Physicians fed up, feel trapped by MOC

We asked members of the Medical Economics Reader Reactor Panel, 200 physicians representing various specialties across the U.S., about their feelings on maintenance of certification and their daily lives in medicine. Here’s what they said about recertification:

"Board recertification has almost nothing to do with my daily work as a primary care physician. It is an angst-generating exercise in arcane minutiae that robs me of work and family time for little gain or benefit. In my opinion, it is academic extortion and a blatant money grab. Unless absolutely forced to because of business reasons, I hope not to recertify a third time as it is a painful experience that does not really help me or my patients.”  

Related: MOC, recertifications are ‘cancers’ doctors should rally against

W. David Smith, MD
Internal medicine, Cincinnati, Ohio

“After starting the MOC process for family medicine, I realized there was no relevance to my current practice of medicine and that it was pure busy work and a waste of my time. Having recertified six times before taking the same test that residents fresh out of training were taking, I could not find any reason for the change.  The certification board was assuming duties left to state licensure boards with a huge overreach grab for power.  As I investigated further, the board could not supply me with a satisfactory explanation or real science to back up their claims.  They were making a voluntary program mandatory with financial gain and power on their part as the real reason. I looked for alternatives and still list myself as board certified by NBPAS and am happy to recertify with continuing education requirements that match the practice of family medicine that I need to ensure my patients receive the best care.”

Rob Jones, MD
Family medicine, Phoenix, Arizona

Next: "Forme of extortion"

“Board certification used to be a mark of excellence, not a form of extortion, revenue generation and busywork. Maintenance of certification, with its practice improvement, patient voice, patient safety, and secured high-stakes examination, has no bearing on what happens in the examination room; there is zero impact on the actual care of patients. I have to recertify, otherwise I cannot maintain my insurance, hospital, or employment relationships; this is what makes it extortion. I am fortunate that I am at the point in my career where I have to take the secure exam only one more time in about five years, and in my case for two specialties. I feel sorry for newly graduating physicians out there. This is just wrong!”

Further reading: Demanding the end of ABIM recertification exams

Christopher J Unrein, DO
Internal medicine and hospice/palliative care, Parker, Colorado

“Board certification under ABMS is not essential to my practice of family medicine. After seven certifications, I let my certification lapse in December 2014. Since then I certified with NBPAS, have renewed my state license, and been reappointed to my hospital staff. Business as usual.”

Robert L. D’Agostino, MD
Family medicine, Canton, Massachusetts

“As an urgent care physician there is no reason that board certification should be required after having been board certified in emergency medicine [for the past] 27 years. The knowledge base for urgent care is within the realm of emergency medicine, and recertification has never been associated with improved quality of care. I do plan to continue my certification with NBPAS. They are much more clinically oriented, and avoid the unnecessary MOC required by the American Board of Emergency Medicine. In addition, the cost of ABEM is onerous, comes to thousands of dollars/ year, while NBPAS is a non-profit, and charges a very reasonable amount.”

Next: Does board certification really matter?

Eugene Saltzberg MD

Emergency medicine, Libertyville, Illinois

“My board certification does not matter when I am dealing with my patients. I had only one person one time ask me if I was board certified. The theoretical knowledge accrued while studying for boards is nil in a practice setting. Who cares if I do the glucose or the [blood tests] first in an emergency setting? What is important is which vaccine I have in stock and which one the insurance is going to pay me for. I am in the renewing cycle of taking the pediatric boards this year and unfortunately would lose my hospital affiliation and my lease, which is through the hospital if I decline to take it. It may be my last time as I am over 50 years old. While I do understand that I need to keep up with modern methods and tests, I do not understand how this is helping my patients. And wouldn’t a conscientious doctor wish to know new stuff? Don’t we all share a scientific curiosity streak? I read everything I get my hands on from scientific magazines with pure science to medical journals. It is what attracted me to medicine in the first place.”

Karin Fiedler MD
Pediatrics, Chicago, Illinois