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.