Mandrola: A Time-Out for ABIM MOC Mandate

From theheart.org (registration required), John Mandrola, MD calls for a "time-out" for the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) mandate:

The matter for debate is whether the ABIM method - and to be frank, it's arm-twisting tactics - is the best means to achieve physician quality.

Doctors are taught to be skeptical of evidence. Here, there is simply no evidence to judge. We can't know whether this brand of medical education achieves improved patient outcomes. Maybe it will. Maybe it will not. Or, perhaps it could make it even worse. How could aggressive education and measuring quality make things worse? Think heart-failure metrics and an 89 year old, who, a week later presents with a broken hip from all those evidence-based pills. I have many more examples, but I promised brevity.

Read the whole thing.

Some additional thoughts and suggestions to the ABIM:

• Given the unproven nature of the MOC process to assure physician quality and the ethical breeches created by the ABIM's proprietary process, "board certification" as defined by the ABIM should revert to a lifelong certification to put the ABMS and its subsidiaries in competition with all the CME sources available.
• The new ABIM MOC rules that are now set to go into effect 1 May 2014 can cause "sudden and unanticipated" revoking of Board Certification based on failure to completely comply with MOC at ANY TIME. This should not be permitted.
• Since state medical boards are all headed by physicians, the marketing my the American Board of Medical Specialties and the ABIM that physician perform their MOC process to prevent government agencies from providing an alternative to their MOC process is pure propaganda. There are many many government and private agencies that monitor physician performance including hospitals, insurance companies, CMS, Medicare, Medicaid, trial lawyers, the Better Business Bureau to name a few.
• The ABIM's "board certification" is based on test-taking ability and not patient care metrics. As such it cannot be considered a patient care quality measure of any kind and should not be tied to CMS Physician Quality Reporting System (PQRS) payments to those who care for Medicare patients.

I believe it would be in the best interest of the ABMS and ABIM to listen the the growing chorus of dissatisfaction that is currently echoing throughout the country. I know many physicians are already boycotting the process. Until the ABIM and ABMS change their policies this boycott will continue, especially since doctors know that the incomes of these societies are being directly paid by their physician fees.

Just sayin'-

-Wes

Here's a link to an anti-MOC petition underway.