Petition to eliminate MOC draws 15,000 signatures


Discontent growing over program’s time, monetary requirements

certification technology

In the latest flareup over the American Board of Internal Medicine’s Maintenance of Certification (MOC) program, more than 15,000 doctors have signed a petition asking the board to eliminate it.

The petition, which is posted on the website, calls MOC “a complex and time-consuming process that poses significant challenges to practicing physicians” because of its fees, paperwork and requirements for ongoing assessments.

It also charges that there is “limited empirical evidence” that MOC participation leads to better patient outcomes or improved physician performance. The petition was started July 21 by Aaron Goodman, MD, a hematologist and associate professor of medicine at the University of California-San Diego. Goodman subsequently announced the petition and linked to it on the social media website X (formerly Twitter)

The petition represents the most recent expression of anger many doctors feel towards MOC dating back over three decades. In 1990 the ABIM, which provides certification for about 25% of physicians, did away with its policy of lifetime board certification. Instead, it required doctors certifying after 1990 to recertify every 10 years.

Then in 2013, the ABIM announced that in addition to the 10-year exam it would require physicians to complete various MOC requirements on three- and five-year cycles. The new requirements caused an outcry among ABIM’s membership, in response to which the board modified some of the changes and eliminated others in 2015.

The 2013 requirements also brought about the launch of the National Board of Physicians and Surgeons (NBPAS), which offered doctors a less intensive path to certification maintenance. NBPAS Associate Director Karen Schatten, MLS, said in an email that the organization has seen a 20% increase in applications since the start of the year. “While I think it would be too soon to comment on trends related to the recent MOC flare-up, NBPAS has seen an overall uptick in physician interest,” she wrote.

Last year, the ABIM introduced another method for meeting MOC assessment requirements in the form of the Longitudinal Knowledge Assessment, a 30-question quiz doctors can take every quarter in place of the long-form 10-year exam. ABIM charges $220 per year for one certification, and $120 for any additional certifications.

Shortly after starting the petition Goodman and Richard Baron, MD, MACP, president and chief executive of ABIM, were guests together on the podcast Healthcare Unfiltered. Baron defended MOC, calling it “an educational and an assessment tool. We know we’re not good at assessing ourselves. How many of us would say we’re below-average drivers?”

“The value that ABIM generates is reporting you as certified by aggregating a bunch of information about you, including the [MOC] assessment and publicly reporting that you are board-certified,” Baron added. “What gives that certification value is there’s a program behind it that has standards and substance.”

Goodman said he launched his petition partly out of frustration over the additional administrative burden MOC imposes. “We already have all these forms to sign, insurance companies to deal with, and it takes away from the satisfaction of practicing medicine,” he said. “I get like three emails a week from ABIM saying I owe them money and I’m done dealing with it,” he said.

In a later conversation with Medical Economics Goodman said “I was fortunate to have a reasonably sized platform on Twitter so I made the petition and started tweeting it, and I noticed right away that nearly 100% of people seemed to support, even people I haven’t gotten along with professionally.”

Goodman said he understands the value of board certification. “I don’t mind doing the exam once, but the certification is a useless waste of time and money” that most doctors participate in because their hospital admitting privileges, and thus their livelihood, depends on maintaining their certification.

“I don’t plan on stopping this until MOC goes away,” he said.

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