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I would like to add my comments to those of my fellow physicians who rightly questioned the value of maintenance of certification (“Docs fix MOC, physicians question value of process,” July 10, 2017).
MOC cannot ascertain how well physicians connect with their patients on an emotional and social level. Many go the “extra mile” in advocating for them with private insurers, Medicare, pharmacies and medical supply organizations.
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MOC cannot measure the efforts of doctors who make the occasional house call, or hospital or [extended care facility (ECF)] visit even though they no longer take care of hospital or ECF patients-and don’t charge any fee. This has particular relevance for primary care doctors.
MOC cannot measure how much time doctors spend being good citizens of medicine by participating in state and local medical society meetings or writing letters to the editor of local newspapers defending patients and physicians against the intrusions of insurers.
MOC cannot measure the efforts that doctors spend trying to move tort reform forward by participating in the advocacy efforts of their medical societies.
MOC cannot measure how much doctors participate in the activities of their hospital medical staff and committee meetings.
MOC cannot measure if doctors consult specialists in a timely fashion or how well they collaborate with their consultants.
MOC cannot measure if doctors report the findings of CT scans and lab tests in a timely manner or how quickly doctors answer their phone calls or how long patients have to wait for an office visit.
Maintaining certification: Gold standard or is luster tarnished?
Doctors who have recertified believe that if they went through the process everyone should. This is a serious internal problem.
The word “certified” is a misnomer. It wrongly confers or implies a legal status and gives the American Board of Medical Specialties (ABMS) immense power that they never were given. Those who pass the test should be called “diplomates.”
Doctors are downtrodden as it is. Making their lives more difficult actually detracts from patient care.
Many test takers, for fear of not passing, engorge themselves with knowledge unrelated to their practices-a waste of time-or attend board review courses-a waste of time and money.
Not recertifying can harm good doctors’ reputations and livelihoods. It can destroy patients’ confidence in doctors with whom they have had longstanding relationships.
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MOC stigmatizes good doctors who decide not to recertify and can harm their reputations and livelihoods. This poses a serious (and legal) problem for the ABMS.
Apart from administering the initial boards which act as a sort of “final exam” after residency, the ABMS ought to take on a teaching role, not a testing one. This could be done with self-assessment programs, done either online or with booklets that doctors can keep as references.
Clearly there is more-much, much more-to being a good and caring doctor than the ABMS acknowledges.
Edward Volpintesta, MD