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    It’s time for MOC to end

    If the new president of the American Board of Internal Medicine wants to be a game-changing advocate for the practicing physician, he should be challenged to dismantle Maintenance of Certification (MOC) and defuse all attempts to tie it to Maintenance of State Licensure (MOL). (“MOC: Debate intensifies as Medicare penalties loom,” June 25, 2013.) Neither has any place in the life of practicing physicians.

    We’ve had an effective system in place for decades, one that is the equivalent of MOC and MOL: keeping up to date through our continuing medical education and remaining in good standing to maintain state licensing. There is absolutely no need or justification for MOC/MOL and its imposed burdens.

    Keeping up-to-date is essential to practicing medicine, but the existing MOC process neither qualifies physicians nor protects patients. MOC’s requirements have not been shown to be fair, accurate, or predictive indicators of a physician’s skills or competency. All licensed professions have continuing-education requirements, but those imposed on physicians by MOC are simply egregious.

    In light of the boards’ unchecked power to regulate physicians, what we propose is fair and in the best interests of our patients and our profession. Our goals remain clear:

    1. MOC should not be associated with hospital privileges.

    2. MOC should not be associated with insurance reimbursements or network participation.

    3. MOC should not be required for MOL.

    4. MOC should not be mandatory.

    5. All board certificates must be converted to lifetime status; only then will MOC be voluntary.

    If these cannot be achieved, then mass MOC noncompliance is the only rational and logical means to reclaiming control of our practices.

     During these changing times of healthcare reform, our Boards sit on nearly a half-billion dollars in assets while hard-working physicians get less and less in reimbursements and many Americans remain without healthcare coverage.

    Beyond restrictive rules for doctors and their own enormous salaries and fees, what do our “nonprofit” boards actually provide? They do not represent us successfully in government matters, and certainly have no understanding of practicing physicians’ interests. It’s time for all of us to get involved and for MOC to end.

    Ron Benbassat, MD

    Beverly Hills, California

    5 Comments

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    • Anonymous
      Dr Benbassat, I totally agree every single word you mentioned. while baby boomers are getting older and sicker and with already shortage of physicians, instead of helping and backing up our physician group, Board and MOC working against and making our lives miserable. i know few of my physician friends who gave up on practicing and now living hand to mouth just because they were not able to pass these board exams and it is insulting to our medical community. we go to school for 20 years so we can have an honest living and help our community by keeping them healthier. i wish our government steps in and take care of this issue before it is too late.
    • Anonymous
      MOC "practice improvement modules" are a huge waste of time for anyone attempting re-certification. Physicians are already strapped for time with learning their new EMR's and trying to comply with CMS and insurance mandates. It's hard to believe that medicine has become such a pile of busy work that must be completed on a regular basis before one gives a single thought to patient care.
    • PATTANAMDSRINIVASAN
      Great article by Dr. Benbassat. MOC is nothing but a money making scheme. There is no correlation between quality of patient care and MOC. Physicians must joint hands in opposing MOC at all levels.
    • PAULMKEMPEN
      Dr Benbassat has provided a clear and fair representation of this issue with effective measures needed to combat the extortion of physicians with wasteful programs. MOC is a mere "confidence scheme". The ABMS is selling "confidence" without assurances, proof or validation to congress, hospitals and insurance companies, which are all more than happy to pressure physicians into economic strongholds, cheapening healthcare by making physicians "too expensive" and non-physician "providers" "cost effective" in comparison. The waste of time and money further constricts physician availability to patients without any improvement in care. The programs were fabricated behind closed doors without any inspection or input from working physicians. The population at large is totally unaware of this program's negative impact as are most physicians busy caring for patients.
    • Dr. horseshrink
      Escalating bureaucratic intrusion will not solve the physician supply problem, nor motivate physicians to maintain board certification. Fortunately I am later in my career, but am among the original cohort for ABPN recertification. Will recert one more time. Then, I'm done. If docs decide generally to take a pass on board recertification, sheer need will prevail. E.g., hospitals cannot function without physicians.

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