Doctors have opportunity to be heard on MOC; commission report critical of process

Young female doctor sitting at desk in front of computer covering face with hand in frustration
Doctors unhappy with MOC requirements can make their opinions known to an independent commission. (Getty Images/PRImageFactory)

Most doctors have doubts about the value of maintenance of certification (MOC) programs, and they now have the chance to be heard.

Comments are due today on a 96-page draft report (PDF) from an independent commission put together by the American Board of Medical Specialties (ABMS) to take a look at the controversial MOC process.

The commission has requested public comment on the draft report, which suggests that the term maintenance of certification be dropped and the system overhauled, by 11 p.m. Central Time.


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Based on the report, many physicians have complaints about MOC. An online survey conducted for the commission that included more than 34,000 physicians found that just one in 10 (12%) said they found value in MOC. Nearly half (46%) said they have “mixed feelings” about the program, and 41% said they do not value the program.

“In summary, approximately half of respondents see MOC as too costly, burdensome and not a true reflection of their abilities as clinicians,” the report said.

Asked how they would like to see MOC changed, some physicians want continuing certification to focus on practice-relevant continuing medical education (84%) or self-assessment questions delivered at regular intervals (52%). Less popular choices were open-book exams and quality and safety of care assessments.

RELATED: Survey—Vast majority of doctors say MOC is a burden

The 27-member Continuing Board Certification: Vision for the Future Commission included its findings that describe many of the MOC problems that physicians have complained about and a series of recommendations. They called on ABMS and its specialty boards to develop new approaches and create common standards for physician recertification.

Frustrated with the MOC process, many doctors agree. Almost 19,500 physicians signed an online, petition-like response to the draft report created by the National Board of Physicians and Surgeons, which has created an alternative certification process. The response requests an immediate moratorium on what it calls onerous MOC components, including an end to requiring secure, “high-stakes” examinations that doctors must take every 10 years to maintain certification and quality initiative/practice improvement requirements. The petition calls for retention of the CME and professionalism components of MOC, such as licensure, and a reduction in fees charged for MOC to less than $100 a year no matter how many certifications a physician maintains.

RELATED: Industry Voices—There's a reason for MOC. But it's time to modernize

The commission will review the comments it receives and will meet one last time to make revisions to the draft before submitting its final report to the ABMS Board of Directors in February, according to the American Board of Family Medicine.

The battle over MOC has also landed in the courts. In December, four doctors filed a class-action antitrust suit (PDF) against the American Board of Internal Medicine alleging it is illegally tying its initial certification to MOC exams and has a monopoly on the market for MOC.

In a survey released last fall by MDLinx, 65% of physicians said MOC adds no clinical value to the practice of medicine, and almost 55% said they want to see those controversial MOC requirements revoked.

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