The American Board of Internal Medicine (ABIM) has announced that it will consider replacing its 10-year maintenance of certification (MOC) exam with shorter, more frequent testing that physicians could take home or in the office.Let's think about this a moment.
The proposal to eliminate the 10-year examination is one of several recommendations issued today by ABIM's "Assessment 2020 Task Force," convened in 2013 to improve its controversial MOC progam for internal medicine (IM) physicians and IM subspecialists. ABIM released the task force report less than a week after the American Board of Anesthesiology (ABA) announced that it would replace its 10-year MOC exam with continuous online testing next year.
"The results of the smaller, more frequent lower-stakes assessments would provide insight into performance and accumulate in a high-stakes pass/fail decision," the task force said in its report. "A failure at this point may necessitate taking a longer exam or another form of assessment in order to maintain certification."
ABIM's Task Force 2020 wants to replace MOC with MORE testing, more often, and still reserve the right to force a physician to take a "longer exam or another form of assessment in order to maintain certification?"
This isn't better, it's worse. Much worse. Instead of every 10-years, it will be daily or weekly MOC-minutes!
More MOC distraction pushing physicians away from their patients and toward even more computer time.
What are these "Task Force 2020" members smoking?
Of course the money can't be denied. Pharmaceutical companies are licking their chops. Think how many MOC® questions we'll soon have to answer on novel oral anticoagulant use instead of that old, cheap, outdated warfarin! Pushed to our iPhones, these new MOC-minute® questions are sure to turn your head away from patient care toward an easy payment plan! I wouldn't be surprised that thanks to the ABMS stumping for Big Tobacco in the sixties, we'll all be answering questions on the praises of e-cigarettes and pharmaceutical aids for smoking cessation, too!
It's truly fascinating to watch these attempts at social engineering of practicing physicians by the ABIM. But the ABIM has already tried voluntary re-certification and knows it failed miserably. They had to make it mandatory by veiled threats over what the loss of Board certification might mean or no one would pay into their scheme.
Want proof that the ABIM isn't serious about ending their MOC® exam? Read the contract physicians must sign before entering into the ABIM MOC® program. Read about "trade secrets" and "federal Copyright Act, 17 U.S.C. § 101, et seq." and "forensic techniques" they use to protect their products. And let's not forget that "disclosure or any other use of ABIM examination content constitutes professional misconduct and may expose me to criminal as well as civil liability, and may also result in ABIM's imposition of penalties against me, including but not limited to, invalidation of examination results, exclusion from future examinations, suspension, revocation of certification, and other sanctions."
These guys and gals of the ABIM mean, er, BUSINESS!
All this for a costly and completely unproven metric foisted on physicians to assure the ABIM's cash flow.
MOC® isn't about physician education or patient welfare, it's about intimidation, $2.3 million condominiums, $1.7 million golden parachutes, and secret transfers of millions upon millions of physician testing fee dollars to the ABIM Foundation in the name of "social justice."
It's about an organization that has allowed itself to sink $47 million in the hole (Fiscal Year 2014 Form 990 line 22) and balances its financials on a whopping $94 million in deferred revenue (Form 990 Page 11 of the pdf, Form X, line 19).
That $94 million will be coming from somewhere (can you say "ACA?") and since the ABIM gets 98% of is fees from practicing physicians, you can bet your last silver dollar that these totally unproven MOC® programs will be paid for by practicing physicians, one MOC® exam or MOC-minute® at a time.
And the ABIM is SERIOUS. Recently, despite all that has been uncovered about the ABIM, they continue to sue doctors over their intellectual property, just as before, this time in Puerto Rico (case 3:15-cv-01016). Oh, golly, what's a few more million dollars in legal fees to protect your income stream, right?
If you believe there will be no MOC® exam of any type, ever, and given the honesty and integrity the ABIM has demonstrated over its finances over the past 30 years, I've got some ocean-front property in Arizona I'd like to sell you.
9 Oct 2015 06:00AM Link to ABIM's Puerto Rico case fixed.