Crossroads for Maintenance of Certification?

Dr. Amos and the white elephant necktieSo I see Dr. Nora, President and CEO of the American Board of Medical Specialties (ABMS) notices the “disconnect” rank and file physicians have relative to our view of Maintenance of Certification (MOC), reported on in a recent issue of Psychiatric News:

Some doctors love it while others hate it. Most hate it. And, as usual, the biggest disconnect is is the persisting blind spot ABMS has for hard-working physicians who have been energetically engaged for years in continuous improvement in the quality of care we provide to patients.

The disconnect the ABMS and other boards have from the majority of doctors is their failure to admit that MOC actually contributes to burnout by interfering with our pursuit of the best possible health care for patients because of the imposition of empty busy work in the form of Performance in Practice (PIP) requirements which are irrelevant to our patients and which may in fact ultimately lead to poorer quality care.

As we prepare to welcome our new residents and medical students (here comes July!), we again are faced with the hard reality that the motivation to improve comes from within, not imposed from without by board executives who barely practice medicine.

The next generation of doctors are at a crossroads. They must embrace the principle of practice-based learning no matter what form it takes. One is an externally mandated rule which will be viewed as unnecessary, stifling, and trivial in most instances by creative self-starters. The other form is what countless physicians who are respected and even loved in their communities truly embrace…the ideal of medicine as a calling.

I’m proud of what I do and I’m proud of what my trainees do. I’m not proud of the ABMS or any other certification board, the leaders of which fail to recognize and respect what we do in the real world every day. There are other crossroads here. The Performance in Practice (PIP) module must be reformed or be abandoned. And certain board executives may have to rethink their roles as leaders and decide whether or not they truly serve patients and the physicians who care for them.

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