From the Journals

Rheumatologists see little value in MOC

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Rheumatologists favor learning, just not MOC

The fact that survey respondents say with almost identical affirmation that MOC helps them stay current on medical knowledge and is redundant with CME suggests that rheumatologists favor continuing to learn about their profession throughout the life of their career but want that learning in an environment they have more control over.

Given the expansion of technology, physicians have access at their fingertips to information, which questions the need for exams that require memorization of details.

New ways are needed to help physicians maintain certification in ways that take advantage of current information technology in a manner that can be more customizable to their practice rather than a one-size-fits-all examination.

David Karp, MD, PhD , is chief of the division of rheumatic diseases at the University of Texas Southwestern Medical Center, Dallas. His comments are paraphrased from an editorial accompanying the survey report (Arthritis Care Res. 2018 Dec 20. doi: 10.1002/acr.23822 ). He had no relevant disclosures.



A recent survey of rheumatologists revealed they are finding little value in the maintenance of certification program.

Among the 515 rheumatologists responding to the survey, 74.8% “did not think there is significant additional value in MOC, beyond what is already achieved from Continuing Medical Education,” Amr Sawalha, MD, and Patrick Coit, both of the University of Michigan, Ann Arbor, wrote in Arthritis Care & Research. The survey was sent to 3,107 rheumatologists in the United States.

The survey also found that 63.5% of respondents “did not believe board recertification and MOC are valuable in terms of improving patients’ care,” although 65.6% did perceive that staying current with new knowledge was a positive effect of participating in the MOC process, Dr. Sawalha and Mr. Coit wrote.

On the flip side, requiring MOC was perceived to be a contributor to physician burnout by 77.7% of respondents and to early retirements by 67.4% of respondents.

“If participation in MOC indeed does not have a significant value on improving patient care in rheumatology, as indicated by the perception of practicing rheumatologists, and if it remains a requirement to practice for at least over a third of rheumatologists in the United States, then an argument can be made that elimination of MOC might be a way to sustain and improve the rheumatology workforce without compromising quality,” Dr. Sawalha and Mr. Coit wrote. “To our knowledge, there have not been any studies to show that rheumatologists participating in MOC activities provide better care.”

Another aspect that the survey revealed is the rheumatologists’ perception of certifying organizations.

“A striking finding from our study is the indication that there seems to be a lack of trust in [the] board-certifying organization and their motives among practicing rheumatologists in the United States,” the authors wrote. “When asked to rank in order what is thought to be the reason for creating MOC programs, financial well-being of board-certifying organizations was the highest ranked answer. Improving patient care, which is the motive claimed by board-certifying organizations, was the least likely ranked answer.”

Indeed, about 60% of respondents believe alternative organizations, such as the American College of Rheumatology, should be administering or overseeing the board certification process for rheumatologists.

“Regardless of what the motive might be, these results suggest that practicing physicians, and in this case rheumatologists, do not trust board-certifying organizations,” Dr. Sawalha and Mr. Coit wrote. “Therefore, we suggest that these organizations revisit their relationship with practicing physicians and facilitate true collaboration with physicians to determine the best way to assess and ensure physician competence and knowledge.”

The authors declared that they have no financial conflicts of interest.

SOURCE: Sawalha A and Coit P. Arthritis Care Res. 2018 Dec 20. doi: 10.1002/acr.23823

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