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:

• The American Board of Allergy and Immunology
• The American Board of Anesthesiology
• The American Board of Colon and Rectal Surgery
• The American Board of Dermatology
• The American Board of Emergency Medicine
• The American Board of Family Medicine (NOTE: new anti-MOC petition drive underway)
• The American Board of Internal Medicine (posted statement)
• The American Board of Medical Genetics
• The American Board of Neurological Surgery
• The American Board of Nuclear Medicine
• The American Board of Obstetrics and Gynecology
• The American Board of Ophthalmology
• The American Board of Orthopaedic Surgery
• The American Board of Otolaryngology
• The American Board of Pathology
• The American Board of Pediatrics
• The American Board of Physical Medicine and Rehabilitation
• The American Board of Plastic Surgery
• The American Board of Preventative Medicine
• The American Board of Psychiatry and Neurology
• The American Board of Radiology
• The American Board of Surgery
• The American Board of Thoracic Surgery
• The American Board of Urology

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.

-Wes