How MOC is Contributing to the Demise of Physicians

Dr. Torie S. Sepah, MD on the KevinMD blog:

Now, one could argue, what’s $500 a year to a physician? Well, it adds up to $5,000 in ten years, at which time I’ll shell out another several grand to take the recertification exam.  Contrary to popular belief, physicians aren’t exactly rolling in the dough. In fact, 8 out of 10 physicians under 40 carry over $150,000 in medical school debt.  It all adds up: the medical license fee, the DEA fee, the specialty association fee.  Is this extra $5,000 really necessary, and if so, what is it for?

Here’s what it is not being used for, to protect what our board certification stands for.

My board certification in psychiatry doesn’t mean much these days because NPs and PAs are also board certified in psychiatry without attending a medical school, completing an ACGME residency program, passing the three-part oral exam in order to become eligible for the written exam in psychiatry, and of course not participating in MOC or taking our rigorous written exam every ten years.

To make sure that the world knows they are board-certified, they often embroider it on their white coats. And now, in 24 states, they can practice medicine independently with board certification in a specialty like psychiatry.

More physicians are waking to multitude of harms caused by Maintenance of Certification (MOC).

This is why multiple antitrust lawsuits have been filed against the ABMS member boards. Right now, the American Board of Radiology has filed a Motion to Dismiss the first amended complaint filed in the lawsuit against them. They argue that MOC and initial certification are all one product (certification) and therefore the anti-trust claim filed has no merit. As physicians, we know better. The detailed 79-page amended complaint explains the differences of initial certification from all other "continuous professional development products" (like CME, MOC, "continuous certification" and NBPAS recertification) and explains why ABR's contention that MOC and initial certification are one product is wrong on many levels. We'll see if the judge in that case feels the physician plaintiff has sufficiently argued his case to move this case to discovery.

The American Board of Internal Medicine also had the original District Court lawsuit dismissed. But that first-pass lawsuit has now been appealed to the Third Appellate Court. That appeal adds lots of new evidence supporting the differences between initial certification and the "continuous professional development" program that is MOC and the ABIM's monopoly control, racketeering, and unjust enrichment that has followed as a result. The ABIM response to that filing is currently due July 6th.  

Our own medical boards have repeatedly poked a sleeping bear with MOC payment and testing requirements. Those requirements have harmed physicians and limited access of care to patients. While this is not an easy path to find justice, the best victories are those that are hard fought with lasting and meaningful results.

-Wes