New Quality Indicator: MOC promotes better care, ABOto director says

BOSTON—With greater scrutiny of doctors and easier access to information about doctors’ education, the American Board of Otolaryngology’s Maintenance of Certification (MOC) program is more important than ever, said Robert Miller, MD, executive director of the American Board of Otolaryngology (ABOto).

“Health care quality is a major issue,” Dr. Miller, who’s also physician editor of ENT Today, said in a presentation at the 2010 Annual Meeting of the American Academy of Otolaryngology-Head and Neck Surgery, held here Sept. 26-29. “I think more and more doctors are recognizing this. And the important point is, if we don’t do something to address physician quality, somebody else will. And I don’t think any of us would like that.”

Dr. Miller says MOC will improve quality of care

The MOC program, started 10 years ago, is overseen by the American Board of Medical Specialties (ABMS) and is a process for life-long learning and improving the quality of a doctor’s practice. It includes four parts: professional standing, continuing education and self-assessment, a cognitive exam, and performance in practice.

The performance in practice assessment, involving a review of a doctor in his working environment, is still being developed. But when it is complete, it will be the most important part of MOC, Dr. Miller said.

“Frankly, if we could develop a really accurate, well-done, easily done Part IV, probably Parts I, II, and III go away,” he said. “But we’re far from that. It’s clearly the most difficult to develop.”

MOC should not be confused with recertification, he stressed. “Some people get maintenance of certification and recertification confused,” Dr. Miller said. “Recertification is basically retaking of an exam every so often, usually every 10 years. Maintenance of certification does include such an exam, but it includes a lot of other activities that make it a more continuous process.”

The essence of MOC is to improve the care of patients, which is the ABOto’s mission, he said.

“The fiduciary responsibility of the board is to the public,” he said. “We don’t act in a vacuum of what effect this is going to have on our diplomates. But when push comes to shove, the board has a very easy decision-making process because we’re always concerned about what’s good for the patient.”

Diplomates certified in 2002 and later are exempt from MOC requirements, but Dr. Miller encouraged everyone to participate regardless.

Other Benefits

Aside from promoting quality care, there are other, practical reasons to do so, he said. Patients going to the ABOto website or calling the ABOto are told about doctors’ certification and whether they’ve participated in MOC. ABMS requires release of that information, he said.