Thursday, January 25, 2007
Physicians and certification of their training
By Dr. Anthony Policastro

Physicians have many different kinds of certification. The basic certification is a medical license. You cannot practice medicine without a license. Therefore, all physicians have licenses. These are state requirements. They are given to physicians who have the required training to practice medicine. When I first joined the military, the physicians practiced on government property. They did not practice in any particular state. For that reason, military physicians did not need licenses. They only needed a license if they practiced off base. Then a newspaper decided to print a story. The headline read: "Military physicians not licensed to practice medicine." While it was accurate, it was not really relevant. The physicians were all qualified for licenses. As a result, we all had to obtain licenses. However, there are other certifications that are more complex. One of those is belonging to a specialty organization. I am a member of the American Academy of Pediatrics. I completed a pediatric residency. I joined the organization. I pay my dues. Therefore, I can use the letters FAAP (Fellow, American Academy of Pediatrics). The letters may sound impressive. However, it is little more than belonging to the national pediatric organization. I am also a Diplomate of the American Board of Pediatrics. This means that I have become board certified in the field of pediatrics. Of interest is the fact that the meaning of board certification has changed over the years. Before the 1950s physicians were only required to complete a general internship after medical school. This internship included time in Internal Medicine, Pediatrics, Surgery and Obstetrics. They could then go into private practice as a general practitioner (GP). When many of us grew up, these individuals were our family doctors. Medical technology was limited. The number of effective medications was small. This was a good way to practice medicine. Some physicians specialized but not all did so. In the 1960s many physicians began to complete residency training in a specialty area. They did this after their year of internship. This allowed several years to specialize in one area. The standard specialty residency was two years long. These individuals would then practice as a specialist. Some of these individuals decided to obtain what is known as board certification. Board certification involved taking a test. The test was sometimes written. It was sometimes an oral exam. Most specialties required both a written and an oral exam. During this period board certification was still an optional thing. In the 1970s the trend moved away from the general internship. Medical students would decide on a specialty early. They would then do an internship in their selected specialty. This would replace the general internship. They would then spend the next two years in a residency in their selected specialty. Three-year Family Practice residencies replaced the one-year GP training. Most of these individuals obtained board certification. The board certification was permanent. Once they obtained it, they would be board certified for life. In the 1980s two things happened. The first was that many residencies became longer. Some lasted four years. Others lasted five years. This was especially true in the surgery areas. The second thing is that board certification was no longer permanent. Physicians had to re-certify. Re-certification was usually required every six to eight years. Physicians who had been board certified before the rules changed still kept their permanent board certification. They did not have to retest like the newer graduates. Some of these organizations allowed optional re-certification if the physician desired it. For example, I had permanent board certification as a pediatrician. I was board certified in 1977. I elected to re-certify by taking a test three times. I did that in 1983, 1988 and 1995. In 2002 I became board certified in a subspecialty of Pediatrics. It is known as Developmental and Behavioral Pediatrics. Because this certification is more recent, it only lasts for seven years. If I want to stay certified, I would have to retest in 2009. While this may sound confusing, it is relatively simple. Physicians who trained long ago are usually not board certified. Those who trained a little later may or may not be board certified. If they are, it is likely a permanent certification. Those who trained more recently are likely to be board certified. Their certification will not be permanent.

Dr. Anthony Policastro is medical director at Nanticoke Memorial Hospital.

Nanticoke physicians support fund for giving prescriptions
This holiday season, a group of Nanticoke physicians made donations to a fund that assists patients who cannot afford their medications when discharged from the hospital. Through the efforts of the Nanticoke Health Services Development Committee, a program was established that encouraged physicians to make a donation to the Prescription Drug Fund, in lieu of giving gifts to other offices. Participating physicians received inserts for their holiday cards, which informed the recipient that a donation had been made to the Prescription Drug Fund in their honor. The Prescription Drug Fund of Nanticoke Health Services was established to help patients who are unable to afford their medications. This fund receives contributions from the community, the Nanticoke Health Services Auxiliary, and from special events such as the annual NHS Golf Tournament. The Development Committee is responsible for the promotion of charitable giving directed toward Nanticoke Health Services and the funds that support the provision of healthcare in the community. Committee members Patricia Olekszyk and Maria Lehman developed this holiday giving program to benefit the Prescription Drug Program. The Development Committee is actively working to create an Annual Giving Program for Nanticoke Health Services.

Nanticoke to hold annual cholesterol screening
Nanticoke Memorial Hospital will be offering cholesterol screenings on February 14, 17 and 21, from 7:30 to 10 a.m. at the Nanticoke Stein Highway building, located in the former PK complex, next to County Bank. The Lipid Profile test requires a 12-hour fasting and reads the HDL and LDL blood levels. Cost for the Lipid Profile is $15. No pre-registration is required. In addition to the cholesterol screening FREE blood pressure checks will be offered. Results from the cholesterol screening will be mailed approximately two weeks after the test is performed. For additional information, call 629-6611 extension 2404.

Nurses' Assistant evening course at Delaware Tech
Delaware Technical & Community College, Owens Campus, is offering an evening Nurses' Assistant course. Instruction will be given at Green Valley Terrace in Millsboro from January 30 through April 17; classes will meet on Tuesday, Wednesday and Thursday from 5-10 p.m. This 150-hour hour course teaches students to safely perform basic nursing skills under the supervision of a licensed nurse. For complete information call 854-6966.

Polar Bear Plunge benefits Special Olympics
The 16th annual Lewes Polar Bear Plunge to benefit Special Olympics Delaware, the state's largest organization dedicated to providing year-round athletic training and sports competition for children and adults with intellectual disabilities, will take place Sunday, Feb. 4, at 1 p.m. at Rehoboth Beach. Sponsored by Wawa, the Plunge has evolved into Special Olympics Delaware's most significant fundraiser and has drawn more than 2,000 participating 'Polar Bears' each of the past four years, including an event record 2,390 participants in 2006. To participate, 'Polar Bears' must register for the Plunge and collect a minimum of $50 in pledges. On-line registration can be completed on the Special Olympics Delaware web site The 2006 Plunge raised $426,000 for Special Olympics Delaware, and has raised more than $2.9 million since starting in 1992.

Delaware Healthy Living Expo planned
The Delaware Healthy Living Expo, featuring an array of speakers and workshops on issues of family, physical, spiritual, financial, emotional, and intellectual wellness, will be held at the Chase Center on the Riverfront in Wilmington on March 10 from 10 a.m. to 4 p.m. Headlining the workshop programs will be Lisa Whaley, founder and president of Life Work Synergy, LLC. Whaley, who is also an accomplished author, will present "Finding the Off Switch in an Always On World" to give insight to attendees on finding a harmonious balance between work and life. Four additional speakers will follow addressing healing, self-sabotage, positive attitudes, and exercise. The day also features several exhibitors, providing attendees with products, services and knowledge which support health, harmony and spiritual awareness and enhance overall quality of life issues. Admission to the Expo is $7. A special luncheon package is also available for $17. You may preregister online at For more information, visit or call 215-968-4593.