Poll for PIP Delirium Activity for MOC

A while back I ran a poll to find out how many psychiatrists (or anyone for that matter) would favor the development of a Maintenance of Certification (MOC) Performance in Practice (PIP) activity for assessment, management, and prevention of delirium in hospitalized patients.

It only got one vote in favor. This was a little hard to understand given how controversial the current MOC format is. Many psychiatrists believe MOC needs to be reformed or even eliminated as a model for ensuring physician competence.

One of the complaints I have about MOC is that it’s not relevant to my practice as a consulting psychiatrist in the general hospital. I think delirium is at least as important as major depression, substance abuse, and PTSD, even though I teach that it’s really not a primary psychiatric problem per se, but a medical emergency.

Delirium leads to excess morbidity and mortality, increased length of stay in hospitals, transfer of patients to long-term care facilities, persisting cognitive impairment, and costs our health care system billions of dollars.

My colleagues in medicine and surgery consult me every day on cases of delirium in the general hospital and critical care units. Delirium is common in the general hospital and the intensive care unit.

Yet there is no PIP activity for delirium offered to diplomates in psychiatry which would give credit for continuing improvement in all of the core competencies the MOC is intended to support.

So I’m running the poll again. I think the American Board of Psychiatry and Neurology (ABPN) would approve a PIP product for delirium management and prevention. Much of the content is available on my blog site and many other web sites devoted to delirium research and clinical care, the links to which are also here.

It should be a relatively simple project for internists and psychiatrists to collaborate together on. So here’s the poll again below.



  1. Sharon Van Fleet says:

    Dr. Amos,

    As a non-physician with extensive experience with delirium at several levels, it seems to me that the current failure to include delirium-related activity in MOC parallels the general avoidance of addressing delirium as a medical emergency. While attention to delirium has certainly increased in the last decade, there is still much work to be done.


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