This question comes up in the context of competency.
We assume that when physicians graduate, complete a residency, and pass specialty board examinations, they are competent to practice. For the most part this is true. But not all doctors specialize, and not all specialists stay current in general medical knowledge.
After time, especially in this era of advanced technological science and abundant information, it becomes impossible for anyone to remain current in all areas of medicine. This, of course, is one of the reasons why medicine has become so specialty-driven.
The public trusts that providers are competent in their fields. We do require recredentialing of some very basic things-CPR, for instance. But we don't test skills in the areas that take a much higher level of knowledge. We should.
Measuring competency doesn't just imply scoring well on a knowledge-based multiple choice test. It also requires evaluating doctors' technical skills and their ability to communicate with their patients.
Other professions such as airline pilots must recredential and demonstrate their ability to fly, every six months. The public trust should demand no less from physicians.
Why is there resistance to this concept? At its core, fear. Or, less palatable, it may be arrogance. Physicians may feel no one has the right to question their practice, or that they are above any form of ongoing demonstration of competence.
This is not an easy idea to implement. But we do have an array of tools (the Internet, satellite downlinking, and telemedicine) that make professional evaluation much easier than in the past. Oral and interactive evaluations with real people and families also have a place. Who better to judge our skills than our peers and our patients?