Your AMA and Their Good Work by Pat Conrad MD


Sometimes a commentary just writes itself: “The AMA’s delegates defeated a resolution that asked the organization to put a moratorium on Maintenance Of Certification until it was proved to improve the quality of care and patient outcomes.” The July issue of Family Practice News headlined some blather about insulin in primary care, and buried this jewel on page 4.

The AMA delegates – cowardly, worthless, out of touch, please quote me! – couldn’t even pass a resolution to tell the American Board of Medical Specialties to quit screwing doctors, ironic, given that you might think the AMA wouldn’t want the competition. But no, the AMA is happy to back this ancillary group of enforcers in keeping the thumb pressed on the lives and livelihoods of U.S. physicians.

AMA delegates voted to:

– Explore the feasibility of studies to evaluate the effect MOC requirements and Maintenance of Licensure have on “practice costs, patient outcomes, patient safety, and patient access.” (It will cost time, money, have no effect on patient outcome, make me hate this job even more, and reduce access because of the time, money, and energy it will subtract from my work year – that and the time spent drinking).

– “Work with the ABMS to collect data on why physicians choose to maintain or discontinue board certification” (Docs who do maintain it by and large do so because they are forced to, in order to make a living. Those who discontinue do so because they can, and because there is no pride in ownership at the point of an economic gun. It’s not fun, and has no value for the vast majority of physicians. Otherwise, it’s great).

– Oppose making MOC a condition of medical licensure. (Here my head explodes, noting that two paragraphs before, these bastards are evaluating that very thing).

One voice of dissent, Dr. James Goodyear from Pennsylvania, noted that practicing physicians “are increasingly burdened.” His view is rebuffed by delegate Dr. Darlyne Menscer, who stated that a moratorium on MOC “would put a wedge in the close working relationship the AMA has had with the ABMS.”

I’m sure the tens of thousands of practicing physicians nationwide are thrilled to know that they are shelling out hundreds of dollars each yearly, along with however many hours not doing something useful like sleeping or changing the air filters, in order to keep a close relationship between two quasi-government organizations whose primary, shared purpose continues to be justifying themselves by screwing physicians.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  3 comments for “Your AMA and Their Good Work by Pat Conrad MD

  1. Gomer Gal
    August 21, 2014 at 1:21 pm

    I’m a family med doc who is largely in administration now but see patients in the ED/Urgent Care two or three days a month. I have to keep my board cert for payers. Unfortunately ABFM has very few modules that are appropriate to my scope of care or practice location. I did a module designed for continuity practice (the handwashing one) that allowed you to download “dummy” data if you can’t have your patients do a survey. It still made me key in all the dummy data which was a total waste of my time – I ended up paying my teenager to key the data for me. The module did nothing to educate me (duh, wash hands every patient, on way in and way out of room) but did burn my time and made me further loathe MOC.

  2. Pat
    August 20, 2014 at 12:55 pm

    Since writing this, I’ve thought a lot more about the ABMS in the context of Direct Primary Care. I don’t want to be a doomsayer, but the more I think on it, the more obvious it appears that the AMA and ABMS (and of COURSE the AAFP) will continue to tighten their control over subject docs through steps like Maintenance of Licensure. As Direct Primary Care becomes the only viable alternative for actual physicians and their patients, the ABMS will be used to corral them in, tying their medical licenses at first to this MOC ripoff, and very soon to active Medicare, Medicaid, and even hospital/ACO participation. Just a matter of time.

  3. William Bodenheimer
    August 20, 2014 at 11:28 am

    I had a recent email thing going with one of the doctors at ABFM. His initial email which I believe was sent to all board certified doctors was basically a tirade about why MOC is important and is helping physician’s provide better care. I had indicated the ABMS’s trying to tie board certification to state licensing. He denied that this is happening which is complete bullshit. We eventually just decided to stop emailing each other.

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