Profession

New specialty approved for treating child abuse

Meanwhile, a specialty in obesity care is being developed by 12 medical associations.

By — Posted Sept. 28, 2009

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A new medical specialty in treating child abuse is becoming a reality after years of work by many pediatricians.

Nearly a decade ago, physicians launched an effort to get the American Board of Pediatrics to offer a specialty in child abuse treatment, said Robert W. Block, MD, professor and chair of the Dept. of Pediatrics at the University of Oklahoma College of Medicine.

Several pediatrician members of the Ray Helfer Society -- a group that promotes education and training in the medical aspects of child abuse and neglect -- pushed for the specialty. After one failed petition, the group gained approval from the pediatrics board in 2006.

The first exam in the specialty will be offered at sites around the country on Nov. 16. An estimated 225 physicians are expected to take the test, which will be given on alternate years.

"By January 2010, we should have the first certificates out," Dr. Block said.

He said there is more knowledge now about child abuse, with thousands of articles and increasing numbers of textbooks on the issue. Supporters of the specialty said such experts are needed to teach medical students and residents about child abuse.

A lot of work goes into getting a new specialty approved by a member board of the American Board of Medical Specialties. "There has to be a demonstration to the board that there is a professional and scientific status to this field," said Gail McGuinness, MD, executive vice president of the American Board of Pediatrics, one of 24 ABMS member boards.

The boards issue certificates in 37 general specialty and 94 subspecialty areas. Board certificates are held by about 85% of physicians licensed in the U.S.

Fighting obesity

Twelve medical associations, including the American Diabetes Assn., the American Heart Assn., and the American Academy of Pediatrics, are seeking board specialization for obesity treatment. With obesity continuing to take a toll on the nation's health, the organizations have started to develop an exam, which they expect to have ready by March 2010.

About two-thirds of adults and one-third of children and adolescents are overweight or obese, said Robert Kushner, MD, president of the Obesity Society, a group of about 2,000 physicians and researchers. The society is spearheading the board-certification effort.

"In light of the complexity and significance of the problem worldwide, the time is right for training and recognizing physicians who are experts in the care of patients with obesity," said Dr. Kushner, who directs the Comprehensive Center on Obesity at Northwestern University's Feinberg School of Medicine in Chicago. "If we develop a group of physicians who are expert, the hope is that they will become the local community opinion leaders and will be able to educate other physicians. They could also serve as a referral base."

Likewise, the child abuse specialty will create needed experts. Dr. Block said the new child abuse treatment specialists also will serve as consultants, educators and researchers. "Hopefully, one of us will be in every school and residency program, and many will be able to speak about community prevention programs. Plus, there is tons of research to be done."

The recognition of a child abuse specialty will allow the Accreditation Council for Graduate Medical Education to approve fellowships in the field. There are about 20 unaccredited fellowships that sprang up in response to the need for expertise in treating child abuse, said Jim Anderst, MD, assistant professor at Children's Mercy Hospital in Kansas City, Mo., who directs one such fellowship program.

"Board certification is a necessary step," Dr. Anderst said. "As time passes and more research is done, we are gaining a greater understanding of the types of abuse children can suffer, including sexual abuse and neglect. The scope of knowledge for the complex cases in particular is often outside the realm of knowledge of the general practitioner."

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