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Combating MOC "Professional self-regulation is under attack" By PL JETER
Physicians are outraged about plans by the American Board of Medical Specialties (ABMS) and its 24 specialty boards to overhaul once again the Maintenance of Certification (MOC) requirements they say have already become too time-consuming, expensive and clinically irrelevant. “The MOC controversy is a David v. Goliath story that may be the most significant corruption story ever uncovered in the history of U.S. medical education,” said Westby Fisher, MD, a cardiac electrophysiologist from Illinois and author of the “Dr. Wes” blog. Under ABMS’s MOC requirements, physicians are assessed every other year, and must pass a re-certification exam in their specialty every 10 years. Here’s the rub: MOC is legally considered voluntary
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Bethany Ballinger,
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and not a requirement to practice medicine in the U.S. The ABMS, doctors insist, has an unfair near-monopoly on the MOC recertification process based on long-term partnerships with insurance companies and hospitals, who often mandate MOC recertification, a brewing problem for the swelling number of hospital-employed physicians. Medicare, the standard bearer for coverage in the American healthcare system, does not. “I’ve seen the forensic accounting on this … it would stop your heart,” said Marni J. Carey, executive director of Orlando-based Association of Independent Doctors (AID). But “then you might need a cardiologist, who won’t be available because (of) studying for recertification. MOC is a hoax and needs to stop.” In a grassroots rebellion against unfair
MOC mandates, AID is among many organizations across the country, including the American Association of Physicians and Surgeons (AAPS), Practicing Physicians of America (PPA), and the recently physicianformed National Board of Physicians and Surgeons (NBPAS), that oppose the ABMS initiative launched Sept. 25. A month before the announcement, 33 national medical societies and 41 state medical societies sent the umbrella organization a letter proposing a meeting with certifying medical boards to address their concerns “regard-
ing the usefulness of high-stakes exams, the exorbitant costs of the MOC process, and the lack of transparent communication from certifying boards (that have led to) damaging the MOC brand, and creating state-level attacks on the MOC process.” The societies also want participation in planning a solution. The ABMS initiative, “Continuing Board Certification: Vision for the Future,” was launched anyway. ABMS CEO Lois Nora, MD, insisted the concept had been brewing for months, noting that “concerns … stimulated our thinking about the commission.” “The best step the ABMS can take is to assure us that MOC is voluntary,” said AAPS spokesperson Jane Orient, MD. (CONTINUED ON PAGE 4)
HEALTHCARELEADER
The Gift of Being a Physician Anup Patel, MD, endeavors to provide surgical access to the underserved on an international level Anup Patel, a plastic and reconstructive surgeon who established Orlando Plastic Surgery Institute, completed his MD/MBA degrees at Yale University. He received his plastic surgery training at Yale University followed by a fellowship in hand and microsurgery at the New York University and Mount Sinai. In a lifetime marked by excellence, Patel graduated as the valedictorian of his class at the University of Florida, majoring in economics, biochemistry and molecular genetics and valedictorian of his high-school class at Lake Highland in Orlando, Florida. Dr. Patel maintains a commitment to serv-
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ing society. He co-founded Cents of Relief, a 501(c)3 nonprofit, that seeks to help victims of human trafficking. The foundation has developed a partnership with Operation Smile to deliver burn care to indigent victims and developed a comic book that teaches burn safety to children. He has been on panels with global health leaders such as NBA Global Ambassador Dikembe Mutombo and Partners in Health’s co-founder Dr. Paul Farmer for his work on reducing the global surgical burden of disease. Dr. Patel’s healthcare efforts have been featured in the New York Times best-seller Half (CONTINUED ON PAGE 14)
What resonated in 2017? …
the Future?
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