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    Maintenance of certification pushed me out of medicine

    Editor’s note: The following was sent to Virginia Moyer, MD, vice president for maintenance of certification (MOC) and quality at the American Board of Pediatrics a year ago. While the author ultimately completed MOC, lack of movement on this issue played a large part in the author’s decision to stop practicing.

    Amy Baxter, MDIt is with a heavy heart and tears that I would like to let you know that I will be unable to continue practicing medicine due to an unfulfilled Maintenance of Certification (MOC) requirement. I conscientiously object to the quality requirement as implemented by the board. 


    Related: Physicians fed up, feel trapped by MOC


    By my own choice, I have been unwilling to complete a hand washing module for physicians who don’t have a consistent practice.  I work one to two clinical shifts a week; I research, lecture, review science and work to help children’s vaccine pain with the other time. I believe in constant personal vigilance to maintain quality care.

    I have participated in quality projects in the hospital, I have developed lectures, book chapters, and created and validated a scale to assess pediatric nausea that is used in hospitals and clinical trials across the world. I have asked the board to consider my work and my nausea scale publications; they do not consider these efforts an indication of “quality.”

    While many good people have not been silent about their dissatisfaction with MOC, most physicians are not in a position to quit practicing. Instead, they are complaining, feel angry and frustrated, and believe they are justified in cheating the system.


    Further reading: Eliminate MOC's cumbersome process and physicians will get on board


    I have spoken to many who did do the hand washing module for compliance, and to a person they acknowledged making up data. Putting ethical, overworked, extensively trained and honorable people in a position of having to be dishonest or shoddy to comply with a regulation is wrong. It erodes the value and purpose of board certification. 

    Next: 'The quality requirement of MOC has been the last straw'

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    • Anonymous
      Thank you for your honest opinion and courage. We should all take your lead and make the necessary changes to certification that are reasonable

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