Who Needs MOC if They Have CME?
Dr. Nora describes her own recertification experience. "I'm a neurologist. I finished my fellowship in 1987, so I was a 'grandparent' and didn't need to recertify." She decided to recertify because she realized she "needed ongoing learning and self-assessment to stay abreast of the astronomical changes in medicine."
But opponents of MOC insist that physicians don't need MOC to ensure lifelong learning.
"Sincere physicians are dedicated to keeping up with new developments in their field, even without these complicated requirements," says Paul Kempen, MD, PhD, an anesthesiologist based in Weirton, West Virginia, and Steubenville, Ohio.
Dr. Kempen, who received his medical degree at Albert-Ludwigs University of Freiburg, Germany, notes that in Europe, "there is no comparable formal structure to MOC, although continuing education is emphasized and there's a high standard of excellence in medicine."
How are physicians expected to remain current without formalized MOC?
CME is designed to accomplish just that, says Kenneth Christman, MD, a Dayton, Ohio-based plastic surgeon. "We all recognize that we don't know everything, and CME is a structured way to further our knowledge. MOC is redundant, expensive, and intrusive."
Adds Dr. Christman, "I'm a board-certified plastic surgeon, and I'm proud of it. But there are equally fine doctors who aren't board-certified. In fact, when I myself needed surgery, I went to a highly qualified surgeon who wasn't board-certified because I thought he was the most competent surgeon I could choose for my condition."
Dr. Nora thinks the current CME requirements aren't enough. "MOC isn't only about the acquisition of information," she explains. "It's a four-part framework focusing on professionalism, practice improvement, and self-assessment. MOC is CME, only it incorporates other things as well." Additionally, she notes, many CME activities can be counted toward MOC points, and vice versa.
Useful Activity or 'Annoying Busywork'?
Some doctors detest the MOC; others feel much more positive about it.
Dr. Weiss regards MOC modules as "annoying, time-consuming busywork inflicted on doctors who already are drowning in paperwork." Like the exam, these modules "harm patients by robbing them of my time and attention."
But other physicians are enthusiastic.
"The purpose of these requirements isn't to meet some meaningless bureaucratic standard but to improve patient care," says Marie Brown, MD, an Oak Park, Illinois-based internist and geriatrician.
The key, according to Dr. Brown, is choosing a relevant practice parameter, such as smoking cessation counseling or foot care for diabetics, and taking a close look at your practice patterns.
Dr. Brown chose to assess her patients' immunization rates and was surprised to discover that she was falling behind in immunizing patients against tetanus every 10 years. She distributed an anonymous questionnaire to the staff in her office (another internist, two LPNs, and two clerical staff), asking what could be done.
"We brainstormed and the receptionist came up with a solution. Now, instead of my asking about immunizations at the end of a visit as a kind of afterthought, the receptionist gives the patients information to read in the waiting room. And I have standing orders for all vaccinations. This has increased the vaccine rate by 20% to 30%."
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Cite this: Do Recertification Demands Waste Doctors' Time and Money? - Medscape - Jun 04, 2014.
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