New MOC Standards Designed to Reduce Physician Error

In efforts to improve the quality of healthcare and reduce the percentage of physician error, many privately run medical boards are enforcing new Maintenance of Certification programs. While doctors have historically been required to pass challenging exams approximately every 10 years to remain certified, many boards have put new regulations in place forcing them to enroll in official MOC programs between exams.

While the new MOC programs are designed to allow physicians to demonstrate a commitment to lifelong learning and quality improvement in healthcare, many are less-than-pleased with the additional workload. This has led to a heated debate regarding the measures board-certified physicians should need to take to prove their skills and knowledge-levels meet minimum requirements.

New requirements designed to reduce physician error

Roughly three-quarters of all U.S. physicians are certified by 24 privately run medical boards ─ in addition to holding an active state medical license. Private board membership denotes a mastery of a wide-variety of specialties, ranging from orthopedics to internal medicine.

The American Board of Internal Medicine put its new regulations into practice in January. With more than 250,000 members, the organization serves as the largest specialty board, making it very vulnerable to criticism. In response to the new system requiring internists to earn points every two, five and 10 years by successfully completing an array of training modules, physicians are fighting back with an online petition that has garnered more than 17,000 signatures since April. Petitioning physicians want the board to waive all new MOC requirements, leaving just the exam every 10 years.

The American College of Cardiology recently conducted a survey of its members ─ most all are board-certified internists ─ finding that 87 percent oppose the new MOC requirements. Similarly, the Association of Clinical Endocrinologists have responded to the new regulations by claiming the MOC programs are becoming a hurdle between patients and physicians. They believe that completing the requirements is both too time consuming and causing many professionals to stop practicing.

However, the American Board of Medical Specialties ─ responsible for the oversight of 24 medical boards ─ has responded by supporting the MOC programs. ABMS President, Lois Nora, says the public holds board certified physicians to a certain standard and merely taking a test every 10 years is not enough to keep skills updated. She says the majority of practicing physicians have not taken formal courses teaching them proper patient safety measures or quality improvement strategies, and MOC is a way to make sure they’re receiving this training.

MOC activities designed focus on quality improvement

In a statement, Richard Baron, CEO of the American Board of Internal Medicine, noted that the skills of many physicians are not as current as they believe. For example, the pass rate on the 10-year exam for internists plummeted from 90 percent five years ago to 65 percent this year. He says many of the MOC activities are designed to promote new demands on physicians to demonstrate quality improvements.

Regardless many physicians still aren’t ready to accept the new requirements. The Association of American Physicians and Surgeons has filed a federal lawsuit against the ABMS with restraint of trade. While the ABMS reasons that board certification is “voluntary,” many doctors say they feel forced to maintain certification to keep hospital privileges and enjoy access to insurance networks.

The ABMS has released a statement claiming that the lawsuit allegations “are without merit.” The organization says that more than 500,000 of 800,000 board certified physicians have enrolled in the MOC programs. Additionally, many physicians are exempt from these regulations because they received certification prior to 1990, when the designation was life-long.