Thursday, April 16, 2015

A Promising Week of Firsts

It was quite a week for America's practicing physicians.  For months the frustration over the lack of accountability of the American Board of Internal Medicine (ABIM) and the American Board of Medical Specialties Maintenance of Certification (MOC) program had been building.  Even anger, an emotion few physicians have time for, was mounting.

Then something wonderful happened.

Physicians stopped working for a moment and picked up the phone. For many, it was the first time they had ever called a Senator's office.  For others, the first time they had written one.

Here's a few examples from Twitter:

For US Senators in Washington DC (or their staffers), it was also the first time they had heard from front line working physicians rather than physician-lobbyists knocking on their door.  Weren't working physicians supposed to just be "excellent sheep?"

But there they were: a pediatrician calling over her lunch hour, a family practice doctor taking a few moments between patients, or a cardiac electrophysiologist ("What's that?" they asked) reading EKGs and calling.

From all over the country.

It was almost as if you could hear them asking, "Why are these doctors calling?  What do you mean there's an anti-trust suit pending?  I thought they wanted this SGR Reform! What is this MOC thing anyway?"

(Click to enlarge)

Last night we had a group meeting of some forty cardiologists in our practice.  Everyone listened politely to the administration explaining their new initiatives, new plans for growth, things we could do better, how the SGR Reform Bill, HR2, had passed.  Doctors listen politely. But there was a buzz in the air.

Younger doctors were questioning if MOC was still part of the bill. They were questioning the regulatory establishment, wondering if they should join the American College of Cardiology if they supported the passage of HR2 that included MOC. Questioning.  Reenergized. Hopeful.

Practicing doctors might not have won the battle to stop the ABMS Maintenance of Certification program from being incorporated into our new health care law, or for parts of the program being used as a medical registry for physician reporting purposes in H.R. 2.  But the other night they won something much better: they learned that they weren't powerless.  They remembered that being  "accountable" for peoples' lives is very different than being "accountable" for dollars.

Thanks to all who raised a voice, wrote a letter, and took a stand against MOC.  I can't tell you how great it was to see so many physician nationwide come together so quickly to stake a stand on this remarkably divisive and corrupt program that extends, like a hydra, throughout our entire health care system.

We have have good reason to smile.

Congress and the public now know about it too.



g. said...

the enemy is shrewd and has resources. there is no time to get lazy. the war for survival of medicine and eventually our collective liberty, will be longer than we think!

Unknown said...

Just before the repeal of SGR I posted a comment on the ACP advocate site

Blogger Ashok V. Daftary, MD, FACP. said...
Do the amendments include repeal of exclusive Maintenance of Certification sponsored by the American Board of Internal Medicine?
The blog does not include the report by the Medicare actuary details the current SGR would not really be beneficial over its ten year life span to either physicians or their patients.
Since blogs are opinion pieces the exclusion of these vital facts can be excused, but since this is also a form of journalism it ought to be more balanced.

April 14, 2015 at 9:40 PM
Blogger B Doherty said...
More later on the SGR repeal bill passed by Congress last night but your information is incorrect. It does not require or designate MOC or any specialty board or penalize doctors based on MOC.

Can you comment?

DrWes said...


HR2 did not have to include the ABMS MOC program because it was already part of Social Security law 1848 (specifically subsection (k)(4)) and was placed there by an the Affordable Care Act in 2010. H.R.2 did NOT remove this section from 1848: "...may provide data on quality measures through an appropriate medical registry (such as the Society of Thoracic Surgeons National Database) or through a Maintenance of Certification program operated by a specialty body of the American Board of Medical Specialties that meets the criteria for such a registry , as identified by the Secretary."

So while B Doherty is correct that the law does not "designate" MOC, he is incorrect to assume the program is not in the Social Security Law - to the best of my knowledge, it is.

Here is a link to the pdf of H.R. brought before the Senate ( )

Use the pdf search feature to search for "(k)". NONE of them remove section (k)(4). There are 13 references to section (k).

Then search for "certification" and you will find 5 hits for that as well, some of which are pertinent.

Note that the "practice improvement" exercises (formerly part IV of the MOC program) are included in H.R. 2 and likely why the ABIM put out their "We're sorry" mea culpa announcement - they knew this requirement was part of HR2.

Valerie said...

I'm so glad that doctors and other medical professionals are raising awareness on this issue. Congress is there to listen to our concerns and voice our opposition or support on an issue, and too many times, no one reaches out to Congress and tells them ideas or concerns. I'm glad to see people get involved, and hopefully, this will be a growing trend in the medical industry.