Key result
Ophthalmologists who initially failed qualifying exams but later became certified prescribed fewer opioids per year compared to those certified on the first attempt (MD -1.7; P=0.0031).
Why the study?
The study was designed to compare opioid prescription patterns of ophthalmologists based on performance on the American Board of Ophthalmology written qualifying examination and oral certifying examinations.
Does ABO certification status correlate with opioid prescription patterns among ophthalmologists?
Observational (n=6,822)
Does ABO certification status correlate with opioid prescription patterns among ophthalmologists?
Mean Difference: -1.7
p-value: p=0.0031
Ophthalmologists who eventually achieved board certification after initial failure prescribed fewer and less costly opioids compared to non-board-certified ophthalmologists.
May associate first-attempt ABO certification with lower opioid prescribing volumes; leaves open whether exam performance influences clinical behavior.
Purpose:. To compare opioid prescription patterns of ophthalmologists based on performance on the American Board of Ophthalmology (ABO) written qualifying examination (WQE) and oral certifying examinations (OE).Design:. All ophthalmologists within the Medicare Prescriber Part D Database from 2013 – 2018 who attempted the ABO, WQE, or OE were included. Opioid prescription data were analyzed based on ABO certification status: certified on first attempt, failed but then certified, and never certified.Results:. There were 6822 ophthalmologists with 32258 records in the Medicare database during the study period with ABO data available. The point estimate for total opioid prescriptions per year was 7.3, standard error (SE) 0.3 for ophthalmologists who were certified on the first attempt (reference). The estimate for those who failed one or both qualifying examinations, but then became board certified (BC) was −1.7, SE 0.6 (p = 0.0031); and the estimate for those ophthalmologists who never became BC was +0.8, SE 1.5 (p = 0.5318). The point estimate for cost of opioids prescribed per year was $55.17, SE 4.4 for ophthalmologists who were certified on the first attempt, with the estimate for those who failed one or both qualifying examinations, but then became BC being $−12.29, SE 8.7 (p = 0.1581); and for those ophthalmologists who never became BC being +$69.54, SE 21.7 (p = 0.0014).Conclusions:. Diplomates who initially failed one or both qualifying exams, but who ultimately became certified, prescribed less opioids, less costly opioids, and less supply of opioids within the Medicare Part D database compared to non-BC ophthalmologists.
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Starr et al. (2023) conducted an observational in Opioid prescription patterns (n=6,822). Failing qualifying exams but later becoming board certified vs. Certified on the first attempt was evaluated on Total opioid prescriptions per year (MD -1.7, p=0.0031). Ophthalmologists who initially failed qualifying exams but later became certified prescribed fewer opioids per year compared to those certified on the first attempt (MD -1.7; P=0.0031).
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