MOC process falls short

Thanks for your interesting article on maintenance of certification (MOC) (“MOC: Debate intensifies as Medicare penalties loom,” June 25, 2013). The one thing that is not addressed is the fact that MOC tries to be a one size fits all. I am a family physician who has worked in the emergency department and now in an urgent care clinic. I have yet to discover how MOC is designed to allow me to participate. I have no ongoing care of diabetic or hypertensive patients that can be followed over time, nor for that matter am I able to submit patient charts for review of the same.

So how is this discriminatory process going to be fair to everyone and allow participation to maintain board certification? Why aren’t all specialties required to participate in the same MOC process? Without being discriminatory, how can Medicare or anyone else penalize physicians who have no way to participate?

With regard to cost, it is out of control. In the past, you just had the cost of the exam, but now the cost is well over $4,000. Why? How is this process truly adding to the quality of patient outcomes? Where are those controlled studies that everyone likes to quote? Where is the evidence-based medicine to support all of this? I do believe in keeping current with education and skills, but the MOC process falls short and discriminates. 

Lawrence Voesack, MD

Odessa, Texas