Hey, AAFP, Why Can’t You Hear Us? Get Rid of the MOC!

In typical administrative fashion, the AAFP President Elect, John Cullin, MD, tried to calm its members down about the MOC (maintenance of certification) issue.  You can read it all here but it is all political speak.   Let me break down the salient points with my opinion in parenthesis:

  • This is an extremely complex topic dealing with the nature of medical professionalism, the historical development of our specialty societies and boards, the constitutional basis of medical licensure and protection of the public, as well as changes in technology that are fundamentally changing how we practice medicine. Further complicating matters is the increasing stress that our members are experiencing due to excessive administrative burden, changes in payment and meeting documentation requirements with poorly functioning electronic health record systems. (It’s not complicated.  Just get rid of the MOC)
  • The AAFP has been involved in intense conversations with the ABFM to address our member’s concerns. Remember that the AAFP and the ABFM are separate organizations and do not have shared governance or an overlying umbrella organization. (But you both financially benefit from the MOC though, right? That’s a major conflict of interest.  If you get rid of the MOC then the AAFP stands to lose a ton of money. Hmmm.)
  • The task force thought that much of the recent anger about continuing board certification can be traced to the perceived value of certification. Value is benefit divided by cost. It can be improved either by increasing the benefit or decreasing the cost. In this case, the costs are more than just fees; they include the significant administrative burden of continuing board certification processes. We look to the ABFM to be mindful about decreasing this unnecessary burden. (Yes, get rid of the MOC.)
  • In addition, a major issue of concern to the AAFP is that board certification is often being used inappropriately as an absolute or sole requirement for credentialing and privileging, and sometimes for employment and payment. (So, get rid of the MOC.)
  • Based on the task force’s recommendations, we believe significant changes are needed to the certification process. (Yes, get rid of the MOC.)
  • Options include improvement of the ABFM certification process, as well as possible assessment of other entities that may provide alternative certification choices for members. And while not being actively pursued at this time, the AAFP will undertake a preliminary evaluation of the steps that would be involved in establishing a certifying body that would meet the needs of members. All this points to the need for process improvement, whether through the ABFM or elsewhere. (Wait, none of this entails getting rid of the MOC. WTF?).
  • Finally, we will continue to strive for more dialogue with the ABFM to work on a common vision that recognizes that physicians are key stakeholders in the certification process, and that our needs are an important consideration in the process. We plan to discuss improvements to the continuing board certification process, including the need for multiple alternatives to the current proctored exam requirement. (Again, you are not listening! Get rid of the MOC. We don’t want improvements. We want it gone!!)

So, once again, the AAFP is trying to play word games.  They are not listening to their members.  ALMOST NO FAMILY DOCTOR WANTS THE MOC!!!  Dollars-to-donuts the AAFP does nothing to rid of us of it.  I shouldn’t say us because I left them years ago.  But for those of you who still believe in them please note the above.  The AAFP makes a lot of money via CME indirectly off the ABFM and the MOC.  They will not help you.  John Cullen just proved that above.  And if he wants to debate me on it then I welcome him on my podcast.  Just shoot me an email, Johnny.

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