Practice Economics

ABIM: Majority meeting Maintenance of Certification requirements

View on the News

Dr. Eleanor Summerhill, FCCP, comments:

The new MOC requirements that became effective on Jan. 1, 2014, have met with significant criticism from practicing physicians. Nevertheless, the majority of physicians with time-limited board certifications have enrolled in the program, as hospital privileges and insurance reimbursements are often linked to active certification.

Whereas it is largely agreed that some measure of ongoing knowledge and competence is vital to setting standards for the profession and protecting the interests of patients, many physicians raise significant concerns regarding the current process. These include overly burdensome costs and time commitments as well as relevance to actual practice.

Finally, there is a paucity of data demonstrating that the MOC recertification process actually translates to improved physician performance in the clinical setting. A number of recommendations have been suggested to improve the recertification process. These include decreasing the costs of recertification by the ABIM; customizing the process to dovetail with an individual physician's actual practice; testing not only rote knowledge, but also physician ability to accesses and utilize information; and further research to demonstrate efficacy in achieving and demonstrating physician competence.


 

The American Board of Internal Medicine says that "a substantial majority" of the nation’s internists have met the new Maintenance of Certification requirements as of May 1, the deadline for doctors to be listed publicly on the ABIM’s website as having met those standards.

The ABIM reported that "despite vocal concerns" from physicians, some 150,000 have enrolled in the MOC program, 50,000 since the new requirements were instituted on Jan. 1.

Dr. Richard Baron

As part of the new MOC, every 2 years, physicians who are certified by the ABIM must earn at least some points by completing some of the educational activities approved for MOC credit. At the 5-year mark, they must earn 100 points, as well as complete patient safety and patient survey activities, to be considered up to date. Previously, physicians were given 10 years to earn 100 points. They must also pass their board exam every 10 years.

"We are listening to the feedback we have received from the community about changes to our program, but at the same time the public is seeking a way to know that their doctor is ‘keeping up in their field,’" Dr. Richard Baron, ABIM president and chief executive officer, said in a statement.

A petition to overturn most of the MOC changes begun by Dr. Paul Teirstein, chief of cardiology and director of interventional cardiology for Scripps Clinic in La Jolla, Calif., has collected more than 14,000 signatures since it was posted in late March.

According to the ABIM, since Jan. 1, physicians have claimed more than 245,000 hours of Continuing Medical Education (CME) through their MOC involvement, and nearly 20,000 physicians have already met their MOC requirements through 2015.

"MOC has clearly sparked a national conversation focused on what regular assessments are appropriate for ongoing specialty certification," Dr. Baron said. "We must look at how the MOC process meets the needs of physicians, patients, and others who rely on it as an indicator of a provider’s expertise."

The ABIM continues to say that MOC is needed because it is desired by patients and payers. "Those who choose to meet ABIM’s MOC requirements are differentiating themselves from some of their colleagues. They are saying, ‘I’m a cardiologist or oncologist, or whatever specialty they are certified in, who is meeting a standard set by my peers.’ That is a powerful statement to make to their patients, and to themselves," Dr. Clarence H. Braddock III, chair-elect of the ABIM Board of Directors, said in the ABIM statement.

The Board also said it is responding to criticism by making changes to the MOC program, including giving "credit" for activities physicians already are doing to maintain their knowledge base and improve their practices. It said it recognizes more than 270 programs created by medical societies, health systems, and others and that 32,000 ABIM diplomates already have fulfilled some requirements of MOC using those pathways.

"We recognize that the MOC program is not perfect, and we are committed to constant assessment of it," said Dr. Baron.

That may not be enough for some physicians.

Another group, Change Board Recertification, was started in 2010 with the aim of completely overhauling the MOC process.

aault@frontlinemedcom.com

On Twitter @aliciaault

Recommended Reading

New ICD-10 deadline: Oct. 1, 2015
MDedge Emergency Medicine
Black children more likely to visit ED with injuries
MDedge Emergency Medicine
Backlash grows against MOC process
MDedge Emergency Medicine
States aim to repeal, raise malpractice caps
MDedge Emergency Medicine
Analysis finds the ED a profit center; ACA may drive higher profits
MDedge Emergency Medicine
Insurers address ACA 90-day grace period issue
MDedge Emergency Medicine
Federal legislation would provide doctors litigation safe harbor
MDedge Emergency Medicine
25% of lawsuits against internists end in payment
MDedge Emergency Medicine
Physician offices provided $10.5 billion in uncompensated care in 2013
MDedge Emergency Medicine
Doctors’ first steps after lawsuit filing are vital, warn attorneys
MDedge Emergency Medicine