Future of board certification in a new era of public accountability.

The American Board of Medical Specialties and its member boards have been serving as a key foundation for professional self-regulation for the past century. During this time the standards for specialty board certification have evolved to meet the public's needs. Recent major changes have included time-limited certification status, the adoption of 6 core competencies, and the multifaceted recertification program termed Maintenance of Certification. During the past decade there has been a dramatic increase in the public's interest in improving the quality, safety, and efficiency of the US health care system. This article describes some of the milestones in the evolving public demand for physician accountability. The public's growing need for better health care delivery is, in turn, creating the need for the American Board of Medical Specialties and its member boards to evolve to meet the public's expectations of the profession of medicine to maintain its privileged status in specialty certification through self-regulation.