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As many of you know, the ABIM recently made a (very) small step in the right direction in addressing the many concerns over the MOC process. By temporarily suspending the Practice Improvement component of MOC, the ABIM seemed to recognize some of the concern over its programs, but no costs were reduced and overall the program remains largely unchanged. http://www.medscape.com/viewarticle/839178?src=sttwit

But now that the first crack has been made in the ABMS armor, I believe that every member board should be pressured to scale back their MOC programs. NOW is the time to put overwhelming pressure on the boards. If we say nothing and do nothing, the moment will have been lost and the status quo will become entrenched. If we capitalize on this moment and put real pressure on the boards, perhaps we can effect further change.

Here's what I believe- if MOC was a cheap, online, interactive, open-book module that covered recent landmark literature, AND NOTHING MORE, it would be acceptable. Bascially, it would be a CME exercise- go on the internet, review what's new in your field, done. Nothing more needed- no practice improvement modules, no secure exam, certainly no simulator, etc. Unfortunately, I don't believe the ABA or other ABMS boards would ever go for that, which is why NBPAS needs to be supported as a viable alternative.

This petition states just that. Hopefully, this can be a show of force to the ABA that its membership is tired of the MOCA abuses and wants meaningful, drastic change. If you agree with me, please sign. Maybe if every specialty board was pressured to begin to scale back MOC, we'd start to see more steps in the right direction.

Let's do this.

http://www.petitionbuzz.com/petitions/changemoca
 

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if MOC was a cheap, online, interactive, open-book module that covered recent landmark literature, AND NOTHING MORE, it would be acceptable. Bascially, it would be a CME exercise- go on the internet, review what's new in your field, done. Nothing more needed-
Then it would be useful and why would the ABA and the ASA do something useful.
The programs are not in place for utility and user friendliness. Its meant to be a program generated to A)make money B) create a hazing atmosphere towards physicians. How any one believes answering questions on the MAC of sevo, and the alveolar gas equation is important for a clinician 10 years later is BEYOND ME. How can anyone support this complete and utter HORSE****?
 
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The boards are colluding to maintain the MOC status quo. The ABFM (family medicine) and ABP (pediatrics) released essentially the same press release in response to the ABIM's move. Both say they will NOT change MOC in any way. http://rebel.md/american-board-of-pediatrics-plagiarizes-moc-press-release/

Please sign to let the ABA know that we are tired of being extorted $5000 per MOCA cycle, for ZERO benefit to us or our patients.

http://www.petitionbuzz.com/petitions/changemoca
what will be done with this petition after i sign?

how are signatures validated?

(I signed and would like to forward the link to my group, but know they will ask these questions)
 
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deleted50478

How are the ABA board of directors selected and how can we replace them with responsive members?
With 12 year term (WTF!!!) it will take forever if it's even possible- there is no discussion of selection on the ABA website.

I did a survey and got results that had nothing whatsoever to do with the concerns of board certified anesthesiologists.
 

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How are the ABA board of directors selected and how can we replace them with responsive members?
With 12 year term (WTF!!!) it will take forever if it's even possible- there is no discussion of selection on the ABA website.

I did a survey and got results that had nothing whatsoever to do with the concerns of board certified anesthesiologists.
can't people like.. sue them?? these board things sound so shady im sure the lawyers can find something to use
 
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what will be done with this petition after i sign?

how are signatures validated?

(I signed and would like to forward the link to my group, but know they will ask these questions)
It will be presented to the ABA. Signatures won't be "validated" per se, but will be checked against the ABA's registry to see which represent board-certified/eligible anesthesiologists and which don't. There will be many from non-anesthesiologists, since others from the anti-MOC movement will/have signed in support.

Email addresses will be kept in the strictest confidence.

Please share this with as many anesthesiologists as you can. Our silence will be interpreted by the ABA as assent to the current MOCA system. By making a statement now, while the boards are faced with the reality of an angry membership, they may be encouraged to change meaningfully.

That said, I'm not very optimistic that they will, which is why I 100% support NBPAS and am working locally to ensure that it becomes a recognized alternative. I encourage you all to do the same in your hospitals.
 

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What is the official stance of the american society of anesthesiologists concerning this issue? Do they even have a stance?,or are they in bed with the aba?,gotta wonder
 

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Just signed...took 5 seconds...we must get that number above the current 50 (only 20% of the 250 minimum signatures)...you guys should talk to your colleagues and get them involved.
 
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What is the official stance of the american society of anesthesiologists concerning this issue? Do they even have a stance?,or are they in bed with the aba?,gotta wonder
I don't think they have an official stance, but they profit greatly from MOCA products. Their hands are most definitely in the cookie jar.

http://education.asahq.org/moca

When I brought this up with my local ASA chapter, it became quite clear the ASA has zero interest in chopping down this money tree.
 
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I don't disagree that there is likely overlap between ASA/ABA and as a result some effective collusion but I would offer that the numbers suggest something of a different picture (though I accept that a different perspective could be had on the same numbers). As a nonprofit their (ASA's) tax returns are public and can be reviewed. The most recent I see is 2012:
http://990s.foundationcenter.org/990_pdf_archive/362/362181944/362181944_201212_990O.pdf?_ga=1.98785438.1817048524.1398464148

It is worth noting that the predominance of their income come from dues ($19.2M) and the annual conference ($7.4M). They receive $2.6M and $1.3M respectively for ACE and SEE and another $1.5M from "other" education. Given that 82% of their income is derived directly from membership dues/annual conference attendance alone I would expect them to be more responsive than the ABA who derives virtually all their income (as far as I know) from the exams, sims, etc. Furthermore if MOCA changed in the desired way not everyone would discard ACE/SEE as useless as they provide CME and at least from my experience are decent products (can only really speak about ACE personally)

An argument can certainly be made that conference and membership dues are in part because ASA offers cheaper CME as a result of membership but that would be a relatively inefficient financial way to accumulate the CME that is already required by most states so I suggest that MOCA is not the primary reason people join. ASA has a lot to potentially lose with respect to dues and annual conference attendance if people are upset by MOCA and believe that ASA is colluding with ABA on MOCA rather than representing its membership. I offer this not as a counterfactual on HawaiiBruin's argument but rather to introduce a shade of grey that I believe I exists.

All that said I still firmly and vigorously support MOCA change and the PetitionBuzz petition but would like to introduce some hope that ASA may listen and be understanding if not supportive
 

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Yeah I wouldn't disagree very heartily with much of anything you said-my point was mainly that I don't think that ASA has a strong financial position relative to MOCA. I concur that ABA leadership has little incentive to listen or innovate but I don't think that is as true of ASA leadership. There are annually elected leaders with a 1 year lag (president-elect) as I recall and the senate is composed of elected members from the state assemblies some/many of which are in my experience (albeit limited) not academics so I think that with aggressive lobbying ASA can indeed be influenced. Surely there is some overlap and limited desire to piss on each other but let's not forget that ASA senators have to pay for this stuff too and academics have even less money so I don't buy the argument that they don't care how much it costs.
 

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it is kind of sad that there are almost 50000 anesthesiologists in the country... and only 160ish signed so far lol...
 

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it is kind of sad that there are almost 50000 anesthesiologists in the country... and only 160ish signed so far lol...
I only found out about the petition through this sdn thread.

The number of signatures increases every time I refresh the browser so perhaps the existence of the petition is spreading.
 
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anbuitachi

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I only found out about the petition through this sdn thread.

The number of signatures increases every time I refresh the browser so perhaps the existence of the petition is spreading.
Though I wonder even if it reach 500 if it will be useful. Since that's only 1% of anesthesiologists
 

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What about phone calls to the aba demanding reform? Any thoughts?
 
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maybe someone who works or trains with an aba member can ask how they got that gig? They don't need to know you're asking from a desire to bring down their secret society of elitist power brokers.
 

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I created a Facebook page to promote the rational argument of changing MOCA. Commencing social media phase of the operation:

https://www.facebook.com/ChangeMOCA

Please like, share and send it to your friends. A link to the petition is already on there. Recognize that this is entirely (at least at this point) a grass roots, person-to-person campaign. It's your job as well as mine to tell everyone you work with and promote it. Tell everyone on The Facebook. #ChangeMOCA. Help us change.
 
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I created a Facebook page to promote the rational argument of changing MOCA. Commencing social media phase of the operation:

https://www.facebook.com/ChangeMOCA

Please like, share and send it to your friends. A link to the petition is already on there. Recognize that this is entirely (at least at this point) a grass roots, person-to-person campaign. It's your job as well as mine to tell everyone you work with and promote it. Tell everyone on The Facebook. #ChangeMOCA. Help us change.
Signed Tommy, and I'll follow you FB page as well. Hope Indiana is treating you well bro!
 
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One third of the way to the goal of 1000 signatures! Pass it on to your colleagues, your attendings, etc. Let the ABA know that significant changes are necessary.
 

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Dear Dr. Blade,

Since its inception, maintenance of certification (MOC) has been an evolving process and the source of significant debate. In recent weeks, that debate has intensified after an American Board of Internal Medicine announcement concerning its MOC program's deficiencies (http://www.abim.org/news/abim-announces-immediate-changes-to-moc-program.aspx).
The ABA has collected 10 years of data and conducted multiple diplomate surveys to ascertain the relevance and applicability of its own Maintenance of Certification in Anesthesiology Program (MOCA®), which launched in 2004. We strongly believe the program assures the public that our diplomates demonstrate commitment to quality clinical outcomes and patient safety. That said, we are constantly looking for ways to improve and enhance the MOCA process to address areas of concern raised by our diplomates.

In collaboration with a group of volunteer anesthesiologists, comprised of subspecialists, private practitioners, academicians, early-career diplomates and anesthesiology residents, we are redesigning our MOCA program. Our vision is to aid anesthesiologists as they continuously assess their knowledge, identify their specific knowledge gaps, and connect to targeted educational resources that will meet their individual needs. Our objective is to integrate the various components of MOCA and provide greater flexibility for diplomates to design an individualized learning plan that adds the most value to their practice

In 2014, we completed development of a new web-based prototype we are calling MOCA 2.0. We solicited the help of our 18 volunteers, who provided their feedback on the design, content and functionality of the prototype. The development will continue in 2015 with the goal of piloting a new MOCA program in the near future.
We are excited about MOCA 2.0 because it will provide diplomates with valuable resources they can use to track their progress and enhance their learning while addressing many of the concerns some of them have raised about the current program. The platform will continue to advance the highest standards of the practice of anesthesiology. It will also align well with the American Board of Medical Specialties' 2015 MOC Standards, which provide for greater flexibility for Member Boards as they consider new and innovative approaches to MOC.
In the interim, the requirements of our current MOCA program will not change. We continue to believe that MOCA is of tremendous value to the public and the practice of anesthesiology. We welcome and appreciate our diplomates' feedback, and are committed to partnering with them to design a program that is more meaningful and less burdensome.
If you have suggestions or recommendations you would like to share with the Board, click theMOCA Feedback link or visit http://moca.theaba.org/fg.pl.

Sincerely,

James P. Rathmell
Secretary
 

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Dear Dr. Blade,

Since its inception, maintenance of certification (MOC) has been an evolving process and the source of significant debate. In recent weeks, that debate has intensified after an American Board of Internal Medicine announcement concerning its MOC program's deficiencies (http://www.abim.org/news/abim-announces-immediate-changes-to-moc-program.aspx).
The ABA has collected 10 years of data and conducted multiple diplomate surveys to ascertain the relevance and applicability of its own Maintenance of Certification in Anesthesiology Program (MOCA®), which launched in 2004. We strongly believe the program assures the public that our diplomates demonstrate commitment to quality clinical outcomes and patient safety. That said, we are constantly looking for ways to improve and enhance the MOCA process to address areas of concern raised by our diplomates.

In collaboration with a group of volunteer anesthesiologists, comprised of subspecialists, private practitioners, academicians, early-career diplomates and anesthesiology residents, we are redesigning our MOCA program. Our vision is to aid anesthesiologists as they continuously assess their knowledge, identify their specific knowledge gaps, and connect to targeted educational resources that will meet their individual needs. Our objective is to integrate the various components of MOCA and provide greater flexibility for diplomates to design an individualized learning plan that adds the most value to their practice

In 2014, we completed development of a new web-based prototype we are calling MOCA 2.0. We solicited the help of our 18 volunteers, who provided their feedback on the design, content and functionality of the prototype. The development will continue in 2015 with the goal of piloting a new MOCA program in the near future.
We are excited about MOCA 2.0 because it will provide diplomates with valuable resources they can use to track their progress and enhance their learning while addressing many of the concerns some of them have raised about the current program. The platform will continue to advance the highest standards of the practice of anesthesiology. It will also align well with the American Board of Medical Specialties' 2015 MOC Standards, which provide for greater flexibility for Member Boards as they consider new and innovative approaches to MOC.
In the interim, the requirements of our current MOCA program will not change. We continue to believe that MOCA is of tremendous value to the public and the practice of anesthesiology. We welcome and appreciate our diplomates' feedback, and are committed to partnering with them to design a program that is more meaningful and less burdensome.
If you have suggestions or recommendations you would like to share with the Board, click theMOCA Feedback link or visit http://moca.theaba.org/fg.pl.

Sincerely,

James P. Rathmell
Secretary

Got the same email. Short on details. They don't say if they are going to make it less onerous, less expensive or is this only lip service to address a growing resentment among the ranks?
 
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They have claimed that the specific changes will be announced in their 2015 newsletter, coming out early March.

Meanwhile, everybody that agrees needs to email the ABA stating that anything less than a complete dismantling of MOCA, including eliminating the test, simulator, and PPAI and replacement with an inexpensive online module will not be acceptable.

Mention the petition too! And now more than ever, pass this info and these links along to your colleagues. Let the ABA know you won't be extorted any longer.
 

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Um, anyone else find it a little fishy that they don't name the 18 people who are in this inner circle that's supposedly reinventing MOCA?

These guys do secrecy like a comedy about the mob: "Hey, everyone, we have information [the survey] that we won't give you! And we have a special clique [these 18 people] we won't identify! Secrets everywhere! Neener, neener!"
 

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Um, anyone else find it a little fishy that they don't name the 18 people who are in this inner circle that's supposedly reinventing MOCA?

These guys do secrecy like a comedy about the mob: "Hey, everyone, we have information [the survey] that we won't give you! And we have a special clique [these 18 people] we won't identify! Secrets everywhere! Neener, neener!"
Yes, who are these 18 volunteers? I would have volunteered but was not asked. Are they participating in MOCA? Are they anesthesiologists? Are they unbiased? I think I know the answer to the last question.
 

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If you guys remember I elluded to this change a few months back. I didn't have any details and as of now we still have no details.
But I do know some of the 18 and I have been relentless with my pursuit to eliminate MOCA as we know it.
 

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Yes, who are these 18 volunteers? I would have volunteered but was not asked. Are they participating in MOCA? Are they anesthesiologists? Are they unbiased? I think I know the answer to the last question.
Supposedly they are all anesthesiologists, according to the letter. But I agree with you, I highly doubt they are unbiased. Until proven otherwise, I am going to regard this as an attempt by ABA to spin their way out of the anti-MOCA mutiny without making any meaningful changes.

I think there should be a petition for ABA to release the *entire* results of the survey, with exceptions made only for personally identifiable information.

Noyac, any insights you'd care to share on how these 18 were selected or what their mindset is?
 
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Did anyone else see the BS the ABA put out yesterday on MOCA?

Booklets. Give me a fukin break.
 
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I saw no meaningful change. Elimination of simulation is the bare minimum of acceptible change.
 

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Was that the "change" they were referring to or is there more to come?
 

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What did they even rename? Booklet looked like no change at all, if you mean the one titled "Maintenance of Certification Booklet of Information, published February 2015"
 
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No wonder MOCA costs so much- we have to support the salaries of these forward-thinking leaders.

Indeed, their acronym-shuffling-based leadership is a rare shining beacon of hope in the otherwise dark sea of medical board administration.
 
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only way to stop or minimize this would be with a lawsuit. when $ is involved, a petition/signatures/whining won't do jack.

anyone with a JD here who can actually explore this further? doesn't have to be strong - as long as there is "something", it will catch fire...
 

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I finished in 2004 and got boarded in 2005. Finished all my moca by August 2014. So I just got "recertication for MOCA" letter that's to be mailed in May 2015. So guess I am good till December 2025 now.

Moca was pretty painless for my 2004-2007 MOCA cohort.

But the one thing I don't like is the requirements get more and more. The 2000-2003. All they needed really was to take a test and report their cme. And for the moca test the 2000-2003 up until 2010/2011 Eliminiate 50 questions. The weren't even required to do moca simuation.

So aba keeps changing the requirements. For 2008 and forward they require more Bs (patient safety CME) that wasn't required for those certified in 2000-2007.

Now they require both MOCA simuation and case report/practice improvement. My cohort 2004-2007 only had to do one or the other.
 

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Agree with a lawsuit if feasible....

In the meantime that petition page (up to 700+ signatures, BTW) has the following update:

Update 3/3/2015- The ABA is asking for feedback on MOC- let them know what you think! Visit our Facebook page for a sample response.

http://moca.theaba.org/fg.pl
 
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Everyone should watch this presentation by Dr. Teirstein, head of NBPAS. Eye opening as far as the risk lack of evidence for MOC.

https://nbpas.org/debate-on-maintenance-of-certification/

Also check out this Newsweek article on the MOC push back-http://www.newsweek.com/ugly-civil-war-american-medicine-312662

Meanwhile the petition is over 1000 signatures and going strong. Keep your colleagues involved, keep the dialogue going, and keep pressure on the ABA.
Interesting. Could be gaining some traction. I hope so.
 
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I joined the day they opened it to anesthesiologists. My ABA cert runs for a while still, but joining NBPAS helps them get off the ground, so I saw it as a worthy cause.

If your med exec committee is like mine, they have never heard of this issue, and are unaware of the MOC pushback. There are a number of things to do in that scenario-

1) Talk to your colleagues, get them on the same page, and ask them to submit similar requests to the MEC requesting recognition of NBPAS.
2) Inform the MEC of the complete lack of data for MOC. Dr. Teirstein's talk linked above will help with that.
3) Inform them of the AMA's position against mandatory MOC- http://www.ama-assn.org/ama/pub/ama-wire/ama-wire/post/ama-adopts-principles-maintenance-of-certification
4) NBPAS has a number of supporting documents you can use in your request here- https://nbpas.org/sample-letters-and-powerpoints/
5) Show them the Newsweek article.

It's a slow process, as with all med exec actions. Mine is still working on it, but they're coming around, especially now that this is hitting the mainstream press.

Here's the thing about NBPAS- it's valid if we say it is. If all the doctors at your hospital collectively said "We are not doing MOC anymore, and we all demand NBPAS be recognized as legitimate," they'd have no choice. It's time for doctors to stop being sheep, to stop being willingly extorted by these organizations.

I do not plan on paying one single cent more to the ABA, unless they radically scale back MOCA.

Disclaimer: I have zero financial relationship with NBPAS.
 

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Here's the thing about NBPAS- it's valid if we say it is. If all the doctors at your hospital collectively said "We are not doing MOC anymore, and we all demand NBPAS be recognized as legitimate," they'd have no choice. It's time for doctors to stop being sheep, to stop being willingly extorted by these organizations.

I do not plan on paying one single cent more to the ABA, unless they radically scale back MOCA.
Instead of saying we are not doing MOC anymore, I would say we will continue to do MOC, but through a reasonable, non-ABMS vendor, since it seems that the NBPAS is all about MOC and not initial certification. This language would likely be more palatable to the hospital board, who want to see their physicians involved in MOC and lifelong learning.
 
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