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If Not Maintenance of Certification, What?

by Robert H. Miller MD, MBA •

3. It’s Time Consuming

Any quality improvement program that encourages lifelong learning requires some time commitment. The ABOto MOC program has evolved a great deal over the past 11 years working within the ABMS-mandated MOC framework. The ABOto carefully studied (and continues to evaluate) each of the four components using the guiding principles of relevance, ease of use and cost effectiveness before sequentially rolling out the complete program. Furthermore, the ABOto has designed and will modify MOC so that diplomates can complete multiple reporting requirements such as PQRS and maintenance of licensure (MOL) by participating in MOC.

One misunderstanding in the debate is that states are going to require MOC to maintain one’s license. The states are developing MOL programs that are similar to, but quite different from, MOC. The fact is that if a diplomate participates in his or her board’s MOC program, he or she will meet the state’s MOL requirement.

If Not MOC, What?

An important point that does not seem to be included in the debate is that the quality improvement train left the station at least a decade ago, and there is no going back to the “old days” of no post-training accountability.

If MOC were to go away as some would like, the practice of medicine would not return to the days of the timeless board certificate without any obligations for quality improvement. Government agencies such as CMS, Republicans and Democrats, payers, and patient groups are all behind quality improvement. Without MOC, the government and others will fill that void, and I think all of us would agree that it is far better for physicians to drive the train rather than non-physician entities.

It is suprising that a few vocal physicians have voiced such strong opposition to something both professionals and lay people view as having a positive benefit for society. I believe we risk a backlash by not endorsing key elements of contemporary medical practice, namely, ensuring the delivery of high quality, evidence-based care. The vast majority of us are willing to go the extra mile to improve our practices and provide the best medical care possible for our patients. If each of us were to switch roles with our patients and ask, “What would I want from my doctor?” the answer is obvious!

Dr. Miller is physician editor of ENTtoday.