Maintenance of Licensure (MOL) in Iowa; A Quick Update

I just recently got my copy of Iowa Medicine, Journal of the Iowa Medical Society, and there was a brief story about Maintenance of Licensure (MOL) in Iowa. I’ve ranted about Maintenance of Certification (MOC) quite a bit and the most recent post was on February 3, 2012 at link Maintenance of Licensure (MOL) in Iowa on the Horizon? « The Practical Psychosomaticist: James Amos, M.D.

The story was written by Jeanine Freeman, JD, who is the Deputy Executive Vice President of Legal Affairs and Policy Development for the Iowa Medical Society. She writes that the Federation of State Medical Boards (FSMB) and state medical boards, the AMA, and organized medicine have been talking about MOL for many years. The Iowa Medical Society (IMS) leadership acknowledges the importance of assuring continuous improvement in physician competency and “discourages additional, burdensome regulatory requirements.”

As I noted in February after my discussion with the Iowa Board of Medicine Director of Licensure, Amy Van Maanen, there’s no immediate plan to establish a MOL here in Iowa although Iowa will participate as one of the FMSB’s 10 state-based pilots ( this was to have been 12) to help state medical boards gain a better understanding of what it might take to successfully integrate a working MOL into existing requirements for licensure renewal. The pilots will probably start in mid-2012, which as of this writing could be as soon as June or July of this year.

The FMSB’s definition of a MOL is similar to that of the MOC. It would be a process that, as a condition of medical licence renewal, would require Iowa physicians to submit documentation similar to that of the MOC to show that they are actively participating in performance improvement programs targeting the core competencies:

  • Medical knowledge
  • Patient care
  • Interpersonal and communication skills
  • Practice-based learning and improvement
  • Professionalism
  • Systems-based practice

And Jeanine Freeman makes some very practical points about what focus continuous learning programs ought to have to foster meaningful continuous improvement for physicians:

  1. What improvements do I need to make (reflective self-assessment);
  2. What do I need to know and be able to do (assessment of knowledge and skills); and
  3. How am I doing (performance in practice)?

I hope the IBM leadership will consider staying in close touch with the other pilot states to compare notes. And I applaud the both/and approach IBM has taken to support the principle of continuous improvement for physicians that will help ensure patient safety and excellent quality of care while at the same time avoiding any nuisance, busy work documentation–which is what I’ve been concerned about and have documented my opinion regarding:

Maintenance of Certification « The Practical Psychosomaticist: James Amos, M.D.

1. Jeanine Freeman, J. (2012). “The Jury is Out on What Maintenance of Licensure Will Look Like in Iowa.” Iowa Medicine 102(2): 10.

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