Michigan State Medical Society House of Delegates approved resolutions against MOC/MOL

TITLE: Maintenance of Certification vs. CME and Lifelong Commitment to Learning

WHEREAS, The Michigan State Medical Society is actively engaged in advocacy to protect physicians from unnecessary regulatory and financial burdens in their practices, and

WHEREAS, The American Board of Medical Specialties (ABMS) has and continues to press legislation coupling insurance payments to active enrollment in “time limited” Board Certification and the associated Maintenance of Certification program in a nationwide fashion, imposing this upon the practice of medicine in Michigan, (1) and

WHEREAS, The Maintenance of Certification program is expensive, unproven, directed toward bureaucratic compliance and entry level medical knowledge, wastes resources by requiring participation in time limited Maintenance of Certification-CME programs directly benefiting selectively the ABMS only, (2,3) and

WHEREAS, The ABMS has changed the concept of Board Certification for life to “time limited” and further implemented yearly participation enrollment (Maintenance of Certification) against active physician opposition, and

WHEREAS, The American Medical Association’s Physician recognition Award and CME program was successfully formed in the late 1960’ and meets all needs of documenting lifelong commitment to learning to include individual physician’s choice and competitive offering of educational materials in CME, (4) and

WHEREAS, These ABMS national efforts continue to impose additional burdens on the physicians of Michigan in an adverse manner, and have resulted in active AMA opposition on a national level, (5) and

WHEREAS, These Maintenance of Certification processes invoke economic credentialing detrimental to physician availability and patient care, which immorally impacts patient care by requiring active experimentation without requiring patient informed consent in violation of the Nuremberg code of 1947, under some Practice Improvement Modules, (6,7), therefore, be it

RESOLVED, That the Michigan State Medical Society continues to support and advocate lifelong continuing medical education and advocate against discrimination against physicians who choose NOT to engage in corporate re-certification programs labeled as “voluntary” by the specialty medical boards, and be it further

RESOLVED, That the Michigan State Medical Society seek legislation in Michigan that will prohibit discrimination by hospitals and any employer, the Michigan Board of Medicine, insurers, Medicare, Medicaid, and other entities, which might restrict a physician’s right to practice medicine without interference (including economic discrimination by varying fee schedules) due to lack of participation in prescribed corporate programs including Maintenance of Certification or expiration of time limited Board Certification,  be it further

RESOLVED, that the Michigan State Medical Society introduce a resolution at the AMA to promote and/or implement a national policy forbidding discrimination by hospitals or employers, the state medical boards, insurers, Medicare, Medicaid, and other entities, which might restrict a physician’s right to practice medicine without interference (including economic discrimination by varying fee schedules) due to lack of participation in corporate programs including Maintenance of Certification or time limited board certification.

Fiscal Note  $50,000

References:

1)     Center For Medicare Services: The Physician Quality Reporting System Maintenance of Certification Program Incentive Requirements of Self-Nomination for 2012  http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/downloads/2012_Maintenance_of_Certification_Requirements_2.pdf

2)     Levinson W, King TE Jr, Goldman L, Goroll AH, Kessler B. Clinical decisions. American Board of Internal Medicine Maintenance of Certification Program. NEngl JMed 2010;362:948-952.

3) Kritek PA, Drazen JM. Clinical decisions: American Board of Internal Medicine Maintenance of Certification Program—polling results. N Engl JMed 2010;15;362(15):e54.

4) American Medical Association. AMA PRA BOOKLET. http://www.ama-assn.org/resources/doc/cme/pra-booklet.pdf

5) Kempen PM. Maintenance of Certification (MAINTENANCE OF CERTIFICATION), Maintenance of Licensure (MAINTENANCE OF LICENSURE), and continuing medical education (CME): the regulatory capture of medicine. J Am Phys Surg 2012;17:72-5. Available at: http://www.jpands.org/vol17no3/kempen.pdf . Accessed Dec 27, 2012.

6) THE AMERICAN BOARD OF ANESTHESIOLOGY,INC:  PRACTICE PERFORMANCE ASSESSMENT AND IMPROVEMENT HOW TO COMPLETE A CASE EVALUATION.  http://www.theaba.org/pdf/Case_Evaluation_Explanation_and_Samples.pdf

7) Jewish Virtual Library: The Nuremberg Code (August 19, 1947)

http://www.jewishvirtuallibrary.org/jsource/Holocaust/Nuremberg_Code.html

Second Resolution
MSMS Rejects MOL!
Maintenance of Licensure
Whereas, plans by licensing boards and “non-profit” certification organizations, among others, threaten to require physicians to complete expensive, time consuming, and bureaucratic certification programs at their own expense and to the detriment of time  spent with patients, and

Whereas, in order to simply keep their medical license or hospital privileges above and beyond the present Continuing Medical Education (CME) requirement, and

Whereas, under the guise of improving medical care, these schemes, in reality, serve to increase the power and balance sheets of their proponents and are counterproductive to quality patient care, and

Whereas, the Ohio State Medical Society recently resolved to oppose and actively defeated the Federation of State Medical Boards, INC. (FSMB), Maintenance of  Licensure initiative in Ohio in 2012, and

Whereas, the FSMB national efforts would impose burdens on the physicians of Michigan in an adverse manner, and have resulted in active AMA opposition on a national level, and

Whereas, maintenance of licensure processes invoke economic credentialing detrimental to physician availability and patient care with no data to show that the current  system of continuous medical education is inadequate; therefore be it

RESOLVED: That MSMS strongly recommend that the present requirement for  licensure of 50 credits per year of Continuing Medical Education (CME) is adequate to  maintain a medical license. Whereas, MSMS is actively engaged in advocacy to protect physicians from unnecessary regulatory and financial burdens in their practices; and be  it further

RESOLVED: That MSMS actively engage the Michigan Board of Medicine and 26 the state legislature to advocate against the adoption of additional continuing medical 27 education (CME) requirements for acquiring or renewing physician licenses in the State 28 of Michigan than what is currently required.

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