ACP reply to Dr. Weiss on MOC

Dear Doctor Weiss,

The College is sensitive to the frustrations you shared about MOC. We have heard ACP members voice these same frustrations many times. I assure you that the College has worked tirelessly on this issue. MOC has been and continues to be a primary agenda item for ACP’s Board of Regents, Board of Governors and Education and Publication Committee.

As you’re probably aware, ABMS and ABIM determine the need for and the direction of the MOC program and it appears that MOC, in some form, will be part of the future of internal medicine for some time. As such, the College’s time is being spent on improving the efficiency of the process, optimizing the educational value to internists and increasing flexibility in complying with MOC requirements.

We have made some progress towards these goals, but still have a ways to go. Here are just some examples. We did convince ABIM to accept practice performance data that is generated as part of a practice’s routine work flow rather than requiring a separate, redundant effort to gather and report data for MOC. Also, ABIM agreed to accept ACP’s MKSAP for MOC credit. This allows MKSAP users to use this one product for self-assessment, CME, MOC and to study for the ABIM exam.

We understand that the MOC process can be tedious and time consuming. That’s why we offer ACP members a variety of resources to help. Here’s the link to ACP MOC resources: http://www.acponline.org/education_recertification/recertification/

Beyond MOC there are other critically important aspects of ACP membership. We believe we offer some of the best, if not the best, CME products in all of medicine through MKSAP and ACP’s annual Internal Medicine conference. Our flagship publication, Annals of Internal Medicine, ranks as one of the top medical journals in the world and is widely read and cited by general internists and subspecialists. We’re offering several new clinical information products to ACP members – a point-of-care resource called ACP Smart Medicine due out this fall, and ACP JournalWise, a customizable journal surveillance service being used by nearly 30,000 ACP members (http://www.acponline.org/clinical_information/journals_publications/journalwise/).

The College also provides a portfolio of products and services to assist our members in improving their practices. These range from practical coding tools to more complex issues like achieving Patient-Centered Medical Home certification.

ACP aggressively advocates for internists and patients at the federal and state level (through ACP’s Chapters). Increasingly, the White House, Congress, HHS, CMS and other agencies call on the College to represent the viewpoints of physicians. Here is a list of some recent advocacy “wins”. http://www.acponline.org/advocacy/advocacy_in_action/top_10_advocacy.htm

Dr. Weiss, the College will continue to commit time and resources to improving the ABIM MOC process, reducing other administrative burdens, and improving practice operations so that our physician members can spend more time with their patients.

As always, I am happy to discuss this with you further if you would like. Please feel free to call or email me with any concerns you have. My contact information is provided below.

I have no doubt that you are an excellent physician. I also think that maintaining your ACP membership will help you stay at the top of your game.
Sincerely,

David Sgrignoli, MD

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3 thoughts on “ACP reply to Dr. Weiss on MOC

  1. Dear Dr. Sgrignoli,
    Thank you very much for the courtesy of your thoughtful and detailed reply, however I, and many others, still take exception to MOC as well as the ACP’s position on MOC. You state that the ABIM and ABMS “determine the need for and the direction of the MOC program and it appears that MOC, in some for, will be part of the future of medicine for some time.” You say this like it is a fait accompli, but I ask you, why? By what authority does the ABIM and the ABMS determine the fate of practicing doctors. I know of no practicing doctor who had a say in determining who runs the ABIM and the ABMS, so why should these self-appointed boards have a say in determining which of us are capable physicians and which are not? If they want, the ABIM and the ABMS are more than welcome to continue to develop the MOC program in any way that suits them, as long as it remains completely and utterly voluntary, with no link to licensure, hospital privileges or reimbursement from Medicare or any other payor. Any physician who feels the MOC program is valuable to them is free to make use of it, and those practitioners who choose other ways to pursue lifelong learning should be free to do so without penalty. In regard to MOC, ensuring that it is forever truly voluntary should be the ACP’s only agenda. We both know that there is no compelling evidence that MOC participation results in better care and we all know that at least some members of these boards are making obscene amounts of money off of our backs. If and when MOC becomes a reasonable and relevant cost and time effective method of life-long learning, than doctors will flock to it voluntarily. I happen to like MKSAP, and might well continue to make use of it for part of my lifelong learning, but not as a part of meeting MOC requirements. Again, as the ACP stands to gain financially from ever greater sales of MKSAP, until such time as MOC is truly and forever voluntary, it is hard not to be suspicious of the relationship between entities like the ABIM and ABMS, who create the tests and modules, and entities like the ACP, who create preparatory materials, which, while they can be used for other purposes, are in fact heavily marketed and promoted as ways to pass MOC. For my part, the only way I can see this potential collusive “taint” removed from the ACP is to see the ACP lobby vigorously against any form of mandatory or obligatory MOC, which again would include any links to licensure, hospital privileges or reimbursement. Until that occurs, I will continue to find it hard to renew my ACP membership.

    Respectfully,
    Dr. Weiss

  2. And then Sgrignolli replied thusly:
    Dr. Weiss:

    I appreciate your comments and have discussed them will those here at ACP that are spearheading our involvement in the MOC issue. We are encouraged that Richard Baron, MD, MACP has taken the helm at ABIM. Dr. Baron hails from a small practice in the Philadelphia area and, as such, we believe will be very sensitive to the concerns of practicing internists regarding MOC.

    We hate to lose you as an ACP member. I hope that you will continue to keep tabs on the College’s activities and perhaps we can persuade you at some time to reconsider ACP membership.

    Please feel free to contact me any time.

    Sincerely,
    David

  3. To which I next replied:
    David,
    It is the general consensus of those of us on the front lines of clinical medicine that Dr. Baron, despite his small practice background, is cut from the same bolt of cloth as Christine Cassel, and, while perhaps providing some lip service to our “concerns”, along with perhaps some token tweaks of MOC meant to make some aspects of it seem more palatable, that he will ultimately tow the party line towards expanding MOC and making it as mandatory as possible. Some of us have reached out to him in an attempt to open a dialogue with him on the issue of MOC and have been met with stony silence.

    Sincerely,
    Jonathan

    And that is where it stands.

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