This is in response to the “Viewpoints” article in the November 4, 2011, issue on maintenance of certification and maintenance of licensure. It seems to me that the most important element regarding these changes of regulation is the question of the effect of these mandates on clinical outcome. I have yet to see any evidence that these changes will improve patient care or patient safety.

My understanding is that these changes are being made because there is no evidence that board certification improves clinical outcome. Likewise, there is no evidence that continuing medical education requirements improve patient care. Therefore, the powers that be, in all their wisdom, have devised these requirements for recertification and relicensure. But again these mandates seem to be based on blind hope and wishful thinking rather than empirical evidence.

One would hope that before physicians are burdened with the expenditure of hundreds of hours and thousands of dollars needed to comply with these demands, the specialty boards and state medical boards would do the research to demonstrate the effectiveness of each of these activities. If the research is not done, we will simply be repeating the failures of past regulations with no improvement in outcome.

MICHAEL V. DELOLLIS

Fresno, Calif.