Posted on July 9, 2014 by Meg Edison MD
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
