Experts discuss pros and cons of maintenance of certification

(HealthDay)—The pros and cons of the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) are discussed in two articles published in the Jan. 8 issue of the New England Journal of Medicine.

Mira B. Irons, M.D., and Lois M. Nora, M.D., J.D., from the American Board of Medical Specialties in Chicago, discuss the controversy surrounding the MOC. To address the exponential increases in knowledge and research, the U.S. medical specialty boards adopted the MOC as part of an integrated quality-improvement framework. The researchers note that there is growing evidence that MOC can improve physician performance and patient outcomes. To ensure the program meets the needs of patients, physicians, and the greater community, periodic reevaluation is necessary. The 2015 MOC provides an opportunity to work toward improving patient care and support physicians.

Paul S. Teirstein, M.D., from Scripps Clinic and the Scripps Prebys Cardiovascular Institute in La Jolla, Calif., describes other aspects of MOC. He notes that evidence supporting the value of MOC is ambiguous at best. Furthermore, the rigorous requirements for initial certification cannot be equated with the requirement for MOC every two years. Lifelong learning alternatives exist in the form of continuing medical education, which physicians have accepted as having value. Many physicians are opposed to MOC and its new requirements. An alternative certification option offered to compete with ABIM would benefit patients and physicians.

"Many physicians are waking up to the fact that our profession is increasingly controlled by people not directly involved in patient care who have lost contact with the realities of day-to-day clinical practice," Teirstein writes.

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