ABMS Reevaluating MOC?
Are you ready for another smokescreen? The head of the ABIM, Richard Baron MD, said:
“We’re figuring out what is the best way to recognize and reward and acknowledge special expertise that doctors have, do it in a way that it results in a credible credential that adds value to their professional ability to do what they do.”
What he is really saying is that “we’re figuring out what is the best way to make money off doctors without them bitching about it”.
Here is more from the article:
The ABMS and those member boards, which represent various specialties, last week announced it will establish a commission that will include multiple partners to reevaluate the MOC system. The goal is to create a system of continuing board certification that “is meaningful, relevant and of value,” while meeting the demand of patients, hospitals and others who expect physicians to maintain their knowledge and skills to provide quality care, the group said.
Who gave them that goal? No one! It’s like me saying that I have a goal to create a system where you give me all your life savings. I feel that goal is best for me. What’s that? You don’t like that? Well, too bad because your board certification depends on it.
Also, they did not create CME. We get CME from other areas. No other profession is held to such unreasonable standards. This is a money grab, plain and simple, and they hold your board certification hostage if you don’t do what they say.
Lastly, Baron goes on to say:
However, Baron told MedPage Today that the cost of just under $2,000 to maintain certification covers a 10-year period and breaks down to less than $200 a year. And there’s evidence that board-certified physicians earn more money than those not certified, he said. Furthermore, he said, the ABMI finances are posted on the organization website in full transparency.
This dude is a joke. Dr. Wes, he was obviously responding to you on this. Any thoughts?
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The bottom line is the argument for making me jump through these hoops to prove I am a competent doctor when a doctor board certified 6 months prior to me NEVER has to waste their time and money and are also considered competent, illustrates the fatal flaw in the entire MOC requirement.
We’re screwed no matter what. ABFM has a new president. The last one must have made enough
to retire on ($800k+ a year) so some one else can pad their retirement fund.
The fundamentals of this subject finds its answer in the mathematics of ecological biology.
In terms of ecology and evolution, the ABMS have decided to prey upon a limited population, i.e. the board-certified in their various specialties. Unlike other predators, their “resource availability” is limited, and they run the risk of driving the prey to extinction, which coincidentally is the direct purpose of other organizations in medicine. The goal of interchangeability of license across scope of practice depends upon driving down the population of the “apex prey.”
The ABMS is best understood as a predator-prey model, or a host-parasite model. Not all predators have to have teeth and claws; nor must they understand what they are doing. All they need to do is feed.
The ABMS invented the MOC, an analogue to the scolex of enteric cestodes such as Taenia solium. The scolex attaches the parasite to the intestinal wall; the host (you) produce its sustenance ($) while it dangles passively.
But any predator that is too efficient risks the extinction of its prey; and shortly thereafter, itself. For a deeper understanding of predator-prey models, look at the Lotka-Voltera equation(s) which allow one to calculate the future population of predator and prey. The problem with extinction is that if the L-V equation drives the population to zero, it stays at zero – the predator and/or the prey become extinct. In physician field study, the large numbers of the herd are, of course, the physicians who graze the Serengeti of healthcare; and the predators are those who make their living not by providing healthcare, but rather by economic parasitism.
Ecology is all mathematics these days – the numbers show, time and time again, that species extinction is nearly inevitable from over-harvesting. So is the ABMS.
“The goal is to create a system of continuing board certification that “is meaningful, relevant and of value,” while meeting the demand of patients, hospitals and others who expect physicians to maintain their knowledge and skills to provide quality care.” In ranching talk, the cattle might agree that their system of herd management is to produce quality beef for the harvest.
For one of thousands of examples, I note that “behavioural inflexibility may limit the ability of (predators) to cope with even subtle changes to resource availability.” (Coral Reefs, December 2014, Volume 33, Issue 4, pp 891–896) Since the members of ABMS are highly specialized predators, they run a considerable risk of killing off their prey. They are vaguely recognizing this risk, not that such recognition would stop them. Parasites are not theoreticians. They only need to feed.