Dear Fellow Physicians,
Opposition to Maintenance of Certification (MOC) continues to gain momentum as a top national medical news story. Nationwide, physicians from most specialties are voicing their views on the pitfalls and merits of Board Recertification and MOC.
Though leaders of the ABIM and other Boards have contacted us to discuss reforming the MOC process, all have conveyed unwillingness to negotiate or compromise, supporting their position with irrelevant propaganda. Even the "apology" by the ABIM is little more than an appeasement to growing dissent in the medical community.
While most polled physicians want MOC abolished, we feel that the system's self-evaluation of medical knowledge modules can function as a worthy alternative to CME—but only if universal lifetime board certification is restored and the extortion and pressure associated with MOC compliance are eliminated. Our responsibility for continuing education credits should be no different from those of other licensed professions, and we can remain up-to-date and in good standing in the community without the further burden of imposed regulations or testing requirements.
We take issue with the bulk of the MOC process: The Practice Improvement Modules and Patient and Peer Reviews amount to little more than busy work, and the costly, time-consuming Secure Examination—which requires an enormous amount of preparation and time off from work —is clinically irrelevant and has no place in the life of a practicing physician.
Of course, these criticisms are a sticking point for our Boards, which derive income directly from this part of MOC. In fact, while the ABIM claims they make no money from MOC and that their members receive a minimal stipend to attend meetings and write test questions, they report that each exam question costs $4,000 to create (through "stringent psychometric testing") and that the Chair of the ABIM makes a salary of $1,000 a day. Add the cost attached to the MOC program to see how the ABIM has increased its revenue with MOC by $122,800,000 from 2006 to 2014—a number which grows yearly and with each modification to MOC. And like extremists unwilling to compromise, the ABIM leadership clings dearly to the Secure Examination, boasting that they voluntarily submit to testing as part of their own requirements for ABIM board membership. (For more eye-opening tax return and financial information about the ABIM and all the Boards, please refer to the "The Boards - Tax Returns" link above.)
We are all for staying current with medical changes, but the onerous MOC program is no way to achieve this. It's a money-making juggernaut with scant data to support any benefit for improving physicians' skills or ensuring patient care and safety. And it lacks reasonable financial transparency.
If the ABIM, ABMS and FSMB have their way, MOC (soon to become CMOC, or Continuous MOC) will become an every-two-year cycle—which, according to the ABIM, will "simplify and streamline the process" and ultimately be tied into Maintenance of Licensure (MOL).
We need to act collectively. The number-one disease afflicting physicians is apathy, and it's the main reason our profession is in trouble.
Our goals remain clear:
- 1. MOC should not be associated with hospital privileges.
- 2. MOC should not be associated with insurance reimbursements or network participation.
- 3. MOC should not be required for Maintenance of Licensure.
- 4. MOC should not be mandatory.
- 5. All Board certificates must be converted to lifetime status; only then will MOC be voluntary.
Please click on all links and review the rest of our website. Educate yourself. Get involved in your community and at the state level, and forward this website to all your colleagues.
It's imperative that each physician get involved in the following manner:
- 1. Organize with colleagues to petition your hospital to eliminate MOC as a requirement for maintaining your hospital privileges.
- 2. Do the same with your individual boards, as they are already collaborating with health plans to base reimbursement on MOC requirements.
- 3. Approach your city and state medical organizations, as they are attempting to tie MOC to MOL.
- 4. Just say no to MOC. Should you feel a need to continue certifications, consider switching to the National Board of Physicians and Surgeons (www.NBPAS.org).
Remember: MOC + MOL = BIG TROUBLE. If MOC gets tied to MOL, it is no longer voluntary; it becomes mandatory.
It's clear that Board leadership ignores its constituency, so follow the steps as outlined above and continue to pressure your board into radically simplifying or scrapping MOC. Also support the Association of American Physicians and Surgeons (www.aapsonline.org), who have already filed suit against the ABMS.
MASS MOC NONCOMPLIANCE is the only rational solution to forces taking over our profession.
But it will take all of us to have an impact.
Please get involved. Feel free to share ideas at this site or join the ongoing discussion on SERMO and LinkedIn (see "Join The Discussion" link above).
Thank you again for your support.