Oklahoma Governor Signs Anti MOC/OCC Legislation!

An Oklahoma physician writes in:

Yesterday, April 11, 2016 our Governor signed a bill preventing entities from using MOC or OCC as a condition for licensure, reimbursement, employment or admitting privileges at a hospital.

Click here to read SB 1148.

This is HUGE!!! We essentially blocked ABMS and AOA lobbying efforts and hopefully blocked the Interstate Compact law (which we successfully squashed for this year’s legislative efforts).

This may be a model to squash MOC and OCC forever.

Note: This victory follows Kentucky’s anti-MOC, bill SB 17, passed earlier this year.

Total betrayal by AOA of ALL its members.

Your AOA dues are hard at work promoting the Interstate Medical License Compact.  This will mean mandatory certification for all new graduates before obtaining a license.  And the claim that OCC isn’t required for licensure through the Compact is pure smokescreen.  Does the AOA underestimate the intelligence of its members? Or perhaps AOA staff overestimates their own?

Is OCC required for licensure through the Compact?  “The answer to this question is ‘no,'” states the Commission. Yet a few sentences later they explain, “a physician must demonstrate current certification to be eligible for licensure via the Compact.”

Except for “grandfathers,” osteopathic physicians must pay in time and dollars for OCC compliance if they want to maintain their certification. OCC IS required for Compact participation.  Q.E.D. Continue reading

Wake up ABOG, you are tearing the House of Medicine apart to protect MOC

Guest Post from Howard C. Mandel, MD

On February 10, 2012 Medical Economics published my letter: Why don’t lawyers have to be recertified?

As an obstetrician/gynecologist who finished my residency in 1985, I earned a 10-year certificate when taking my boards. If I had graduated in 1984, I would have been certified for life. The American Board of Obstetrics and Gynecology (ABOG) requires a two-part exam. The first part is written, and the second is a 3-hour oral examination, part of which is based on the entire list of all the physician’s hospitalized patients plus representative outpatient visits. I passed and was recertified 10 years later. In 2001, my specialty board modified the certificate to be valid for 6 years. Continue reading

MOC: This Abuse Has to End NOW

Dr. Ken Lee weighs in on KevinMD blog post “The Real Cost of MOC is Stunning” :

This profession is too used to abuse . It begins in pre-med, medical school and our training as “students” where our US labor rights are violated. Even college athletes have won a Federal case to get classified as employees of the colleges that were using them as “students”.

We have to influence our colleagues to stop swallowing each cup of poison they want us to drink. The costs of MOC for Int Med exceeds what I get paid from any contract I have with United, Aetna or Cigna, making the MOC a huge loss anyway you look at it. The summer months are supposed to be slow for medical care but I was seeing 23 patients a day with another 90 minutes of computer work at night to just do the documentation, MU, PQRS etc.

The only way I could do MOC is to not sleep or sacrifice my family time which my wife says will never happen again as she has seen hundreds of hours lost in the past due to the re-certification exams. I have lost entire weeks of my life for this certification scam.

The human cost of MOC is not fully exposed and must be. The hundreds of hours of our scarce free time is lost for trivial pursuit that we all know does NOT improve patient care ( 2 JAMA studies 2014 prove this ) . The psychological toll of fear , potential loss of income and actual loss of money on this coercion is glossed over, as if we were all CEOs making $4million a year at a non-profit hospital.

I never see written interviews of the families who suffer the absence of a parent who is hostage to recertification /MOC; what does it do to them? This abuse has to end now . People call us doctor which seems to elevate us but in reality we have become almost slaves. One of my long times friends finally got his BA degree and he runs a hospital physician system that employs 22 MD/DOs ; they have to answer to him . So much for the doctor title.

Ken Lee , Internal Medicine, private practice.

Poll: How Much Time, Money Do You Spend on MOC?

Via Medical Economics:

A new study has set out to quantify the time and cost many internists and internal medicine (IM) subspecialists will spend to meet the American Board of Internal Medicine (ABIM) maintenance of certification (MOC) requirements. Over the course of 10 years, a 35% increase in fees and 26% increase in hours spent was found.

The study also found when the dollar value of physician time is added to MOC fees, internists and IM subspecialists will spend $23,607.

ABIM President Richard Baron, MD, disputed the study’s assumption that continuing medical education (CME) credits will only amount to 25% of the requirements. Baron said that CME could easily satisfy 100%, not 25%, of the requirements.

Medical Economics asks: Do these numbers accurately reflect an increase in the time and money you expect to spend on MOC over the next 10 years?

Give YOUR feedback in short poll at: http://www.medscape.com/viewarticle/849196

Viewpoint of Abandoning MOC Deserves Discussion & Publication

Paul Kempen, MD, PhD writes Howard Bauchner, Editor-in-Chief JAMA

Dear Dr Bauchner,

While you have taken great care to include various viewpoints on ways to perform MOC, you have never allowed a viewpoint that argues for abandoning MOC entirely. Instead, you use Tierstein and Topol’s work as an “opposing view” on MOC when, in fact, it is another permutation of the same concept-only industrial competition has invited this view. Therefore, I respectfully ask you to consider publishing a perspective piece (“viewpoint”) that makes a case for abandoning the “MOC” program entirely in lieu of a more conventional CME model. I would also emphasize the difference Between MOC and CME is that CME is self-directed and MOC is centrally-directed — hence, a VERY different concept that has large patient care ramifications (and not to mention the recently documented by the very salesmen of this product (ABIM/ABMS, Etc) to have been a mistake). Continue reading

$8.5 Million Judgement Against MDVIP, Is ABIM Next?

Paul Kempen, MD, PhD writes in:

Please check these stories from Feb Modern Healthcare (links below). I think application of this information to the ABIM and ABMS would be a new and possibly very effective strategy. If a concierge firm can loose $8.5 million for essentially false advertisement-the ABMS “higher standards better care” is also false advertisement and THEY actively sell their certification based on “quality indicator” to patients and CONGRESS! Hundreds to Thousands of ABMS certified docs commit malpractice each year-not better medicine!

The second article indicates the FTC and the US Justice Department’s Antitrust Division should also be willing to investigate the ABMS for clear waste of funds as the same “Quality indicator” lie. The AAPS could stand to win MiIlions from a Qui Tam suit BECAUSE the FEDs PAID millions to doctors for nothing under the 4 years of PQRS-MOC and because it was now discontinued before the feds could introduce large penalties for NOT doing MOC, this was all a waste of federal Medicare dollars. I demonstrated per CMS FOI data the $1 million was spent in 2011 alone on MOC PQRS.

Antitrust enforcers study impact of new models on competition
http://www.modernhealthcare.com/article/20150221/MAGAZINE/302219947

Concierge firms rattled by med mal award
http://www.modernhealthcare.com/article/20150221/MAGAZINE/302219969