Letter to the editor: ABMS and other boards force MOC on doctors

April 10, 2014

A reader writes that maintenance of certification has never been proven to improve the quality of care doctors provide, so it should not be required of them.

Thank you for publishing Paul Kempen, MD’s well-reasoned viewpoint. (“MOC must go: One physician’s view,” January 25, 2014.)

I am a strong believer in the Oath of Maimonides. It reads: “Grant me the strength, time and opportunity always to correct what I have acquired, always to extend its domain; for knowledge is immense and the spirit of man can extend indefinitely to enrich itself daily with new requirements. Today he can discover his errors of yesterday and tomorrow he can obtain a new light on what he thinks himself sure of today…”

I have previously published that maintenance of certification (MOC) has never been proven to improve the quality of medical practice. To the contrary, it has been associated with the decreased collegiality of our profession as well as decreased involvement in local as well as national medical societies.

Most practicing physicians find MOC to be clinically irrelevant, and polling of physicians in clinical practice showed that only 1.6% wished to maintain the current system – whereas 4.7% supported reform and 93.7% voted to abolish requirements altogether.

The American Board of Medical Specialties (ABMS) has published that the quality of research on MOC does not meet commonly accepted research standards and that certification does not “guarantee performance or positive outcomes.”

As respected professionals, physicians believe in our own continued education and quality improvement. Accordingly, if MOC has not been empirically proven to improve our practices, or be clinically relevant for most of us, than why is it being forced down upon us?

The American Medical Association (AMA) House of Delegates’ study of MOC’s impact on physicians concluded that these programs were “burdensome, costly, and have little known positive impact on patient outcomes.” Resolutions against MOC have recently been enacted by the AMA and the state medical societies of New Jersey, Michigan, Ohio, Oklahoma, New York, and North Carolina.

 

Unfortunately, the ABMS and the coalition of boards that make it up are in a tyrannical campaign that is being forced upon the physicians of America. They have conspired to manipulate the public, our governments as well as organized medical societies with an agenda that increases their revenue without any scientifically sound evidence that MOC is beneficial to the care and treatment of patients. Their media campaigns, including “Choosing Wisely,” have specific political goals that are not necessarily in every patient’s best interests.

The oaths that physicians take upon earning their degrees speak of dedication to the individual. MOC has been used to further the interests and goals of that those leading the boards believe are in the best interests of society. Yet that is in direct contradiction to the ethical obligations of physicians.

In the words of Thomas Paine, “He that in defense of reason rebels against tyranny has a better title to Defender of the Faith.”

 

 Howard C. Mandel, MD, FACOG  

Los Angeles, California