When it comes to our health, we want the best. That means a physician we can trust, and a large part of that trust comes from understanding a doctor’s credentials. What do all those initials and degrees behind your doctors’ names mean? And is your doctor keeping abreast of cutting-edge medical advances and patient care? Establishing whether a physician is board-certified is one step in the process of finding an expert health care provider.

is your physician board certified?
Board certification—not to be confused with basic state licensure, which simply establishes a minimum competency to diagnose and treat—is a sign of a physician’s commitment to exceptional expertise in their particular specialty. Certification is granted by a number of boards, but the American Board of Medical Specialties (ABMS) is widely recognized as the premier assessment system. “More than 840,000 physicians are certified in one or more of the 150 specialties and sub-specialties offered by the ABMS member boards,” says ABMS communications director Susan Morris. There are 24 boards under the ABMS umbrella, including Emergency Medicine, Family Medicine, Obstetrics and Gynecology, Psychiatry and Neurology, Pediatrics, Radiology, Surgery and Urology.

Although obtaining board certification is voluntary, the qualification is increasingly required by hospitals and insurance companies. The ABMS Maintenance of Certification (MOC) program is the system of ongoing professional development, and it focuses on lifelong learning. “Research has shown repeatedly that physicians lose knowledge and skills as the years pass after their training,” Morris says. “The MOC addresses this problem.” The six core competencies measured by the MOC are: practice-based learning and improvement, patient care and procedural skills, systems-based practice, medical knowledge, interpersonal and communication skills, and professionalism.

To see if a doctor is certified by an ABMS member board, log on to certificationmatters.org. For a list of ABMS member boards, visit abms.org/member-boards. In addition, The Official ABMS Directory can be found in many public libraries.

what does board eligible mean?drbackground
Morris explains that ‘board eligible’ is a term that refers to the time lag between a physician completing an accredited residency program and becoming certified in a specialty. The ABMS established its Board Eligibility Policy in 2012, Morris says, to establish parameters for this time period. “The policy recognizes physicians’ need to use the term ‘board eligible’ as a way to signal their preparations for specialty certification, and closes off the potential for indefinite use of the term.” Physicians now have no fewer than three years and no more than seven years to achieve their initial certification. If that doesn’t occur, they must complete requirements of that member board for re-entry into the certification process.

finding a doctor: questions to ask.
Some important questions to consider asking if you’re interviewing a doctor:
• Are you board certified?
• By which board?
• In which specialty?
• Do you participate in the ABMS Maintenance of Certification program?
• What does this involve?
• Where did you attend medical school?
• How long have you been in practice?
• What hospitals do you use?
• Are they accredited?

mental health
on our minds
According to the National Institute of Mental Health, more than 30 million Americans need help dealing with feelings and problems that seem beyond their control at some point in their lives. These could be problems with a marriage, the loss of a job, the death of a loved one, an addiction, or a severe mental illness for which medication is needed. But untangling the distinctions among mental health professionals can be complicated. What’s the difference, for example, between a psychologist and a psychiatrist? What does a social worker do? What exactly is a pastoral counselor?

psychiatrist vs. psychologist: how do they differ?
Psychologists and psychiatrists are different types of doctors trained in different ways to treat mental disorders. A psychiatrist is a medical doctor who can prescribe medication, while a psychologist has a Ph.D. in psychology (the study of mind and human behavior) and cannot prescribe drugs. Psychologists spend an average of seven years in graduate education and training to earn their degree. A psychiatrist, says Dr. Tristan Gorrindo, director of education at the American Psychiatric Association, takes eight years to earn his or her degree—four years of medical school, four years of residency and, if desired, a further two or three for specialization in child, forensic, addiction psychiatry or some other specialty.

While psychologists look closely at behavior and thought patterns, psychiatrists also focus on biology and neurochemistry. Both, however, are trained to practice psychotherapy, which the American Psychological Association defines as a collaborative treatment grounded in dialogue and based on the relationship between doctor and patient.

According to the health-3-backgroundAmerican Psychiatric Association (APA), it is the largest organization of psychiatrists, with 36,000 members. APA psychiatrists are exclusively board certified by the American Board of Psychiatry and Neurology. However, not every APA psychiatrist is board certified. “Historically, psychiatrists felt board certification was less important than most do today,” explains Gorrindo. “This means that our more senior members may not have their certification, but still are excellent doctors.”

Gorrindo says psychiatrists are more in demand these days than in the past. “As the public becomes more aware of mental health issues, we find we are struggling to keep up,” he says. Over the course of a lifetime, he notes, one in five adults will have a mental health problem that reaches a clinical level. One result of this demand, he says, is the emergence of telepsychiatry. The U.S. Department of Veterans Affairs has been one of the main pioneers of this new way of delivering care to people who otherwise might not have access to it. “This is especially useful for those living in rural areas or for people with disabilities who have difficulty leaving the home,” he says. Patients are usually connected to telecare through hospitals and private clinicians.

The American Psychological Association (also APA) was founded in 1892 with 31 members. Today, it is the largest organization representing psychology in the U.S. with more than 120,000 members, including researchers, educators, clinicians and consultants. Clinical psychologists are typically sought for psychotherapy, employing a range of talking therapies to process and resolve patient issues. The APA defines psychology as “a diverse discipline, grounded in science, but with nearly boundless applications in everyday life.” Psychologists can assess behavioral and mental function, test intelligence and personality, and work as consultants in companies and organizations.

The American Board of Professional Psychology (ABPP) is the primary certifying board for psychologists. It offers a ‘Psychologist Locator’ service, which allows users to narrow their search by specialty, location, insurance, gender and languages spoken.

what does a social worker do?
Lorien Carter, MSW, assistant professor of practice at the Washington University George Warren Brown School of Social Work, says a social worker differs from other mental health professionals by addressing both the individual and the environment. “We use the ‘person in environment’ perspective to understand how individuals and their behaviors are influenced, positively or negatively, by the families, neighborhoods and communities in which they live,” Carter says. “We don’t just focus on individual- or family-level change but on community interventions with schools or other systems to develop effective prevention programs.”

Social work also focuses on providing services to disadvantaged and under-resourced populations. “This doesn’t mean that social workers aren’t working with middle and upper socio-economic classes,” Carter says, “but our profession recognizes that for those who lack resources, the barriers to service access are significant.”

As for credentials, Carter says most states require social workers to have a clinical license (LCSW). This is considered to be the gold standard of social work credentials and typically involves training in psychotherapy in a clinical setting. A licensed master’s of social work (LMSW), she notes, is sufficient for only therapy that is supervised. A social worker with an LMSW may not open a private practice. Both have master’s degrees, but in Missouri, an LCSW needs to pass an exam and have 3,000 hours of supervised social work in a 24 to 48 month period.

professional counselor
A professional counselor, says Lynn Linde, senior director at the Center for Counseling Practice, Policy and Research, “approaches from a wellness perspective, with the idea that everyone has the ability to grow and change.”

Licensure requirements, she says, vary from state to state. According to the Missouri Committee for Professional Counselors, a Licensed Professional Counselor (LPC) in Missouri has a master’s degree in counseling psychology and no less than 24 months of experience supervised by a psychiatrist or psychologist. Currently, five colleges in Missouri offer counseling degrees—Lindenwood University, Missouri State and Southeast Missouri State universities; University of Missouri-Kansas City and University of Missouri-St. Louis. In addition to mental health problems, Linde says, a counselor is trained to help with problems like career planning and difficult decision making.

New in the field of counseling, Linde notes, is life coaching. Based in Lexington, Kentucky, the International Coach Federation (ICF) was formed in 1995 and is the world’s largest organization of professionally trained coaches. The ICF defines coaching as, “a thought-provoking and creative process that inspires clients to maximize their personal and professional potential by achieving goals in their professional or personal life.” To become an ICF member, a person must complete at least 60 hours of training that meets ICF standards.

pastoral counselor
Reverend Dr. Kristen Leslie is professor of pastoral theology and care at Eden Theological Seminary. She explains that a pastoral counselor uses both psychological and spiritual/theological theories to help people. Although pastoral counseling may reflect the counselor’s particular religious community, she says they can help anyone. “Changing someone’s religious tradition is not their aim,” she says. A pastoral counselor usually has a master’s of divinity, M.Div., which includes the appropriate training, she says. While this type of counseling can deal with complex problems and be lengthy and in-depth, pastoral care, she says, “is a free service offered by a minister that deals with normal life-cycle issues—grief, marriage and general suffering.”

In the past, pastoral counseling was largely a Western Christian practice, but Leslie says that is changing. “Jews and Muslims are now training within their own disciplines, too,” she notes.

Two main national organizations oversee accredited pastoral counselors: the American Association of Pastoral Counselors and the American Association of Christian Counselors.