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  • Medical Board MOC

    I initially passed IM boards a couple of years ago. Realized I am not currently enrolled in the MOC. Turns out it is about $200/year. Obviously there has been a lot of blow back against the various medical boards in the past couple of years with high fees and uncovering of unsavory spending by the board (especially ABIM). My question is- does it matter to be in MOC? Does it even matter to be board certified? Would rather put my money towards loan debt than keeping the ABIM administrators in luxury condos and cars. What do you guys do/think?

  • #2
    Start here: https://www.whitecoatinvestor.com/forums/topic/moc-a-waste-of-money/

    This topic has generated a ton of discussion - maybe you will get the ball rolling again.
    Working to protect good doctors from bad advisors. Fox & Co CPAs, Fox & Co Wealth Mgmt. 270-247-6087

    Comment


    • #3
      Presently, my hospitals and my group require board certification, so jumping through the hoops is non-negotiable.  I find value in saying that I am "board certified" when talking to non-doctors (patients, hospital or government bureaucrats, media).  Of all the ridiculous things we need to do in our professional lives, this is not where I would start with reform.  That said, ABIM -- by being so ludicrous -- has done a favor to all the other Boards, making them look angelic in comparison.

      Comment


      • #4
        Thanks, I had forgotten about that thread- did read it a few months ago. We don't have to rehash all of the same talk about how corrupt some of the boards are. There didn't really seem to be an answer on if it matters or not. Seems like biggest issues are

        -Hospital/group privileges. I know mine needs it for initial privilege but will have to ask them if they will take it away if I don't re-certify when it comes up

        -Some people argue will look better if in a lawsuit.

        Personally as a hospitalist I do not find much value in being "board certified". I never mention it and it never comes up. I will be keeping uptodate on medicine on my own anyway and of course have CMEs anyway. I do not believe there is currently any difference in insurance reimbursement if you are board certified or not. Are there any compelling reasons I am missing on why one would need it if your hospital/group did not require it?

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        • #5
          I sit on a committee that looks at malpractice cases.  We input whether to defend or settle.  I am surprised at how often hospitalists get sued so yes it might increase your liability.  If you were not boarded a plaintiff attorney would pounce on that fact.

          Comment


          • #6
            Board certification doesn't prevent you from getting sued.  I know of no evidence that speaks to the contrary.  No state medical board requires board certification.  The problem is that most hospitals do.  Beware of the interstate compact going around, which does require board certification.  Camel's nose under the tent sort of thing.  The ABMS mandates MOC, so a given board would literally need to break away from the ABMS, not mandate MOC and still board certify you.  Alternatively, some state legislatures have tried putting forward bills requiring that board certification be removed from any credentialing requirement.  Beyond that the best way to fight it is at the hospital level, where you can propose an alternative board (ABPAS?) certification be accepted.

            As for the legitimacy of MOC, it has good intentions.  But so do most things, right?  The biggest problem MOC suffers from, in my opinion, is that it has little to no evidence that it independently improves quality.  Additionally, with all the crap that we have to deal with it seems all the more insulting that we should deal with it from our own.  I personally think it's worth the fight - to either compel the ABMS boards to prove legitimacy or scrap it all together for something that actually signals quality.

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            • #7
              No I was not implying that board certification prevents a lawsuit.  It is just another avenue of attack by a plaintiff attorney.  Depositions and trials are uncomfortable enough without adding something else to get questioned about.  Board certification may be meaningless now.  Certainly MOC is.  I am just saying if you are boarded the attorney will likely not ask you any questions off your educational history.  If you choose to be non-boarded expect a big deal about it in a deposition/trial.

              Comment


              • #8




                I initially passed IM boards a couple of years ago. Realized I am not currently enrolled in the MOC. Turns out it is about $200/year. Obviously there has been a lot of blow back against the various medical boards in the past couple of years with high fees and uncovering of unsavory spending by the board (especially ABIM). My question is- does it matter to be in MOC? Does it even matter to be board certified? Would rather put my money towards loan debt than keeping the ABIM administrators in luxury condos and cars. What do you guys do/think?
                Click to expand...


                I am not board certified (yet) and I have been practicing as a hospitalist for 6 years.  I am currently 60% convinced that I want to pass IM boards just to prove that I can, but so far I haven't made it happen.  I just personally have a hard time devoting so much energy into memorizing tons and tons of information that I know won't help me do my job and that I know I will forget as soon as I walk out of the test.  However, my hospital requires boards.  I am leaving that hospital at the end of the year because of this.  I found a different hospital and outpatient opportunity that does not require boards.  I am personally pretty upset with the whole board system and the fact that they have become required to practice in most situations.  That makes them completely meaningless.  They're just another hoop to jump through.  Not only that, but I see no correlation between "good doctors" and their board status.  We have some very bad board certified doctors in my hospital (actually quite a few that I would not want taking care of me or my loved ones).  And there's really very little, if any, good evidence that board certification proves anything other than you are capable of memorizing a lot of information and spitting it back out on a multiple choice exam.  I know that doesn't mean a lot coming from someone who has not yet passed that test, but I am thoroughly convinced it is a virtually worthless exercise in terms of improving my ability to take care of patients.  Just had to give you my two cents

                Anyway...

                If you're asking this question simply for financial reasons, then yes, you should keep your current boards active via compliance with MOC.  Its unfortunately a valuable thing to have checked off these days.

                Comment


                • #9




                  No I was not implying that board certification prevents a lawsuit.  It is just another avenue of attack by a plaintiff attorney.  Depositions and trials are uncomfortable enough without adding something else to get questioned about.  Board certification may be meaningless now.  Certainly MOC is.  I am just saying if you are boarded the attorney will likely not ask you any questions off your educational history.  If you choose to be non-boarded expect a big deal about it in a deposition/trial.
                  Click to expand...


                  Unfortunately, I think you are exactly right.  Being non-board certified puts an easy target on your back.  The public demands compliance with something.  And when you're seen as "non-compliant," you're going to be judged differently.  Its not right and we all know that it shouldn't matter, but that's the unfortunate truth.

                  Comment


                  • #10







                    No I was not implying that board certification prevents a lawsuit.  It is just another avenue of attack by a plaintiff attorney.  Depositions and trials are uncomfortable enough without adding something else to get questioned about.  Board certification may be meaningless now.  Certainly MOC is.  I am just saying if you are boarded the attorney will likely not ask you any questions off your educational history.  If you choose to be non-boarded expect a big deal about it in a deposition/trial.
                    Click to expand…


                    Unfortunately, I think you are exactly right.  Being non-board certified puts an easy target on your back.  The public demands compliance with something.  And when you’re seen as “non-compliant,” you’re going to be judged differently.  Its not right and we all know that it shouldn’t matter, but that’s the unfortunate truth.
                    Click to expand...


                    The decision to file a suit has been studied, and I don't recall ever seeing board certification (or lack thereof) influencing the patient's decision.  The key is to prevent the occurrence of a lawsuit.  Once a claim is filed being board certified or not is the least of your worries.  You still have to get dragged through the mud.  The target isn't just on your back - you now have an arrow in your back.  The decision to settle or go to trial is often a mathematical one, based in the ability to defend against standard of care attacks and the kind of injury/individual affected.  Since only 15% of cases go to trial (typically won by the doctor) the idea that board certification factors into the lawyer's calculus at any point seems far-fetched.  Negligence can be judged irrespective of board certification.  Standard of care is met, it's not, or it's unclear.  For these go-to-trial, negligence unclear cases perhaps board certification can help.  But I don't believe I've seen this proven anywhere.  Lawyers typically recommend a slew of other things to protect yourself in the event of a lawsuit.  Don't recall board certification as being on the top of any of those lists.  Otherwise it's just a fear-driven approach to getting board certified.  Board certification is supposed to be about the pursuit of quality.  I would also hold that you are compliant with something - state board certification by nature of the CME process.

                    Comment


                    • #11










                      No I was not implying that board certification prevents a lawsuit.  It is just another avenue of attack by a plaintiff attorney.  Depositions and trials are uncomfortable enough without adding something else to get questioned about.  Board certification may be meaningless now.  Certainly MOC is.  I am just saying if you are boarded the attorney will likely not ask you any questions off your educational history.  If you choose to be non-boarded expect a big deal about it in a deposition/trial.
                      Click to expand…


                      Unfortunately, I think you are exactly right.  Being non-board certified puts an easy target on your back.  The public demands compliance with something.  And when you’re seen as “non-compliant,” you’re going to be judged differently.  Its not right and we all know that it shouldn’t matter, but that’s the unfortunate truth.
                      Click to expand…


                      The decision to file a suit has been studied, and I don’t recall ever seeing board certification (or lack thereof) influencing the patient’s decision.  The key is to prevent the occurrence of a lawsuit.  Once a claim is filed being board certified or not is the least of your worries.  You still have to get dragged through the mud.  The target isn’t just on your back – you now have an arrow in your back.  The decision to settle or go to trial is often a mathematical one, based in the ability to defend against standard of care attacks and the kind of injury/individual affected.  Since only 15% of cases go to trial (typically won by the doctor) the idea that board certification factors into the lawyer’s calculus at any point seems far-fetched.  Negligence can be judged irrespective of board certification.  Standard of care is met, it’s not, or it’s unclear.  For these go-to-trial, negligence unclear cases perhaps board certification can help.  But I don’t believe I’ve seen this proven anywhere.  Lawyers typically recommend a slew of other things to protect yourself in the event of a lawsuit.  Don’t recall board certification as being on the top of any of those lists.  Otherwise it’s just a fear-driven approach to getting board certified.  Board certification is supposed to be about the pursuit of quality.  I would also hold that you are compliant with something – state board certification by nature of the CME process.
                      Click to expand...


                      Hatton is saying is that there is just another possible line of attack that a plaintiff's attorney could use if you're not boarded.  Although I've not yet had the lovely experience of a trial, I've been to several depositions.  In every one of them I was asked if I was board certified.  Since I was/am, I can't tell you what the following questions would have been if I wasn't.  Yeah, we all know that board certification means horse manure in terms of care quality, but the courtroom is a suboptimal place to philosophize the failing of MOC.

                      That, plus the rare times I use the term (actually used it twice this month, once when talking to a hospital CEO and another time with a patient, both describing my awesome partners), is worth $200/yr to me.

                      Comment


                      • #12
                        As a hospitalist that has seen so many changes in groups and administration, I would say stay board certified, continue to participate in MOC. In any situation have a plan B. Being board certified/MOC compliant makes it easier for you to move on in you CEO or VP lose their mind and make some sweeping change which effects your quality of life. Since you already passed the boards the yearly fee is the easy part. Your job may pay for it since it's required for your job, if not see if you can use your CME money for it. Pay the 10 year fee with your CME then you don't have to think about it again...for 10 years at least. Hopefully by then things will be different.

                        BTW next year for IM there will be a shorter 2 year test option and the 10 year test will be open book. They're slowly making changes.

                        Comment


                        • #13













                          No I was not implying that board certification prevents a lawsuit.  It is just another avenue of attack by a plaintiff attorney.  Depositions and trials are uncomfortable enough without adding something else to get questioned about.  Board certification may be meaningless now.  Certainly MOC is.  I am just saying if you are boarded the attorney will likely not ask you any questions off your educational history.  If you choose to be non-boarded expect a big deal about it in a deposition/trial.
                          Click to expand…


                          Unfortunately, I think you are exactly right.  Being non-board certified puts an easy target on your back.  The public demands compliance with something.  And when you’re seen as “non-compliant,” you’re going to be judged differently.  Its not right and we all know that it shouldn’t matter, but that’s the unfortunate truth.
                          Click to expand…


                          The decision to file a suit has been studied, and I don’t recall ever seeing board certification (or lack thereof) influencing the patient’s decision.  The key is to prevent the occurrence of a lawsuit.  Once a claim is filed being board certified or not is the least of your worries.  You still have to get dragged through the mud.  The target isn’t just on your back – you now have an arrow in your back.  The decision to settle or go to trial is often a mathematical one, based in the ability to defend against standard of care attacks and the kind of injury/individual affected.  Since only 15% of cases go to trial (typically won by the doctor) the idea that board certification factors into the lawyer’s calculus at any point seems far-fetched.  Negligence can be judged irrespective of board certification.  Standard of care is met, it’s not, or it’s unclear.  For these go-to-trial, negligence unclear cases perhaps board certification can help.  But I don’t believe I’ve seen this proven anywhere.  Lawyers typically recommend a slew of other things to protect yourself in the event of a lawsuit.  Don’t recall board certification as being on the top of any of those lists.  Otherwise it’s just a fear-driven approach to getting board certified.  Board certification is supposed to be about the pursuit of quality.  I would also hold that you are compliant with something – state board certification by nature of the CME process.
                          Click to expand…


                          Hatton is saying is that there is just another possible line of attack that a plaintiff’s attorney could use if you’re not boarded.  Although I’ve not yet had the lovely experience of a trial, I’ve been to several depositions.  In every one of them I was asked if I was board certified.  Since I was/am, I can’t tell you what the following questions would have been if I wasn’t.  Yeah, we all know that board certification means horse manure in terms of care quality, but the courtroom is a suboptimal place to philosophize the failing of MOC.

                          That, plus the rare times I use the term (actually used it twice this month, once when talking to a hospital CEO and another time with a patient, both describing my awesome partners), is worth $200/yr to me.
                          Click to expand...


                          I understand.  But if that additional line of attack doesn't result in any tangible effects then so what?  You're already being roasted on the fire regardless.  Whether in deciding to settle or in a trial, if board certification was independently predictive of non-payment on multi-variate analysis then I'll agree that board certification and litigation concerns belong in the same sentence.  Evidence?

                          Comment


                          • #14
                            We are a rare private/independent hospitalist group so no free money for CMEs. If needed to bite the bullet would expense it though the group at least (which I always consider getting something at 50% when considering tax savings)

                            Comment


                            • #15
                              I was recently deposed and they didnt even ask, and Im not and dont care to be. However, its a bit of a totally ridiculous case and the plaintiffs firm sent their most inexperienced person, likely due to not wanting to spend too much on it.

                              I can see them trying to attack on that level, but what can truly come of it? They are the first to say its voluntary and no legal protections exist when asked about it specifically (contrary to all their other talk). You either met the standard of care or didnt. It may be slightly uncomfortable, but really how bad could it be, its a meaningless stamp that has zero weight on anything else. Even having just been deposed and possibly going to trial, this is one of the least annoying aspects of the case.

                              No one understands, cares, etc...in fact the 2 or 3 that have known to ask have turned out to be terrible pts that I wanted nothing to do with. Its pretty hilarious and simultaneously sad when they ask, and have zero frame of reference or context for which to apply the answer. This is true of all the "q's to ask your doctor". The knowledge asymmetry makes it a non starter, similar to consent and letting pts participate in their care, etc...How many times have you let a pt "participate" by choosing a terrible or deadly/dangerous option? Ah, zero? But you let them choose when the two choices are equivalent or dont matter, well thats just patronizing and it surely isnt being a partner in their care. Cant stand that illogical stuff, and so sad to see many docs buying into it.

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