STOP OCC, MOC, MOL: Call to ACTION from Robert Maurer, DO

To ALL concerned osteopathic and allopathic physicians:

This message is urgent. I will try to briefly sum up recent events. My Email list is limited. It is imperative that you spread the word among as many physicians as you can across the country.

Please forward this on to your physician list. Wide distribution is needed for change to occur.

Several of my colleagues have labeled Maintenance of Licensure (MOL), Maintenance of
Certification (MOC), and Osteopathic Continuous Certification (OCC) as essentially EVIL.
Promotion of these mandates will bring about the end of the wonderful and compassionate office based Primary Care Medicine that we and our patients have known for the past 100 years.

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Ezekiel Emanuel is at it again

Comments by Lawrence Huntoon, MD, PhD on latest editorial in JAMA by Ezekiel Emanuel. JAMA Vol. 310 No. 4 pp. 374-375, July 24/31, 2013

Zeke bemoans the fact that physicians have not yet completely given up in defeat and joined his unsinkable ship, the SS Socialist (new and “improved” version of the Titanic).

Zeke says physicians are “in denial” – i.e. he says physicians are not willing to accept full blame for the spiraling cost of medical care.

Zeke, however, fails to address the major cause of increased costs of medical care – government intervention. Government intervened between the “seller” and the “buyer,” so that neither was concerned about costs because “someone else” (taxpayers) would foot the bill. When neither “seller” nor “buyer” care about costs, costs predictably increase.

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Florida opposes MOC Maintenance of certification

The following resolution was just approved by the Florida Medical Association’s House of Delegates:
“RESOLVED, That the Florida Medical Association opposes any efforts by the Florida Board of Medicine and the Florida Board of Osteopathic Medicine to require the Federation of State Medical Boards, Inc., (FSMB) “maintenance of licensure (MOL)” program, “maintenance of certification (MOC)”, or recertification by a specialty medical board as a condition of licensure in the State of Florida, and be it further
RESOLVED, that the Florida Medical Association Delegation to the American Medical Association submit a similar resolution for national consideration.”

A few Points from Paul Kempen, MD, PhD on ABMS Monopoly

1) The ABMS is forcing an unwanted and monopolistic policy on all USA physicians. It is a world village. In the USA there are now multiple NON-ABMS Boards registered as non-profits as per this list from the 2011 990 registry THAT I HAVE FOUND. The ABPS is not event the largest and the ABMS boards all started small. Break the monopoly and form bonds with the other “independents” I know the AOA has “followed suit”with the ABMS, but if they were to go “independent” with a better program-this group alone could ultimately providxe the clinical “machine” to put the ABMS in the background-given the size and scope of THAT organization.

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NJ DOs bring resolution against MOL to AOA

The DO Magazine
News and Features About Osteopathic Medicine
Monday, July 22, 2013
By Carolyn Schierhorn / Staff Editor

AOA House refers contentious resolution opposing maintenance of licensure

The New Jersey Association of Osteopathic Physicians and Surgeons submitted a last-minute resolution to the House calling on the AOA to oppose maintenance of licensure.

It would be counterproductive for the House to take a position against maintenance of licensure, argues California delegate Geraldine T. O’Shea, DO, during a lengthy floor debate. (Photo by Patrick Sinco) Continue reading

AOA Colludes with ABMS on OCC/MOC Certification and MOL Licensure

The AOA is now in collusion with the ABMS for restriction of trade via MOC OCC MOL per the AOA daily news email:

AOA President Ray E. Stowers, DO, called the AOA Board of Trustees’ Annual Business Meeting to order this morning. In a special item of business to commence the meeting, American Board of Medical Specialists (ABMS) President and CEO Lois Nora, MD, JD, MBA, gave a presentation on the ABMS Maintenance of Certification (MOC) program and how the AOA and the ABMS can work more collaboratively on issues like MOC and Osteopathic Continuous Certification and the future global standards for board certification and patient care. This afternoonthe Board broke into several reference committees to review the resolutions upon which it will vote tomorrow or forward to the House of Delegates later this week. – John Crosby, JD Exec. Dir.


NJAOPS House of Delegates Approves Resolutions
Monday night, July 15, 2013, A Special Joint Meeting of the NJAOPS House of Delegates and Board of Directors approved two resolutions: “Affordability of Osteopathic Continuous Certification” and “Opposition to Maintenance of Licensure.” The former urges transparency and affordability from the AOA in Osteopathic Continuous Certification (OCC). The latter would have the AOA oppose Maintenance of Licensure (MOL). Both resolutions have been forwarded to the AOA House of Delegates for special consideration to be included when it convenes Friday morning in Chicago. Click here to read the complete resolutions on the NJAOPS House of Delegates web page.

DO Family Physician’s View of PPACA Obamacare

claim: ACA will decrease the clout of insurance monopolies:
reality: The affordable care act (the ACA) empowers insurance companies and expands their power to control healthcare in a way that may be catastrophic for community based primary care doctors. The ACA does this by giving strategic preferences, through accountable care organizations, to large monopolies who can support and develop metrics necessary to run such organizations, and which further, can only be derived by institutions with huge IT and Mathematician (Statistical) budgets. The ACA seeks to structure healthcare competition in a way which will be profitable only for the monopolies which it seeks to create. These monopolies will then directly compete against community based physicians, in a patently unfair playing field. The ACA incentivizes these created monopolies to hire unqualified (but inexpensive) non physicians (nurse practitioners and physician’s assistance ) to directly compete against DO’s and MD’s in primary care, and perhaps in other fields as well. The above referenced phenomena are obvious and real, they will not decrease the clout of insurance monopolies, but instead will create new monopolies, and will strengthen previously existing monopolies many fold.

Claim: PCP’s will be aided by the ACA
reality: Funding for Medicaid will skyrocket under the affordable care (the ACA). A large portion of the patients, newly “created” by the ACA, will be covered only under Medicaid. Primary Physicians, will therefore, not be substantially aided, unless the PCP accepts a large mix of Medicaid patients. Not only is it not financially possible for most primary care osteopaths to accommodate a large percentage of Medicaid patients, but doing so will be exceedingly hazardous. I would like to bring your attention to the June 8 2013th issue of the American medical news, please see the article entitled: “Medicaid’s mounting audit pressure” in which the AMA alleges that “a new auditing program that rewards contractors for identifying improper payments” is being created and “healthcare professionals who treat Medicaid patients are being warned to prepare for more audit activity”.
Even if accepting Medicaid patients were miraculously to become “an aid” to primary care physicians, we would still be harmed by the ACA. This is because the ACA imposes upon community-based primary care physicians marked increases in unfunded governmental mandates. These massive overhead imposition include electronic health records whose costs can be astronomic, and who’s dysfunction frequently impedes patient care. To make matters worse, the enormous unfunded governmental mandates created by the ACA, comes synchronously with movements on the state levels to have nurse practitioners be given the same recognition, and rights to practice as primary care osteopathic physicians. This production of a large class of “pretend physicians” will further aid the monopolies which the ACA will create in competing against real and legitimate doctors. The ACA further empowers insurance companies, retail establishments ( Wal-Mart, insurance companies) to take the most profitable part of our practices ( upper respiratory tract infections, acne, low back pain) and leave us with only the most difficult and least profitable cases. I don’t see how that represent an environment in which PCP’s will thrive.

claim: small businesses and patients will benefit from the ACA
reality: the ACA offers little more than a convenient internet site through which consumers can organize and purchase insurance. The ACA had initially promised to decrease healthcare costs by creating mechanisms which would incentivize insurers to decrease their profits in order to participate in a system where they would be confronted with a simple choice: decrease profits and benefit from volume, or be excluded from the marketplace. That tact would have benefited physicians and consumers alike. Alas, this market strategy was derailed by the influence of insurance company lobbyists. As it stands, the ACA currently does nothing to increase competition among insurers, in fact, since the ACA mandates insurance coverage, and penalizes the lack of such coverage, and since the ACA does nothing to increase competition among insurance companies, then the ACA paradoxically destroys whatever diminutive current market incentive may exist among insurers to compete! This anti-competitive consequence of the ACA will NOT reduce insurance profits (and the subsequent cost of healthcare) but instead will increase the cost of care in a way similar to what we experience in NJ in the auto insurance arena

My concerns over the provisions and potential consequences of the ACA are not fatuous. The ACA will enable, incentivize, and give strategic advantage to monopolies. Insurance companies, retail businesses, and medical schools will compete directly against primary care doctors. I am fearful that this new medical economic reality will destroy the ability of community-based primary care physician to operate successfully. Because primary care community physicians remained the backbone of Osteopathy, the devastation of this cohort will, over the course of a couple of decades, lead to the extinction of the Osteopathic profession.

The concerns listed above, should lead prudent physicians to take an analytic approach to the ACA, and should compel all Osteopathic Physicians to think hard about how we should respond to its challenges.


Bradley Kline DO