When I paid ABIM a large sum of money to become board certified in Internal Medicine for 10 years, I naively assumed I would remain board certified for 10 years, since that’s what I paid for. And that was only after I passed an absurd test that I spent 6 weeks studying for, filled with bizarre questions relevant only to subspecialists. Then after forking over more than two grand in testing and membership fees, ABIM changed the rules and attempted to blackmail me and physicians like me. Hand over the money for MOC, or I would be listed as “not certified” on their website, despite the board certification I had just earned. Eventually, after an uproar, they relented, but now ABIM has quietly relisted all those unwilling to submit to blackmail in the form of MOC as “not certified” again. It’s pay up or jeopardize your livelihood.
To maintain my board certification, ABIM insists that I, and any physician in Internal Medicine and its subspecialties, participate in MOC, or maintenance of certification. And pay more money over single year for the privilege of saying we are participating in MOC. What happened to the implicit promise made to me that the board certification I earned and paid for would continue to be valid? Since the ABIM has a stranglehold on the market for board certification, the organization makes the rules and changes them at a whim, filing its coffers with no repercussions. And those coffers are deep, as an expose from Newsweekrevealed.
Which is why in 2018, after years of grumblings from physicians, four physician plaintiffs brought a lawsuit against ABIM, alleging illegal and anti-competitive conduct and violations of the RICO act. The lawsuitis still winding its way through the court system and the physician plaintiffs have a GoFundMeto offset burgeoning legal costs. Since the ABIM essentially has a stranglehold on certification for IM and its subspecialties, the plaintiffs’ position is that ABIM is using its monopoly power to charge inflated prices for MOC and unfairly limit competition in the marketplace for certification. Although the lawsuit is still in the early stages, there is hope as states have started to prohibit MOC as a condition of licensure or reimbursement, thanks in part to groups like NBPAS, which is lobbying against ABIM’s monopoly and MOC.
As physicians, we are already under fire from all sides. Our certification boards should be a source of support but instead these certifying bodies hold us hostage, demanding money in exchange for the right to continue practicing. The absurd profitability of MOC has spilled over to family medicine and pediatrics as well, forcing even more physicians to pay up or risk losing privileges and insurance reimbursements. If the judicial system shatters the ABIM monopoly in court, then there is hope for family practice and pediatrics as well. This insanity will only stop we stop when we make it stop, by supporting our colleagues in the lawsuit against MOC and supporting organization like NSPAS.Tweet