• linkedin
  • Increase Font
  • Sharebar

    The man behind MOC defends the program against critics

    Efforts to ease requirements for maintaining board certification have not quelled internists’ complaints about the time and costs the maintenance process demands. Still, the president of the American Board of Internal Medicine—the body that oversees certification for internists and many other subspecialties—remains convinced that maintaining certification is important for physicians, and that the board’s path for doing so is the best one.

    “Putting out a credential that speaks to whether doctors are staying current in knowledge and practice, I think overwhelming numbers of doctors want to have a way to reassure themselves that they’re doing that,” says ABIM president Richard Baron, MD, MACP. “And they want a way to communicate to their patients and colleagues and institutions that they’re doing it.”

     

    Related: MOC is crazy and unfair

     

    Even so, the ABIM has been trimming many of the changes it made to the maintenance of certification (MOC) process in 2014 and that led to the outcry among physicians. Last year, for example, the board invited practicing internists to review the outline—or “blueprint”—of the assessment exam and rate the topics it covers for their relative frequency and importance to everyday practice. 

    Then earlier this year the board announced plans to introduce a shorter assessment test in 2018, one that doctors can take on their own computers rather than in a central testing location. Doctors who do well on these assessments can “test out” of the current assessment, which is required every 10 years. 

    Baron’s comments were part of a wide-ranging interview with Medical Economics regarding MOC and other issues facing the ABIM that took place during the American College of Physicians scientific meeting in May.  The full transcript follows: 

     Medical Economics: One of the complaints we hear about MOC is that the process has very little relation to the kinds of problems most practices face on a day-to day basis.  Do you anticipate that the changes you outline in the announcement are going to address that complaint?

    Richard Baron, MD:  I would say that a number of changes we’ve already made have taken important steps to address that. We’ve been engaged in what we call a blueprint review process where we invited practicing doctors, all board-certified doctors in a discipline, to give us feedback on what’s called the blueprint, which is the design specification for putting together the exam. We did it in IM in the MOC exam in the fall of 2015 and had very positive reviews from doctors that it was more relevant and moving in the right direction.

     

    Opinion: Maintenance of certification pushed me out of medicine

     

    So crowd-sourcing in how to put the exam together has helped a fair amount in the relevance area and we’re rolling that out across all our disciplines. So I think we’ve taken a number of important steps there and will continue to.

    The changes we made with ACCME [the Accrediting Council for Continuing Medical Education], creating a way for more CME programs that met ABIM standards to seamlessly generate MOC recognition is something we also think was in the direction of saying this is a program that gives people credit for the work they are doing that is sustentative, valuable educational work.

     ME: Can you point to any specific changes in the blueprint that you feel are making it more relevant to everyday practice? 

    RB: I’d have to say it’s too numerous to count. In other words, the blueprint review is pretty technical. It not only gets into different diseases but it gets into is it important to be able to diagnose this, to treat this? Is it important to understand the disease mechanisms? Those are all things that exam questions might test. So some of the things we’re asking doctors is, how important is this? 

    Next: Why doesn't ABIM advocate more on behalf of its members with hospitals?

    6 Comments

    You must be signed in to leave a comment. Registering is fast and free!

    All comments must follow the ModernMedicine Network community rules and terms of use, and will be moderated. ModernMedicine reserves the right to use the comments we receive, in whole or in part,in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

    • UBM User
      Reading this reminds me of a farmer mandating all his chickens learn how to make more and better eggs. Nothing good for the chickens, only making more money for the farmer.
    • UBM User
      Oh yes! Doctors need the self reassure cr of being able to pass an exam!! Where does he come off speaking for other docs? He is simply justifying his existence which is a disgraceful attempt to perpetuate this ignorant process. Come forward with real evidence that justifies his belief and we'll listen. O/W all the docs beholden to this process need to rise up against and walk swiftly from these mandates! Remember that the hospital needs you!!
    • UBM User
      The arrogance of these people is astounding. It's just like Washington, DC, just on a smaller scale. The rules don't apply to them. Rules are for the peasants. Just like Hillary Clinton, who is never held accountable for anything she does. All animals are equal, but some are more equal than others...
    • Lawyerdoc@------.com
      "It is difficult to get a man to understand something, when his salary depends on his not understanding it.” ― Upton Sinclair
    • Anonymous
      "Doctor" Baron is just another wacky didactic physician gone wild administrator making rules and regs from his Ivory tower. Rules he'll never have to follow cause he makes 'em up as he goes. MOC is a farce
    • Anonymous
      Said the physician executive from the study of his million dollar home.

    Latest Tweets Follow