There is much controversy surrounding MOC (Maintenance of Certification) requirements. The American Board of Internal Medicine (ABIM) along with the American Board of Medical Specialties (ABMS) continue their stance imposing these duties upon doctors. Yet, 97% of physicians surveyed on Sermo (the largest online doctors-only community with over 300,000 members) oppose MOC as it currently stands.

While life-long learning is very important in our profession, most of us feel MOC is not the way to achieve it. For one thing, we are already required to earn a certain number of CME hours in order to maintain our state medical licenses. So, there is a redundancy of work here. MOC is time-consuming, and many of us feel that the guidelines set in place have no relevancy to medicine in the real world. For learning to be effective, it needs to match the knowledge that is necessary in treating our patients in the exam room. Esoteric medical facts rarely come into play in clinical practice. Yet, that is much of what we are being tested on in our recertification exams. In fact, this past year I took my recertification exam and was expected to answer questions using outdated PAP test guidelines.

“…we are not going away. We are seeking fairness and to abolish corruption in this process forced upon us.”

 

It is not just the time and lack of real world medical knowledge that we oppose but the cost. Doctors are forced to pay 10’s of thousands of dollars out-of-pocket for something we do not believe provides us any value. And we have no choice but to comply because our hospital privileges are most often tied to being certified. The cost for this process is exuberant. Where does this money go? If you look into the financials of the ABIM and its leaders, they are making a huge profit off the whole MOC process. Surely, ensuring public safety and life learning of doctors should not be a money-making business. We have no choice and have to pay whatever we are told in order to keep practicing medicine. This is just wrong, and corruption has leaked into the system.

Last week, JAMA sponsored a Webcast surrounding the “controversy” of MOC. The speakers included Richard J. Baron, MD, FACP, the President of the ABIM and other physicians with academic ties. No physician purely practicing clinical medicine was on the panel. This was clearly a promotional event on behalf of the ABIM. Participants were allowed to submit questions online. Those presenting our opposing views were largely ignored in favor of questions supporting MOC. There were simultaneous twitter chats occurring at #JAMAMOC and #MOCDebate. Doctors were live tweeting our concerns and opposition. We were accused by the speakers of “dumbing down medicine” by not supporting MOC and told that we should understand that MOC was no different than learning in medical school. Rather than addressing our questions or concerns, we were called “the complainers.” Apparently, doctors who do not fall in line and comply silently are complaining.

The ABIM rejected hearing any opposing comments or questions. They cast us in a negative light for trying to present our different opinions. Yet, 97% of us do not agree. The majority of doctors cannot be silenced forever. You can shut us out of your webcast, but we are not going away. We are seeking fairness and to abolish corruption in this process forced upon us. Life-learning is good; inefficient, evidence-lacking corrupt means of achieving it is not. When do you think the ABIM will hear us? Is the MOC process here to stay?

 

Dr. Linda Girgis MD, FAAFP, is a family physician in South River, New Jersey. She holds board certification from the American Board of Family Medicine and is affiliated with St. Peter’s University Hospital and Raritan Bay Hospital. Dr. Girgis earned her medical degree from St. George’s University School of Medicine. She completed her internship and residency at Sacred Heart Hospital, through Temple University and she was recognized as intern of the year. Over the course of her practice, Dr. Girgis has continued to earn awards and recognition from her peers and a variety of industry bodies, including: Patients’ Choice Award, 2011-2012, Compassionate Doctor Recognition, 2011-2012. Dr. Girgis’ primary goal as a physician remains ensuring that each of her patients receives the highest available standard of medical care.

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