Remember the good ol' days when taking a single board certification examination from the American Board of Internal Medicine (ABIM) was good enough to call yourself "board certified" in a medical specialty?
Those were the days.
In 1990, things changed. Board certifications became time limited. To remain "board certified," the ABIM stipulated that doctors had to undergo a Maintenance of Certification (MOC) examination every 10 years to remain board certified, even though no data existed then (or now) that such testing achieves the ABIM's stated goals of promoting "lifelong learning and enhancement of the clinical judgment and skills essential for high quality patient care."
Now things are changing again.
I just received a notice in the mail (pdf here) that states the following: beginning 1 January 2014, the ABIM will require that at least one Maintenance of Certification "activity" be performed every TWO years and for EVERY TWO YEARS thereafter. In addition, doctors will have to earn 100 ABIM "points and complete a patient survey and a patient safety module by December 2018 (in FIVE years and EVERY FIVE YEARS thereafter). That's right: more testing of doctors and no data to support the testing's ability to maintain a quality physician workforce.
For those interested, more information can be found at http://moc2014.abim.org
. According to this website, annual cost to physicians will be "about
$200 per year" and "If you are maintaining more than one certification,
the cost will be the
fee of the most expensive certification plus half for each of the
Instead of assuring quality, then, it seems doctors are really being asked to improve the ABIM's cash flow. Also, as a result of this initiative doctors will be spending consistently more time away from patients.
Clearly no one is listening to doctors on the front line. Doctors are already overburdened with too many unproven bureaucratic requirements. Adding these costly, unproven "certification" requirements to things like meaningful use, pay-for-performance, results checking, email answering, patient satisfaction surveys and the like just adds insult to injury. How much time do the members of the ABIM think we have?
How much quality to we impart to our patients when we asked to stare at more and more computer screens rather than care for our patients?