s and early 1990s, according to the ABMS. Today, all board certifications are time-limited.)
Interestingly, Paul dissolved his alternate board a year after it was founded, before reinstating it in 2005 -- the same year he allowed his ABO certification to expire. It is unclear if Paul has been certified by his own board.
Paul's work as a physician has been central to his campaign; indeed, the second paragraph of his election bio concerns his work: "Dr. Paul and his family live in Bowling Green, where Rand has practiced medicine and performed eye surgery for 17 years. Rand owns his own ophthalmology practice, which employs 3 full-time staff members." A call to Paul's campaign office was not immediately returned.
