American Board of Ophthalmology Certifying Examination Performance and Opioid Prescription Patterns

Abstract

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). 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. 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). 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.