ABIM does about-face on changes to MOC program
In a surprising development, the American Board of Internal Medicine (ABIM) is changing or suspending several of the recent revisions made to its maintenance of certification (MOC) program—and has apologized for making those revisions.
“A year ago, ABIM changed its once-every-10-years MOC program to a more continuous one,” ABIM’s president and chief executive officer Richard Baron, MD, MACP, said in a written statement. “This change generated legitimate criticism among internists and medical specialty societies. We got it wrong, and sincerely apologize.”
The changes ABIM is making include:
- immediate suspension of the practice assessment, patient voice, and patient safety requirements of the MOC process for at least two years. “This means that no internist will have his or her certification status changed for not having completed these activities in these areas for at least the next two years,” according to the ABIM statement;
- changing, in the next six months, the language on the ABIM website used to report a diplomate’s MOC status from “meeting MOC requirements” to “participating in MOC”;
- updating the internal medicine exam to make it more reflective of what practicing physicians are doing;
- keeping MOC enrollment fees at or below 2014 levels through at least 2017, and
- assuring “new and more flexible ways for internists to demonstrate self-assessment of medical knowledge by recognizing most forms of ACCME-[Accreditation Council for Continuing Medical Education] approved Continuing Medical Education.”
"While ABIM’s Board believes that a more-continuous certification helps all of us keep up with the rapidly changing nature of modern medical practice, it is clear that parts of the new program are not meeting the needs of physicians like yourself,” Baron said.
In addition, Baron pledged that ABIM “will work with medical societies and directly with diplomates to seek input regarding the MOC program through meetings, webinars, forums, online communications channels, surveys and more.”
The ABIM is the largest of the 24 boards comprising the American Board of Medical Specialties.
Prior to 2014 physicians who boarded after 1990—and who did not therefore have lifetime certification—had been required to recertify every 10 years. Last year, however, ABIM announced it would require physicians to complete various MOC requirements on three- and five-year cycles. It also said that physicians who certified in 1989 or earlier, and who had not subsequently recertified, would be listed as “certified, not meeting MOC requirements.”
The 2014 changes provoked heated opposition among individual physicians and medical societies, who said that MOC is expensive, time-consuming and unnecessary. In a June, 2014 article in the journal Anesthesia & Analgesia Paul Kempen, MD, an outspoken MOC critic, called MOC “untested, unnecessary, ethically questionable, and lucrative to academic-based physicians, board corporations and national medical specialty societies.”
Ron Benbassat, MD, a board-certified internist and a founder of the anti-MOC organization Change Board Recertification called today’s announcement “just a small first step.”
“Physicians are no longer afraid to speak their minds about MOC. We are on the right side of the truth here and will not rest until the MOC scam is fully revealed and abolished,” he said.
Steven Weinberger, MD, FACP, chief executive officer and executive vice president of the American College of Physicians, was more conciliatory. “I would say we were very pleased,” he said. “We’d been focusing for a long time on providing to ABIM the concerns and complaints we heard from our members and ABIM’s diplomates. This announcement today is a real game-changer and we’re delighted to see it.”
Weinberger added that Baron and ABIM’s leadership deserve credit “for being able to come out and admit that ABIM has to take some responsibility for the way the MOC program was and the problems that resulted. It’s to their credit that they have taken this responsibility and are willing to make changes.”
The American Medical Association (AMA), in a written statement, said “The AMA is delighted that ABIM is listening to physicians’ concerns and recognizes the need to better align the requirements of its MOC program with physician learning and practice improvement needs. Today’s announcement aligns with the AMA’s MOC principles as we have strongly advocated for a process that is evidence-based and evaluated regularly to ensure physician needs are being met and activities are relevant to clinical practice."