Monday, February 14, 2022

Can There Ever Be a "Kinder and Gentler" MOC?

It has been a long time since I have written anything concerning the American Board of Medical Specialties' (ABMS) Maintenance of Certification (MOC) board re-certification program. But when I read pieces in the media, like the one recently published in Medscape that spin the soothing narrative that MOC can become "kinder and gentler," I feel the need to speak out.

Like a child bring groomed by serial molester, the media miss the seriousness of the harms imposed to physicians and patients by the industry-levied Maintenance of Certification mandate begun in 1990, largely because patients and the public really don't understand US physician board certification and the conflicts of interest with industry that exist. The public knows they want a "board certified" physician (thanks to the marking muscle and self-generated congratulatory "research" articles generated over the years by these multimillion-dollar organizations), but they fail to realize that board certification, once little more than a voluntary lifetime marketing accolade before 1990, became time-limited, mandatory, and an economic necessity for physicians to work, have hospital privileges, or be included in insurance panels since then. 

This change from a lifetime accolade to a time-limited necessity for physicians was unilaterally imposed on (only) US physicians by the highly conflicted and highly political ABMS and their member boards in conjunction with their parent organizations (where the ABMS is also a "member organization") from the Accreditation Council of Graduate Medical Education (ACGME), including the American Medical Association (AMA), American Hospital Association (AHA) and the Association of American Medical Colleges (AAMC). Thanks in large part to the nuances of often-delayed non-profit tax filings, all of these organizations enjoy their tax-exempt status and multi-million dollar budgets on the backs of working US physicians who are the major source of their funding.

The seemingly impenetrable nature of medical journal pay-walls has served to perpetuate the ruse of the scientific validity of time-limited US board certification. There is simply no scientifically valid proof that "longitudinal assessment" questions pushed to physician cell phones or taking day-long tests every 10 years improves patient care. Could it be these actions distract from patient care just to keep the money flowing?

More importantly, patients suffer as physicians become burned out or quit. Patients suffer as the boards  sell all the physician data they reap from that testing to Group Purchase Organizations (like Premier, Inc) and hospital organizations (like Kaiser) that increasingly consolidate and limit access in the name of lucrative health care "efficiencies."

The monopoly stranglehold on US board Certification (and specifically time-limited "Maintenance" of Certification, or MOC) and the vast conflicts of interest and millions of dollars it generates, is why the ABMS member boards are being sued right now. Their actions, I (and thousands of others) believe, violate anti-trust and unjust enrichment laws. It is not okay that a physician with years of dedicated service to his or her patients can lose their job or ability to care for their patients based on an unproven testing mandate. Nowhere does a physician's years of experience count to these AMBS member boards; only their money.

This is why I, along with many other men and women, help co-found Practicing Physicians of America, a non-profit 501(c)(6) organization, in part so we can work collectively to attempt to end the monopoly status of the American Board of Medical Specialties and their member boards on US Physician board certification. We hope that justice can be served to the hundreds (and perhaps thousands) of physicians  harmed by this discriminatory mandate imposed on us since 1990.

Physicians wanting to learn more or want to help can e-mail me at wes - at - practicingphysicians dot org. Donations for our work can be made at or (if you don't want to use GoFundMe, mailed to our organization at the following address:

Practicing Physicians of America
876 Loop 337 Bldg 101
New Braunfels, TX 78130


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