Wednesday, December 13, 2017

It's Official: MOC® is Dead. Let the Cover-up Begin

It's official: MOC is dead.

You heard that correctly doctors, the American Board of Medical Specialties' Maintenance of Certification® (MOC®) program is over, finished, kaput.

The one thing that resonated loud and clear from the December 4th meeting in Chicago of the multiple specialty societies and state medical societies that were in attendance was "the current MOC® process is problematic."

But don't get too excited.

In a remarkably Orwellian twist of fate, a new "vision initiative" to reinvent "Continuing Board Certification" was just announced by the original MOC® creators serving as the "Planning Committee."
The Planning Committee is comprised of representatives from the Accreditation Council for Continuing Medical Education (ACCME), Accreditation Council for Graduate Medical Education (ACGME), Coalition for Physician Accountability, Council of Medical Specialty Societies (CMSS), Council on Medical Education (CME) of the American Medical Association (AMA), the public, and the American Board of Medical Specialties (ABMS).

Jo Buyske, MD, ABMS/ABS
Sandra Carson, MD, CMSS/ACOG
Joyce Dubow, Public Member
Jack Evans, Public Member
Larry Green, MD, ABMS/ABFM
Thomas Hess, JD, ABMS
Lynne Kirk, MD, AMA CME
Graham McMahon, MD, ACCME
Thomas Nasca, MD, ACGME
John Prescott, MD, AAMC & Coalition
Stephen Wasserman, MD, ABMS/ABAI
Steven Weinberger, MD, CMSS/ACP
Norman B. Kahn, Jr., MD, CMSS, ex-officio
Lois Margaret Nora, MD, ABMS, ex-officio
You just can't make this stuff up.

We now see the ABMS and their sycophants at the ACGME, AMA, American College of Physicians, CMSS, and American College of Surgeons taking nominations for 21 to 25 individuals to serve on the planning Commission. This Commission will "bring together multiple stakeholders to assess the current state of continuing board certification and vision its framework for the future. ... Specialty societies, state medical societies, academic medical centers, hospitals and health systems, other health care systems, consumer organizations, patient advocacy organizations, ABMS member boards, and other groups are encouraged to submit nominations."

This is not rebranding.

This is not just a "pivot" to a new model.

This is an attempted cover-up.

Unless and until there is a full investigation of wrongdoing of these institutions regarding MOC®, including, but not limited to, potential tax fraud, misuse of physician testing fees for personal use, civil liberties violations, strongman tactics, and even possible racketeering, the current "vision initiative" should not be allowed to go forward, lest it happen again.

After all, medical professionalism demands accountability and many, many doctors want to see justice served.

-Wes

Addendum: Nice to see at least one medical society voiced concerns regarding MOC at the December meeting.

6 comments:

  1. Nonetheless: sing the song, do the dance
    https://www.youtube.com/watch?v=PHQLQ1Rc_Js

    ReplyDelete
  2. I am a plastic surgeon, grandfathered in so I am not subject to MOC requirement,however my younger partner is and I have seen how onerous this is. I am in agreement with you regarding MOC and as I continue to follow the anti-MOC movement, I find my self both optimistic and concerned. I am optimistic that there will eventually be a return to sanity and fiscally responsible, less intrusive and expensive processes to insure that physicians remain up-to-date and practice within their core specialties. I am concerned that in the rush to correct the ills of MOC or eliminate it altogether, we may throw away the baby with the bathwater. We need to have proper credentialing processes and protocols in place. The chaos that is the cosmetic surgery marketplace, the large numbers of doctors practicing outside their core specialties, and the stream of physicians seeking to specialize in plastic surgery, especially the cosmetic side, by pursuing non-traditional, alternative pathways threatens the time-honored process by which we develop competent physicians, i.e. residency in a program accredited by the ACGME and board-certification by an ABMS board. My present position is that once a physician has obtained legitimate board-certification in their specialty, that certificate should be life-long, with no expiration date. I submit that I, and my patients, have not suffered because I am not required to undertake MOC due to the date of my certificate. There should be a generally agreed upon amount of continuing education and there should be more than one way to obtain this. It should not be that difficult to accomplish and, I feel, would go a long way in lessening the burden that practicing physicians feel in their professional lives.

    ReplyDelete
  3. Rick -

    Thanks for your voice of reason. Yours is the model long held high as the standard to which doctors should demonstrate their commitment to lifelong learning and I agree with you. Unfortunately, market forces have colluded with the ABMS/ACGME infrastructure to insist doctors relinquish their testing and practice information for industry's benefit. MOC requires physicians to agree to a HIPAA Business Associate Agreement that allows their practice and performance data to be sold to the highest bidder for profit. As such, MOC (and any future "continuing medical education" program created) will remain mired in this conflictual relationship unless and until ALL such programs are ENDED. Since the 1960's, the ABMS has had a long history of serious ethical conflicts like Thomas Brem's lucrative deal with the Tobacco Industry testifying under oath on their behalf after receiving funds from "Special Account No. 4." This collusion was bad, but tying MOC to a physicians' hospital privileges or receipt of insurance payments threatens the very essence of patient care delivery and might be even more dangerous.

    MOC is so corrupt, it even extends to the international community, with ACGME International, ABMS International and ABMS Singapore as concerning examples of double standards funded by practicing US physician fees. Until there is a FULL investigation of the dealings that have been unaddressed for years, yet need to be. Just like the sexual harassment #MeToo movement, the physician harassment scandal supported by the ACGME hierarchy needs a thorough house-cleaning.

    ReplyDelete
  4. Dr. Wes,

    We have a delegate in my state who has put up a bill to stop MOC being a requirement for hospitals, BoM, etc. Can you help us? We're trying to support the Del. with information and also are trying to get individual MD's, etc. to support it. We have 2 sections of the state where we believe we can get some help but the major one and the last major area we don't.

    Thanks for any advice, help, and links to articles, etc. showing MOC is nothing but a bogus grab for money and doesn't benefit doctors in the trenches or patients alike.

    ReplyDelete
  5. Happy Holidays everyone.

    Food for thought about the composition of the MOC planning "committee" in procuring an MOC "commission"

    Jo Buyske: academic surgeon; Sandra Carson: academic gynecologist; Joyce Dubow: an agent for the NQF thinly veiled as a "public member"; Jack Evans "public member" no additional background information that lists his qualifications; Larry Green: academic FP; Thomas W Hess, JD Partner Dinsmore Shohl Columbus Ohio ABMS Board member; Lynne Kirk academic Internist; Graham McMahon academic endocrinologist; Thomas Nasca, academic nephrologist and bureaucrat of the NHPF; John Prescott academic EM and bureaucrat at the AAMC; Stephen Wasserman academic allergist; Steven Weinberger academic pulmonologist bureaucrat at the ACP.

    In sum, this group is the same cohort of bureaucrats with no real life clinical responsibilities or experiences. Yet somehow they will guide us into the next iteration of ABMS MOC? Is this not the same issue pointed out by Dr. Cutler when Zeke Emmanuel was a leader of ABIM 2020? Where are the real physicians? Why are they not listed? Where are the names Fisher, Cutler, Teirstein, Benbassat? How dare they veil an NQF lackey as a "public member"?

    ReplyDelete
  6. How about putting up regular Joe's like me, on a webex, where we can say chuck this MOC? Even back in the '90's, IT people knew the certifications didn't give you anything like real world experience, taught to fool the test, and put money in the hands of the corps.

    Learn from IT: dump them.

    ReplyDelete