[nradov]

I think you might be a little confused about how the practice of medicine works. State medical boards license physicians. Earning a license usually requires an MD/DO degree, passing the USMLE exam, and completing some amount of post-graduate training (residency). Once you're licensed you can legally perform pretty much any medical procedure regardless of whether it's in your specialty or not. There may be separate contractual restrictions on scope of practice imposed by insurance or employment agreements. Some physicians also choose to seek certification from private medical boards such as the American Board of Medical Specialties; this indicates that they take their job seriously but it isn't required.

[treis]

They didn't say license. They said certification which is issued by the relevant board. While theoretically a medical license gives you the right to perform heart surgery without the relevant certification no hospital will let you, no insurance company will cover you, and your license will be immediately revoked.

[nradov]

Medical licenses are not revoked based on lack of certification. There are plenty of working and employed physicians who lack board certification. Hospitals and health systems in areas with a shortage of doctors can't afford to be too picky, at least not for primary care.

[treis]

There aren't any practicing cardiology or nephrology which is the GP's point and my point.

[otterley]

Board certification is completely voluntary, even for specialists like cardiologists and nephrologists. They can also still be issued malpractice insurance (although the premiums may be higher).

[nradov]

Your point is simply wrong. Especially in underserved rural areas you'll often see primary care doctors delivering cardiology and nephrology treatments even though they lack board certification in those specialties. There are no certified specialists available so they make do.

You guys need to expand your horizons a bit.

[foco_tubi]

“Practicing” and providing maintenance care of a condition are two completely different concepts, and the point you replied to stands.

[nradov]

Nah, the point was just wrong. In many cases these primary care doctors are doing more than just maintaining a treatment plan prescribed by a specialist. Apparently you don't understand how the practice of medicine is legally defined in US states.

[treis]

Primary care doctors are performing heart surgery?

[nradov]

There's a lot more to cardiology than performing heart surgery. Many cardiologists don't perform surgery either.

[ryzvonusef]

Again, maybe I could have phrased things better, but I feel you are digging to deep into the analogy rather than seeing the broader picture that I was attempting to present.

The point was that certifying/licensing exams have a more direct correlation with a specific job/set of jobs than a simple degree, which are more open-ended.