MOC changes haven’t quieted uprising

There have also been a huge number of complaints about the self-evaluation of practice assessment MOC, often referred to as practice improvement modules or PIM’s. There will be less direct data collection by the ABIM, and more of a focus "on improvement activities doctors may already be doing in their practice," Dr. Baron said.

But Dr. Kim noted that it might not be that simple. Existing EMR products do not have the capability to assess most subspecialty-specific measures. "We urge the ABIM to bring its influence to bear on the health IT industry, to develop standardized templates and reports," said Dr. Kim. Ideally, maintenance of certification practice assessments will harmonize with federal quality reporting programs.

Among other things, ABIM is also looking at changes to the secure exam and whether it needs to change how it describes on its website whether physicians are meeting MOC requirements (see related story on p. 5 for more details on ABIM changes).

However, many at the July meeting questioned whether the current exam truly reflects physicians’ clinical abilities. Pass rates for the recertification exam have steadily declined over recent years for many subspecialties. AGA has communicated this concern to ABIM on several occasions, helping to instigate the new changes to ABIM’s governance and operational structure.

"AGA wants a role in determining the components of recertification. We will ensure the requirements are a reflection of competent clinical practice," said Dr. Rose.

Despite the newly announced changes from ABIM, critics remain dissatisfied.

Dr. Ron Benbassat, an internist in Beverly Hills, Calif. and a founder of Change Board Certification, said, "No one is drinking the ABIM’s Koolaid." He added, "The momentum is increasing and I believe we’re reaching the tipping point. As to what form it will take – widespread noncompliance or political or legal, I don’t have the answer."

Dr. Teirstein was a bit more muted in his criticism. "They are certainly taking many good steps. But, the devil will be in the details." He, like many physicians, said that he still sees the ABIM’s fees as a big problem. "To reestablish credibility, ABIM will need to roll back its fee schedule," said Dr. Teirstein.