Take This MOC Load Off: Updated July 24, 2014

[Original video about MOC by ABIM leader unavailable because it’s now marked “private” and was replaced by Dr. Richard Baron’s video below]:

As most of you know, I’ve  been trying to navigate the complexity of Maintenance of Certification (MOC) and Maintenance of Licensure (MOL) mostly as it relates to psychiatrists and mostly for psychiatrists in Iowa.

But this is a national debate and what is happening to board-certified internists across the U.S. regarding MOC is staggering. It seems like there’s always another load of trouble around every corner. Even the doctor in the American Board of Internal Medicine (ABIM) video delivering yet more bad news to internists finds it difficult not to appear visibly disturbed and seems to hear the groans of doctors all over the country in reaction to yet more empty bureaucratic busy work documentation as the complexity of continuous MOC looms on the horizon for 2014. See the link for more details…if you can follow it, http://moc2014.abim.org/.

UPDATE JULY 24, 2014 (updated again as of November 24, 2014): I realize the original ABIM video is now “private,” but that was not the case when I originally published this blog post. I suspect the video was taken down because the speaker was obviously wincing as he was giving the bad news about the new rules for the ABIM MOC. Initially, after I discovered this I refused to post any new video, especially the one by Dr. Richard Baron, because I believed many internists simply do not think he’s credible. However, in all fairness, I’ve changed my mind and posted it because both sides need to be heard. And a blog post you can read here is probably representative of the opinions of most rank-and-file internists. The number of signatures on the petition (which you can also no longer read and I’m sorry I can’t go back to every post in which I mentioned the link because I’m sure I can’t find all instances because there were so many) opposing the recent changes to the ABIM MOC continues to grow. And now there is a new petition pledge (also no longer available) to not comply with the ABIM MOC which has a small but slowly growing number of supporters. I’m going to leave the so-called “private” video up here as a silent symbol of the ABIM’s failure to communicate.

This is also relevant to psychiatrists who want to specialize in combined specialties like internal medicine and psychiatry and family medicine and psychiatry. We have excellent combined residency programs here at Iowa, and I remain concerned about the ability to continue recruiting to these fine postgraduate residency programs.

And I wonder if there’ll be a domino effect, in which Iowa, like a variety of academic medical centers, may continue to face the considerable challenges addressing the physician shortage areas. Iowans continue to develop creative solutions. Last year, the Iowa legislature established the Rural Iowa Primary Care Loan Repayment Program-a joint public-private program that offers annual loan repayment incentives to physicians specializing in family medicine, pediatrics, psychiatry, internal medicine, or general surgery, when they agree to practice in a rural area for a minimum of five years.

Moreover, University of Iowa Health Care is training the next generation of doctors to address the physician shortage in rural Iowa. We have a new career path leading to the new Carver College of Medicine Rural Scholars Program, CRISP, which embeds rural elements in the medicine curriculum through mentorships, seminars, and more in smaller Iowa communities.

In light of the estimated shortage of 90,000 physicians by 2020 as 32 million newly insured American enter the health care system under the Affordable Care Act, Iowa will rise to the challenge as it always does.

I just wish that the ABIM and the American Board of Medical Specialties (ABMS) would stop making it harder for physicians from every specialty to do what we love, not just what we’re trained for.

In light of this piling on the MOC phenomena, I was intrigued to learn of the upcoming debate entitled “Be it Resolved that Maintenance of Certification requirements fail to improve the quality of medical care while placing unnecessary burdens on physicians”,  between Dr. Paul Kempen, Md. PhD from Cleveland, Ohio, who championed the defeat of MOL in Ohio, and Martin Levine, DO, MPH from Bayonne, New Jersey.BRSInvitePennApril2013

The event is free to the public, and I expect it will be well attended by physicians. I can’t make it partly because I’m scheduled to be at the discussion about the resolution to oppose MOL at the Iowa Medical Society House of Delegates meeting in Coralville, Iowa. I hope the debate will be televised or otherwise available on video. I’m sure it will be riveting no matter the outcome because of the jugular issue that MOC continues to be for physicians all over America.

And by the way, just this past weekend in Columbus, Ohio, by official action, Resolution No. 16-13 was adopted:

Maintenance of Certification and Licensure vs Board Certification, Continuing Medical Education and Lifelong Commitment to Learning

RESOLVED, That the Ohio State Medical Association (OSMA) insists that lack of Specialty Board Certification does not restrict the ability of the physician to practice medicine in Ohio.

Who’s going to save the relationship between patients and doctors if we’re loading the MOC on doctors everywhere?