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    Maintaining certification: gold standard or is luster tarnished?

    In the rankings of anger-causing acronyms physicians contact us about at Medical Economics, maintenance of certification (MOC) sits comfortably atop the list, looking down at EHR and CMS.

     

    Further reading: Docs sound off, question MOC

     

    Maintaining certification, specifically under the American Board of Internal Medicine (ABIM), has come under fire for a number of reasons, ranging from test material that has no connection to day-to-day practice to the salaries of those running the organization. Doctors often feel held hostage to the test to retain hospital privileges and remain on payer panels. 

    The American Board of Medical Specialties, which oversees the ABIM and 23 other specialty boards touts its 80-year evolution of “standards for medical specialty practice and certification to support advancements in medicine, science and technology.” 

    While I’m sure the information on MOC exams are up-to-date, the methods used to test physicians are not. Requiring physicians to sit for an SAT-style test in a testing center, where they must empty their bags and pockets like going through airport security, is outdated and perhaps not the best use of their time. Although the ABIM is moving to a shorter, open-book and even online platform, if these organizations truly represent physicians, they should be more accommodating in testing methods and the costs incurred.

     

    Funny Bone Comics: Is there a MOC for monks?

     

    As you’ll read in this issue, the cost of maintaining certification is an issue in and of itself. From purchasing testing materials (often furnished by the same groups who administer the test; a little “double dipping” there) to lodging and travel expenses and even having to close a practice or find coverage for the day, this is no small price tag for today’s private practice physician.

    Next: Is board certification as it exists in 2017 still a necessity? 

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    • wes@------.com
      From 2000-2016, ABIM failed 12.8% of physicians on their MOC exam. From 1990-2007, the ABIM secretly took $77 million of physician testing fees to fund their ABIM Foundation that invests retirement assets offshore in the Cayman Islands and fraudulently completes its tax forms in an attempt to cover all this up. Tell me again why any credible doctor in the United States shouldn't sue the hell out of ABIM? Oh wait, they have! (1:14-cv-02705). Will our legal system please wake up?
    • WCLARKB@------.NET
      The lack of trust between the diplomats and their respective boards is overwhelming. The boards as a group, generally following the ACIM elephant, have become less and less a part of the lives of their unwilling fellow travelers as they get more and more intimate with their pocket books. The MOC was supposedly a response to a stealth groundswell of opinion. Its blatant grab for money was self-evident and probably would have been tolerated had it returned equal services for the money rendered. Instead we all got recycled resident "gotcha" questions and many more hoops to jump through. None of these have been demonstrated to do more than what CME does. I do locum tenens work exclusively, submitting 3 to 4 hospital applications a year since my initial MOC lapsed in 2009. Since then I have had two applications denied due to MOC requirements out of 25 hospital applications. It seems that the hospitals know a scam when they see it. I wonder how long it will take for the hard-working practitioners will figure it out as well?
    • WCLARKB@------.NET
      The lack of trust between the diplomats and their respective boards is overwhelming. The boards as a group, generally following the ACIM elephant, have become less and less a part of the lives of their unwilling fellow travelers as they get more and more intimate with their pocket books. The MOC was supposedly a response to a stealth groundswell of opinion. Its blatant grab for money was self-evident and probably would have been tolerated had it returned equal services for the money rendered. Instead we all got recycled resident "gotcha" questions and many more hoops to jump through. None of these have been demonstrated to do more than what CME does. I do locum tenens work exclusively, submitting 3 to 4 hospital applications a year since my initial MOC lapsed in 2009. Since then I have had two applications denied due to MOC requirements out of 25 hospital applications. It seems that the hospitals know a scam when they see it. I wonder how long it will take for the hard-working practitioners will figure it out as well?
    • mccoy.loren@------.com
      We need to address MOC for what it is, a money grab by the ABMS and especially the ABIM. No study has EVER showed the utility of MOC. I just took and passed my third MOC 10-year exam. It was dificult and the questions literally had nothing to do with anything I or any of my colleagues do on a daily basis. The whole process was miserable and made me feel like a slave to the ABIM. I thing Richard Baron, M.D., has sold us all out in order to enrich himself and his organization. I fully support and am a member of the NBPAS.

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