Thursday, May 01, 2014

Who's In?

“If you understand, things are just as they are; if you do not understand, things are just as they are.”

― Zen Proverb

Today, the clock strikes one: One May, 2014.  Today, doctors who failed to enroll in the ABMS Maintenance of Certification (MOC) process will wear the scarlet letter of "Not Meeting MOC Standards" on the American Board of Medical Specialities' CERTIFICATION MATTERS™ website (provided you register on the website and follow the ABMS Terms of Use Agreement).

Just a few days ago, on 28 April 2014, the American Board of Internal Medicine refused to change their policy of requiring physicians to enroll in the MOC process and pay "$200-400" per year to the ABIM despite a petition signed by over 11,800 board-certified physicians who felt the frequency of participation to be expensive and excessively complex and called on the ABIM "to recall the changes in MOC and institute a simple pathway consisting of a recertification test every ten years."

Despite this request from over 11,800 board certified physicians, they refused to budge on their every-two-year MOC requirement.

So at least we know where the American Board of Internal Medicine stands.

But where do the other member boards stand?  Do they stand with practicing board certified physicians or do they stand with regulators who continue to heap more unnecessary busywork of uncertain value on already stretched physicians? We should understand that the threat to physicians and our profession is much more severe, especially when MOC is increasingly tied to hospital credentialing and doctors'  ability to earn a living.   The MOC pass rate for internists was only 78% in 2013.

Today, each member board of ABMS has a unique opportunity to demonstrate their solidarity with the practicing board-certified physicians of their subspecialty.  Each member board should publish a statement regarding the MOC petition circulated by physicians on their websites and where they stand on the issue, just as the American Board of Internal Medicine did.  Subspecialty physicians deserve a response.

Nietzche once wrote, " Hope is the evil of evils because it prolongs man's torment." What we need in the face of what Nietzche calls "a strict, hard factuality" is a clear view of the playing field.  When physicians are feeling increasingly anxious and unclear who truly represents them, we need to have "courage in the face of reality."

Here's a list of the 24 member boards of the American Board of Medical Specialties:
To the leadership of the above organizations: your board certified physician members would like to know where you stand on the new MOC changes imposed by the ABMS today.



Anonymous said...

Dear Dr Wes
I see that Dr Teirstein (who initiated the petition) and yourself listed on the ABIM site "Meeting Maintenance of Certification Requirements". I am not trying to criticize you and am a regular reader of your blog. However, I am disappointed that there is less resistance. I understand that it is required by hospitals and insurances. But if many of us stand together they will fail. thank you for all your efforts.

Anonymous said...

Propaganda: Lifelong learning
Truth: Lifelong testing

DrWes said...

Anony 01:42pm -

I took and passed both my cardiology and EP boards in 2013. At the time I purchased my materials and paid for my board review courses, etc., I was lead to believe that my certification would last 10 years. At the conclusion of that process, I took a survey asking which board certification I would plan on maintaining. I checked cardiology and EP (I am "grandfathered" in Internal Medicine).

Through this process, I learned that the written materials that I had paid for would not "count" for CME - I had to take the computer version of the material. I found the page-load times excessively long, irrespective of browser I used or PC or MAC platform. I even communicated my concerns as to how long this was taking with the ABIM leadership who said "they'd look into these slow load times." Needless to say, the computer took MUCH longer (think page load times of 15-20 seconds each), probably because of the way they load the information with EACH page and the metrics they measure along the way.

Only after agreeing to the (earlier) MOC process, did I learn that by listing my chosen re-recredentialing preferences at the completion of the online version of the material, that I had "registered" for the new MOC process. (Hence why I am in "good standing"). If I had known then what I know now, I would not have registered.

I have no plans to pay for additional testing in the next two years. I've JUST spent nearly $5000 (not to mention the time I took from work to take my tests) for what I thought was to be a valid certification until 2023. Now I find otherwise: I need to pay more money before then. Ridiculous.

Had I not experienced this new process first-hand, I would not have known what was involved nor have experienced the physical and psychological burdens created by this excessively costly, time-consuming, onorous process that is far removed from clinical practice. Hence, why I am now such an outspoken critic on the whole mess.

Anonymous said...

Dear Dr Wes
Good evening
Thank you so much for taking the time to answer to my comment.

Dr Baron's response is shallow and unacceptable. I really believe our next step has to be through AAPS General Counsel, Mr Andrew Schlafly or another attorney who could represent us as a group/class action.

with best regards

Thomas Pane said...


It is hard not to participate, especially for early-mid career docs. It is not *voluntary*, so some have to participate while supporting antiMOC efforts.

Anonymous said...

Since Dr. John Harold was both President of the ACC and sitting on the governing body of the ABMS, will the ACC ultimately be liable for damages that physicians claim who lose their hospital privileges due to MOC requirements?