Fellow Council members,It appears the thrust of this "meeting" was to try and get states to NOT pass anti-MOC legislation. It didn't take long for an analysis of the Ohio synopsis to appear in my inbox from one observant physician (printed here with permission):
The following are my thoughts following the long-anticipated MOC® meeting in Chicago. An official report that will be distributed to the general membership will follow.
The meeting was hosted by the American Society of Anesthesiologists in Schaumburg, IL. The auditorium designed to hold 150 people, was filled to standing room only.
A bit of background, this meeting was the brainchild of Donald Palmisano, Jr., CEO Medical Society of Georgia, and Hal Lawrence III, MD (Executive Vice President and CEO) ACOG. (Editor's note: The American College of Obstetrics and Gynnecology (ABOG) are subcontractors for "Test Development" with the ABMS.) During the interim and annual meetings at the AMA, the state and specialty societies meet. It was during this meeting in Chicago that the idea for today's meeting was formed.
Dr. Lois Nora, current President and CEO of the American Board of Medical Specialties spoke first. In her 20-min remarks, she acknowledged each of the points raised in the letter penned by the state and specialty societies. Dr. Nora's term ends on December 30, 2017. Her successor is Richard E. Hawkins MD, who is leaving his position as Vice-President of Medical Education at the AMA to take this position.
Her Key Points:Summary of the comments from state and specialty society representatives:
- Committed to improving continuing certification
- Add state society representation to the Committee on Continuing Certification
- Admits that the current MOC® process is problematic
- MOC® should not be used as the only criteria for state licensure, credentialing, or employment
- Agrees that professional self-regulation is valuable
- Asked that the states not support anti-MOC® legislation (citing possible unintended consequences)
- Physicians insist on trust, input, transparency, and improved communication from the boards
- Create a process that is developed with us not forced upon us
- Process should not be punitive. Use the carrot and not the stick
- MOC is an irrevocably tarnished brand
- Following initial certification, the high stakes exam should be only one of several options
- Create a process that is fair to physicians holding more than one certification
- Several specialties have already implemented processes that offer ongoing demonstrations of competency as an alternative to the high stakes exam.
- Two specialty societies (Family Medicine and Psychiatry) stated that they were considering up thir own boards as a solution
- Anesthesia was the only specialty that admitted that reducing the burden on physicians had a negative effect on their bottom line
- Multiple states vowed to continue legislative efforts until tangible efforts in the MOC® process can be seen
- Need for dur process for physicians whose ability to work has been adversely affected by inappropriate use of MOC®
- The hospitals (AHA) and insurers (AHIP) should be invited to the discussion as they are the entities most likely to use MOC® inappropriately.
Please note that I spoke personally to the organizers of this meeting to request that Ohio be included in future discussions regarding MOC.
RF Chatman MD, MPH
President, Ohio State Medical Association
It seems to me as though this debate has now been quietly and cleverly re-framed in terms of retaining and "improving" (compulsory) MOC®.
Remember, it is only made "compulsory" through collusive "enforcement" by those twin paragons of virtue, the insurance and hospital corporations.
"No more high stakes exams we promise" they cried. The implied subtext being that the obligatory ABMS MOC parasite will remain Ebola-like, in some mutated and quiescent form, and continue to infect us all.
Debating the "character" of MOC® was four years ago. Pretty please. That didn't work. Now the issue is not MOC® but the utter and complete repudiation of ABMS lock, stock, and barrel. (Editor's note: Recall the AMA House of Delegates already voted to do so in June, 2016. We now see the AMA's answer to that resolution: to place physician puppets in position of power at the ABMS to assure their lucrative international medical data mining project grows ever stronger and more valuable.)
MOC® should be in reality just another innocuous and palatable Continuing Medical Education (CME) option, but has become a forced and toxic one. A most profitable and poisonous bubbling brew concocted and fed to us by our "peers in leadership positions." The ABMS have become the very caricature of witches on MacBeth's "blasted heath."
The ABMS and their 24 specialty lackeys should now go off and hawk their wares like any tawdry CME street vendor in the chaotic for-profit "medical education" bazaar. Through their grotesque avarice the ABMS have irreparably tarnished their brand. No physician will ever respect them again. Ever. They are done.Somehow, I didn't think I could improve on this cogent analysis.
Why on earth does anyone even stoop to converse with the ABMS anymore? It is too late for that. As Texas Medical Association President Carlos J. Cardenas, MD said "Physicians in Texas and across the country... do not see the certifying boards as 'self.' They are, instead, profit-driven organizations beholden to their own financial interests. In fact, they are now one of the outsiders intruding into the practice of medicine."
States should pass their anti-MOC laws, the ABMS and its apologists should be disregarded, and we all should move on.
Why did the state medical societies, which (with very few exceptions) also lack any standing amongst rank and file doctors, even bother to meet with the ABMS?
It is a total charade, a Jersey boardwalk puppet show populated by unrepresentative and self-aggrandizing narcissists lobbying each other. What on earth were they doing, imploring the ABMS on a bended knee to change their wicked ways?
"My" state medical society (sadly not one of the exceptional ones and one having less than 5% of state physicians as members) has no right to negotiate the character of MOC® on my behalf. It is too late for that. The state medical societies have become little more than the mini me's of the hated and corrupt AMA.
The single demand going forward should be to break up the ABMS monopoly and open up the market to competing boards like the NBPAS, recently delineated in an article by an FTC member. Let the physician marketplace decide which boards truly represent their interests. Period.
The hospital and insurer enforcers should be met head on now. Forget the disgraced ABMS. The MOC® debacle has catalyzed the onset of a transformative phase in medicine, one we physicians must be the first to recognize and guide.