Dear Legislator

Physicians, consider providing the following letter (or a modified version) to every state legislator considering anti-MOC legislation.

Dear Legislator -

Across the country, bills are appearing in state House and Senate chambers regarding a trademarked  educational product owned by the American Board of Medical Specialties (ABMS) called Maintenance of Certification (MOC). No doubt a team of gray-suits representing the insurance companies and hospital systems in your area (aka, lobbyists) will be knocking on your door explaining why this program is so important to assuring the public that their physicians are of the highest quality and competency. They will insist that this proprietary physician continuing educational program is the only integrated system of physician education that assures quality educational content for doctors while also providing a multitude of practice improvement modules to assure the highest quality of care for patients.

Please don't be fooled. As your life-time certified ABMS Board certified doctor, I have seen the implementation of "continuous" MOC in 1990 and watched it grow into a cottage industry costing physicians nearly $1 billion and 32.7 million hours away from patients annually (over $23,000 per doctor every 10 years) without proven benefit to patient care. ABMS MOC product replicates Continuous Medical Education we already are required to do to maintain our license in each state and does not permit physicians the freedom to chose the education they need for their practice, but rather forces them to comply with an unnecessary, expensive, and repetitive mandated computer-testing exercise. Imagine having to retake your high school trigonometry final examination to continue to practice your trade today. This is the equivalent to what physicians must now endure every 10 years.

The ABMS MOC program grew from a financial need of the ABMS and their 24 member boards, especially the American Board of Internal Medicine (ABIM) which "certifies" one quarter of all US physicians. The  ABIM is currently $50.6 million dollars in debt (according to its most recently-available 2015 public tax returns) while their executives earn three- or four-times the salaries of the average working physician, enjoy complementary spousal air travel, and purchase luxury condominiums complete with chauffeur-driven town cars for themselves - all at working physicians' expense. They then sell our testing information for profit to ABMS Solutions, a for-profit corporation based in Georgia.

The ABMS and their lobbyists say that a computerized test or a continuous question-and-answer barrage fed to our cell phones or laptop computers is superior to direct patient care experience for maintaining our competency to practice. I would hope you can see through their propaganda.

Finally, the ABIM and the ABMS have been involved with highly irregular financial dealings, including falsifying tax forms and transferring many our our testing fees to the ABIM Foundation in the Cayman Islands. They also perform "research" on physicians and their practices without informed consent or Institutional Review Board oversight - potentially in violation of federal law.

For these reasons I would ask that you strongly reject the importance and value of the ABMS MOC program to practicing US physicians. We have carefully researched the financial and political dealings of this conglomerate of independent non-profit agencies that are pushing for MOC and would ask to have them investigated by the appropriate authorities, including the Federal Trade Commission and Internal Revenue Service before siding with their lobbyists' demands.

Such an action would be in the best interest of our patients and US healthcare, not the endless ABMS MOC testing of physicians who struggle to serve as patient advocates in our increasingly regulatory healthcare environment.

Your caring physician -