Last week, the American Medical Association (AMA) released a position statement against the American Board of Medical Specialties (ABMS). In their position statement, they call for an immediate end to Maintenance of Certification (MOC)  and state that their is no proven benefit over traditional continuing medical education (CME). For the past 2 years, doctors shouted this out to whoever would listen, and we went largely unheard.

A forensic accountant, Charles Kroll, began an investigation of the American Board of Internal Medicine (ABIM), the largest specialty board. What he found in the financial records was quite shocking, yet the ABIM refused to back down. The more dirty finances that were revealed, the more they dug in their heels that MOC must stay and doctors be chained to its tether. Several physicians brought these concerns to light, even to the point that it ended up in Newsweek and other media outlets.

But, in the light of these revelations, ABIM leaders attacked the bearers of the message. Doctors were blocked from commenting on their social media pages and they went so far as to insult the wife of the journalist,  Kurt Eichenwald, who published his opinion piece about their dealings in Newsweek. In a podcast and twitter chat sponsored by JAMA, they refused to answer questions and called those questioning their tactics “complainers”.

Over the past two years, doctors repeatedly expressed concerns that MOC is not evidence-based, costly, and takes time away from patients. Whole movements started to end MOC and even innovate alternate boards. Medical societies in several states, including Florida and Pennsylvania, issued position statements against mandatory MOC compliance. Last week was a true victory in the fight against these corrupt leaders who ignore the pleas of doctors, who are made slaves of the MOC system.

The AMA is the largest organization representing doctors in the US. When they issued their position statement, doctors finely felt our voices were heard. Yet, the ABMS still  rejects any wrong-doing or faults in their way of doing business. The leaders of these boards are making obscene amounts of money by forcing doctors to comply with a program they don’t agree with. Yet, there is little remedy here until the ABMS acknowledges doctors voices and admits they are wrong.

Why do doctors need CME and not MOC?

  •  There are many CME activities available that are evidence-based. MOC is not and the leaders of the medical boards reject any questions on showing statistics that show they have any use. They cannot provide any that show MOC activities improve patient care or doctors knowledge.  They do not even attempt to answer but block these questions from view.
  • Doctors have areas that they specialize in, even within their own specialties. A doctor can choose CME activities that are relevant to the medical areas that they deal with every day. This will improve their skills and knowledge base and directly be beneficial to patient care. MOC does not give you so many options and often force out-dated and irrelevant information on doctors. This is a waste of time and doctors need to take time away from patients to study this useless data.
  • CME is needed for life-long learning. Medicine changes rapidly and doctors need to stay abreast of the changing medical landscape. CME is kept current; MOC is not.
  • There are multitudes of sources available for free or inexpensive CME. MOC is costly and over-priced.

When the AMA at last spoke out on behalf of frustrated physicians across the US, it would seem reasonable to expect the ABMS to listen. Yet, they did not but rather came out with their own position statement against the AMA.

The ABMS claims patients and consumers want doctors to be up-to-date and current and to submit to external testing to verify this. No, patients want competent doctors who listen to them In over 15 years of practice, not one ever asked about my testing status. Most doctors echo the same.  They claim CME is not enough to reach this goal; MOC is needed. However, the ABMS cannot offer any evidence to support this assertion.  I, and many other doctors, asked them on their position statement page, and they did not even allow those comments to be made public. They can hide our comments but they cannot hide the fact that they have no evidence.

They state that they are trying to make MOC more relevant. That, in my mind, is an admission of the fact that they are not currently relevant. Yet, we have been forced to comply and pay for the past several years. We are not guinea pigs to try out testing standards on us. Show us the evidence or let us go back to our evidence-based CME.

They claim they want self-regulation. No, they don’t. They want complete and total control over doctors and their money. If we were allowed to self-regulate, we would do relevant CME, not mindless MOC activities that line a few corrupt doctors’ pockets.

Our voices will not be silenced. You can block us and delete our comments. You can reject the position statements of the organizations that represent us. But, your corruption will end, even if you hang on to the end. Your downfall will be grand and the longer you wait, the greater the fall. Listen to the doctors, ABMS. The medical world is now listening. Perhaps, you should lay down your pride and open your ears as well.

© 2016, Linda Girgis MD. All rights reserved.

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3 thoughts on “The Death of Maintenance of Certification is Coming

  1. Well done! ABIM is scrambling after having stiff-armed us for years. Why did they do it? Because they could. They forfeited many opportunities to do the right thing. Now, hopefully, they will enjoy the fate of external reform.

  2. Linda,

    We are going to beat these a**holes! Thanks for all your effort. I’m working it here in Virginia and bending the ears of all the doctors I work with constantly!

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