Several months ago on Medscape there appeared a discussion question “Why be Board certified?” The opening paragraph detailed the issue of pediatricians now competing for jobs with mid level providers. These latter are lesser educated, permitted to work without physician supervision in a growing number of places, have no requirement for the kinds of extensive, expensive certification/recertification processes as do pediatricians, and are paid quite well. With that stated, the question was asked “Is it worth maintaining Board Certification...?” Comments were almost all negative and the vote was almost 70% saying “no” with over 500 votes cast thus far. Similar sentiments have been expressed at pediatric meetings, in independent discussions, and elsewhere on the web. With that as background we the undersigned believe it is the AAP’s clear responsibility to its Lifetime Certified (and other) Fellows to pressure the ABP to: 1. Institute a moratorium on the MOC process until an independent body of pediatricians can demonstrate with good science (evidence based medicine) that the entire process (or perhaps that some part it ) has directly improved the care we provide and also directly improved the health of children. 2. Provide financial data to demonstrate their cost effective use of our money ($40 million now in their bank), including that for staff compensation, to reduce the expense of certification/recertification to pediatricians to the actual direct cost of preparing the exam. 3. Identify Pediatricians only as Board Certified without including the not “meeting the requirements of Maintenance of Certification” which has little meaning to other than regulatory agencies.