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Pa. Medical Society issues 'no confidence' vote in ABIM's leadership

The Pennsylvania Medical Society’s board of directors has issued a “vote of no confidence” against the Philadelphia-based American Board of Internal Medicine over the ABIM’s Maintenance of Certification (MOC) program.

Dr. Scott E. Shapiro, president of the Pennsylvania Medical Society.

In a letter sent Monday to members of the state medical society, Dr. Scott Shapiro, the organization’s president, said the vote “represents our members’ high level of dissatisfaction” with the ABIM’s physician recertification program for internists.
“Early in this process, we concluded that the reason ABIM leadership was so out of touch with practicing physicians was because nearly every member of the ABIM’s board is not involved in the full-time practice of seeing patients,” Shapiro states in the letter. “We attempted to work collaboratively with ABIM’s leadership to help them better understand that their punitive process is needlessly time-consuming and takes physicians away from their patients.

"We demonstrated to them that their process is exorbitantly and unnecessarily expensive compared to other continuing medical education activities through which medical knowledge and excellence in patient care can be maintained and demonstrated. Most importantly, we clearly expressed to the ABIM that the content and available medical resources of their secure, high-stakes computer exams bear little to no relevance to the care we render to our patients in our offices and hospitals," said Shapiro.

Shapiro goes on to assert that ABIM, through marketing efforts, has “worked hard” to give the impression that their recertification exam demonstrates competency, but that the ABIM has been unable to provide the medical society with “reliable independent evidence that a secure, high-stakes exam — taken every 10 years by some and for which others are “grandfathered” and therefore exempt — leads to better patient care.”

Asked about the medical society's action, ABIM issued a statement in which Dr. Richard J. Baron, ABIM's president and CEO said:

“While we are disappointed by the Pennsylvania Medical Society statement, we agree with the need for meaningful reforms to ongoing certification of physicians, which is why we are engaging with thousands of physicians—and many professional societies—to achieve those changes. Certification and Maintenance of Certification are important indicators for doctors and patients about who is staying current in a rapidly changing medical field. As a physician who practiced in the same Philadelphia community for 30 years, I know firsthand how important it is for doctors to have a mechanism to assess their skills and ensure their practice is current, while simultaneously communicating to their patients and their colleagues that they have done so.”

Shapiro first disclosed the medical society “vote of no confidence” at last week at the American Medical Association’s annual meeting in Chicago.

In addition to its vote, the medical society called for the immediate replacement of the entire ABIM Board and the installation of new leadership that is representative of physicians actively participating in the full-time practice of clinical medicine. “In the absence of this happening in a timely manner, we plan on calling on all specialty boards and societies to listen to their members and to work to remove the MOC process from ABIM oversight,” Shaprio writes in his letter.

The ABIM admitted to flaws in its 2014 MOC program and said it was taking step to improve the exam.

Last month, the organization announced plans to begin offering a new Maintenance of Certification (MOC) assessment option starting in January 2018. ABIM said its assessment taken every 10 years will remain available as a second option. Both options, ABIM said, will reflect the input it has received from a diverse range of physicians and stakeholders during the past year.

The new option, the organization said, will take the form of shorter assessments that doctors can choose to take on their personal or office computer — with appropriate identity verification and security— more frequently than every 10 years, but no more than annually.

Such more frequent testing, ABIM said, is designed to “provide feedback on important knowledge gap areas so physicians can better plan their learning to stay current in knowledge and practice, and allow physicians who engage in and perform well on these shorter assessments to test out of the current assessment taken every 10 years.”

John George
Senior Reporter
Philadelphia Business Journal