Aren't physicians who are specializing and have had training referred to as
board eligable before they take or pass their certification exams?  Any
doctor can hang out a shingle and call himself a cardiologist or whatever.
  It is up to the consumer to find out if he's board certified and decide for
himself whether or not to use that physician for what ails him.  In some
cases that doctor may be fine, and in others it might be wise to seek out
someone with board certification - In my view it's the same with
breastfeeding counseling or consulting or whatever you want to call it.  Even
among those IBCLC certified, I'm sure they also come to the profession with
different skills and strengths.