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    Docs sound off, question MOC

     

    Q: Do you think anything you’ve done through the MOC process has helped you? 

    A: No more than being a conscientious doctor and getting a lot of CME credits. And to that end, there’s also the NBPAS. I got certified through them when they first got started. The credential doesn’t do me any good, but I think if we have enough people getting behind them it may eventually mean something.

    Q: How would you design the MOC process if it were up to you?

     

    Hot topic: Waiting on Congress to fix healthcare could be hazardous to physicians

     

    A: Why can’t we just continue to take good CME? It either reaffirms you in what you’re doing and that you’re doing it well, or you learn some new things. And these guys at the ACP conferences are really the experts in their fields and at the cutting edge of a lot of stuff. 

    There are always going to be people who try to cheat the system, but we’re all supposed to be adults here. We prescribe dangerous medications, we cut people open. So we’re given all this responsibility then treated with this parochial mentality when it comes to MOC. Why can’t we be trusted as the professionals that we are?

    Maria Chandler, MD

    Type of practice:  Pediatrics, clinical professor at the University of California-Irvine and chief medical officer for The Children’s Clinic, a system of nonprofit clinics affiliated with UC-Irvine

    Location: Long Beach, California

    Years in practice: 25

    Most recent board certification: 2007

    Recent MOC-related financial costs: Review course, $1,000; annual MOC fees, $240

    MOC-related time costs: None; time away covered by employer

    *Member, Medical Economics
    Editorial Advisory Board

    Q: Where are you now in the MOC process? 

    A: I’m recertifying right now, after taking a review course. I’m very fortunate that in 2017 people were offered a pilot program. They [the American Board of Pediatrics] send me a batch of questions every quarter this year. You can look things up, but you only get five minutes to answer each question. You can do it at home and you can start and stop. I took the first two quarters worth of questions and I really liked it compared to going to a test center.

    The questions are very different from what I’ve seen in the past. You used to see questions like, ‘you’re in Uganda, and you see a puffy nodule, what insect bit you?’ Well, I don’t practice in Uganda. But now the questions are like ‘a 13-year-old girl comes in. Her grades are dropping and she cries when you ask her questions.’ So it’s a lot more practical.  

    Q: What have been the costs of MOC to you?

    A: The review course cost about $1100, but I was able to use the $1,200 I get from my employer for CME activities to pay for it. I stayed in Los Angeles [where the course was held] for five nights. The room was about $140, so I probably paid around $1,000 when you include meals and everything. 

    Q: Do you feel you’ve gotten any benefits from the MOC process?

    A: It made me go to a review course, but that was so esoteric it didn’t really help me. I also don’t know that I’ve really learned anything from the exam questions. I think I proved to them I’m still capable of seeing patients, but it has nothing to do with skills like bedside manner. So I don’t think it’s that helpful, but I understand they feel they have to do something.

     

    Physicians: Your fate lies in the hands of one of your own

     

    Q: What would your ideal MOC process look like? 

    A: Here in the real world, I have to prove that we provide quality clinical care. I have to send outcome measures on all 50,000 of our patients, and we’re graded on those. I think that is a much better measurement of what kind of care you’re giving. I don’t know that sitting for a test proves much about your patients. And that’s the whole point: how are your patients doing? So if I designed something, I think I’d go more toward the pay-for- performance side where you have to prove your patients had good outcomes.

    Next: 'A MOC process that says the majority of you folks are doing fine'

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