It is certainly a challenging time to be a doctor. When even the New York Times is writing articles about record-breaking levels of burnout in the profession, we know that there is much that is askew in the world of medical practice. We recognize many of the causes: inbox overload in the EHR, increasing administrative burden in everything from prior authorization to billing compliance, evolving health care systems that aren’t reliably designed to help us achieve the best results for our patients.

But I think one of the deepest challenges we face together is a very broad assault on expertise and a deepening of distrust between our patients and the health system in which we work, even, sometimes, in the very expert, science-based advice we are trained to offer them. Every one of us has worked hard to get and maintain our internal medicine or specialty and/or subspecialty certification. We know the work it takes to get through initial training and to stay current in rapidly evolving fields. And, we know the stakes for our patients couldn’t be higher. So, to find ourselves living in a world where the very foundation of our practice—the science that generates all the amazing things we are able to offer in service to our patients—comes under attack, well, that makes every day even harder.

Lack of trust clearly makes people more susceptible to accepting misinformation and being skeptical of science. And there is plenty of earned mistrust in medicine—whether it is glaring inequity and disparities in health outcomes based on race, or high medical expenses that drive people into personal bankruptcy, many of our patients have good reason to be dubious about the advice we give them. Which makes it all the more important that we distinguish and differentiate ourselves from those who do not have the expertise we have.

Board certification has always been about that: a publicly recognizable way to identify doctors who have been well-trained and have demonstrated their continuing expertise through an independent, substantive process. Anyone can create a certificate—my son was married by a web designer friend who got ordained online after a one-hour course and a $50 fee. That may work for performing a wedding ceremony, but few of us would want to rely on that for treatment of cancer or heart disease. In a world of self-declared “experts,” all of whom have access to huge, influential social media platforms, it can become really hard for patients to know the difference between people who know what they are doing and people who don’t. Board certification is a core part of the “trust equation” with patients and colleagues.

I’m proud to be leading an organization that is rapidly evolving to better meet the needs of doctors, even as we preserve our core function of creating meaningful, valid distinctions based on substantive demonstration of ability. A credential is only worth whatever is behind it. At ABIM, we will continue to work to improve the quality of what we do and offer options for better integration of assessment and learning. It means a lot to be a board certified internist, and I am proud of the colleagues who have done and are doing the work to offer the best to their patients every day.

Richard J. Baron, MD, board certified in Internal Medicine and Geriatric Medicine