38 Onward and, Eventually, Upward right time to get the job done. The BurnettNamey team was truly right for ACOFP. Wise on financial matters, yet tough and pragmatic in dealing with the opposition, they were able to react quickly to problems. Though presidents would come and go, these two established the mold and set the long-range strategy for many years. They were formidable foes to those who stood in the way of ACOFP’s progress. They were generous protectors to those who shared their vision. Whether friend or foe, everyone agreed that Dr. Burnett’s and Dr. Namey’s philosophy and leadership were very effective, and they brought ACOFP to where it is today. DISCRIMINATION: THE DRIVING FORCE FOR EXPANDING CERTIFICATION The development of certification examinations and subsequent residencies was pushed by government and third-party discrimination between specialists (certified and residency trained physicians) and non-specialists (generalists and non-residency trained physicians). The discrimination occurred primarily in the matter of higher fees for certified physicians, but non-certified physicians were experiencing other subtle pressures. This was especially apparent in the area of hospital privileges. “Non-certified” physicians had less access to facilities and equipment needed to perform procedures and provide care for their patients. The change from general practitioner to family practitioner occurred about the same time, because governmental agencies offered better reimbursement levels for family practice, which was now a recognized specialty. The idea of certifying the general membership was first proposed by Robert G. Haman, DO, FACOFP. Dr. Haman developed a method of certifying continuing medical education known as Continuous Certification of Medical Education (CCME). Dr. Haman partnered with several pharmaceutical corporations to create a concept in medical education new to American medicine. Using his plan, the member would be given a pretest at the beginning of a series of educational lectures and a posttest at the end. Passing the test would validate proficiency in that subject, and that proficiency would be recorded. A member could accumulate certification gradually, one subject at a time, rather than sitting for one large certifying exam. This idea never caught on, but it was instrumental in guiding the thinking of policy makers to develop the Clinical Pathway to Certification that existed for many years. The Clinical Pathway to Certification allowed a physician who entered practice before the availability of residencies to become certified. Physicians who graduated prior to 1995 and completed six years of practice and 600 hours of continuing education could sit for the certification examination. Physicians eligible under the clinical pathway had until the end of 2001 to successfully complete the certification examination. This process recognized the value of clinical experience and provided a method for thousands of physicians to become certified.
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