Class Action Lawsuit Against ABIM and MOC Moving Forward

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. 

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Cathy Carroll MD

Catherine Carroll, MD, CFA is an internist in Southern California. She grew up in North Carolina then moved to Massachusetts where she earned her Bachelor’s in Economics. After becoming a CFA (Chartered Financial Analyst) and finishing a Master’s in Global Financial Analysis, she went on to work in equity analysis for a money management firm in Boston. She then embarked on a second career in medicine, graduating from UC Davis with her MD and completing her Internal Medicine residency at Santa Clara Valley Medical Center in San Jose. When not caring for patients, Dr. Carroll is a real estate investor, as well as the author of and, where she endeavors to teach physicians about alternative career paths and personal finance. 

  9 comments for “Class Action Lawsuit Against ABIM and MOC Moving Forward

  1. Nicole M. Johnson
    May 30, 2019 at 8:36 am

    Thank you Dr. Carroll! The MOC product monopoly and forced use is extortion. It serves no purpose other than to line the pockets of board execs.
    Please support the fight at

  2. Natalie Newman
    May 29, 2019 at 9:43 pm

    I fell sick. This is so criminal.

  3. Debbie S
    May 29, 2019 at 7:46 pm

    ABFM did the same to me— took the damn test (feeling like a felon trying to get into the testing site!), PASSED (for the 4th time!) but since I didn’t continue to pour time and money into their coffers, I am now no longer ABFM certified…. Although I am now certified by NBPAS.

  4. Pat
    May 29, 2019 at 4:43 pm

    When I earned my first board certification I was very proud of the accomplishment.

    I have had to recertify twice more in the subsequent 20 years, enduring expense, stress, and degradation, while being told by the MOC extortionists that being board certified is “very important” to patients.

    My board certification no longer holds any value to me. It is merely one more thing I have to do to work in a field that punishes its practitioners. It is a negative reminder of lost years, and of being controlled by others. Great legacy.

    • PW
      May 29, 2019 at 5:40 pm

      Aside from not getting a rectal probing, being admitted into the testing site is pretty much like going into prison .

  5. Al
    May 29, 2019 at 4:07 pm

    Yes, subspecialty level and relevance material was the way to shame and bully into recerts. What better way to prove inadequacy of internists and push for testing that reaching into dubious, not practice related stuff. Ingenious and diabolical! Yet another no value service to the nation whose economy suffers the most from “just in case; I have a concern; you better” burden

  6. Terry Nugent
    May 29, 2019 at 3:52 pm

    Is not the real issue credentialing for hospital staff privileges?

    It is sad that it has come to this.

  7. May 29, 2019 at 2:00 pm

    Imagine, non-grandfathered board certified physicians are now receiving letters from their hospital systems threatening “automatic retirement” SOLELY for not getting enough “MOC points” in a state with anti-MOC legislation.

    These bastards will stop at nothing to maintain their monopoly.

  8. Marc Gorayeb MD
    May 29, 2019 at 1:17 pm

    Maine Statute:
    “Notwithstanding this subsection, an applicant who is board certified by the American Board of Medical Specialties is deemed to meet the postgraduate training requirements of this subsection.”
    “The board may not require an applicant for initial licensure or license renewal as a physician under this chapter to obtain certification from a specialty medical board or to obtain a maintenance of certification as a condition of licensure. For the purposes of this subsection, “maintenance of certification” means a program that requires a physician to engage in periodic examination, self-assessment, peer evaluation or other activities to maintain certification from a specialty medical board.”

    Then why does an application for initial license or renewal license ask a question about board certification? The question should be about residency training. If the agency is prohibited from requiring board certification for licensure, then questions about it should be off-limits. It merely serves as an advertisement for the licensee, and unfairly disadvantages those who have elected not to renew their board certification. A form of public discrimination that the law was meant to reject. If your medical board exhibits the same contradictory posture, then a letter writing campaign to the state medical board is in order.

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