The MOC:PQRS; Now More Than Ever, We Need Leaders

I just got an email from a colleague containing the link to Dr. Kempen’s Medical Economics article on MOC:PQRS. You’ve read my thoughts and I think everyone who believes in the principle of lifelong learning but is opposed to Maintenance of Certification (MOC) as an avenue for achieving it should know Dr. Kempen’s views. He’s been a tireless champion of the critical importance of exposing the MOC machine as an unworthy candidate for realizing the principle of lifelong learning for years and is the leader who showed that the Maintenance of Licensure (MOL, which was defeated in Ohio), a move to tie medical licensure to MOC promulgated by the Federation of State Medical Boards (FSMB), could be defeated if physicians united and just said “no.”

Leadership in the pursuit of practical, meaningful, and non-burdensome lifelong learning is sorely needed, and I’m reminded of my membership on the committee for cultivating a culture of leadership for psychiatry residents in preparation for an upcoming departmental retreat in early February. What better way to present Stephen Covey’s view that “leadership is a choice, not a position” than to encourage residents and fellows in psychiatry to get involved in this jugular issue for all physicians, including psychiatrists?

This comes at the same time that insidious efforts to advertise MOC and MOL are being perpetrated by the news media and by a major product of the American Psychiatric Association (APA) which has supported the MOC enterprise, the Focus Journal of Lifelong Learning in Psychiatry. In the Fall 2013 issue, below the table of contents there is a “Call for Papers” announcement “…requesting papers for a new section of the journal that will feature original research and reviews in the following areas related to lifelong learning and quality improvement”:

  • Maintenance of Certification
  • Maintenance of Licensure
  • Self-Assessment
  • Practice and Performance Evaluation (audit and feedback)
  • Quality Improvement research and projects
  • Patient and Family Centered Outcomes research

The announcement goes on to say that the submissions for this new section should be “evidence-based, drawing upon data and outcome measures or practice guidelines.” They welcome “comprehensive reviews and case reports of successful programs (italics mine).

The submissions will be peer-reviewed and should be sent to Kristen Moeller at email address Authors should indicate in the cover letter for which topic the submission is intended. Please looks at the Focus Journal guidelines for authors and reviewers if you plan to make a submission. Although I suspect the journal will slant the new MOC and MOL section towards promotion of these processes, I’m urging everyone who has skin in this game to attempt to submit articles presenting opposing views. I strongly suggest they be well-researched, data-driven, and balanced.

I think it’s also worth pointing out that one of the APA candidates running in the election for President-Elect, Dr. Mark Hyman Rapaport, MD, is on the editorial board of Focus Journal. While I respect Dr. Rapaport’s position on encouraging MOC reform (which he acknowledges should be a priority for APA leadership), I support the candidacy of Dr. Renee Binder, MD whose position is, in my opinion, more well-developed and unencumbered by any ties to a product which has obviously been supportive of the MOC agenda. The elections close in just a few days, so please vote!

Our leaders need to know what rank and file psychiatrists know about MOC and MOL and whether we think these processes will promote safer and more effective patient care, improving outcomes and reducing the high cost of health care in this country. A large and steadily growing number of us believe they do not.

Our leaders can’t represent us if we don’t speak.



  1. Reblogged this on IP4PI – Independent Physicians for Patient independence and commented:
    MOC OCC MOL PQRS: overwhelming force
    Need physician leaders in the trenches


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