Just Let MOC and MOL Be?

Well, this is just an announcement about the new Maintenance of Certification (MOC) rules from the American Board of Psychiatry and Neurology (ABPN), which is summarized in the tweet below:

Because of my position in an academic medical center, I’m required to comply with MOC. On the other hand, I’m also opposed to MOC and Maintenance of Licensure (MOL), as many of my readers know. I am aware that I’m not just letting it be.

I sponsored a resolution to support lifelong learning and oppose MOL which was adopted by the Iowa Medical Society House of Delegates (IMS HOD) in April 2013. It was co-sponsored by the Iowa Psychiatric Society. Many state medical societies have passed similar resolutions. While that didn’t stop the Iowa Board of Medicine from pursuing the so-called MOL Implementation Pilot Projects, my contact at the IMS tells me that IBM has “placed MOL on a back burner.”

I also participated in the ironically named Physician Acceptability Survey by our Iowa Board of Medicine (IBM) regarding MOL (http://iowamedical.org/news_detail.cfm?newsID=665 ) that closed April 21, 2014. I urged physicians to oppose MOL by answering Question 31, which asked for our views about it. While Executive Director Mark Bowden tells me that it’s unlikely that IBM will adopt MOL, the continuing collaboration with the Federation of State Medical Boards (FSMB) on the MOL implementation projects (including the survey) concerns me. We’ll see what happens.

Now that South Carolina adopted its resolution to oppose MOC, which specifically opposes “mandatory maintenance of certification for licensure, hospital privileges and reimbursement from third party payers.” I’ve proposed to the Iowa Medical Society a similar resolution in Iowa, which has been accepted for further discussion in September.

And I’ve spoken with the representative of a public relations firm called Getting Your Message Right as part of a panel of between 10-20 physicians with whom the MOL committee is conducting personal interviews, seeking further details about Iowa physicians’ opinions about MOL. I think it’s vitally important that Iowa physicians let the FSMB know exactly whether MOL would be welcome in Iowa. I have told the Iowa Board of Medicine in no uncertain terms that I think MOL would be bad for Iowa because MOC and MOL generally are controversial at best in the opinions of many thousands of physicians. I think it would hurt recruitment of physicians to Iowa as well as retention of doctors trained in our state.

I realize I’m trying to change the world as it is. Sometimes I get so worked up about this, I wonder whether I just need to go meditate to calm down and relax. But then a leader in meditation has said:

But the paradox is that you can only change yourself or the world if you get out of your own way for a moment, and give yourself over and trust in allowing things to be as they already are, without pursuing anything, especially goals that are products of your thinking. Einstein put it quite cogently: “The problems that exist in the world today cannot be solved by the level of thinking that created them.” Implication: We need to develop and refine our mind and its capacities for seeing and knowing, for recognizing and transcending whatever motives and concepts and habits of unawareness may have generated or compounded the difficulties we find ourselves embroiled within, a mind that knows and sees in new ways, that is motivated differently.–Copyright © 2005 Jon Kabat-Zinn, Ph.D. Excerpted from the book Coming to Our Senses: Healing Ourselves and the World Through Mindfulness by Jon Kabat-Zinn. Copyright © 2005 Jon Kabat-Zinn, Ph.D. (Published by Hyperion; January 2005).

Kabat-Zinn also referred to this as “radical acceptance.” So I’m sort of accepting the world as it is.

Comply and Oppose


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