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    MOC, recertifications are ‘cancers’ doctors should rally against

    Editor’s Note: Welcome to Medical Economics' blog section which features contributions from members of the medical community. These blogs are an opportunity for bloggers to engage with readers about a topic that is top of mind, whether it is practice management, experiences with patients, the industry, medicine in general, or healthcare reform. The series continues with this blog by H.L. Greenberg, MD, a board certified dermatologist . The views expressed in these blogs are those of their respective contributors and do not represent the views of Medical Economics or UBM Medica.


    We are in the midst of a common sense revolution in the house of medicine. 

    On Sunday, March 6th, I will be presenting a resolution for a vote by the full membership of the American Academy of Dermatology (AAD) to change the bylaws of the AAD to read that the organization is fully opposed to Maintenance of Certification (MOC) and board recertification. 

    The old guard in the house of medicine put-in-place rules that do not apply to themselves by “grandfathering” in those older physicians who do not need to jump through the same extra hoops as themselves in order to remain board certified. 

    Demanding the end of ABIM recertification exams

    Having made themselves immune to the unfair and unjust systems of (MOC) and board recertification, the older leadership—which currently maintains a stranglehold on the power structure of medicine—will soon be replaced with a younger generation of physician tired of a system that has long ago sold out its young physicians for their own benefit.

    Next: "I let my ABIM certification expire years ago"

    H.L. Greenberg, MD
    H.L. Greenberg, MD, (Twitter: @hlgreenberg) is a board certified dermatologist and founder of Las Vegas Dermatology- practicing in Las ...


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    • ABIM keeps on coming with patchwork solutions for our problems.they are holding our family and professional life and our emotional and physical health hostage.they need to follow suit as anaesthesiology board and scrap the MOC exam with immediate effect and not wait till 2018.what happens to all the doc who are due this year and also 2017.we need to organise and put a unified voice in front of these people who dont have to deal with the onerous way medicine is practiced now.you have no family life no time for your own health.w eneed to make all thses officeors in the board be in our shoes for few weeeks the ask tehm how many exams they want to sit for.
      March 6, 2016 Medical Economics Blog Re “MOC, recertifications are ‘cancers’ doctors should rally against” posted March 5, by HL Greenberg, MD. Bravo for the dermatologists. I knew that it would only be a matter of time before all specialties were encouraged by the show of outrage against the American Board of Internal Medicine. Physicians are overburdened with work and many are either burned out or on the verge. This decomposition of spirit and joy in practice has been going on for at least a decade and it represents a crisis as great as any that doctors have been dealing with—including insurers’ intrusions and the medical liability system’s intimidating methods. After initial certification, the American Board of Medical Specialties should focus on medical education not testing. This can be done with home study programs, updates on treatments and procedures and any other methods that would help doctors. Edward Volpintesta MD Bethel, CT
    • Dr. David W. Allison
      Dr. Volpintesta, I agree with your comments. However, in another article I just read in Medical Economics, "If the (presidential) election were held today", most of the physicians polled would vote for Hillary Clinton, as well as Bernie Sanders. Are doctors stupid people? Both of these candidates have the goal of socialized medicine with a single-payer system. Why would we want the same people who have incompetently run Medicare, Medicaid, and the VA to take over everything. They want all of us to be slaves to the federal government. Doctors in Britain recently went on strike in protest to lower pay and longer working hours. Such a great system! The same physicians who whine about the erosion of their incomes and government mandates are the same ones that voted for Obama/Obamacare. I call that stupidity.
    • Anonymous
      David, the aged, the poor and veterans are already covered under government plans which are the highest risk groups to insure, so only the working young and their families are left. Please tell me how medicine has faired any better under its incorporation and how you have any more input. The AMA used to be one of the most powerful "unions" in America--the failing is not government or insurance but our inability as physicians to unite to confront those who have taken the control of medicine away. Until we can follow our forefather's guidance of "out of many, one" Or "united we stand, divided we fall" they will continue to pick us off one by one. Perhaps we need to that the staff of Aesculapius and put it on a flag and write "Don't tread on me!" It has always been within our power to take control--so we need to quit blaming others.
    • Anonymous
      Boycotting works. A non-physician named MR Charles Kroll has been tracking the activities of the ABIM ; since they are "non-profit" they must release tax data. The 2015 income for the ABIM took a huge drop of over $4.2 million as physicians nationwide began to boycott the recert/MOC product of ABIM. If we all resist this coercion, how will they replace us? With ARNP and PAs via skype tele-med? The other problem inherent in this recertification is the secrecy of these holy exams. The ABMS copyrights the questions & answers. If they are so sacred why are they secret? Medical care allows no secrets ; we cannot practice secret techniques, keep secret charts or data; that would lead to license revocation. Can hospitals keep secret patient data? I suspect that if we could do peer review of the questions and answers to the board recert exams we would find outdated answers. Thus the exams would be scientifically and legally fraudulent! End of coercion. Why no one looks at this simple fact is startling to me.
    • Dr. alan shiener
      As an older grandfathered in doctor, I can tell you that we were grateful but all felt it was unreasonable for anyone to have to retake a meaningless exam every 10 years with all the time and expense involved. It was our colleagues in our professional societies, mostly academics, who jumped on the bandwagon. When MOC first hit the fan, The American College of Cardiology gleefully sent us mailers telling us that we were no longer protected by the grandfather clause and that they would be right there to provide us with all the expensive courses and paperwork that we would need to navigate the MOC requirements. Congress was behind them and included MOC in the PQRS requirements. Committees manned by ACC academics even said it didn't matter if this helped push some of us into retirement. Even our AMA didn't have the guts to come out against MOC because it would have been a bad PR move to come out against "quality.". I am happy to see people revolting, but believe that revolting will ultimately fail. The ABIM will bide their time and over the next 5 years will ultimately prevail.
    • Dr. Adam Lauer
      Great article Doc. The way to stop ABMS and its specialty boards from making M.D.'s re-ceritify could be as simple as every doctor refusing to re-certify. Thus the revenue of these boards would dwindle and they would lose much of their lobbying power. If every doctor refused re-certification, would the nations hospitals drop every doctor from their staff? No....they would have to change their bylaws or close their doors. Granted the first few thousand docs would prob lose their jobs first, but might get them back if literally everyone followed suit. Sadly getting doctors to agree on political subjects is like trying to herd cats....which is why our careers have nearly been ruined by outside parties. We D.O.'s have a parallel system called OCC. I've decided to let my board cert expire in 2020. I re-certified once a few years ago. It was horribly expensive and complete was of time. I won't do it again. Adam Lauer, D.O. Brewer, ME
    • Dr. James Lumeng
      It is important that physicians who sit in the medical staff committee of hospital begin to work towards not requiring recertification. There is no basis for the requirement, it does not mean that the physician is providing quality care. There are mechanisms in the hospital to insure high quality of care is provided.
    • Dr. James Lumeng
      It is important that physicians who sit in the medical staff committee of hospital begin to work towards not requiring recertification. There is no basis for the requirement, it does not mean that the physician is providing quality care. There are mechanisms in the hospital to insure high quality of care is provided.
    • Dr. Greenberg: So Congressman Heck discussed with you, your concerns re MOC. As an individual running for the US Senate is he willing to definitively say that MOC has to go? Is he willing to agree with you, me and 99% of physicians who say if lawyers, accountants, architects and engineers only have to be certified once in their lives...what's good for the goose is good for the gander---that physicians are only to be certified once in their lives? If he isn't willing to publically commit to that, why would any practicing physician ever want to support him? The physicians of Nevada need to put his feet to the fire. Dr. Heck built his career through big government; it's time for him to stand with those of us fighting for the soul of private practice medicine.
    • Agree with you Dr. Greenberg but I am 66 years old, grand fathered intonIM through no fault or actions by me and no longer certified in Geriatrics because I refused to decertify in 2002 and since then. There is an ABIM executive office need to generate income to pay their organizational expenses which is why MOC exists. You can blame the ABIM officers but not all us practicing old farts please.
    • Dr. David W. Allison
      Good article Dr. Greenburg. We need to keep up the pressure and continue to speak out against this tyranny. MOC and recertification is all about money and control administered by unelected, private corporations, otherwise known as "the boards". What makes it especially egregious is the fact that our fellow colleagues put their own self-interest above patients and our autonomy. The backlash against Washington and the establishment Democrat/Republican cabal is mirrored in the outrage of rank and file physicians against the specialty boards. I am up for recertification this year and I will defy the establishment by boycotting MOC and recertification. If more doctors could just come together and muster the courage to give these people the middle finger, there would be no stopping us! Stop sending these jerks your hard earned money!
    • Dr. christine park
      Well spoken. One of our local hospitals recently started a process for changing the medical staff bylaws not to require recertification. This is only because the "in-crowd" on the medical executive committee got tired of recertifying. The other competing hospital would still require recertification. Those of us who do hospital work cannot get out of this completely, yet.

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