Final ‘Vision’ report addresses MOC woes


“We would certainly hope that the ABMS and the member boards will follow the direction of the Vision Commission very directly and succinctly,” he said. “That is why we suggested that some of the recommendations from the Vision Commission should use words like ‘should’ and ‘must’ and not just ‘encourage’ and words like that.”

That recommendation was taken and implemented in the final document.

Societies differed in how often participation in the certification process should occur.

The American College of Rheumatology in its comments challenged a recommendation that certification should be structured to expect participation on an annual basis.

“The ACR supports the importance of ongoing learning,” it stated. “However, no discussion is provided as to how and why the recommendation for annual participation by diplomates was conceived. For some ABMS Boards, an annual requirement will increase physician burden unless continuing certification is modified to a formative pathway. If this recommendation is to be retained, the commission would be encouraged to emphasize that inclusion of annual participation should be part of an overall program structure plan that supports a formative approach to assessment. In addition, the ACR requests that ABMS Boards allow exceptions without penalty to be made to this annual requirement to all for live events.”

The American College of Cardiology took a different point of view with regard to this recommendation.

In its comments, ACC stated that it “concurs with this recommendation. Annual participation is a feature of the ACC’s proposed maintenance of certification solution. The ACC believes that ABMS boards should recognize, and make allowances for, physicians who may, for valid reasons (illness, sabbatical, medical or family issue) may not participate in MOC for a period of a year.” ACC generally concurred with the recommendations in the draft.

The final document presented the commission’s view that the ABMS member boards “need to engage with diplomates on an ongoing basis instead of every 2, 5, or 10 years. The ABMS Boards should develop a diplomate engagement strategy and support the idea that diplomates are committed to learning and continually improving their practice, skills, and competencies. The ABMS Boards should expect that diplomates would engage in some learning, assessment, or advancing practice work annually.”

The American Gastroenterological Association, in its comment letter on the draft, said it was “greatly concerned” about the inclusion of practice improvement data, noting it is “debatable whether it is even within the appropriate domain of the boards to assume responsibility for clinical practice performance and quality assurance.”

The final report states that ABMS “must ensure that their continuing certification programs recognize and document participation in a wide range of quality assessment activities in which diplomates already engage,” and added that “when appropriate, taking advantage of other organizations’ quality improvement and reporting activities should be maximized to avoid additional burdens on diplomates.”

ABMS and its board are not bound to follow any of the recommendations contained within the report, but the commission states that it “expects that the ABMS and the ABMS Boards, in collaboration with professional organizations and other stakeholders, will prioritize these recommendations and develop the necessary strategies and infrastructure to implement them.”

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