Monday, January 13, 2014

The AMA's Role in Maintenance of Certification

Andrew Schlafly, attorney for the Association of American Physicians and Surgeons and the group who sued the American Board of Medical Specialties over the Maintenance of Certification process, recently described (video - scroll ahead to 5min, 30 sec) the scene in court:
When I sued the ABMS and six attorneys showed up on the other side to oppose the lawsuit, the lead attorney on the other side was an attorney that has represented the AMA for decades. He was on the other side defending this MOC and trying to stop our lawsuit and trying to stop the discovery. We’re going to get in and get discovery and find out what they have in mind for this and how they’ve been doing this, how they’ve been getting this into hospital medical staff requirements for so long.

And already I’ve traced that they paid this ABMS group (which is the umbrella group) something like $600,000 to a law firm in Newark, New Jersey. It popped up on their IRS Form 990, which discloses what their expenditures are, and I raised that with the court. 'They say they don’t practice in New Jersey, they don’t do business in New Jersey and here they are paying $600,000 plus to a Newark, New Jersey law firm. What’s that for?'  And by the way, what this Newark, New Jersey law firm does is it has a relationship with hospitals. And they came back and said 'Oh, no, what that money was for that was to help us set up MOC in Singapore.' They’re going worldwide with this!

I was surprised the AMA (who is touts themselves as the political voice of US physicians) is defending the Maintenance of Certification (MOC) process and (more troubling if true) going to such efforts to expand this process to a country in which it has no jurisdiction.  Most physicians find the MOC process onerous, overly time-consuming and ridiculously expensive.  Why are US doctors paying dues to support AMA activities involving credentialing and licensure overseas?  A little digging shows that the AMA holds furvent support for the overall progression of the Maintenance of Certification process evolving to a Maintenance of Licensure (MOL).  From their own Council of Medical Education minutes (pdf):
The AMA has robust policies related to medical licensure. A review of all AMA policies related to licensure was conducted to validate that the policies are consistent with the AMA Principles of MOL (Maintenance of Licensure).

AMA policy supports the underlying principles of MOL which are consistent with the direction that the practice of medicine is evolving. The recommendations of the Advisory Group contain options for doctors to meet MOL requirements that can also be used to meet other purposes and will provide an opportunity to monitor outcomes and produce useful data. The AMA will await the final document of the FSMB (ed note: Federation of State Medical Boards) with great interest and hopes that the MOL program will be carefully coordinated as much as possible between the states.

CME will predictably be a major component of the MOC/MOL model.
Physician members of the AMA might want to ask a few pointed questions to their leadership. After all, they're paying for this in more ways than one.

I just endured the maintenance of certification process for both cardiology and cardiac electrophysiology and can attest to the stressful nature of this process for working physicians. The thought that this unproven testing process could also be used to revoke my license to practice medicine in the future is unconscionable.



Anonymous said...

right on bringing this to light! I went thru recert process last year. While self-study exams were useful, content was clearly based upon obscurity. As a proceduralist, the ABIM makes a point to say that this is not evaluated. Wonder about relevancy here. The practice assessment exercises were an enormous waste of time, costly to my practice and an intrusion of privacy all for the purpose of data gathering. Signing up for "meeting MOC requirements" includes a series of must answer mega-data gathering, irrelevant questions unrelated to continuing education.

When will the lemmings realize the cliff is no longer over the horizon but rather here and push back, and demand an alternative to the strangle hold of ABIM?

Unknown said...

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Anonymous said...


It's been said that the medical profession eats it's young. They have now added the most experienced among us to the menu.