In the past, obtaining board certification in a medical specialty was straightforward. One completed a residency, studied, took and passed a test, and was deemed “board certified”. Later, certificates required a re-test after ten years. Now, the process of Maintenance of Certification (MOC) has taken hold of essentially all medical specialties.
MOC involves meeting certain requirements every few years, culminating in a re-examination at the end of each ten-year cycle.
Keeping up with MOC involves paying fees and completing various tasks purported to keep the physician up-to-date with the latest developments in their field. The specific tasks vary by specialty. How this improves existing continuous medical education (CME) programs is not known. It is known that the MOC process involves substantial time and money. Meeting the requirements often diverts doctors from clinical practice. There is minimal evidence that increasing certification requirements improves patient outcomes, affects malpractice statistics, or otherwise impacts any healthcare metric, other than money spent in the MOC effort.
Maintaining competence and knowledge in medicine is important, but MOC does not represent progress in medical education. Organization against the MOC requirements has begun forming, notably with the website changeboardrecert.com. Rather than advocating for an elimination of the program, the organization seeks removal of the more onerous MOC criteria, while preserving some of the continuing education elements.
From the site:
“We are all for staying current with medical changes, but the onerous MOC program is no way to achieve this. It’s a money-making juggernaut with scant data to support any benefit for improving patient care and safety or for making one a better physician. And it lacks reasonable financial transparency.”
It is fascinating that the MOC requirements for physicians are increasing, at a time when health reform stands poised to turn much of the American primary care system over to non-physicians.
It remains to be seen if opposition efforts will alter MOC programs, but the resistance highlights the pitfalls that occur when sweeping programs are implemented without evidence that they have any benefit.