	Thank you for publishing a well-written article by Beth Thomas Hertz regarding Maintenance of Certification. (“MOC: Debate intensifies as Medicare penalties loom,” June 25, 2013.)

	MOC has evolved into a costly burden to physicians, patients, and the healthcare system. I would like to point out that Drs. Malangoni, Holmboe, and Phillips, whom Hertz quotes, all work for one of the boards that have become a profiteering juggernaut without any reasonable proof of benefit, efficacy, or patient protection. As she points out, certification is being tied to the privilege of practicing medicine.

	As physicians, we should demand evidence-based analysis of strategies proposed to improve our ability to practice, just as we do our research. We should not give in to potential threats of government mandates. For two centuries, the medical profession has evaluated the proper use of techniques, procedures, and therapies that have proved to be of important benefit.

	Most practicing physicians find MOC to be clinically irrelevant, and it has not been found to correlate with creating better physicians. Yet with an ever-increasing physician shortage, the self-serving boards are creating systems that potentially will decrease access to healthcare for many Americans.

	Perhaps the American Board of Medical Specialties or any of the individual subspecialties can spend their resources on studying why camaraderie, collegiality, and membership in local organized medicine has plummeted since the introduction of recertification.

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Practice Management

A reader says the maintenance of certification process has not been shown to improve the quality of care doctors provide.