Is MOC worth the time and effort it requires?

In response to your excellent article on Maintenance of Certification (“MOC: Debate intensifies as Medicare penalties loom,” Medical Economics, June 25, 2013) I would like to ask Eric Holmboe, MD, if any evidence exists to show that all the work expected of diplomates achieves better outcomes for patients and physicians. Perhaps Holmboe can consider that the American Board of Internal Medicine Foundation has written that physicians should be skeptical of studies funded by the pharmaceutical industry. Does it follow that diplomates should be skeptical of studies funded by the American Board of Internal Medicine attempting to demonstrate any value to maintenance of certification? And if there is no conclusive evidence of MOC efficacy, should all the effort, time, and money spent on pursuing MOC continue?

Also, thanks to Mark Malangoni, MD, for advising us to consider MOC as “a fact of life.” Perhaps he can answer whether the lack of diplomate representation on specialty boards mandating MOC participation is not a form of taxation without representation. And perhaps he could comment on forcing diplomates to participate in this expensive, onerous, procedure of uncertain value. How would he advise diplomates who disagree with many ABMS/specialty society MOC policies to proceed?

Marc S. Frager, MD

Boca Raton, Florida