My Public Statement to the Iowa Medical Society Policy Forum to Oppose MOC

Dr. Amos' messy desk3The following statement in the link and copied below is my public comment on the Iowa Medical Society (IMS) regarding my proposal for a new policy supporting the principle of lifelong learning and opposing Maintenance of Certification (MOC) in Iowa. I believe we can influence the physician shortage in my state by ensuring we don’t create disincentives for doctors to stay in or relocate here. Allowing Maintenance of Licensure (MOL) to gain a foothold in Iowa and failing to send a strong message to the American Board of Medical Specialties (ABMS), the Federation of State Medical Boards (FSMB) and specialty boards would likely exacerbate the shortage.

I don’t want to let that happen. I’m urging all Iowa physicians to be mindful of why they became doctors in the first place and recognize that our mission to support high-quality patient care and lifelong learning is being distorted and misdirected by misguided (and probably greedy) regulatory agencies and the government.

It’s time for Iowans to stick together and to get our message right. We’re not pretending to defend the practice of medicine, not pretending to preserve the physician-patient relationship, and not pretending that continuous professional development and the pursuit of excellence are all vitally important. But I think the boards are pretending.

Let’s show the nation we’re the real deal.

Dr. Amos award (2)“I’ve been a staunch supporter of the principle of lifelong learning for my entire career as a psychiatrist at The University of Iowa. Please check my website,, to verify my commitment to continuous improvement of medical knowledge and clinical skills as well as promoting humanism in medicine.

I’m the sponsor of the issue “Opposition to Maintenance of Certification” which I’ve submitted to the new IMS Policy Forum. You may recall that I also sponsored the resolution to support lifelong learning and oppose Maintenance of Licensure in Iowa, which was adopted without dissent at the IMS House of Delegates meeting in April of 2013. This was co-sponsored by the Iowa Psychiatric Society.

Numerous state medical societies have adopted resolutions opposing MOC and MOL in recent years. Most notably, the South Carolina Medical Association passed its own resolution which specifically opposes “mandatory maintenance of certification for licensure, hospital privileges and reimbursement from third-party payers.” I drafted a similar resolution applicable to Iowa, which will now be under discussion.

I believe the proposal to oppose MOC is necessary because, despite the American Board of Medical Specialties (ABMS) claim that MOC is voluntary, many hospital organizations have chosen to make hospital privileges, assignment to insurance panels contingent on participation in MOC. And, the Iowa Board of Medicine (IBM) has been participating in MOL implementation projects, which the Federation of State Medical Boards (FSMB) is promoting in several states. Despite FSMB leadership’s statements to the contrary, this would essentially tie medical licensure to participation in MOC. Ironically, almost every state which is supposedly partnering with the FSMB has adopted resolutions opposing MOL.

When I was interviewed by Becky Watt Knight, Senior Vice President of public relations firm, Get Your Message Right, as part of the IBM implementation project for MOL (an important piece of which was the Iowa Physician Acceptability Survey), she asked me if I thought a systematic process for helping physicians achieve competency in lifelong learning is needed. I told her I agreed wholeheartedly that something like it is sorely needed.

I just don’t believe that MOC or MOL, as currently designed, are the right vehicles for achieving that level of lifelong learning—not by a long shot. Neither do thousands of doctors across America, which you can see in petitions to boycott MOC and to change it; see links and

Comply and OpposeI believe that making it clear to the boards that doctors are committed to the principle of lifelong learning and know best how to implement it in their own practices is the right thing to do now. Every day we systematically apply the principle. Iowans don’t need expensive, time-wasting MOC programs whose efficacy for improving patient outcomes has not been tested in high-level research and whose relevance to our practices are dubious at best.”


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