Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Feel over-boarded by MOC? Fight back.

Niran S. Al-Agba, MD
Physician
October 22, 2017
Share
Tweet
Share

According to recent Ohio statistics, 1.3 million people have limited or no access to primary care physicians. Based on the 2015 Ohio Primary Care Assessment, 60 of 88 Ohio counties have medically-underserved populations. The Patient Access Expansion Act (HB 273), co-sponsored by Representative Theresa Gavarone (3rd District) and Representative Terry Johnson (90th District), specifically addresses health care access by prohibiting physicians from being required to comply with maintenance of certification (MOC) as a condition to obtain licensure, reimbursement for work, employment or admitting privileges at a hospital or other facility.

Recently, I spoke with Representative Gavarone on the critical importance of this legislation for Ohio. Physician family members have grumbled about the expense of MOC compliance however, a practicing cardiologist better clarified the connection between MOC regulations and the growing physician shortage. “He shared his frustrations at the time and money involved participating in a program that has absolutely no scientifically-proven benefit for patient outcomes,” said Representative Gavarone. The cardiologist discussed numerous hours wasted preparing for an exam with little to no bearing on his day-to-day work serving his patients.

While the public may not be familiar with the harm of MOC regulations, many have experience searching for a new physician when their doctor retires earlier than anticipated. “Patients are waiting months for appointments,” said Representative Gavarone. “As physicians leave their practices through cutting back or early retirement, this translates to reduced access to care for everyday Ohio citizens,” she said.

Gavarone is touching on a vital issue facing practicing physicians across the country: there are fewer incentives for compassionate, brilliant minds to enter the field of medicine.

Oklahoma was the first state to enact anti-MOC legislation, and six more states (Georgia, Maryland, Missouri, North Carolina, Oklahoma, Tennessee and Texas) have passed laws prohibiting the use of MOC as a condition for obtaining medical licensure and hospital admitting privileges. Doctors are being “boarded to death.” To become licensed to practice medicine in the U.S., we must pass four exams, each lasting 16 hours in duration over two days. The U.S. Medical Licensing Exam (USMLE) has three parts: USMLE Step 1 and 2 are taken during our second year and fourth years of medical school, and Step 3 is taken over a two-day “vacation” during internship year.

After a three-to-five year residency program, we must pass a specialty-specific board exam, such as internal medicine, pediatrics or surgery to become licensed. While drowning in more than $100,000 in educational debt, the $1500 exam fee seemed exorbitant, yet passing the pediatric certification exam was only a one-time requirement. States already mandated completion of Continuing Medical Education (CME) hours annually for physician licensure, so why were additional requirements necessary?

The American Board of Medical Specialties (ABMS) eliminated “lifetime” certification to shore up their financial outlook; a modification having little to do with quality and much to do with rate of return. Between 2003 and 2013, the ABMS member boards’ assets ballooned from $237 million to a staggering $635 million, an annual growth rate of 10.4 percent. MOC is outrageously lucrative. Almost 88 percent of their revenue came from certification fees.

The testing environments to which physicians are subjected are abominable; those who are disabled, ill, pregnant or nursing find their requests for accommodations in accordance with federal ADA guidelines denied, having no recourse for blatant discrimination. MOC requirements violate our basic right-to-work, an intrusion deemed intolerable in other professions.

Groups lobbying heavily against anti-MOC legislation will likely be hospitals, insurance companies and specialty groups, such as the American Society of Plastic Surgeons (ASPS) and Ohio Valley Society of Plastic Surgeons (OVSPS), who are out of touch with front-line physicians. Both organizations vehemently opposed a tax on elective (read: unnecessary) procedures projected to add $25 million to the state budget, calling it “discriminatory, economically damaging and fiscally unsound.”

They oppose HB 273 on the grounds that allowing board certification to “lapse” will prevent patients from receiving the “highest quality of care;” a statement that is altogether unproven, misleading, and deceitful.

If you like your doctor, support HB273 — the Patient Access Expansion Act — so you can keep them. The MOC program forces physicians to spend time away from our patients, clinics, and families for no demonstrable benefit. Financial corruption touches every facet of MOC; the American Board of Medical Specialties has $701 million reasons to oppose this bill.

Representatives Gavarone and Johnson are David bravely battling Goliath. Physicians and patients must help them fight for high-quality, affordable health care to be delivered by physicians free of futile testing regulations.

Niran S. Al-Agba is a pediatrician who blogs at MommyDoc. This article originally appeared in the Health Care Blog.

ADVERTISEMENT

Image credit: Shutterstock.com 

Prev

Dos and don'ts for patients who consult Dr. Google

October 22, 2017 Kevin 1
…
Next

The flu vaccine doesn’t cause the flu. Period.

October 22, 2017 Kevin 14
…

Tagged as: Practice Management, Primary Care

Post navigation

< Previous Post
Dos and don'ts for patients who consult Dr. Google
Next Post >
The flu vaccine doesn’t cause the flu. Period.

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

More by Niran S. Al-Agba, MD

  • Is there hope for COVID with home visits?

    Niran S. Al-Agba, MD
  • A tale of two epidemics: COVID and obesity

    Niran S. Al-Agba, MD
  • Delivering health care at a retail clinic isn’t something to be proud of

    Niran S. Al-Agba, MD

Related Posts

  • Fight the opioid crisis with physician assistants

    James Cannon, PA-C
  • Family medicine and the fight for the soul of health care

    Timothy Hoff, PhD
  • Crazy is how you feel when working within a system you feel you cannot change

    Nina Mirabadi
  • Why health care replaced physician care

    Michael Weiss, MD
  • More physician responsibility for patient care

    Michael R. McGuire
  • A physician’s addiction to social media

    Amanda Xi, MD

More in Physician

  • How the 10th Apple Effect is stealing your joy in medicine

    Neil Baum, MD
  • When a doctor becomes the narrator of a patient’s final chapter

    Ryan McCarthy, MD
  • Gaslighting and professional licensing: a call for reform

    Donald J. Murphy, MD
  • When service doesn’t mean another certification

    Maureen Gibbons, MD
  • Why so many physicians struggle to feel proud—even when they should

    Jessie Mahoney, MD
  • If I had to choose: Choosing the patient over the protocol

    Patrick Hudson, MD
  • Most Popular

  • Past Week

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • Physician patriots: the forgotten founders who lit the torch of liberty

      Muhamad Aly Rifai, MD | Physician
    • The hidden cost of becoming a doctor: a South Asian perspective

      Momeina Aslam | Education
    • How medical culture hides burnout in plain sight

      Marco Benítez | Conditions
    • Why fixing health care’s data quality is crucial for AI success [PODCAST]

      Jay Anders, MD | Podcast
    • How the 10th Apple Effect is stealing your joy in medicine

      Neil Baum, MD | Physician
  • Past 6 Months

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • Make cognitive testing as routine as a blood pressure check

      Joshua Baker and James Jackson, PsyD | Conditions
    • How dismantling DEI endangers the future of medical care

      Shashank Madhu and Christian Tallo | Education
    • How scales of justice saved a doctor-patient relationship

      Neil Baum, MD | Physician
    • A faster path to becoming a doctor is possible—here’s how

      Ankit Jain | Education
    • The broken health care system doesn’t have to break you

      Jessie Mahoney, MD | Physician
  • Recent Posts

    • How the 10th Apple Effect is stealing your joy in medicine

      Neil Baum, MD | Physician
    • How medical culture hides burnout in plain sight

      Marco Benítez | Conditions
    • How functional precision oncology is revolutionizing cancer treatment [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • When a doctor becomes the narrator of a patient’s final chapter

      Ryan McCarthy, MD | Physician
    • Why innovation in health care starts with bold thinking

      Miguel Villagra, MD | Tech

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 4 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • Physician patriots: the forgotten founders who lit the torch of liberty

      Muhamad Aly Rifai, MD | Physician
    • The hidden cost of becoming a doctor: a South Asian perspective

      Momeina Aslam | Education
    • How medical culture hides burnout in plain sight

      Marco Benítez | Conditions
    • Why fixing health care’s data quality is crucial for AI success [PODCAST]

      Jay Anders, MD | Podcast
    • How the 10th Apple Effect is stealing your joy in medicine

      Neil Baum, MD | Physician
  • Past 6 Months

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • Make cognitive testing as routine as a blood pressure check

      Joshua Baker and James Jackson, PsyD | Conditions
    • How dismantling DEI endangers the future of medical care

      Shashank Madhu and Christian Tallo | Education
    • How scales of justice saved a doctor-patient relationship

      Neil Baum, MD | Physician
    • A faster path to becoming a doctor is possible—here’s how

      Ankit Jain | Education
    • The broken health care system doesn’t have to break you

      Jessie Mahoney, MD | Physician
  • Recent Posts

    • How the 10th Apple Effect is stealing your joy in medicine

      Neil Baum, MD | Physician
    • How medical culture hides burnout in plain sight

      Marco Benítez | Conditions
    • How functional precision oncology is revolutionizing cancer treatment [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • When a doctor becomes the narrator of a patient’s final chapter

      Ryan McCarthy, MD | Physician
    • Why innovation in health care starts with bold thinking

      Miguel Villagra, MD | Tech

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Feel over-boarded by MOC? Fight back.
4 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...