MedCity Influencers

Are Medical Specialty Boards Extorting Its Physicians?

Over the last few months, we have seen a great increase in the number of doctors writing articles and blog posts speaking up against the current MOC (maintenance of certification) that is now in place. In fact, according to a recent poll of physicians on Sermo (a physicians only community of 270,000), only 4% agreed […]

Over the last few months, we have seen a great increase in the number of doctors writing articles and blog posts speaking up against the current MOC (maintenance of certification) that is now in place. In fact, according to a recent poll of physicians on Sermo (a physicians only community of 270,000), only 4% agreed that the MOC should stand as it currently is. While the medical boards have stated that complying with the MOC requirements is voluntary, this simply is not true. It is now necessary to complete the MOC requirements to be board-certified in your specialty. Most hospitals across the USA require doctors to be board-certified to maintain their staff privileges at the hospital, without which the doctor cannot treat patients inside the hospital. Additionally, in order to be on insurance panels, a physician must be board-certified and/or have hospital privileges.;In order to treat patients and earn a living, there is simply no way out of having board-certification, unless you have a cash only outpatient practice.

Why do doctors not want to comply with MOC requirements?

1. The majority of doctors believe it is not relevant to the every day practice of medicine. We feel we are forced to learn facts that are not used in clinical practice but are merely academic points. Therefore, the MOC is not really testing a physician’s competency as it claims. Rather, it is requiring physicians to memorize irrelevant medical minutia.

2. It is costly. In order to maintain compliance with MOC, you have to pay the board. Some doctors have estimated over the course of a career, this could total more than $20,000 just to the board. Then, there are the thousands of dollars for the study materials and the courses to attend to prepare for these requirements.

3. It is time consuming. The board claims it takes  less than 20 hours per year to remain compliant. This simply is not true. Since it requires doctors to go back and memorize trivial facts that they do not need to practice quality medicine, they need to study and this requires time. And as the country’s physician shortage grows, should doctors be taking time away from patients to study those things which they do not find beneficial?

4. There are no studies proving that the MOC improves patient care or clinical outcomes. As doctors, we are increasingly called to practice evidence based medicine. Shouldn’t the boards be held to the same standards?

5.  Many doctors feel that the requirements are being developed by academic doctors and not those actively practicing medicine. Shouldn’t the requirements to determine whether doctors are competent to practice medicine be devised by doctors who are actually practicing clinical medicine?

6. The boards claim that patients want these requirements and trust the board certification. No, my patients want me to listen to their concerns and spend more time with them. They don’t want me to be out of the office trying to prepare for the MOC when they are sick. Many of my patients do not know what board certification is. Many do. But, the doctor-patient relationship is one based on trust that is built over time in a relationship. It is not forged by a certificate hanging on the exam room wall.

7. The leaders of the specialty medical boards are making exuberant salaries, 3-4 times what a physician in clinical practice is making. Clearly, they have a financial conflict of interest in keeping the MOC going.  Many doctors wonder how much of our MOC dollars are going into their pockets. Perhaps it is time for them to disclose their financial conflict of interest and make it transparent how much they are earning from this endeavor.

 

Some doctors are going so far as to say the medical boards are extorting its doctors. We have no choice but to comply if we want to remain in practice. We have no say in setting the standards. No one listens to our opinions of how the MOC process can be made more relevant. And surely, such a process as this, that physicians are essentially forced into against our will, should not be making other people rich.  Is this extortion or no? Clearly, the board needs to make some changes because the doctors’ revolt is coming.

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