Paper in the Journal of the American Board of Family Medicine makes for hilarious blog fodder

I'll have to agree with the blogger at Rebel MD, that the premise of this study, that MOC is a valid indicator for medical knowledge is, to say the least, flawed. I don't think the results turned out the way they hoped, so I'll give them their due for publishing it in spite of that. From the paper:

OBJECTIVE:

Health disparities exist between rural and urban areas. Rural physicians may lack sufficient medical knowledge, which may lead to poor quality of care...

METHODS:

We studied 8361 FPs who took the American Board of Family Medicine maintenance of certification (MOC) examination in 2009. Data sources were examination results and data from a demographic survey of practice structure and activities, completed as part of the examination application process. FPs' location of practice was categorized as either rural or metropolitan using a moderate and conservative definition based on reported community size. Univariate statistics assessed differences in FP characteristics between rural and metropolitan areas. Logistic regression analyses determined the adjusted relationship between rural status and the odds of passing the MOC examination.

RESULTS:

Metropolitan FPs were less likely than their rural counterparts to pass the MOC examination using both the moderate (odds ratio, 0.67; 95% confidence interval, 0.54-0.83) and conservative (odds ratio, 0.56; 95% confidence interval, 0.42-0.74) definitions. Physicians in solo practice were less likely to pass the examination than physicians in group practice.

CONCLUSION:

Rural physicians were more likely to pass the MOC examination, suggesting that rural health disparities do not result from a lack of provider knowledge.