AMA resolution on pursuing MOC OCC and MOL

Introduced by: Subject:
Referred to:
Resolution: 3 (A-11)
Joshua Cohen MD, MPH, Kelly Caverzagie MD, Noel Deep MD, Annette Matthews MD, Liana Puscas MD, Stephanie Stanton MD
Public Reporting of Individual Physician Performance Data Collected During Maintenance of Certification (MOC), Osteopathic Continuous Certification (OCC) and Maintenance of Licensure (MOL)
AMA-YPS Reference Committee
1 Whereas, In 2000 the American Board of Medical Specialties (ABMS) implemented
2 Maintenance of Certification (MOC) with a goal of continuous professional development
3 for individual physicians1; and
5 Whereas, Prior to 2013, the American Osteopathic Association (AOA) will require
6 osteopathic physicians to begin assessing and improving their practice performance as
7 part of Osteopathic Continuous Certification (OCC)2; and
9 Whereas, The Federation of State Medical Boards (FSMB) has recently approved
10 principles for implementation of Maintenance of Licensure (MOL)3; and
12 Whereas, Under MOC, OCC and MOL, all certified and/or licensed physicians will need
13 to be engaged in a culture of continuous quality improvement and lifelong learning
14 assisted by measurement of objective data leading to demonstrable actions with the goal
15 of improving patient care and their practices; and
17 Whereas, In MOC and MOL physicians may be required to enter individual performance
18 data, including process and outcome measures, as part of demonstrating their
19 commitment to continuous quality improvement and lifelong learning; and
21 Whereas, Reporting of individual performance data as it relates to MOC, OCC and MOL
22 is intended to be formative in nature, whereby physicians can perform an honest
23 assessment of practice performance and should not be intended to penalize individual
24 physicians for sub-standard performance or be used for purposes other than individual
25 or practice performance improvement; therefore be it
27 RESOLVED, That the AMA oppose the public reporting of individual physician
28 performance data collected by certification and licensure boards (New HOD Policy); and
29 be it further
31 RESOLVED, That the AMA support the principle that individual physician performance
32 data collected by certification and licensure boards should only be used for the purposes
33 of helping physicians to improve their practice and patient care (New HOD Policy); and
34 be it further
1 RESOLVED, That the AMA investigate how certification and licensure boards are
2 currently using, or may potentially use, individual physician performance data (other than
3 for individual physician performance improvement) that is reported for purposes of
4 Maintenance of Certification (MOC), Osteopathic Continuous Certification (OCC) and
5 Maintenance of Licensure (MOL) and report back to the HOD no later than A-12
6 (Directive to Take Action).
1. American Board of Medical Specialties: Accessed April 28,
2. American Osteopathic Association: aoa/development/aoa-board-certification/Pages/osteopathic-continuous- certification.aspx. Accessed April 28, 2011.
3. Federation of State Medical Boards, Report from the Maintenance of Licensure Implementation Group, February 14, 2011.
Fiscal Note:
Received: 5/5/11 RELEVANT AMA POLICY
H-275.923 Maintenance of Certification / Maintenance of Licensure
Our AMA will: 1. Continue to work with the Federation of State Medical Boards (FSMB) to establish and assess maintenance of licensure (MOL) principles with the AMA to assess the impact of MOC and MOL on the practicing physician and the FSMB to study the impact on licensing boards. 2. Recommend that the American Board of Medical Specialties (ABMS) not introduce additional assessment modalities that have not been validated to show improvement in physician performance and/or patient safety. 3. Encourage rigorous evaluation of the impact on physicians of future proposed changes to the MOC and MOL processes including cost, staffing, and time. 4. Review all AMA policies regarding medical licensure; determine if each policy should be reaffirmed, expanded, consolidated or is no longer relevant; and in collaboration with other stakeholders, update the policies with the view of developing AMA Principles of Maintenance of Licensure in a report to the HOD at the 2010 Annual Meeting. 5. Urge the National Alliance for Physician Competence (NAPC) to include a broader range of practicing physicians and additional stakeholders to participate in discussions of definitions and assessments of physician competence. 6. Continue to participate in the NAPC forums. 7. Encourage members of our House of Delegates to increase their awareness of and participation in the proposed changes to physician self-regulation through their specialty organizations and other professional membership groups. 8. Continue to support and promote the AMA Physician’s Recognition Award (PRA) Credit system as one of the three major CME credit systems that comprise the foundation for post graduate medical education in the US, including the Performance Improvement CME (PICME) format; and continue to develop relationships and agreements that may lead to standards, accepted by all US licensing boards, specialty boards, hospital credentialing bodies, and other entities requiring evidence of physician CME. 9.
Collaborate with the American Osteopathic Association and its eighteen specialty boards in implementation of the recommendations in CME Report 16-A-09, Maintenance of Certification / Maintenance of Licensure. 10. Continue to support the AMA Principles of Maintenance of Certification (MOC). 11. Monitor MOL as being led by the Federation of State Medical Boards (FSMB), and work with FSMB and other stakeholders to develop a coherent set of principles for MOL. (CME Rep. 16, A-09; Appended: CME Rep. 3, A-10; Reaffirmed: CME Rep. 3, A-10)

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