Letter to the editor: MOC requirements repeat medical profession's past mistakes

July 10, 2014

A reader calls maintenance of certification an example of academic medicine exerting control over practicing physicians.

Howard Mandel, MD in his April 10 letter (“ABMS And Other Boards Force MOC On Doctors”) was correct to point out the tyrannical move to force maintenance of certification on the medical profession by the very organization that physicians helped to create almost a hundred years ago. At the time sitting for the boards was ­voluntary. 

But slowly the leadership of the boards has positioned themselves so that certification has become a credential for admission to hospital medical staffs, for medical licensure, and it has been used by medical insurers as an indicator of physician “excellence.” It will not be long before insurers will decrease their payments to physicians who are not certified.

This is another example of the long arm of academia extending its grip over doctors. This also happened after the recommendations of the Flexner Report of 1910 were adopted by medical schools. Flexner lamented that the curricula of the medical schools were too rigid and forced students to march in lock-step, leaving them little time for personal development.

Sir William Osler, one of the founding fathers of Johns Hopkins Hospital, believed the changes overemphasized the science of medicine and trained medical scientists more than medical doctors because of the lack of attention to the social and psychological and personal factors that doctors also need in dealing competently and humanely with their patients.

By its increasingly mandatory status and its punitive pass/fail, MOC repeats the same deplorable “lock-step” defect and narrow-mindedness that followed the recommendations of the Flexner Report of 1910.

Edward Volpintesta, MD

 Bethel, Connecticut