Though physicians are certainly committed to lifelong learning, we've heard from many Pennsylvania Medical Society (PAMED) members that Maintenance of Certification (MOC) is a time-consuming, burdensome disaster that is out of touch with their current practice of medicine. PAMED and its physician leaders, as well as several other state medical societies, continued their advocacy efforts on behalf of physicians at the recent annual meeting of the American Medical Association (AMA) House of Delegates in Chicago.
At this meeting, PAMED and the Pennsylvania delegation to the AMA extended their leadership roles in our initiative to further educate their physician colleagues on matters related to the fiscal affairs of the American Board of Internal Medicine (ABIM) and the questionable value of MOC as we support AMA, state, and specialty efforts to create a continuous professional development process that works for all physicians.
"The Pennsylvania delegation took the position we've been hearing from members for quite some time in opposition to MOC to the annual AMA meeting," said PAMED President Scott Shapiro, MD. "During this meeting, PAMED continued its leadership on this issue, convening a national discussion panel to present their research findings, insights, and recommendations regarding the failures of the ABIM and the MOC process. The discussion regarding the actions, finances, and possible historical motivations for the ABIM's actions was eye-opening and alarming."
The AMA House of Delegates ultimately approved resolution 309 as amended, which includes language that:
- Calls for the immediate end of any mandatory, secured recertifying examination by the American Board of Medical Specialties (ABMS) or other certifying organizations as part of the recertification process for all those specialties that still require a secure, high-stakes recertification examination.
- Directs the AMA to continue to work with the ABMS to encourage the development by and the sharing between specialty boards of alternative ways to assess medical knowledge other than by a secure exam.
- Directs the AMA to continue to support the requirement of CME and ongoing, quality assessments of physicians, where such CME is proven to be cost-effective and shown by evidence to improve quality of care for patients.
- Directs the AMA to support a recertification process based on high quality, appropriate CME material. This process will be directed by AMA-recognized specialty societies covering the physician's practice area, in cooperation with other willing stakeholders that would be completed on a regular basis as determined by the individual medical specialty, to ensure lifelong learning.
The adoption of this resolution was viewed as a strong message from physicians across the country to have the AMA take a stronger position on the matters related to the ABIM and MOC. Resolution 309 was cosponsored by Pennsylvania, Florida, California, Georgia, Washington, New York, and Virginia.
Prior to the resolution being adopted, the stage was set by the panel discussion sponsored by PAMED and the Pennsylvania delegation featuring Charles Kroll, CPA, Bonnie Weiner, MD, Wes Fisher, MD, and PAMED President Scott Shapiro, MD, and the announcement that PAMED issued a statement of no confidence in the ABIM.
One physician said that the "Pennsylvania Medical Society melted the meeting down with a blistering two hour exposé on the abuses of the ABIM and the boards in general. With a much needed boost in morale and the data to support strong action, the full house convened on Wednesday and the delegates soundly rejected the Committee's butchering of the resolution, extracted it to a full vote on the house floor, and restored the strong language of the first resolved."
Dr. Shapiro added: "This was a continuation of efforts that have been ongoing for years led by physician leaders in Pennsylvania. The Pennsylvania delegation is very proud to announce that the culmination of years of our hard work resulted in the AMA passing a resolution that was co-authored by our Pennsylvania delegation that ultimately creates AMA policy calling for the immediate end of all high-risk security risk certification examinations by the ABIM, and all our specialties that still require a needless similar exam."