When the first nationally recognized medical specialty board was established
in 1917, board certification was seen as a way for professional peers to grant
formal recognition of a physician's qualifications in a chosen field. Then,
as now, it was a voluntary process. However, board certification is becoming
less of an option and more of a necessity to gain credentialing privileges
on hospital staffs and participate in managed care plans. In addition, nearly
every board has begun issuing time-limited certificates, thus requiring recertification
every so many years.