MOC is medicine’s self-inflicted wound


Right now, there’s nothing more angst-producing to physicians than maintenance of certification (MOC).

Go to the physician-only message board Sermo, and you’ll see dozens of threads on the topic.  Not surprisingly, all are negative.

But rather than debating MOC itself in this post (if you want to do that, there are other places to do so), I want to take a step back and highlight a larger issue.

Physicians are wasting valuable time and resources fighting MOC.

Let me be blunt: The public doesn’t care about the mechanics of how doctors recertify.  They just want board-certified physicians.  They don’t care about the busywork of completing practice improvement modules and hounding patients to fill out tedious surveys.

While I applaud doctors like Danielle Ofri, who wrote about MOC in the New York Times, to most patients it must seem petty for doctors to be squabbling about this, especially against the backdrop of the larger health issues they face.

And they’re right.  The MOC overreach by the American Board of Internal Medicine (ABIM) is medicine’s self-inflicted wound.  MOC has unified doctors in a way that other issues haven’t.

Rather than spending our energy on issues that really matter — medical malpractice reform, making EMRs more user friendly, and easing the crushing bureaucracy impeding today’s physicians, to name a few — we’re wasting our resources fighting MOC.

Indeed, in a recent communication from the American College of Physicians, addressing MOC is their “#1 priority.”

Really? Of all the issues we face in health care, this is the one where we collectively draw a line in the sand?

Pardon me, but that’s just stupid.

While it’s encouraging that professional organizations like the ACP are actively responding to the concerns of their members, it’s also taking away from efforts that matter more in the long-term.

We’ve taken our eyes off the ball.  Fighting among ourselves on MOC means that more concerning problems that threaten our profession are left unchecked.

Thanks to our medical leaders for shooting the medical profession in the foot.

Kevin Pho is an internal medicine physician and co-author of Establishing, Managing, and Protecting Your Online Reputation: A Social Media Guide for Physicians and Medical Practices. He is on the editorial board of contributors, USA Today, and is founder and editor,, also on FacebookTwitterGoogle+, and LinkedIn.

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