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Experts offer guidance, acknowledge challenges of MOC requirements
CHICAGO — In an effort to assist its members with the new maintenance of certification — or MOC — regulations implemented by the American Board of Internal Medicine, the Endocrine Society held an instructive course at its annual meeting, in addition to an open forum for discussion of the hurdles these regulations put forth for endocrinologists.
“MOC is controversial, as all of you know. Some people are angry about it. Some people are frustrated about it. And the Endocrine Society is very aware of those issues,” Graham T. McMahon, MD, MMSC, of Brigham and Women’s Hospital in Boston and chair of the Clinical Endocrine Education committee of the Endocrine Society, said during a session called “MOC Made Easy.”
New requirements
McMahon and Rachel I. Gafni, MD, chair of the pediatric self-assessment committee, went through checking one’s MOC status, taking the necessary exams, performing self-assessment required points over a 5-year period (which differ in distribution between pediatrics and internal medicine) as well as their preferred modules available to maintain affordable recertification, including free modules offered by the Endocrine Society.
“The idea behind MOC is that you have a structured program that helps physicians demonstrate their awareness and their knowledge of their field of specialization and it’s designed to try to demonstrate that not only are you aware of what’s going on and current in that, with an idea that you also set some thresholds to ensure our community is staying competent, is keeping our patients safe,” McMahon said. “Ultimately there’s a recognition that we can’t all keep taking general pediatrics or general medicine exams for the rest of our lives. We have to demonstrate our ability to have expertise in our specialty area.”
Gafni added that physicians will need to tailor their own certification courses to their individual needs.
“We see patients with rare diseases. There’s never going to be a [practice improvement module] for a disease that I see at the NIH. So, I have to do handwashing and hygiene or develop our own [quality improvement] activities. ... It just depends on the practice you’re in what works best for you,” she said.
Obstacles to success
As of February, 2014, about 80% of endocrinologists maintained their endocrine certification with the American Board of Internal Medicine (ABIM), he said. But as of Jan. 1, 2014, the requirements to maintain that certification changed. The American Board of Medical Specialties and, therefore, the ABIM now require 100 points in a 5-year period in contrast to the previous 100 points in a 10-year period. In addition, all physicians, including those previously grandfathered, will have a public report as to whether they are or are not meeting MOC requirements. Additionally, costs have increased, which Graham acknowledged as a point of contention.
Amidst these controversies, McMahon reminded the audience that the Endocrine Society and many other professional organizations have addressed the ABIM with their concerns and, in another session at the conference, members aired their grievances about the process, the changes in requirements and cost and discussed how the society should make their continued approach toward the ABIM regarding MOC.
“There are a lot of changes, a lot of controversy, a good deal of irritation in the community,” he said. “It’s not necessarily as overwhelming as it might first appear. ... [but] there are a lot of reasons to be frustrated and irritated with the process.”
“The fact that we have to have a session called ‘MOC Made Easy’ at all says something,” McMahon added.
For More Information: McMahon GT. MOC Made Easy. Presented at: The joint meeting of the International Congress of Endocrinology and the Endocrine Society; June 21-24, 2014; Chicago.
Disclosures: McMahon and Gafni report no relevant financial relationships.