Maintenance of Certification… Is it DOA?

Maintenance of Certification. Is it DOA?Do you remember the Wendy’s commercial, when they cleverly parodied how most fast food restaurants where providing all bread and no meat? This is the same feeling doctors possess about Maintenance of Certification.

According to the American Board of Internal Medicine (ABIM), the purpose of Maintenance of Certification (MOC), is to “promote lifelong learning and the enhancement of the clinical judgement and skills essential for high quality patient care.” In theory that‘s admirable, but where’s the beef? Ain’t no beef.

Physicians all over the country, have been highly critical of these exams / certification, arguing they serve no patient interest. Dr. Juliette Madrigal-Dersch

[1] said as much during her eye-opening keynote address at an AAPS (American Association of Physicians & Surgeons) event. She questioned the benefit of doctors taking time away from their practice to acquire this particular certification, when the test questions are antiquated, and the process to taking the exam is so onerous and burdensome.

TweetFor any doctor looking to take the MOC test, one must first accumulate 100-points, and go through a tedious patient survey process, which includes useless “quality of care questions”. By useless, I mean “quality of care” questions that have nothing to do with true quality of care.. So who really benefits? The lines are blurry… Some entities claim the public demands MOC, but where’s the data? Where’s the beef?

We often hear rhetoric about improving the patient experience, but when are healthcare industry influencers and decision-makers actually going to make it easier to do so?

Healthcare institutions need to do a gut check and better determine where’s the bun and where’s the beef. In other words, what directly impacts the quality of care – the metric that matters the most.

By | 2016-12-09T13:10:02+00:00 September 4th, 2014|News, Trends|3 Comments

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  1. Jay Nichols September 5, 2014 at 6:18 pm - Reply

    These tests serve only one purpose. To pad the coffers of the organizations who administer the tests and those organizations who provide seminars to learn the test.
    Physicians who have spent thousands at review courses and to take the tests, only to fail (the passing rate for ABIM internal medicine certification is less than 30%?). Most doctors have given up. They would rather spend the time on something that is going to benefit the patient. There appears to be a revolt in progress.

  2. Eric M. Joseph, M.D. September 6, 2014 at 12:16 pm - Reply

    Took and passed MOC in FPS 6/2013, which keeps my certification valid with the ABFPRS till I’m 58. In FPS, we have to take two oral exams and a written exam which is administrated in DC on a yearly basis. Cost for examination plus hotel and expenses exceeded $3,000. Time away from the office and the OR results in further loss of revenue. Stress level during preparation is immeasurable, and this led to a miserable 6 months for me and my family. Has it changed the way we practice medicine: No

    MOC = Unnecessary expense and aggravation with no proven benefit for the public.

    Here’s the summary written by the ABFPRS at the end of the application for MOC:

    To summarize, the oral examination is a stressful event. The
    presentation of 12 patient problems and the related lines of
    questioning are difficult for examinees at any level of
    competence. To maximize performance, sound training,
    relevant experience, and broad scholarship will help overcome
    handicaps that may negatively affect oral examinees.

    Thanks for those words of reassurance. 🙂

  3. Cecil Durham September 12, 2014 at 5:42 pm - Reply

    Of all the testing the medical,legal political community has foisted upon physicians in the Hope of proving to the lay community that passing tests makes a good Dr this is the most useless.To pass a test ,even boards means that you knew enough on paper for several hours to pass a test and that is about all it means..Some of the most capable physicians have never had time to take the boards and there are awful physicians with boards all over the wall.When does the medical profession step up to the plate and tell the country we will decide who is competent by working with them,lawyers be damed.No doubt this won’t happen since we have let people with no knowledge of medicine tell us what to do.We as a group are pretty cowardly.

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