June 1997


By Michael J. Katin, MD

One of the dilemmas in managed care is to assure that the specialist (that the patient will, of course, not be allowed to see) is competent. Board certification is often used as an acceptable standard, as Iong as it is overlooked that often this depends on one's biorhythms having been favorable on the day of the oral section. There is then the possibility that even if one knew enough on the days of the board examination this would not eliminate the risk that this knowledge has been jettisoned on the trip back from Louisville. Nonetheless, board certification remains similar to that of being a Jedi Knight. Even if you go over to the dark side you still retain that certification.

It therefore seems logical to require board recertification to make sure that practitioners remain competent despite doing the same primitive level of work day in and day out for ten years, fighting off any opportunities for innovation unless forced into it by the nearest competitor. Although we favor recertification every two (rather than ten) years for everyone who achieved board certification after I did, perhaps a fairer approach would be to have mandatory retraining camps for radiation oncoloists the same way professional football teams require for veterans each season. The location would have to be undesirable in order to allow concentration on the seriousness of the project. I will pass up an opportunity for a cheap shot at any particular city, but in a11 probability the prefix "San" or '"Las" would not be part of the name of the location. Radiation oncologists would be put through one week of vigorous physics drills, simulated simulations (redundant?), and radiobiology exercises. The final day could be a grueling and realistic 16 hour obstacle course including evasive action against patients' Long-lost relatives suddenly appearing from out of town, defensive moves against hospital administrators, and other practical applications.

Since certification, recertification, and other quality assurance programs have become big business, I fully expect to see this idea implemented in the near future and I hope to be legally entitled to royalties from this enterprise since my originating this idea has now been documented on this web Site as of today.

For those waiting for the end of May's column--good news! You still have something to which to look forward.

email: mkatin@radiotherapy.com