UPDATED Petition to Support Lifelong Learning and Oppose Maintenance of Licensure (MOL) in Iowa

James Amos
James Amos Iowa City, Iowa 31 Comments
68 Signatures Goal: 100


The Maintenance of Certification (MOC) was mandated by the American Board of Medical Specialties (ABMS) in the year 2000 for their 24 specialty boards, including the American Board of Psychiatry and Neurology (ABPN). The rationale for creating the MOC was to address a perceived need by the public for greater accountability from physicians in terms of safe practice for protection of the public, continuous quality improvement, and competence.


If you were board-certified after 1994, you are required to participate in the MOC program. If you have a time-unlimited certificate in psychiatry, you are not required to participate although you will be publicly identified as “certification inactive” if you don’t. The MOC is for physicians who have time-limited certificates in psychiatry, which means during each 10 year cycle during their careers, they are responsible for demonstrating they are keeping up to date with their medical knowledge and practice.


There are several MOC components that diplomates are required to complete over the 10-year cycle. Many physicians believe they take time away from patient care and there is no high level research evidence showing that they improve patient outcomes, ensure safety, or enhance the physician-patient relationship. There is some evidence that they lead to non-profit boards making a great deal of money which tends to be associated with very large salaries of top executives. The Association of American Physicians and Surgeons (AAPS) filed a lawsuit in Federal court in April 2013 against the ABMS regarding antitrust concerns about MOC.


The Maintenance of Licensure (MOL) is another regulatory layer on top of Maintenance of Certification (MOC) promulgated by the Federation of State Medical Boards (FSMB) for the purpose of providing evidence that physicians are participating in a program of continuous professional development. According to the FSMB, if you’re compliant with MOC, you would be in substantial compliance with MOL.


It’s being proposed that MOL be a condition of medical licensure. The FSMB is a non-profit organization representing the nation’s 70 state medical boards with whom it is working to develop a MOL system for the United States. Implementation pilot projects are reportedly underway in several states including Iowa to study and implement MOL.


A resolution to support lifelong learning but oppose MOL was adopted in Iowa in April 2013 by the Iowa Medical Society House of Delegates. The resolution was sponsored by Dr. James Amos, MD and co-sponsored by the Iowa Psychiatric Society. MOL was defeated on the grounds that it would be duplicative as it really is not distinguishable from MOC, especially since the FSMB essentially makes MOC a sufficient condition for satisfying requirements for MOL. Several similar resolutions have been adopted in many states including New York, Michigan, Wisconsin, North Carolina, New Jersey, Ohio, Pennsylvania, California, and Oklahoma.


But the Iowa Board of Medicine (IBM) is still pursuing MOL implementation pilot projects. The next step for the IBM is to distribute an online survey to Iowa licensees to investigate a number of items, including board certification status, how licensees manage their continuing education, and hopefully, a poll query as to whether or not licensees favor the imposition of MOL.


This petition is for the purpose of supporting lifelong learning but opposing the implementation of MOL in Iowa. The IMS has already adopted a resolution to oppose MOL and the IBM knows that. Iowans and anyone else who supports this petition needs to send a strong, clear message to the IBM and the FSMB that we don’t want MOL in Iowa.


Thank you for your support in signing this petition.




Sponsor

Dr. James J. Amos, MD is currently the sponsor of the resolution to oppose Maintenance of Licensure (MOL) in Iowa. The Iowa Psychiatric Society is in support of and has agreed to co-sponsor this petition, which is also the resolution, and the resolution was adopted with minor changes by the Reference Committee at the Iowa Medical Society House of Delegates meeting on April 21, 2013 at The Coralville Marriott in Coralville, IA. The petition here has also been updated accordingly.

Links

http://thepracticalpsychosomaticist.com/ where you can find Dr. James Amos's blog posts on Maintenance of Certification and Maintenance of Licensure under the menu heading "Let's Rap About Maintenance of Certification".
  • Clifford Feiner
    Clifford Feiner United States, Floral Park
    Jul 07, 2014
    Jul 07, 2014
    MOL in any state is a mistake. Dr. Hank Chaudhry, the president of the FSMB, is mentally bankrupt and does not consider patients in his decision. Please, please don't let Iowa become a state he can point to with pride!!
  • Wendy Buresh
    Wendy Buresh United States, Cedar Rapids
    May 03, 2014
    May 03, 2014
    Whoever decided that requiring more and more testing would improve quality of care? Is there some hidden research that proves this?
  • Kathy Murrayleisure
    Kathy Murrayleisure United States, Plymouth
    May 03, 2014
    May 03, 2014
    Nice comments, Dr Amos, especially about high stakes MOC shakedowns "paid under duress". This Iowa petition and, more importantly, legislative or judicial respite from the ABIM testing monopoly is critical for rebuilding medical manpower and keeping good physicians and surgeons in ALL states, not only for Iowa. With 10% or more of previously Board certified doctors, -- physicians and surgeons, academics and community doc's, young docs and gray professors, mid career specialists, medical society leaders -- every doctor first Board certified since 1988 (ABIM) at risk every year for losing Board recognition and losing viable practices and university roles solely due to failure to complete these peculiar, thousand dollar MOC programs of dubious relevance, this issue should become an emergency action for the AMA, state societies, and our state legislatures. Independent scholarship, lifelong learning, and unbiased CME programs would replace better the arbitrary demands of MOC since 1990. MOC has no benefits for patient care but clearly curtails the supply of physicians available to care for patients. Stopping MOC-precipitated disruptions to the physician workforce and breaking the MOC business monopoly is needed for seamless, cost effective US health care and universal patient access to their physicians of choice. It's an un American restriction of medical trade to allow a few wealthy physicians within the powerful, high revenue, tax exempt MOC industry, unelected, with no external oversight, to choose whom will remain "Board certified" over time. Licensure, hospital appointments, university appointments, and health insurance reimbursements should be INDPENDENT of MOC. Licensures, privileges, and physician payments should not be limited to those doctors who paid their thousands of dollars and completed MOC clearly "paid under duress".
  • Katherine Murray L, MD
    Katherine Murray L, MD United States, Plymouth
    Apr 28, 2014
    Apr 28, 2014
    Lifelong learning, independent research and investigation, and our professions dedicated to teaching, excellence in practice and scholarly pursuits, including many different forms of CME, should not be constrained or strangled by high revenue MOC programs of questionable relevance and scientific accuracy. Thank you, Iowa, for working to stop the MOC testing industry and virtual monopoly in your state.
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68

Signatures

  • 3 years ago
    Matt Stuart, OMS2
    3 years ago
  • 3 years ago
    Clifford Feiner
    3 years ago
  • 3 years ago
    Daniel D'Auria
    3 years ago
  • 3 years ago
    Wendy Buresh
    3 years ago
  • 3 years ago
    Kathy Murrayleisure United States
    3 years ago
  • 3 years ago
    Chantal Nouvellon United States
    3 years ago
  • 3 years ago
    Antonio M Licata, DO
    3 years ago
  • 3 years ago
    Puneet Garcha
    3 years ago
  • 3 years ago
    Erin Underwood D.O.
    3 years ago
  • 3 years ago
    Ben Van Raalte
    3 years ago
  • 3 years ago
    Wael Nasser
    3 years ago
  • 3 years ago
    Katherine Murray L, MD
    3 years ago
  • 3 years ago
    Robert Yin
    3 years ago
  • 3 years ago
    Sandra Garred M.D.
    3 years ago
  • 3 years ago
    Michele meyer
    3 years ago
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