The Monthly Dose: May 2025

Welcome to the latest edition of "The Monthly Dose"!

Let’s dig in!

As the Texas legislative session comes to a close, we are disappointed to share that SB 2207 did not make it into law–though it came remarkably close. While it ultimately didn’t make it onto the Texas House calendar for a final vote, the bill’s progress was both meaningful and revealing, signaling growing momentum for physician transparency and choice.

Quick Recap:

SB 2207 sought to modernize Texas’ outdated “Advertising as Board Certified” rule by removing a de facto Maintenance of Certification (MOC) requirement. This commonsense reform would have allowed physicians certified by NBPAS to truthfully advertise their board certification. Texas remains one of only a few states with such restrictive regulations, and this bill would have advanced a fairer, more transparent system, and helped Texas recruit and retain board certified physicians.

What Happened:

Throughout the legislative process, NBPAS remained fully engaged. Karen Schatten, NBPAS’ Associate Director, was present in Austin providing invited testimony in support of the bill at every stage. In the final hearing—held in the early hours of May 13—she testified alongside several groups and individuals opposing the bill, including:

• Charles Sheffield, VP of Government Affairs, ABMS
• Dr. Ezequiel "Zeke" Silva III, Chair, Texas Medical Association Council on Legislation
• Dr. James McMichael, a Texas physician with a Time-Unlimited (“grandfathered”) certification
• Sara Allen, lobbyist for the Texas Chapter of the American College of Emergency Physicians (registered against the bill but left before the 3 a.m. hearing)

Regrettably, the opposition, led by ABMS, relied on misinformation to sow doubt, including claims that portrayed NBPAS as a "diploma mill," misleading comments suggesting that grandfathering started in 1933 but is no longer relevant, and assertions that a new, selectively applied “national standard” for board certification limited to organizations who offer initial certification represents the gold standard. These misleading tactics are a reminder of how entrenched interests resist change—even at the cost of transparency, clinical data, and physician autonomy.

NBPAS urges Texas physicians to contact the Texas Medical Association (TMA) and seek clear explanations for its disappointing stance on SB 2207—specifically, how and why it chose to oppose a bill despite being championed by so many Texas physicians and one that promoted transparency, fairness, and upheld the gold standard of physician education and training.

Why It Still Matters—and What We Gained:

Despite this setback, there are powerful takeaways:

• Bipartisan, Broad-Based Support: Facts consistently prevailed over falsehoods. SB 2207 passed unanimously out of the Senate Health and Human Services Committee, received a 29–2 vote in the full Senate, and passed 9–1 in the House Public Health Committee. In the end, we only needed a little more time.
• Unprecedented Momentum: The bill’s journey began as a welcome surprise and quickly gained traction in a crowded session where more than 7,000 bills were introduced but only 437 became law with three days left in session.
• Awareness and Education: We engaged lawmakers across the political spectrum and educated them about the importance of board certification choice and the dangers of anti-competitive gatekeeping practices.

Texas’ biennial legislative cycle and compressed calendar presented significant logistical challenges, but SB 2207’s progress demonstrates that truth, persistence, and professionalism resonate—even under pressure. It’s also a powerful reminder that physicians must stay alert to the activities of boards, medical societies, and associations that may not always act in their best interest—especially when those decisions are made at 2 a.m.

To watch the full testimony:
https://youtu.be/nyn4Xws4byE

We’re not done. This experience has only strengthened our resolve. The foundation is laid, the support is there, and we will be back—more prepared, more informed, and more determined than ever to advocate for fairness, accuracy, and physician choice.

Colorado recently enacted HB24-1153, which introduces a new requirement for physicians to complete 30 hours of continuing medical education (CME) every 24 months to maintain state licensure. The law also defines “national board certification” in a way that applies only to certifying bodies that offer both initial and continuing certification, thereby excluding NBPAS from meeting this definition. While board certification is not required for licensure under this new law, the legislation allows participation in Maintenance of Certification (MOC) programs to count toward the CME requirement.

Specifically, the law defines "national board certification" as a program that includes:

1. A process for defining specialty-specific standards for knowledge and skills; and
2. An independent, external, psychometrically valid assessment of knowledge and skills for both initial certification and recertification or continuous certification by the certifying body that granted the initial certification.

While the Colorado Medical Society advocated for this bill, NBPAS feels it does not reflect the preferences of the thousands of physicians in Colorado and across the country who are seeking alternatives to burdensome, unproven Maintenance of Certification (MOC) requirements.

NBPAS remains committed to advocating for inclusive certification standards that prioritize clinical relevance and evidence-based education over monopolistic testing models.

If you're a physician in Colorado or another state considering similar legislation, we encourage you to speak out and join us in promoting fair, inclusive reform.

Advocate for Your Hospital to Accept NBPAS

With growing payer acceptance, including recent affirmations from UnitedHealthcare and Elevance Health, now is the perfect time to introduce your hospital to NBPAS. Many hospitals simply are not aware that NBPAS exists. You can help change that. Visit our website to access a step-by-step resource for presenting NBPAS to your hospital’s credentialing team: nbpas.org/pages/introducing-nbpas-to-your-hospital.

Your Voice Matters - help bring choice and clinical relevance to continuous board certification.

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.

The National Board of Physicians and Surgeons (NBPAS) is proud to recognize Dr. Sandra Peyton MD, as our May Champion of Change.

Due to the intensity of the legislative schedule, Dr. Peyton ultimately delivered her testimony around 2:30 a.m. on Tuesday, May 13th. Throughout the long day and night, she waited patiently—steadfast in her determination not to leave until her mission was fulfilled.

The NBPAS team is profoundly grateful for her dedication, perseverance, and grace under pressure. Dr. Peyton championed the voices of many NBPAS physicians that day, and her testimony offered a vital perspective on how a de facto Maintenance of Certification (MOC) requirement adversely affects physicians in Texas. We are deeply thankful for her efforts to correct the record and advocate for meaningful change.

About Dr. Peyton: Dr. Peyton is a board-certified family medicine physician who earned her medical degree from McGovern Medical School at the University of Texas Health Science Center at Houston. She completed her residency in family medicine at Arrowhead Regional Medical Center in San Bernardino, California. With over 30 years of clinical experience, Dr. Peyton is affiliated with Olin Teague Veterans Health Center in Temple, Texas as well as White Rock Lake Medical Center in Dallas, Texas. Her current area of expertise is in Emergency Medicine with interest in Functional Medicine. She is licensed to practice medicine in Texas.