There exists much controversy surrounding the MOC ( maintenance of certification) program that doctors need to comply with in order to keep their board certification. Every specialty has its own regulatory requirements. Over the past year, doctors cried out against this inefficient and costly burden placed on us. Yet, no one heard us.
Doctors are the first to admit that we need to study for the rest of lives. We get it. We spent 12+ years following high school studying and we know how fast medicine changes. Much of what I learned in residency is now obsolete and newer treatments replaced it. Not only do we understand that we need to continue being educated to provide our patients with the best care, we also bear all the liability if we don’t. We are required to practice within a certain standard of care, which keeps changing as medicine innovates itself. Not only do we get it that we need to keep up our learning, we don’t want to be sued either. So, it makes perfect sense that all doctors clearly support life-long learning.
Today, I was truly disheartened to read this article in Forbes by Steve Pociask: http://www.forbes.com/sites/stevepociask/2015/09/21/keeping-up-with-the-latest-medical-science-costs-versus-benefits/. This article attacks doctors calling us lazy and arrogant because we do not wish to accept the mandates of the MOC program. This reporter explains that doctors reject MOC because we do not wish to stay up with the medical trends and innovations and that we do not want to learn new procedures. He states that doctors think they know it all and don’t want to give up free time. I think with what doctors see everyday, we are the first who realize we don’t know it all and wish we knew more. Based on one study he found, he makes a case that we are over-estimating the costs and we don’t know how to do a cost-benefit analysis. He admits he doesn’t know much about the certification process or requirements but then goes on to call us arrogant or lazy and calls on consumers to call out those of us who are not board -certified.
I have been certified since 1998 and recertified twice so I have witnessed the process up close and personal. Much of the information that unknowing people are reporting is just in fact false.
Why do doctors need life-long learning and not MOC?
1. We need to stay current as noted above. CME achieves this as do many educational events that we attend and participate in. MOC does not. On my last family medicine recertification exam, I was expected to answer questions based on out-dated pap smear guidelines. The ABMS does not possess any data to show that MOC is a valuable tool to improve education of physicians or improve patient outcomes.
2. MOC makes us study many topics that are irrelevant to our daily practice. I needed to answer questions about complicated obstetrical cases. I do not do prenatal or obstetric care nor do I plan to. I’d rather invest my efforts learning about diabetes which I treat everyday. CME allows us to chose the topics and learning materials we need.
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
3. Doctors are not lazy and do want to learn. Many studies show that the majority of doctors work 60-80+ hours per week. We work hard but we don’t like to waste our time. When we spend our time on educational activities, we want to really learn and not just participate in a “fake” learning activity to maintain our licences.
4. In the cited article, the author claims that board-certifed doctors earn more than those not certified. This simply is not true. I have not earned one penny more from my certification.
5. He claims doctors do not know how to do a cost-benefit analysis otherwise, we would see the great financial benefit of participating in MOC. Well, many of us are not only doctors but business owners as well. I purchase all my supplies. I do a cost-benefit analysis on everything I purchase, even down to the urinalysis test strips. And he failed to report the complete financial picture in his article. The MOC process does not only include fees, but also study materials and conferences as well. When I go to a conference, I close my practice and do not get paid. And not only do I pay for the conference and not get paid, I need to continue to pay my over-head costs which is thousands of dollars every week. Yes, it is costly to doctors but perhaps not economists.
Do doctors need life-long learning? Yes, absolutely. Patients should demand that we keep current and offer them the most innovated care. Doctors get this and we want to provide this. However, MOC does not achieve this goal but rather hinders it. Do we want doctors to learn what they will use in their practice, or just to go with the mock learning MOC modules that fulfill an agenda and line a few peoples’ pockets?
