What Doctors Think Is Worth Fighting For

Shelly Reese


February 24, 2016

In This Article

Fed Up and Ready to Do Something

Some physicians, such as Paul Teirstein, MD, chief of cardiology at the Scripps Clinic in La Jolla, California, are goaded into activism when an annoyance becomes an intractable problem.

Dr Paul Teirstein

In early 2014, Dr Teirstein launched a crusade to overhaul the maintenance of certification (MOC) process after trying to apply for recertification on the American Board of Internal Medicine's website. Frustrated by the cumbersome process, and by MOC modules he felt were of little value, Dr Teirstein asked other physicians about their experiences with the recertification process. The response was overwhelming and vituperative. Dr Teirstein had stumbled on a hot-button issue.

"I didn't go into this because I'm an activist," he says. "I went into it because I needed to fulfill a responsibility."

Recognizing that complaining wouldn't fix the problem, Dr Teirstein created a petition, which roughly 22,000 physicians signed, and a noncompliance pledge. When those measures failed to achieve the desired reforms, Dr Teirstein and like-minded physicians created the National Board of Physicians and Surgeons (NBPAS) to provide physicians with an alternative route to recertification that enables them to use continuing medical education credits from accredited programs, rather than MOC modules, as evidence of lifelong learning.

Dr Teirstein says MOC reform now commands about 20% of his time. That's a lot, he admits, but the progress has been rewarding. "You can't just complain," he says. "Physicians are really good about complaining: We complain, see our patients, and then complain in the lunchroom again. I think the surprising thing for a lot of physicians is, if you spend a little time on these issues, we can make progress. It's been a real eye-opener."


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as: