On February 25, 2015 the American Board of Pediatrics published their “long-awaited” response to the growing physician outcry against the “Maintenance of Certification” scheme. I started writing a full response to their blog article, but I can’t even get past the graphic posted at the top of the page. Read their graphic carefully.
Bottom Line: The ABP believes that accountability to the public, continuous improvement of our operations, and transparency are important core values for the board.
Yeah, I know. Not a single mention of actual pediatricians, their diplomates, who are working daily in the care of children.
There are currently over 200 moderated comments allowed on the blog, I’ve read every one. 100% are negative, not a single comment in support of MOC. But it doesn’t matter what pediatricians think, because board president David Nichols started out with their Bottom Line: They don’t care about pediatricians.
They are accountable, not to pediatricians, but to the “public”. I honestly have no idea who the public is, because patients are not demanding board certification, let alone MOC. I’ve never, ever, had a family ask if I was board certified. My guess is that “the public” is pure imagination.
They are not focused on continuous improvement of MOC for pediatricians, they are focused on continuous improvement of their operations for themselves. MOC is an incredible revenue source. All the physician opposition to MOC revolves around three main concerns: Useless Part 4 “Performance in Practice” modules, never-ending and irrelevant secure examinations, and exorbitant costs. But because their focus is on their operations, ie. revenue, there’s no way they can respond and improve MOC for pediatricians when their revenue depends upon those issues opposed by their diplomates.
They claim transparency, but refuse to be transparent. They post silly grade school graphics of their budget and projected revenue, but refuse to release real numbers. They post data that makes it look like they’re $1/2 million in the red, poor guys, just barely making ends meet on $28 million dollars in revenue! Maybe posting data on board member salaries would help explain the $1/2 million shortfall. Previous ABP president James Stockman took home a cool $1.3 million annual salary, but David Nichols refuses to post his and other board member’s salaries. That’s the real transparency we want. But then again, they’re not accountable to us, remember?
But there is a way out of this mess, and I thank David Nichols for advertising it to my fellow pediatricians:
In the midst of debate around MOC, a different model has emerged. The National Board of Physicians and Surgeons (NBPAS) now offers a certificate for individuals with a valid license, a history of initial board certification, and evidence of at least 50 hours of CME credit. The reliance on CME for maintaining certification mirrors the requirements for renewal of licensure.
The National Board of Physician and Surgeons (NBPAS) is a new certification board open to pediatricians, recently created by practicing physicians in direct response to the failure of our boards to listen and adapt to diplomate concerns about MOC. The pediatric board member of NBPAS is none other than David John Driscoll, M.D., Professor of Pediatrics, Mayo Clinic College of Medicine. Take a look down the list of board members, it’s a veritable who’s who of medicine. No wonder the ABP is worried.
NBPAS certification standards are straightforward, egalitarian, inexpensive, and physician-focused: Pass a board examination once, hold an active unrestricted state medical license, demonstrate commitment to ongoing education through 50 hours of CME every 2 years. Seeing how the ABP has made it abundantly clear in their “Bottom Line” that they do not care about practicing pediatricians, it’s time we stop supporting a corporation that doesn’t support us and pursue certification through a physician-minded organization that does.
The ever-changing ABP rules say my certification expires December 2015, at which point I’ll breathe easy knowing my certification will no longer be at the whim of a board that doesn’t care about me. Instead, I’ll be a proud diplomate of the National Board of Physicians and Surgeons only.
Meg Edison MD is a pediatrician in private practice. You can follow Dr. Edison on Twitter @megedison