Is Maintenance of Certification as burdensome as critics claim?

When the American Board of Internal Medicine (ABIM) adopted the new maintenance of certification (MOC) requirements in early 2014, many physicians balked vocally. Today, the criticism has yet to subside, with some physicians alleging that the burden of taking the exam every two years instead of 10 costs them not just money but also time with patients, according to an article from the Longview Daily News.

And increasingly, physicians say these sacrifices may not be worthwhile, as the "hoops" they must jump through to recertify diminishes the ritual's perceived value, pediatrician Anne Mette Smeenk, M.D., told the newspaper.

Underlying this prediction is a history of physicians claiming the exam content is not relevant to their everyday practices. What's more, much of the testing material is somewhat outdated due to the lag time required for boards to approve the content, Smeek said.

However, in a recent interview with MedPage Today, Lois Nora, M.D., president and chief executive officer of  the American Board of Medical Specialties (ABIM's parent organization), defended the group against these and other claims.

Essentially, Nora explained that the MOC process is a work in progress, with changes on the horizon that will make exams more modular to specific specialties and also give physicians more credit for quality improvement activities they carry out on their own or through hospitals. "So it's the new standards that are enabling and encouraging the transition," she said.

Nora also addressed accusations that the financial burden of MOC has become too high. For starters, many other forms of continuing medical education physicians undergo counts toward MOC requirements as well, she said. "I think where price sometimes becomes an issue is around the exam. I just took my exam in February. I tried to keep track of this for myself, and I think I probably did one or two more continuing education projects last year than I would have normally. That ups the cost by about $150. I did take an online exam prep course. That was another $1,000. These costs are spread over 10 years, and I'm not sure that is much of a burden."

Finally, Nora claimed that as part of its ongoing quality improvement initiatives, ABMS is working to identify additional burdens created by MOC and reduce them where possible.

To learn more:
- read the article
- here's the interview