The American Board of Pediatrics’ ever-increasing Maintenance of Certification demands have become so time consuming, expensive and convoluted that I’ve often wondered…well, what if I just don’t do it? Doctors are talking about “mass non-compliance with MOC”…maybe that’s the way to go? What happens if I just DON’T do my MOC? I mean, it’s an unaccountable outside corporation that can’t override my state board of medicine…
Well, today I learned the truth as one of my colleagues was late to complete a “Part 4 activity”. In this case, the Part 4 activity was an incredibly demeaning hand washing lesson, requiring the doctor to ask 90 patients to fill out a form “rating” his hand washing over the course of 2 weeks. He queried the ABP MOC website on what would happen if he was unable to complete a MOC portion on time, and the website stated:
“If you do not fulfill your Parts 2 & 4 requirements and re-enroll in MOC by the due date listed in your ABP Portfolio, then you will no longer be listed as meeting MOC requirements in that area.”
That doesn’t sound so bad. It almost sounds reasonable.
What it didn’t say, was:
“If you do not fulfill even a portion of your Parts 2 or 4 requirements and pay us $1200 by the due date….we will DESTROY you.”
It should, because that’s what happening. Today he was notified that he has been dropped from a major insurer, which means he is banned from seeing his patients with this insurance, with other insurers to follow. His hospital privileges are in jeopardy. In short, the ABP is destroying his medical practice. All because he didn’t do the American Board of Pediatrics “handwashing lesson” on time.
There is something terribly wrong, when an unaccountable corporation with a CEO that earns $1.3 million a year can completely supersede the state board of medicine and ruin a private physician’s practice while denying children access to their primary care physician.
Compulsory MOC must end. This is the “hostile takeover of medicine”, as colleague Dr. Paul Kempen says. There is no data to support their claim that it produces more competent doctors, indeed the data shows that doctors who pass MOC have poorer patient outcomes than those who do not pass MOC. It is a waste of time and money, monopolizes the continuing education opportunities, and exacerbates access to medical care as physicians either retire early or are dropped by insurance companies for not complying with MOC.
The noose is tightening around physicians. Dr. Westby Fisher’s recent piece on the boards’ unethical conflicts of interest is dizzying. While physicians work daily caring for patients, the ABMS crony capitalists are in DC procuring more favors and monopolies to further enslave physicians, their expenses covered by the money they forcibly take from doctors. It’s maddening.
Clearly, “mass noncompliance” is not the answer, as stepping even a hair out of line will result in utter destruction of your medical practice. On the national level, the federal antitrust lawsuit by AAPS against the ABMS is moving ahead, contributing to their legal fund is an excellent way to support this effort. On the local level, state legislation must be pursued to prevent this clear usurpation of our state medical boards. ALEC just approved model legislation for this purpose. Our state medical societies, as much as it pains me to say it, can be our allies in this fight. Membership in state medical societies is waning (with reason, because they’ve pretty much failed at protecting us from…everything), but fighting MOC is their moment in the sun.
This is an issue that unites the most liberal and conservative, urban and rural, independent and employed physicians. Get involved in your state medical society and get a resolution passed to prevent MOC from being linked to hospital privileges, insurance participation and licensure. Then get that resolution pushed into state legislation.
My colleague’s story is not unique, I’ve since spoken with many physicians locally and nationally, and all report similar horror stories. This is a battle we can fight and win, it just takes a few physicians willing to stare down the barrel of the ABMS gun.
Meg Edison MD is a pediatrician in private practice. You can follow Dr. Edison on Twitter @megedison
MOC is a money making racket, nothing else…like URAC, JACHO and BB, they just want your money and then pretend to care by auditing, making everyone who signs up “in order to get their accreditation”, take tests, change little stupid things, fill out paperwork, generally disrupt a perfectly good,lucrative and safe person or organization’s way of operation to their ways. They run around nitpicketing and pretending to be oh so important and actually they are legally scamming.
I believe we are approaching a critical mass here on opposition to MOC.Those in Ohio are spearheading efforts to protest.Protest is legal , and fundamental to our country’s principles.See our discussion thread in OSMA forum.More is in the works.Also,donate to AAPS,who has launched a legal action,
I agree Larry, it’s no longer a few specialities fighting MOC, it’s affecting us all now.
I think mass-noncompliance is the answer-nothing important is ever achieved without sacrifice, and it is unlikely that thousands of doctors would be thrown out of hospitals and insurance panels at once. (While I do think that, long-term, replacement of physicians with mid-levels is the goal of private insurers and the government-they simply cannot achieve this en masse in a short period of time.)
where are those hungry lawyers when you need them? There has to be enough evidence now for a class action lawsuit to stop this extortion!
Well stated, Meg. A hand washing module is appropriate for first graders…..
Whereas I agree that there is entirely too much over reach of control and hoops to jump through, especially where governmental regulations are concerned, I can certainly think of more than one physician I have known whose hand washing skills were less than stellar and they made the student nurses and nurses cringe at a time when you dared not speak up. Thank God times have changed
This is absolutely sickening.
Doctors stand up fight and unite. We are intelligent beings and we can win! Resist the urge to recert!!
I think we should just call it “ROC,” or “Rental of Certification.” They can cut the intervals down to real-time; you didn’t do your CME this week, you can be put on the list of “Possibly Deficient Physician.” Or if you have doubleplusungood thoughts about the Hive Mind, the Borg Certification process. Are you Borg Certified, doctor?
Take BCBS Michigan to court in addition to ABMS. Sickening abuse of the doctor’s constitutional rights to practice medicine. The Interstate Medical Licensure Compact, under the guise of “licensure portability” will enforce the same corrupt practices w loss of physician (and patient) due process for access to health care. Michigan doctors are in peril, grave danger.
Yes- we allowed a monster to be created, and unless many, many act together, (which Pediatricians in particular are loathe to do if not specifically to help kids), we will get picked off and the stranglehold will remain.