Be it resolved: “Maintenance of Certification requirements fail to improve the quality of medical care while placing unnecessary burdens on physicians.”
Benjamin Rush Society presents debate above on MOC, OCC, & MOL at University of Pennsylvania Saturday April 20, 2013 at 6:00pm
Board certification began as a means to assess the knowledge of physicians emerging from residency programs that varied in length of training, program requirements and quality. Since 1981 when ACGME assumed the task of accrediting residency programs, specialty training has become standardized and highly regulated. Certification exams continue as a voluntary test, a lifetime mark of achievement, similar to passing the bar for lawyers. In spite of multiple mechanisms for assessing physician competency (peer review, hospital privileging, state license boards, malpractice liability, etc.) certification is increasingly used as a requirement for hospital privileges, insurance and Medicare payment, and more recently attempts are being made to tie maintenance of certification to licensure. This push is occurring as the certification process is simultaneously requiring increasing amounts of physician time and expense –all without evidence of benefit for the costs. The American Boards of Medical Specialties have grown into multi-million dollar entities, closely entwined with government regulatory agencies, possessing near-monopoly control over certification. The CEOs earn $800,000 to $1.2 million dollar annual salaries. Re-certification costs individual physicians thousands of dollars, and many hours away from their patients, businesses and families –which also aggravates the problems of rising health care costs and physician shortages.
Physicians unanimously support life-long learning and excellence in medicine, but in these days of increasing concern over fraud, waste and unnecessary spending in healthcare, it’s time to take a closer look at the process and role of certification in assuring and improving quality. The standard of “evidence-based” is relevant not just for medical practice, for health care policy as well.
What’s the evidence for and against the new requirements for Maintenance of Certification and its connection to Maintenance of Licensure? In arranging for a pair of experts to argue the issues before an audience of medical students, faculty and community physicians, the Benjamin Rush Society promotes a rigorous examination and discussion of controversial issues.
Beth Haynes, MD
Executive Director, Benjamin Rush Society
“Committed to solving health care challenges through innovation, abundance and an inviolate doctor-patient relationship.”