MOC Update: Physicians Championing Change Press Onward
The founder of an alternative to MOC "would love to disband it" if boards come up with a new plan to make MOC meaningful and cost-effective.
The debate around maintenance of certification (MOC) has been raging for more than two years, during which some physicians have effectively changed the conversation around what it means to stay current in their profession.
This week, I spoke with two of them: Paul Teirstein, MD, is chief of cardiology for Scripps Clinic in San Diego, and creator of an alternative certifying body, the National Board of Physicians and Surgeons (NBPAS).
Scott E. Shapiro, MD, FACC, FCPP, is a cardiologist at Abington (PA) Medical Specialists, president of the Pennsylvania Medical Society, and member of the American Medical Association (AMA) House of Delegates.
They spoke about their respective thoughts on the state of MOC, ongoing advocacy efforts, and what this work means to practicing physicians. The transcript below has been lightly edited.
HLM: Dr. Teirstein, how do you feel about what you've achieved so far with the NBPAS?
Teirstein: We've had great success. We have over 4,000 diplomats and over 40 hospitals have accepted the National Board. It continues to grow. We get a handful of doctors that apply every day.
I would love to disband it if the American Board of Member Specialties (ABMS) member boards would come up with a plan that is meaningful and was the right price and not despised by doctors.
They've made changes in the right direction, but we have a long way to go until we have less onerous, less costly, meaningful ways of demonstrating that we're keeping up with changes in medicine.
The changes have been too slow. And they're being replaced with take-home tests, which give us doubts about whether they'll be any real learning going on. Finally, we've not heard a thing about reducing costs.
HLM: Dr. Shapiro, how have attitudes within the culture of medicine shifted regarding board certification in recent years?
Shapiro: I think the AMA is a very good litmus test of the current environment.
The AMA doesn't [traditionally] make decisions like we did in June to really condemn those boards that still have these high-stakes, punitive computer exams. And in debate, many really applauded those that focused on continuing education and not maintaining profits.