Mercy Killing the MOC


It is time to applaud the people hammering the American Board of Internal Medicine (ABIM) and their MOC (Maintenance of Certification).   Recently, the ABIM sent out a letter to internists that stated:

Dear Internal Medicine Community:

ABIM clearly got it wrong. We launched programs that weren’t ready and we didn’t deliver an MOC program that physicians found meaningful. We want to change that.

i am with Dr. Wes Fisher who reacted on his blog by saying, “But perhaps we should ask first: Why MOC at all?”

He is right.  I hope that the internists destroy their board and the MOC and that momentum cross pollinates over to the American Board of Family Medicine.  I beg my internist colleagues to not let up.  You have them on the ropes.  Give them no mercy.  As General Lewis Addison Armistead said when he led his brigade from Seminary Ridge at Gettysburg during Pickett’s Charge, “GIVE EM’ THE COLD STEEL, BOYS!”

Then again, we all know how that worked out.

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] 

  11 comments for “Mercy Killing the MOC

  1. msdelta
    February 11, 2015 at 5:10 pm

    Did you know of the grass roots movement for an alternative board? check it out, go to The guy who started this was long ago fed up with all this MOC crap, like we all are, that he just started a new board.

  2. Stella Fitzgibbons MD
    February 11, 2015 at 3:56 pm

    Internists already HAVE something far better than the stupidity of the MOC put out by the ABIM: it’s produced by the American College of Physicians and called the Medical Knowledge Self-Assessment Program. It is issued every 3 years, impeccably researched and referenced, and provides about 140 hard-won CME credits…which I should point out were accepted by the ABIM for MOC. This was the only part of the whole MOC that was of ANY value to me professionally, and ironically I would have done it anyway, just as I have every time since 1984 when I became board certified. Why can’t the ACP simply announce that it will do its own board certification?

  3. Joe Smegma
    February 11, 2015 at 2:50 pm

    Agree to abolish the MOC programs. I attended a recent CME activity. The lecturer asked the physician crowd (numbering about 200), to raise their hand if they are happy with the current MOC for their given specialty. Not one hand was raised. Everyone started grumbling. Why do we put up with this BS? It certainly is a money maker for the boards.

  4. Pat
    February 9, 2015 at 8:20 am

    As the recent communique’s from the ABIM and AAFP regarding this have stated, both organizations still persist in the rhetoric that this crap is to ensure the public confidence. This is the same public that was spooked by that damn IOM safety report in 1999 that led to this idiocy, and the same public that continually uses its politicians to hamstring, degrade, enslave, and bother its doctors. All the MOC ever represented to me was the ability of untrained, unskilled people to tell me that they knew better, and had even more homework for me. It has never – will NEVER – influence my medical practice in anyway, save increasing my resentment toward organized medicine and the public at large.

    As for Gen’l Armistead…I only wish that charge has succeeded.

    • Doug Farrago
      February 9, 2015 at 10:38 am

      Awesome. Need to put that in the blog.


    • Pat
      February 9, 2015 at 11:26 am

      Maybe you and Doug have concocted the answer. Many of our IM/FP/peds colleagues have to maintain board certification for hospital privileges, and insurance eligibility; they do not however, have to be members of their worthless, self-harming professional organizations.

      What if all the active members of the AAFP, AAP, et al, etc just declined to renew their dues for a year? Wanna bet those organizations would literally turn on a dime to support the actual physicians’ views on MOC? It might create the right kind of pressure on these non-accountable boards.

  5. February 9, 2015 at 7:28 am

    Thanks Doug,
    While the fight is not over, we should understand that this will not be the first story of corruption we’ll encounter thanks to the many billions of dollars at stake in healthcare. The apparent collusion happening between the leadership of our professional societies to support MOC despite these obvious financial dealings is even more worrisome for the working doctor and will make this effort particularly daunting. We have division in our own ranks and because of it, our profession may never fully recover.

    • Doug Farrago
      February 9, 2015 at 10:36 am

      Wes, I agree 100%. That is why I do not belong to the AAFP anymore. That is why I do direct primary care and opted out of Medicare. The groups I belong to are about free market medical care. That is the only way for us to recover, in my humble opinion.

      • fredlave
        February 11, 2015 at 12:26 pm

        I retired in 2002 and I was flushed from the list of Medicare Provider physicians a few years later. Since I had no plans to see patients any longer I let it slide UNTIL I received an email from Medicare:
        “New Requirements for Prescribers of Medicare Part D Drugs
        The Centers for Medicare & Medicaid Services (CMS) finalized CMS-4159-F, “Medicare Program; Contract Year 2015 Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs” on May 23, 2014. This rule requires physicians and, when applicable, other eligible professionals who write prescriptions for Part D drugs to:
        be enrolled in Medicare in an approved status, or
        have a valid opt-out affidavit on file for their prescriptions to be covered under Part D…”
        In other words if you want to write Part D prescriptions for Granny or an old Medicare patient who would like a refill for an Rx you wrote years ago you have to be a participating physician or a valid opt-outee.
        BTW, the American Board of Otolaryngology, my certifying board, allows members certified before 1992 to forgo MOC. I find that the Academy of Otolaryngology Home Study Course is more than adequate to keep me up to date. I suspect that senior otolaryngologists, who are sub-specializing, put the arm on the Board to exclude us old guys from MOC.

  6. drbonz
    February 9, 2015 at 7:21 am

    I wish my Orthopedic Surgical MOC would go away. Mine is coming up this summer and for the PRIVILIGE of being allowed to take the exam, I get to pay THEM $2700.00! It is a joke.

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