Sunday, October 07, 2018

The MOC Fight

From Medical Economics:
“Physicians are pushing legislation on the state level because they don’t trust the ABMS [American Board of Medical Specialties] and its financial conflicts of interest,” says Paul Mathew, MD, a volunteer board member of the NBPAS in Cambridge, Mass. “Many feel the only way to declaw the tiger is legislative action due to insurance companies and academic institutions having no reason to change their pro-MOC policies.” The ABMS oversees MOC for its 24 boards.
-Wes

Friday, October 05, 2018

For Whom MOC Tolls

He saw me in the hall between cases and our eyes connected, however briefly. I probably looked a bit tired, hair askew, and rushed after a long ablation case as I scurried to grab a quick bite to eat before my next case started. He was one of our best fellows in cardiology - hard working, innovative, never one to skip a clinical detail or shirk a responsibility, who clearly wanted to chat. He approached respectfully, smiling timidly, and said quietly:

"Dr. Fisher, is it true that I have to pay ABIM $155 to maintain my certification even though I passed my boards? And do I have to do this for life? I went to the ABIM website and it really isn't clear what we have to do."

I explained the ABIM's current iteration of fees and testing as best I could in the brief time we crossed paths. The ever-shifting sands of the ABIM parsed fee and "point" structures, "discounts," programs, credits, and value of participating (or not) in Maintenance of Certification have lead, I believe intentionally, to the current chaotic state of US physician Board certification. I felt sorry for him but was not surprised he was confused, especially since explaining the board process was equally difficult. I sensed he knew that speaking candidly about his concerns with others in positions of leadership might compromise his reputation as a hard-working, reliable cardiology trainee and was grateful he felt he could approach me with his concerns.

This is what US physician board certification has become: little more than a shakedown of our best and brightest to fund a bloated bureaucratic credentialing system that adds little to no value to our trainees' learning experience. After our conversation, I grabbed a salad and returned to do my pre-operative checklist for my next patient. My phone received a text message:

""They also included a discount on multi-year payment."



"$155 is my annual savings during fellowship..."

-Wes