MOC changes haven’t quieted uprising
The ABIM charges $1,940 for a 10-year basic internal medicine certification, which includes a secure examination for each specialty the diplomate chooses to maintain, access to all ABIM self-evaluation products, and any CME credit a physician can claim through completion of an ABIM module. There are basically four requirements: MOC participants have to take a secure exam; they have to complete a module that contains knowledge and patient management questions; another module is on practice improvement; and, a third covers a survey of patient safety and satisfaction.
The fees vary for different practices within the field of internal medicine: $2,060 for a focused practice in hospital medicine for 10 years and $2,560 for any subspecialty – including gastroenterology – for the 10 years.
"Physicians are forced to spend unreasonable time and expense to collect this data," says Dr. Kim. "The time needed to fulfill new expanded MOC requirements should not come at the expense of time spent on patient care."
The ABIM said in its July 28 letter that extensive evidence does exist that the ABIM process works – with more than half of the studies coming from non-ABIM researchers – but that maybe it hasn’t done the best job of communicating that to diplomates. However, it does say it welcomes partnering on new projects "and a broader discussion of [sic] potential research agenda."
Many say that they are in favor of requiring lifelong learning, but that the ABIM has gone about it the wrong way. Dr. Steven Weinberger, chief executive of the ACP, said that his organization wants to see more customization of the secure board exam "so that it’s more relevant to a particular physician’s practice."
Many who attended the ABIM’s July 15 meeting said that they felt like the organization had heard their concerns. But they are still waiting to see what will happen next.
The changes already announced "are a very good start," said Dr. Weinberger, who said that the ACP hopes that the ABIM board might make more changes at its meeting in August.
Likewise, Dr. Eric Green, chair of the MOC Task Force at the Society of General Internal Medicine, said that the SGIM would continue to work in cooperation with the ABIM. The question is how much the ABIM will use the input from the subspecialty societies, he said.
Dr. Christopher White, professor and chairman of medicine at the Ochsner Clinical School, New Orleans, a founding member of Physicians for Certification Change, who has signed the pledge of noncompliance, is a bit more skeptical. "I think the ABIM is going to have to be a lot less arrogant," he said, calling for more accountability by the organization.
