IBBM Certification for Blood Management Technoligists (A Letter in Opposition)
It has only of late become clear to me and many other Perfusionists I have heard from, that the IBBM, a wholly owned subsidiary of AmSECT has embarked upon a mission to offer certification to NON PERFUSIONISTS to perform medical procedures which are explicitly included within the scope of practice of perfusionists. The involvement of AmSECT in the creation of the IBBM and in the ultimate direction it has taken has never before been made clear to or approved by the AmSECT membership. This first exam is scheduled to occur at the next International AmSECT meeting, and should be immediately stopped in order that the AmSECT membership be given a full opportunity to become informed of the implications of this venture and voice their opposition or support by a vote.
The IBBM, funded entirely by AmSECT, has scheduled a one day course for any person with at least a high school level of education, and proof of a minimal number of cell saver cases to attend, and then offer an examination that will lead to a certification in Blood Management by the IBBM, and AmSECT.
The argument presented in favor of this venture is that these people are already practicing and that they should have formal training and certification in order to satisfy the AABB and protect the public from unsafe practitioners. The added benefit is that AmSECT can collect the revenue from this venture. Another argument is that Perfusionists will somehow be able to exert some “oversite” or “supervision” over these people if AmSECT gives the credential. This is an extremely short sighted and flawed argument.
The implication of this credentialing is that a new group of previously unrecognized people may now become recognized as capable by the leader in Perfusion technology (AmSECT) to perform activities within the scope of practice of a Perfusonist. Essentially, we are saying that a high school graduate can do what we do just as well. For every dollar AmSECT makes on this credentialing venture, how much will perfusionists pay in lost practice opportunities competing against this “fast food” level of service provider? Compare the compensation level and the expertise of a Perfusionist with a High School graduate and the argument is clear. Do you believe that it is in the best interest of patients to have these procedures performed by the latter, or is this just a means to provide credibility and thereby a shield from liability for the facility that would allow them to practice there. As to the argument regarding “oversite”, it should be obvious that it is impossible to assume control over any other person without their consent, and even if Perfusionists wanted to assume a “supervisory” role over (and liability for) these people, we are again only acknowledging that someone of this level of training is competent to do our jobs. If “public safety” is the rationale, the conclusion can ONLY be that these procedures are unsafe if done by anyone other than a Perfusionist or another LICENSED heath care provider whose scope of practice and training includes this activity.
I would like to state for the record that I am strongly opposed to the involvement of AmSECT in the credentialing of NON PERFUSIONISTS to perform ANY activity within our scope of practice. Regardless of how many of these people are already performing these activities, it is inconsistent with the entire argument for certification, education, and legal recognition of Perfusionists to argue that they should be allowed to perform these acts. It is even more inconsistent that the very organization purported to represent the interests of Perfusionsts should be in the business of enabling and promoting this recognition and lending its name to this credential. In states where Perfusionists are licensed, these activities are exclusively reserved for the Perfusionist unless contained within the scope of practice of another LICENSED practitioner.
Clearly, Perfusionists are required to have a high level of post graduate education, with didactic and clinical training in a formal program, followed by passing the National Certification Exam given by the ABCP. This is in stark contrast to the IBBM requirement of only a high school education and a minimal case requirement, and a one day class and exam.
A clear and significant part of the practice of perfusion involves perioperative blood management, and these activities are explicitly contained within the scope of practice of Perfusionists. At least in the beginning, I was led to believe from information contained in the Presidents Messages in each issue of AmSECT Today that AmSECT’s focus on “blood management” was in renewing the involvement of Perfusionists in the this area of practice and to encourage Perfusionists to remain involved in clinical practices beyond merely “running the pump”. Because the Society has seen a decline in overall pump cases, this renewed focus was intended to aid the profession in retaining its viability. Somewhere along the process however, AmSECT elected to become a certifying agency for NON PERFUSIONISTS and thereby lend recognition to a group whose activities are DIRECTLY in competition with Perfusionists and, at least in Licensed states, illegal to perform. By the creation of the IBBM, it was made unclear what the level of AmSECT’s involvement was. This is not consistent with the AmSECT Mission, and in opposition to the best interests of the profession of Perfusionists and the best interests of the Public Safety. In fact, the granting of this credential will only lead the public to believe that those who have received this credential from AmSECT are thereby considered “safe” by AmSECT.
Before this process is allowed to proceed any further, a period of time for the AmSECT membership to become fully informed of and educated regarding the issues and consequences of this venture should be allowed. Then, a vote of the membership should be held regarding the involvement, if any, of AmSECT in this process.
I submit, and request, that the AmSECT Board of Directors place this upon the Agenda of the next Business Meeting to be held during the International Meeting in Orlando, for discussion by the membership, and in the interim, delay the exam and credentialing process until such time as the AmSECT membership has had the opportunity to fully explore the issues and to vote on whether or not to support this activity.
