Board certification: Valid indefinitely is no longer rings true

I trained in internal medicine and cardiology at the tail end of the era of lifetime board certification by the American Board of Internal Medicine. In fact, my timing was perfect — I was “boarded” in medicine in 1987, and in cardiovascular disease in 1989, which (I am pretty sure) were, respectively, the last years that the ABIM offered certificates without an expiration date in those disciplines.

Late last year, I received a ABIM letter about my “enrollment status” in the ABIM’s maintenance of certification (MOC) program, which stated, among other things, that:

  •  I was not enrolled in the MOC program
  • My ABIM certifications were “valid indefinitely”
  • I could enroll in the MOC program in January, and by so doing, would hence forth be listed as “Certified, Meeting MOC Requirements”

I thought this all a bit strange. After all, how could there be MOC requirements if the certificate was valid indefinitely? I didn’t give it much thought until last week, when I tried to enroll. After a tedious registration process and a very long and somewhat annoying mandatory survey, followed by several more verification steps (medical school, NPI number and state license) I finally got to the enrollment page, where I was asked to provide credit card information to cover the annual $353 charge (including “applicable discounts”).

Now I was really confused, so I called the ABIM.

After a bit of back and forth, here is what I learned:

  • Yes, my board certification is valid indefinitely
  • If I don’t “enroll” in the MOC program, I will be listed as “certified, not meeting MOC”
  •  I don’t have to actually do anything except pay the registration fee to be listed as “meeting MOC”

Does this make sense? I have no requirements, but if I don’t pay $353/year, I will be listed as not meeting requirements? What requirements? I thought I had a certificate that was valid indefinitely.

The only conclusion I could come to is that I was being shaken down by the ABIM, which was saying, in essence, that they would officially downgrade my status if I didn’t play ball and pay up. Whatever you think of MOC, this seems like nothing more than extortion to me.

Ira Nash is a cardiologist who blogs at Auscultation.

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  • Ron Smith

    Hi, Ira.

    It doesn’t matter what specialty. I believe MOC has absolutely nothing to do with quality of medical care. Its a tax and scare scam pure and simple.

    Warmest regards,

    Ron Smith, MD
    www (adot) ronsmithmd (adot) com

  • NormRx

    It’s all about the money? Well, who would have thought?

  • querywoman

    Sounds like a normal monopoly.

  • msfwally

    Dr Nash, does your hospital require MOC for privileges? If so, why?

  • mitiquin

    Of course it’s extortion, and like the passive sheep that we doctors have historically been, we allow such things to haven to us, but no more! Time to take a stand. Mass noncompliance!

  • Gregory Phillips

    The military uses something called the tooth:tail ratio. The tooth being the units that actually do the fighting and the tail the support units. Support units while necessary can be a burden to the ability of the armed forces to perform their primary job if not held in check.

    In medicine the doctors and nurses that actually provide heath care are the tooth and everybody else is the tail. In civilian terminology the tail is overhead. Unfortunately the overhead has metamorphisized to parasites. How many parasites can the body support without killing the host?

    I think we are at a point in medicine where the host is about to die. Not only are we being attacked by lawyers and the government but by our own kind (the boards).

    I’m sure the chairman of the board is a very nice man but what exactly does he do to justify the $500,000+ per year salary.

  • David Mokotoff

    Yes. This is extortion, pure and simple. I like you was grand-fathered into the ABIM for both Cardiology and IM. All of these sub speciality boards have created a cottage industry where ivory tower specialists make money designing the tests and running the training programs. Thank goodness I am retiring from medicine in just five months.

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