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

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!!

Whoever decided that requiring more and more testing would improve quality of care? Is there some hidden research that proves this?

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".

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.

http://www.propublica.org/article/citing-distraction-quality-forum-ceo-resigns-board-seats

The ABMS should demonstrate conclusively that the onerous and expensive MOC process that they have mandated, actually does what it purports to do. Evidence based assessment is no less important than evidence-based medicine and to simply assert that the process they have adopted is valid, does not make it so.

i am signing the petition to stop the MOC

1. I believe a routine exam would be sufficient to assess competence. 2. The incompetent may still practice without board certification. 3.The MOC serves bureaucrats and not the patients or their physicians. 4. Free market and superego (internal) are better regulators than centralized authorities and ego ([police)!

I found a more succinct version of the provision for MOC in the ACA law at link http://www.dpc.senate.gov/healthreformbill/healthbill53.pdf "Sec. 3002. Improvements to the physician quality reporting initiative. Extends through 2014 payments under the PQRI program, which provide incentives to physicians who report quality data to Medicare. Creates appeals and feedback processes for participating professionals in PQRI. Establishes a participation pathway for physicians completing a qualified Maintenance of Certification program with their specialty board of medicine. Beginning in 2014, physicians who do not submit measures to PQRI will have their Medicare payments reduced. Section 10327 provides an additional 0.5 percent Medicare payment bonus to physicians who successfully report quality measures to CMS via the new Maintenance of Certification program and eliminates the MA Regional Plan Stabilization Fund." My point is to distinguish this from MOL, which is not mandated by the ACA law. I sponsored the resolution to support lifelong learning and oppose MOL predicated partly on the recognition that it's duplicative and therefore unnecessary. And allowing MOL to get established in any state could make it harder to recruit physicians to practice there, especially in physician shortage areas. Many physicians don't want participation in MOC tied to obtaining and renewing their medical licenses, which is what MOL would mean. The only mandate for MOL comes from the FSMB, a corporation whose leadership has recently changed and which I hope augurs well for physicians--hopefully a deemphasis on MOL which might make it easier for the Iowa Board of Medicine to let go of the implementation pilot projects.

The officials of ABMS first of all should not be allowed to get total salary and benefit package of more than average physician's Package in US before they can prescribe something that will be perceived their self serving interest.

NO to MOC NO to MOL

This effort needs to be replicated in all 50 states so our patients can learn about this sham financial windfall for the ABMS and our colleagues can understand there are alternatives.

All the thanks goes to all of you for signing on to the principle of lifelong learning. You know I hear from some people about how MOC and MOL are "mandated" by the ACA, CMS, and the Joint Commission, almost as if they thought I were not aware of this. I won't pretend I've read the entire 974 page ACA, but the language about the ACA "mandate" for MOC (which is on p. 278 in case anyone's interested) is a paragraph essentially about the role of MOC as a payment modifier. That's a lead-in to the CMS "mandate", meaning the PQRS incentive system, which is pretty unimpressive given what I recall from Dr. Kempen's excellent research using the Freedom of Information Act. Finally, the "mandate" from the Joint Commission is all about the possibility that MOC could be used as a metric to satisfy the Ongoing Professional Practice Evaluation (OPPE). The irony for me, as a psychiatric consultant in an academic medical center, is that since my hospital's choice of metrics makes me invisible to the OPPE...the MOC then might become the only available metric to keep my privileges active. Consequently, one of my blogger friends referred to me as the winner of the 2013 Medal of Irony. But what is mandated is not always practical or right. We don't have to reach very far back in history to know that. Thanks again everyone! Every signature counts. The Iowa Board of Medicine plans to roll out the survey for Iowa Licensees on MOL in just a few months. Let's hope they ask us what we want...something the ABMS failed to ask anyone when it counted.

Thank you, Dr Amos, for carrying the fight in Iowa!

Congratulations to Iowa for joining the growing number of states to oppose MOL. MOC is a scam on practicing physicians who must waste money and take time away from patients to prepare for and take a test that has no proven value. Every patient is a test on our ability to diagnose and treat them, and our smart phones have the latest information at our fingertips. We do not need MOC.

The movement to link MOC to MOL is yet another scam to further subjugate physicians while enriching a few. Having done MOC for over 20 years, I came to the realization that MOC had done nothing but waste my time and money, and certainly did not improve my medical practice. I believe in life long learning, no life long testing.

This is not true: ". 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." THe FSMB Contends that it represents the medical boards-but it merely USES them to push their testing agenda! They are a 501 (c) 6 corporation- a MEMBERSHIP corporation which has NO membership fees listed as income in spite of over $35 MILLION in gross income. Look at their 990 (@ http://www.guidestar.org/FinDocuments/2012/751/092/2012-751092490-0915b01b-9O.pdf see page 9 @ 1b) They actually PAY medical board members to attend their meetings to give themselves LEGITIMACY! It is more true to call them a testing organization out to scam medical students through USMLE parts 1-3 and are now looking to institute part 4 tests every 5 years for lifelong physician consumption!

MOC must go. There is no reason the ABMS and member boards should generate outrageous profits from this MOC stuff

MOC makes as little sense as, let's say, "MOD". Should any school from which you have once graduated now be able to require participation in a "Maintenance of Degree" program to keep your degree?

Completely support this drive; MOL is an ill-conceived program. No study has ever demonstrate its usefulness or benefit. a Lifelong Learning program is the way to go.