The American Board of Internal Medicine is irrelevant.  It has always been.  I realized this when I first certified in internal medicine in 2002.  The test was largely fact-based and filled with information that I would never need to know in practice.  It did not measure my diagnostic acumen, or my physical exam skills, or my ability to listen and empathize with my patients.

After passing the original test, I forgot mostly about it.  I filed my large diploma sized certificate in a drawer in the back of my office.  You see, I didn’t display it prominently because I really didn’t care if anyone saw it or not.  It meant nothing.  Not a single patient over ten years asked about my certification status.  It was irrelevant.

A decade into practice I recertified.  This time I was forced to do a number of maintenance of certification activities.  They were time-consuming and expensive, but I figured it was the cost of doing business.  I didn’t learn anything by participating in these activities.  They didn’t help me take better care of my patients, and I didn’t exit the process a more informed doctor. It was a waste of time and money.  Irrelevant.

Unfortunately, now the ABIM is trying to be relevant.  Not by creating a superior product or innovating in the continuing education space.  Instead, it is foisting a new, sub-par, laborsome, and most importantly costly product in its physician marketplace.  And it is doing it with the force of governmental mandate (ACA will require board certification as a quality indicator) and tacit support of hospital administrators everywhere (hospitals require board certification for hospital privileges).

This mostly annoying, but previously manageable requirement, has become a thorn in the side of American physicians.

The new MOC is just as irrelevant as the old; it’s just a heck of a lot more difficult and expensive to complete.

I feel that it would be overly optimistic to expect the government or the hospital executives to release us from this arduous burden.  In fact, many of us suspect the government cheers on as physicians are forced to close doors and join the big academic or corporate sweat shops.  There is no political will to uncouple the ABIM from health care reform.

Hence, we physicians are left with two options.  We can either expose The ABIM as not only irrelevant but also crooked as Dr. Wes Fisher has so excellently done.  Maybe this grand foolhardy organization will fall on its own sword.

Or we can gather together and refuse to certify en mass, and see what happens to hospitals as they try to take away privileges from all their internal medicine doctors and specialists.

I think the time has come to make a decision.  Which will we choose?  We better choose wisely.

Jordan Grumet is an internal medicine physician who blogs at In My Humble Opinion. Watch his talk at dotMED 2013, Caring 2.0: Social Media and the Rise Of The Empathic Physician. He is the author of I Am Your Doctor: and This Is My Humble Opinion.

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