Monday, July 27, 2015

Why Maintenance of Certification is Bad for Physicians and Patients

Is MOC Necessary ?

Dr Tierstein a fellowship trained cardiologist, renders his opinion regarding maintenance of certification. Dr Tierstein works at the Scripps Institute in the Department of Cardiology. He is board certified by the ABIM and in cardiology by the specialty section of the ABIM (like all sub specialties of Internal Medicine).

The ABIM web site serves as a 'cookbook' or guide of "How to become Board Certfied in Internal Medicine and/or one of it's sub specialty groups, and how to complete MOC (Maintenance of Certification)

There has been much controversy about the effectiveness or benefit of MOC . It has evolved in a manner whereby stakeholders and  insurers use it to rate provider physicians. While they do not categorically state that not having an MOC will disqualify you from continuing to be a provider, the veiled threat is apparent.

At one time initial board certification was not required to join a hospital medical staff,  As time evolved the 'voluntary' nature of board certification evolved into a mandatory requirement. 

This form of 'certification creep' is occurring again in the area of MOC. MOC developed as many specialty groups became aware that if they did not set a standard for their membership, someone else would. Another veiled threat, that a state, or federal regulatory agency would impose rules upon physicians.  The AAGME reflexively established MOC programs in all specialties.

This action caused a large increase in administrative expenses and spawned an entire new medical-education industry. It also evolved into a large revenue source for the organizations.

It has taken 10-20 years for physicians to cycle through the process. Now most have gone through at least one MOC cycle.

Many MOC physicians who have re-certified state it was a waste of time, money and detracted from their professional status and work-life.


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