MOC on Trial
In 2013, the Association of American Physicians and Surgeons (AAPS) filed an antitrust suit in New Jersey federal court, claiming that MOC is a "moneymaking, self-enrichment scheme" that "restrains trade and causes a reduction in access by patients to their physicians." The lawsuit focused on a New Jersey-based physician who was denied hospital privileges because he had not recertified. According to AAPS, "there is no justification for requiring the purchase of [ABMS's] product as a condition of practicing medicine or being on hospital medical staffs."
"AAPS feels that the medical recertification industry is a monopoly whose net keeps widening," comments Dr. Christman, a past president of AAPS. He mentions that AAPS has received many complaints from physicians who have been forced into retirement because they didn't comply with MOC or they failed the exam. "In light of the physician shortage, this is alarming."
Dr. Nora states that she is not at liberty to discuss the lawsuit but believes the claims are "without merit."
Making MOC Manageable
Opponents of MOC urge physicians to "stand up to the tyranny" of ABMS and the MOC requirements of the specialty boards. "I call it 'civil disobedience' and regard myself as part of an incipient mass-noncompliance movement," says Dr. Weiss, who has decided not to recertify.
But many physicians will sign up for MOC because they think it's valuable or are afraid of the consequences if they refuse.
If you've decided to recertify, here are some tips to make the process more manageable.
• Don't wait until the last minute. Stay abreast of the literature. Some boards (such as the American Board of Obstetrics and Gynecology) regularly recommend specific studies and articles.
• Make use of online tutorials. Check your board's Website for tutorials with practice exams. The ABIM, for example, offers a free tutorial. The American College of Physicians (ACP) offers a paid tutorial, the MKSAP16. ACP recently piloted a project called MKSAP Study Hall, consisting of weekly one-hour Webinars incorporating humor to make the material engaging.
• Attend an in-person review course. The ACP, for example, offers two- to three-day courses prior to the exam.
• Collaborate with colleagues. Cover each other's practices during MOC-related activities. Create a study group to review, exchange tips, and provide mutual encouragement.
• Work with staff support for practice improvement modules. For example, a nurse can review charts to see how many patients were vaccinated.
The decision to recertify isn't one-size-fits-all, so educate yourself about both sides of this complex issue. Whichever path you choose will require courage. MOC isn't for the faint of heart; it requires determination to overcome its stresses and challenges. And avoiding MOC requires the commitment and strength to swim against the current. But courage and dedication are not foreign to physicians. They're prerequisites for the practice of medicine.
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Cite this: Do Recertification Demands Waste Doctors' Time and Money? - Medscape - Jun 04, 2014.