The Monthly Dose: December 2025
Posted by Jorge Francisco on
Welcome to the latest edition of "The Monthly Dose"!
Let’s dig in!
An Update from NBPAS President
A Note of Thanks and Looking Ahead
From Paul Teirstein, MD
As we close out 2025, I want to thank the physicians who have taken a stand against the MOC status quo, especially those of you who have brought NBPAS directly to your hospital leadership, credentialing committees, and medical staff offices. Every conversation started and every bylaw reconsidered challenges long-standing assumptions about who defines certification standards and how physician competence should be measured.
For years, NBPAS has taken a deliberate, physician-led approach. We focused on building a credible, evidence-based alternative, earning hospital acceptance, and supporting physicians one conversation at a time. That foundation matters. In 2025, it allowed us to take this work beyond individual hospitals and directly to government officials and policymakers concerned with physician workforce sustainability and retention.
This year, I authored a Wall Street Journal Op-Ed calling out the American Board of Medical Specialties (ABMS) for consolidating control over continuous board certification in ways that burden physicians without demonstrable benefit to patient care. That message was reinforced by a Medical Economics article written by our Associate Director, Karen Schatten, which examined how ABMS advances and protects its dominance through lobbying and messaging that often obscures legitimate alternatives like NBPAS.
At the same time, ABMS continues to push policies and narratives designed to further entrench its role as the sole arbiter of ongoing board certification. Challenging an organization this entrenched requires more than conviction. It requires persistence, credibility, and sustained effort. The progress we have made shows that change is possible, but the work is far from finished.
Behind the scenes, I want to recognize the NBPAS team, led by our Director, Katie Collins, who are working relentlessly to support this effort. We are a small but mighty nonprofit, and with your support we are building the infrastructure, policy engagement, and physician-facing tools necessary to push back against entrenched interests and expand NBPAS acceptance so that it can be a choice for all physicians nationwide. Each physician advocate strengthens our position. Each hospital conversation weakens the assumption that there is only one acceptable continuous certification pathway.
As we approach year end, I want to thank you for your support and everything you have already done and ask whether you would consider making a tax-deductible, end-of-year donation to help sustain and expand NBPAS’ work. Your support directly enables physician education, hospital engagement, and government outreach as we prepare for a consequential year ahead.
We enter 2026 with real momentum, built on years of groundwork and the growing courage of physicians willing to challenge the status quo. Each month, we highlight physicians who are champions of change, and I am continually inspired by the growing number of you who have taken NBPAS to your leadership and helped change hospital credentialing bylaws. That impact is extraordinary, and it is happening because physicians are supporting physicians.
Thank you for being part of this movement. I look forward to what we will continue to accomplish together.
With gratitude,
Paul Teirstein, MD
President and Founder, NBPAS
MOC In The News
“Are ABMS’ lobbying tactics misleading politicians and the public?”
NBPAS is proud to share a new article by our own Karen Schatten, published in Medical Economics.
In this timely piece, Karen describes the experience going up against ABMS lobbyists at a middle of the night hearing in Texas, fighting for passage of SB 2207 which would have allowed all NBPAS physicians to advertise as "board certified" in Texas. She raises important questions about the transparency, evidence base, legality and ethics of ABMS’ lobbying efforts that impact practicing physicians. The article explores how ABMS and affiliated organizations shape state and national policy discussions despite the lack of clear data supporting MOC requirements.
It's a must-read for physicians, policymakers, and anyone interested in positively impacting medical regulation and professional standards.
American Osteopathic Association (AOA) Announces Lawsuit Against the American Board of Internal Medicine (ABIM)
This month, Medical Economics also covered a newly-announced class action lawsuit against the ABIM’s policies that prevent osteopathic physicians from serving as internal medicine residency and fellowship directors without ABIM certification. The lawsuit argues this restriction blocks qualified Doctors of Osteopathic Medicine (DOs) from leadership roles, steering trainees toward ABIM certification, thereby limiting choice, competition, and restricting access to academic employment.
NBPAS applauds the AOA’s fight for change, and will be following the case closely, keeping you updated as it unfolds.
Doctor Shortages and U.S. Military Readiness
A new article in RealClear Defense cited NBPAS President Paul Teirstein, MD’s Wall Street Journal op-ed. The article explores how gatekeeping related to board certification impacts physician shortages particularly in the U.S. military. The article further addresses military readiness and strains on the civilian health systems caused by public policies that limit access to care.
NBPAS is encouraged to see these issues receiving national attention, underscoring the urgent need for evidence-based solutions to support physicians and their patients.
Hospital Acceptance
Start the Conversation at Your Hospital
Although awareness of NBPAS continues to grow, many hospitals still refer to outdated assumptions about board certification. Physicians are often the most effective messengers in moving those discussions forward.
To support those conversations, NBPAS offers practical steps, tools, and resources you can share with medical staff leadership that are designed to address common questions and help hospitals evaluate NBPAS as a physician-led, evidence-based approach to continuing certification.
When physicians speak up, institutions listen. Your advocacy helps expand recognition of NBPAS and strengthens options for colleagues — ultimately supporting better systems for patient care.
Help bring NBPAS to your hospital with the resources and downloadable materials available on our website.
NEW: The Break Room
A Quick Learning Stop with NBPAS Associate Director, Karen Schatten
We’re excited to launch The Break Room, a new feature of The Monthly Dose designed to deliver quick, clear answers to your most common questions—whether about certification requirements, points of confusion, or regulatory updates.
Check in each month to sharpen your certification knowledge and stay current on the opportunities and challenges that matter as you advocate for NBPAS within your hospital and the broader health care community.
December's Question:
Accepted, versus Recognized, versus Acceptable–What’s the significance of these terms with respect to
payor acceptance?
NBPAS receives many questions regarding payor policies related to what boards or board certifications are “accepted” or "recognized." Confusion around these terms is well justified–legal language can often be a challenge to understand.
To start, “recognized” and “accepted” have slightly different meanings with respect to NBPAS certification (and certification in general). Recognized generally means that a payor has explicitly named the organizations whose certifications automatically qualify under a company’s credentialing rules. Using the example from Highmark Blue Cross Blue Shield below, you will see that NBPAS is clearly listed and that the term, ‘recognized’ applies:
Highmark Recognized Boards for Certification
Highmark recognizes the following boards for certification:
- America Board of Medical Specialties (ABMS)
- American Osteopathic Association (AOA)
- American Board of Podiatric Medicine (ABPM)
- American Board of Foot and Ankle Surgery (ABFAS)
- American Board of Multiple Specialties in Podiatry (ABMSP)*
- American Board of Oral and Maxillofacial Surgery (ABOMS)
- American Academy of Oral and Maxillofacial Radiology (AAOMR)
- American Board of Orthodontics (ABO)
- National Board of Physicians and Surgeons (NBPAS)
*If ABPM or ABFAS boards not available to practitioner
In some cases, a payor’s list of board certification will not list NBPAS by name, but NBPAS physicians may still meet the payors credentialing criteria. In such cases, NBPAS certification may still be accepted, even when not explicitly stated. A good example is the policy of Elevance Health, which does not list NBPAS on its recognized boards list. However, most NBPAS physicians would meet, and be accepted, under its alternative credentialing criteria which require initial board certification, 10+ years of clinical experience, and ongoing participation in high quality CME, subject to Elevance’s approval.
So while it would not be accurate to say that Elevance ‘recognizes’ NBPAS, NBPAS may still be ‘accepted’ in a majority of cases.
Key takeaway: Don’t be immediately discouraged if you're told that NBPAS is not recognized. It's often worthwhile to dig deeper into a payor’s policies and verify the true intent and interpretation of the policy language. The NBPAS team is always available to help research and clarify. As more payors acknowledge the quality and value of NBPAS certification, we anticipate these concerns will continue to diminish.
NBPAS Leadership Academy
Thank you to everyone who attended Session Five of the NBPAS Leadership Academy: Physician Leadership Roundtable.
This session featured a standout panel of physician leaders—each bringing unique expertise, insights, and real-world perspective to the conversation. Listen in to the recording to hear:
- Paul Teirstein, MD, FACC - discussing the reasons why he founded NBPAS and why they matter even more today; and,
- Rupa Dainer, MD, FASA - sharing her experiences serving as a board director of an ABMS-member board, providing a sharp analysis of the boards’ finances, ethics, and what they really think about the "evidence" for MOC; and,
- Herb Bravo, MD - sharing his insights as a pediatrician and children’s health advocate, and what must change to preserve pediatricians in practice.
Champions of Change
Thank you to all NBPAS physicians who go above and beyond to champion life-long learning while advocating for competition and choice in continuing certification.
Meet our December Champions of Change:
This December, NBPAS proudly thanks our more than 15,000 physician diplomates, our Champions of Change. By choosing NBPAS, you’ve supported a physician-led, evidence-based certification pathway grounded in choice, transparency, and lifelong learning. Your leadership is helping build a more relevant and sustainable certification model for physicians today and for those who follow. We are deeply grateful for your trust and support.
Latest from the NBPAS Store
Our newest addition — Retractable Badge Holders — is a simple, visible way to show support for the NBPAS mission.
Support the cause with every purchase.
Whether it’s on your jacket or at your desk, NBPAS gear helps spark dialogue and show solidarity in the
movement for choice in board certification.
Each item — badge holder, mug, or pin — helps amplify awareness, strengthen our collective voice, and reinforce choice in continuing certification shaped by physicians, for physicians.
Small items. Visible support. Real impact.
We’d love to see how you’re showing your NBPAS pride!
Feel free to send us an email with a photo or
tag us on social media.
Not yet a Diplomate? Apply for NBPAS Certification today.
Suggestion Box
Have an idea, need help? Reach out to NBPAS at info@nbpas.org.
We look forward to hearing from you.
