Our time is precious, and healthcare professionals HATE it when people waste it with meaningless busywork.
Dr. Paul Teirstein, Chief of Cardiology at the Scripps Clinic is on a mission to stop these time thieves. Maintenance of Certification (MOC) for medical boards has little convincing evidence to support that it actually improves outcomes, yet the American Board of Medical Specialties (ABMS) and related orgs held a monopoly on forcing physicians to spend money and precious time annually to “maintain” a certification that they already attained through hard work and long study.
Why? Money. Executives in these organizations make high salaries and the testing and MOC process generates millions every year. Watch our interview to learn why this needs to stop.
Dr. Teirstein founded the National Board of Physicians and Surgeons (NBPAS) to counter this “Maintenance Industrial Complex” monopoly. It’s a vastly superior approach that’s gaining grassroots steam, but only if enough docs and healthcare people support it and lobby to have insurance companies and hospitals recognize it. I certainly will be.
Go to the NBPAS now, apply for certification or sign up for their email list…there is strength in numbers! It’s time we let doctors be doctors.
Here’s a summary of the key concepts in the video (Thanks to Dr. Giri Venkatraman for his contributions to our video summaries: He’s an ENT Surgeon who broke the golden handcuffs and escape the Measurement Industrial Complex)
“Maintenance of Certification (MOC) is a recently implemented and controversial process of physician certification maintenance through one of the 24 approved medical specialty boards of the American Board of Medical Specialties (ABMS) and the 18 approved medical specialty boards of the American Osteopathic Association” – that’s the “official” web definition of The Notorious MOC.
Why the controversy? Other professional organizations for attorneys, pilots or even other providers in healthcare such as optometrists or nurses require similar processes. However, good intentions poorly executed = disaster — which is the issue with the current ABMS-sponsored MOC. The MOC program has not been accepted by a majority of physicians and this has spawned a large grassroots movement against it’s continuation in the current form. Why?
Problems with the current Maintenance Of Certification process:
- Evidence that physicians who pass the MOCs provide higher quality or more “updated” care is limited and of poor quality. Most of the studies showing this have significant biases (including being funded by and performed by the board entities themselves)
- The concept of “grandfathering”. Older physicians or those who passed their initial speciality boards before the 1990s do not have to pass or take an MOC exam. It is these very physicians, farther out from their training, that theoretically most need watching in terms of practice and knowledge. Notably there were a lot fewer women and minority physicians prior to the 1990’s, so in effect this constitutes older white men regulating their younger, more diverse colleagues while being exempt themselves.
- The exams do not reflect clinical practice or reality. For example, an orthopedic surgeon who focuses on sports medicine would have to study up on pediatric orthopedics. Normally such a patient would be referred to the appropriate sub-specialist.
- The entire process is very time consuming, requiring physicians to travel to a testing site or complete time-consuming modules. Time is the one commodity physicians have in extremely short supply. They don’t mind working hard, but the work has to be meaningful.
- Private insurance payers and specialty societies mandate passing of MOC exams for continued “board certification.” Seven states, in response to physician complaints, have passed laws over-ruling this requirement.
- The fees charged for MOC amount to millions yearly in revenue for the speciality board organizations. Executives in these “not-for-profit” organizations make high 6-figure salaries, creating the appearance of financial motivation to the MOC process.
In response to these issues a new not-for-profit organization called the National Board of Physicians and Surgeons was founded by our guest. The alternative certification created by NBPAS takes much less time and is less costly. It focuses on CME requirements to maintain knowledge and proficiency, as well as maintaining a medical license in good standing and avoiding revocation of hospital privileges. If a plurality of physicians supported this organization and lobbied through it at a state level, we could overthrow the MOC Industrial Complex once and for all and let doctors be doctors.
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