Wednesday, January 28, 2015

NEJM perspective piece on maintenance of certification

This is an interesting read and it is available as free full text.

Some of the features of the article:

Recent changes in the maintenance or certification (MOC) process are briefly reviewed.

A web based petition now has over 19000 anti-MOC signatures.

MOC is not supported by outcome based evidence, though some research has been done.

Claims that MOC has solid support from practicing physicians are debunked.

The relevance of MOC to the realities of clinical care is questioned.

The American Board of Internal Medicine is beset with the perception, if not the reality, of financial conflict of interest.

The MOC process has been criticized formally by numerous professional organizations, one of which has a lawsuit pending against the American Board of Medical Specialties.

The article concludes:

Regardless of how the MOC issue is resolved, the recent focus on the ABIM has shed a bright light on how medicine is regulated in the United States. The ABIM is a private, self-appointed certifying organization. Although it has made important contributions to patient care, it has also grown into a $55-million-per-year business, unfettered by competition, selling proprietary, copyrighted products. I believe we would all benefit if other organizations stepped up to compete with the ABIM, offering alternative certification options.

More broadly, many physicians are waking up to the fact that our profession is increasingly controlled by people not directly involved in patient care who have lost contact with the realities of day-to-day clinical practice. Perhaps it's time for practicing physicians to take back the leadership of medicine.

1 comment:

DrWes said...

Dr. Donnell -

The corruption inside the ABIM goes further than discussed in the NEJM article you cite. I'd encourage your readers to learn more about the ABIM Foundation's purchase of a $2.3 million condominium complete with a chaueffer-driven Mercedes S-class town car in December 2007 on physician testing fees here: