This year we have made enormous progress fighting MOC and recertification. There is now widespread awareness of the problem by both practicing and academic physicians, regulators, and hospital administrators. Many mainstream organizations including the AMA have passed anti-MOC resolutions.
Several of the ABMS member boards are making changes to their MOC programs. We believe most of these new programs fall far short of what physicians believe is the most effective method of “keeping up.” Many of you may have viewed and disagreed with Dr. Richard Baron’s (CEO of ABIM) recent perspective in NEJM (1). The NBPAS believes, despite all the apologies, emails and discussion about modernizing MOC and recertification, there is still no evidence MOC, recertification, or take home computer modules improves patient outcomes. The proposed new tests (secure or take-home) still cannot be tailored to individual physician practices. For most physicians the work of MOC lacks meaning and is considered busywork.
I invite you to view a 14 minute talk I gave at the California Medical Association’s House of Delegates meeting in Sacramento last month. This was my side of a debate against Dr. Lois Margaret Nora the CEO of the ABMS (Dr. Nora declined to let us post her comments). To view this video click the link below:
WHAT’S WRONG WITH THE MOC PROCESS?
In a recent physician survey performed by the Mayo Clinic, only 14.8 % of respondents agreed with the phrase “MOC is worth the time and effort required of me.” This number dropped to 6.4% when those who only “slightly agree” were removed (2). Importantly, there is an appearance of a financial motivation underlying all the new MOC requirements. In 2013, even before MOC was required, the publicly available ABIM Form 990 shows revenues of $30M from initial certification and $24M from recertification. Now that MOC is required, these revenues will dramatically increase. Participating in MOC may improve test scores and increase revenue to ABMS member boards, but there is no evidence it improves quality of care.
We now have almost 4,500 National Board of Physicians and Surgeons (NBPAS.org) diplomates. We are growing at a rate of approximately 1200 per year, a clear indication of continued physician discontent over recertification and the MOC process. As we begin our third year in operation many diplomates will be renewing their NBPAS certification. NBPAS is working with other groups on novel methods of earning CME you will hear about shortly.
We encourage you to:
a) Obtain board certification from NBPAS. We offer certification in every ABMS and AOA member board specialty. Find us at: NBPAS.org
b)Take the time to spread the word. We are making progress but continue to need your help. Many resources including sample letters and PowerPoint presentations and News are available at NBPAS.org. Obtaining support from your state medical associations is key to this process. Do your part to help the anti-MOC movement.
Paul Teirstein, MD
National Board of Physicians and Surgeons