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Your Voice: Doctors are exploited by Maintenance of certification


MOC, frustration with insurance company payment fees and physicians being bought by pharmaceutical companies are the hot topics readers discuss in this issue's Your Voice.

Yes, “Recertification is crazy and unfair (May 10, 2016).” It is also exploitive and extortionate

It has survived only because of doctors’ fears of being excluded and being stigmatized for not having the MOC label.

We physicians revel in anything that elevates our self-esteem and anything that increases our prestige in our patients’ eyes.

MOC, I believe, is one of them.

We deserve whatever aggravation that MOC is inflicting on us. It is the price we pay for falling asleep at the wheel and trusting that we would never be exploited from within the house of medicine.


Edward Volpintesta, MD

Bethel, Connecticut


Physicians are not bought by pharmaceutical companies

Thank you, Keith Martin, for the article, “Irresponsible to say physicians can be bought to put patient care second (June 25, 2016).”

What “eating meetings” accomplish for physicians is knowledge about a particular product that we may/may not prescribe.  We all recognize this is a promotional meeting, but still need more information on a particular medication or medication class in general.  

My most recent attendance at a meeting was for the PCSK9 class-Repatha and Praluent.

I have never written a prescription for either of the medications, but several of my patients have been started on these by cardiologists.  

I have been reading about this class for several years in anticipation of the eventual availability and wanted to know what to look for in my patients who were prescribed the drug(s).  Very helpful for patient care for those of us not wishing to spend time away from practice on a trip to a meeting.

Those with an agenda to stop these kinds of meetings have no clue of the valuable nature for patients of these meetings.  And, additionally, I would ask: has the cost of pharmaceuticals diminished since all the Stark regulations were implemented?  No.  In fact, with absolutely no data on my part, anyone can see there has been a logarithmical increase in drug prices-including generics.


Don Blackmon, MD

Pensacola, Florida


Frustrated with insurance company payments and fees

I enjoyed the article, “Direct primary care may become the norm,” by Dr. Scherger.

You cannot charge the patient for any service even if the service is not covered. This has been a nightmare for us. I run a travel med clinic. I have patients show up that are requesting specialized immunizations. I am not their primary care MD, yet they indicate that since I participate with their insurance company, I cannot charge them for the immunizations. 

Many of the immunizations are not covered and the money is lost-this gets rather expensive and frustrating. 

I have had a lawyer review it, and even went so far as setting up a separate business entity, yet because my name is associated with it, insurance companies are indicating I still cannot charge any patients any fees other than approved copays.

Therefore, I would find it highly unlikely that they would let me charge a patient x dollar per month for secretarial services etc.  However, I think it’s a great idea!


M. Niziol, MD

Dryden, New York

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