Several bills have been introduced in state legislatures at the behest of state medical societies that would restrict the use of board certification and Maintenance of Certification (MOC) by hospitals, health plans, and insurers for credentialing purposes. One argument put forth by the state medical societies is that board certification and MOC are onerous without benefit and discriminatory, and should not be included in the evaluation of the quality of a physician. I believe this movement will result in the end of professional self-regulation which is a status medicine has held since it came into the modern world.
The recent anti-MOC/board certification movement is, in my opinion, based on the realities of medical practice today. The first is doctors having to deal with electronic health records, various reporting requirements, continuous professional development demands (including MOC), and a general sense of loss of control of their practices, particularly for employed physicians, all of which I understand completely. It is not surprising that physicians are reacting to these new pressures which eat away at what is now the most valuable commodity to physicians—time.
The concern I have is that physicians have focused on the certifying boards (in particular the American Board of Internal Medicine) because of MOC. First, MOC does require a time commitment and although the goals (encouragement of lifelong learning and quality improvement) are laudable, it is not perfect. However, the vast majority of medical boards have been careful to develop programs that are not onerous and are developing new products that make MOC less time consuming and more meaningful to the individual physician’s practice. The second reason physicians have directed their ire at the certifying boards is that they are the only entities on which physicians feel they can have any impact. Large healthcare corporations, insurers, and the federal government are simply not assailable.