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    MOC reform: One year later

    This article reports the latest developments in the process of reform for the American Board of Pediatrics’ Maintenance of Certification (MOC) requirements, what transformations already have occurred, and what changes still lie ahead.


    More nays

    There are many physicians opposed to the MOC certification.

    Cardiologist Paul Teirstein, MD, has started an alternative board of medical specialties called the National Board of Physicians and Surgeons (NBPAS) and is encouraging interested physicians to promote this alternative board to hospitals and insurance companies as well as to other physicians. The NBPAS requires previous board certification and participation in yearly continuing medical education, and membership costs only $169 every 2 years. As of this writing, the NBPAS has enrolled over 3000 members and is accepted by 26 hospitals nationwide.

    Next: Communicating in the high-tech office

    Many pediatricians continue to express their opposition to MOC. Interested pediatricians should view the many anti-MOC blogs available on the Rebel.MD website. Last year, several pediatricians developed the Peds4MOCreform.org website to express their opposition to MOC. So far their site has garnered more than 6500 signatures supporting MOC reform.

    The first anti-MOC laws

    The state legislature of Oklahoma unanimously passed a law that went into effect on April 12, 2016, making it illegal for medical facilities to make MOC a requirement for medical practice.

    The law states: "Nothing in the Oklahoma Allopathic Medical and Surgical Licensure and Supervision Act shall be construed to require a physician to secure a Maintenance of Certification (MOC) as a condition of licensure, reimbursement, employment, or admitting privileges at a hospital in this state."

    Other states such as Michigan and Missouri have similar laws currently under consideration. In addition, in early April, Kentucky governor Matt Bevin signed SB17 into law. This bill is the first state law to be passed and signed that makes it illegal to require specialty medical board certification or MOC as a requirement for practicing medicine in the state.

    There are also 19 state medical societies that have officially expressed opposition to MOC. These are California, Florida, Georgia, Indiana, Iowa, Massachusetts, Michigan, New Jersey, New York, North Carolina, Ohio, Oklahoma, Pennsylvania, South Carolina, Texas, Virginia, Washington, West Virginia, and Wisconsin.

    To be continued

    This concludes my brief reportorial update on MOC reform and opposition. Just because I have not expressed my opinion does not mean that you should not express yours. Has the ABP done enough, or should it do more? Please contact the editors of Contemporary Pediatrics to tell them what you think of these ABP MOC changes.


    Andrew J Schuman, MD, FAAP
    Dr Schuman, section editor for Peds v2.0, is clinical assistant professor of Pediatrics, Geisel School of Medicine at Dartmouth, ...


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      I just signed the Peds4MOCReform petition and have forwarded it to several of my Pediatric friends/colleagues. . . I have passed this thing three times - the last time in 2013, during perhaps the most trying/awful time of my professional life (and given my horrific experience as a public-servant-turned-medical whistle-blower back in the days of "Hillary's village" that's saying a lot). . . Responding to a request for feedback at the end of this last exam, I wrote the ABP's present/past Presidents - telling them my story (it took, I think, a considerable amount of courage to do that). I might as well have tossed the letter into a black hole. . . I've read about the new protocol - and I still think it's too much. I certainly recognize the need to stay current, and after passing the original exam, I am perfectly fine with regular CME and/or some form of low-pressure/open-book testing to be done at MY CONVENIENCE, but I am NOT FINE with the proctored test, or the practically useless/time-consuming "Part 4" activities (seriously, how many times can you do a "hand-washing" or "breast-feeding" module and not want to kill yourself?), or with answering the timed e-mails that the ABP now wants to hurl at me once a week (NO PRESSURE! and as if I don't have enough to do). It's just for the birds. . . I have decided that if the ABP continues down this road, as an older-but-not-quite-old-enough-to-be-grandfathered-in Pediatrician who has suffered mightily because of her ADD (only diagnosed as an adult/after training), I will be seriously considering legal action based on discrimination law (for instance, when I inquired about accommodations for my ADD during the last test, the ABP offered only extra time - completely MISSING the crux of the problem - which, to me is pretty sad given that Pediatrics is the medical specialty that is supposed to understand more than others that not all brains work/process/learn/TEST the same way). . . It's never been fair or right . . . OBTW, when I inquired about participating in the recent feedback sessions - the ABP's "schedule" could not accommodate the response. . . And/so enough is enough. The ABP needs come down out from its rarefied academic towers in Chapel Hill and start LISTENING to its diplomates on-the-ground and in-the-trenches . . . and give credence to voices that they have long/determindedly ignored. . . In point-of-fact, over the years, my Board certification in Pediatrics has meant absolutely NOTHING to a series of smug, self-important, way-over-paid hospital executives and/or lawyers (who do not have to re-pass their bar exams every ten years) who regard Pediatricians as "a dime a dozen" - lowly pawns on their chessboards of power and greed. . . they've done whatever they wanted with no checks or balances and the ABP looking the other way. It's WAY past the time that changed.
    • Dr. Vic Strasburger
      I agree with Mary and feel bad that she's not being treated fairly. Sure, the ABP is making changes -- under pressure -- and the changes they're making are INSUFFICIENT! MOC should be fun, educational, online, and CHEAP! The testing component could be a short quiz at the end of (an educational) module just to show you didn't click through it all at once. The idea that somehow the public and Congress DEMANDS MOC is ludicrous -- in 35 years, I've never been asked if I'm Board-certified (and only been asked once where I went to medical school -- Harvard, BTW). Time for the ABP to make substantive changes, not just window-dressing.


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