It’s time for MOC to end

October 25, 2013

A reader writes that maintenance of certification requirements should be eliminated.

If the new president of the American Board of Internal Medicine wants to be a game-changing advocate for the practicing physician, he should be challenged to dismantle Maintenance of Certification (MOC) and defuse all attempts to tie it to Maintenance of State Licensure (MOL). (“MOC: Debate intensifies as Medicare penalties loom,” June 25, 2013.) Neither has any place in the life of practicing physicians.

We’ve had an effective system in place for decades, one that is the equivalent of MOC and MOL: keeping up to date through our continuing medical education and remaining in good standing to maintain state licensing. There is absolutely no need or justification for MOC/MOL and its imposed burdens.

Keeping up-to-date is essential to practicing medicine, but the existing MOC process neither qualifies physicians nor protects patients. MOC’s requirements have not been shown to be fair, accurate, or predictive indicators of a physician’s skills or competency. All licensed professions have continuing-education requirements, but those imposed on physicians by MOC are simply egregious.

In light of the boards’ unchecked power to regulate physicians, what we propose is fair and in the best interests of our patients and our profession. Our goals remain clear:

1. MOC should not be associated with hospital privileges.

2. MOC should not be associated with insurance reimbursements or network participation.

3. MOC should not be required for MOL.

4. MOC should not be mandatory.

5. All board certificates must be converted to lifetime status; only then will MOC be voluntary.

If these cannot be achieved, then mass MOC noncompliance is the only rational and logical means to reclaiming control of our practices.

 During these changing times of healthcare reform, our Boards sit on nearly a half-billion dollars in assets while hard-working physicians get less and less in reimbursements and many Americans remain without healthcare coverage.

Beyond restrictive rules for doctors and their own enormous salaries and fees, what do our “nonprofit” boards actually provide? They do not represent us successfully in government matters, and certainly have no understanding of practicing physicians’ interests. It’s time for all of us to get involved and for MOC to end.

Ron Benbassat, MD

Beverly Hills, California

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