When do we file against ABA?

[caligas]

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Dr. Wes: Boarded to Death: Physicians Sue the ABIM

 

[chocomorsel]

Last year, being the procrastinator that I am, I waited till the last three days of the year to do mine. Little did I know you could only do a limited number of questions a day. Those jerks gladly took my money knowing I didn’t have enough days in the calendar to do all the questions. Of course when I hit the road block that first day and called them, they said NO REFUND and there was nothing they could do to let me have access to all the questions and I would be non MOC certified.

Of course it’s a scam. Why the hell is there a limit on how many questions I can do at a time? What a bunch of crap.

 

[Psai]

Why do we need all these merit badges? Are we in the boy scouts? Every step of the process is ridiculously expensive and I'm not entirely sure what we are paying for.

 

[Mr.S]

Over the summer, Wesby Fisher was pushing for funds so he set up a go fund me page which i donated into. I believe it was for this suit.

Its all a freakin racket. I ve known it since ever.And to @Psai,youre not sure what you re paying for?

Youre funding many peoples lavish lifestyle. Including those directors in the ASA and ABA. I say unfund all of them.

Unjoin all the professional societies including the ASA because they support MOCA.

DO you have to pay your college a fee everyyear for maintenance of education?

 

[gasdoc77]

I look forward to the day when enough physicians are employees and we can unionize. I feel confident that we will see this reach the courts in the not-too-distant future

 

[Mman]

While I do not believe the process of MOC is very well done, I 100% support the idea of it. Being a physician is a privilege and it is a privilege that society allows us to regulate ourselves. Unless you want to argue that the day you get board certified you should never have to open another book or read another journal or take another test and should be good for life, that means we either regulate ourselves or ask non physicians to do it for us.

Lifetime certification is a dumb idea. I see docs out there that got certified in the 1970s and still practice like it and I would not want one of my family members being treated by them.

 

[dannyboy1]

While I do not believe the process of MOC is very well done, I 100% support the idea of it. Being a physician is a privilege and it is a privilege that society allows us to regulate ourselves. Unless you want to argue that the day you get board certified you should never have to open another book or read another journal or take another test and should be good for life, that means we either regulate ourselves or ask non physicians to do it for us.

Lifetime certification is a dumb idea. I see docs out there that got certified in the 1970s and still practice like it and I would not want one of my family members being treated by them.

C’mon now. The only thing required to maintain certification is a valid credit card. These “courses” are all just pay to play. Everyone passes. Yes, a serious and professional physician should stay up to date but that is not what is happening with MOC....

 

[GravelRider]

I don’t think anyone really is complaining about staying up to date. The problem comes down to cost. These MOC programs do not provide an educational experience that is on par with what they cost. That’s the bottom line.

Once you enter a specialty, you are a captured audience for that particular certifying body that is now expected to shell out whatever fee they throw at you for whatever crummy educational experience they deem acceptable. Between various licensing, credentialing, and certifying fees every year the average physician is paying over a $1,000 (I don’t know the real number) per year just to be allowed to practice. That’s a lot of money for the average solo internist to be paying every year.

 

[ryanjmy]

I don't mind the questions, cme or even the money. Some of that is helpful. The points system is the rediculous part. A simulator is a complete waste of my time. As is documenting an improvement project

 

[Mad Jack]

Over the summer, Wesby Fisher was pushing for funds so he set up a go fund me page which i donated into. I believe it was for this suit.

Its all a freakin racket. I ve known it since ever.And to @Psai,youre not sure what you re paying for?

Youre funding many peoples lavish lifestyle. Including those directors in the ASA and ABA. I say unfund all of them.

Unjoin all the professional societies including the ASA because they support MOCA.

DO you have to pay your college a fee everyyear for maintenance of education?

Someone has to be paid to sit on their ass while AMCs and CRNAs salt and burn the field

 

[deleted50478]

While I do not believe the process of MOC is very well done, I 100% support the idea of it. Being a physician is a privilege and it is a privilege that society allows us to regulate ourselves. Unless you want to argue that the day you get board certified you should never have to open another book or read another journal or take another test and should be good for life, that means we either regulate ourselves or ask non physicians to do it for us.

Lifetime certification is a dumb idea. I see docs out there that got certified in the 1970s and still practice like it and I would not want one of my family members being treated by them.

Nonsense. You have to do CMEs to maintain your medical license anyway. MOCA adds nothing of value.

 

[vector2]

While I do not believe the process of MOC is very well done, I 100% support the idea of it. Being a physician is a privilege and it is a privilege that society allows us to regulate ourselves. Unless you want to argue that the day you get board certified you should never have to open another book or read another journal or take another test and should be good for life, that means we either regulate ourselves or ask non physicians to do it for us.

Lifetime certification is a dumb idea. I see docs out there that got certified in the 1970s and still practice like it and I would not want one of my family members being treated by them.

MOCA is a joke. The threshold for getting a passing score on the quarterly questions is so low that anyone who fails is not only incapable of being an anesthesiologist, they're likely incapable of breathing and walking at the same time.

What's wrong with just having the old CME system but making sure that 50% or more of the credits are anesthesia related?

 

[Mman]

Nonsense. You have to do CMEs to maintain your medical license anyway. MOCA adds nothing of value.

MOC is specialty specific. You could do any random CME in the world to maintain your medical license. As I said, I've seen docs certified in the 1970s that haven't advanced since then but they are still board certified.

I'm not arguing that MOCA is useful as it is currently structured. I'm saying it is 100% necessary to maintain our professional standards. If we don't do it, someone else will.

 

[Mman]

What's wrong with just having the old CME system but making sure that 50% or more of the credits are anesthesia related?

I think part of the problem is that the standard for getting something eligible for CME is so low as to be pointless. Doing CME basically means you have a pulse.

 

[TheLoneWolf]

While I do not believe the process of MOC is very well done, I 100% support the idea of it. Being a physician is a privilege and it is a privilege that society allows us to regulate ourselves. Unless you want to argue that the day you get board certified you should never have to open another book or read another journal or take another test and should be good for life, that means we either regulate ourselves or ask non physicians to do it for us.

Lifetime certification is a dumb idea. I see docs out there that got certified in the 1970s and still practice like it and I would not want one of my family members being treated by them.

Agree 100%. Would you rather be policed by your peers or a pencil pushing clip board toting monkey in a suit or someone who could no longer hack it as a nurse. Bureaucracy is not your friend. Everyone say it with me as this bears repeating:
Bureaucracy is not your friend.

The rising cost of healthcare closely parallels the increase in medical administration.

 

[Mr.S]

While I do not believe the process of MOC is very well done, I 100% support the idea of it. Being a physician is a privilege and it is a privilege that society allows us to regulate ourselves. Unless you want to argue that the day you get board certified you should never have to open another book or read another journal or take another test and should be good for life, that means we either regulate ourselves or ask non physicians to do it for us.

Lifetime certification is a dumb idea. I see docs out there that got certified in the 1970s and still practice like it and I would not want one of my family members being treated by them.

Do you advocate also making maintenance of education for college diplomas? how about high school? Medical school?

It's the same thing.

The purpose of lifetime board certification is not to say you are going to be good and up to date forever. Or be a good doctor. THat is the job of state licensure, peer review, NPDB reporting etc etc. There are multiple ways to weed out bad doctors. Especially in our field where we practice on stage in front of everyone. SO people know when we are bad. The purpose of lifetime initial board certification is to state that you have reached a milestone and you have achieved a standard at a certain point in time. Just like your college diploma.

I dont think anything (including MOCA) can guarantee you will be a good doctor.

This is all a money grab. corrupt as all get out. I cannot believe everyone cannot see it. Its as clear as day.

 

[Mr.S]

MOC is specialty specific. As I said, I've seen docs certified in the 1970s that haven't advanced since then but they are still board certified.

.

My ex-wife is a PH.d in mathematics. Seriously. She got it perhaps 11 years ago. She currently runs our flower shop and has for the past 10 years. The only math she does is calculate how much i owe her every month. Does that make her Doctor of Philosophy degree null and void? Does she have to take a math test every few years to maintain it. NOPE..

 

[vector2]

I think part of the problem is that the standard for getting something eligible for CME is so low as to be pointless. Doing CME basically means you have a pulse.

That's my point. MOCA in its current form and CME are basically both worthless in differentiating a competent and incompetent anesthesiologist. The key difference is that MOCA costs thousands of dollars.

 

[BobLoblaw78]

So what is the pass rate for the MOCA app questions??? I have often wondered. They seem very simple questions sometimes, so I worry people are getting 90's %-wise. Then I miss 4 in a row and feel like I should quit anesthesia! LOL

What do most people get percentage-wise? I'll put mine out there- 80's. I have dipped into the 70's briefly which worried me. All in all, I think it is ridiculous, because someone could always grab a colleague and take it as a group (but I'm sure no one would do that). I more appreciate the reasoning and explanation along with the literature sources. Although, the questions are sometimes not applicable to my practice.

 

[Mad Jack]

While I do not believe the process of MOC is very well done, I 100% support the idea of it. Being a physician is a privilege and it is a privilege that society allows us to regulate ourselves. Unless you want to argue that the day you get board certified you should never have to open another book or read another journal or take another test and should be good for life, that means we either regulate ourselves or ask non physicians to do it for us.

Lifetime certification is a dumb idea. I see docs out there that got certified in the 1970s and still practice like it and I would not want one of my family members being treated by them.

MOCA should not be this costly nor this ill-designed

 

[GravelRider]

Agree 100%. Would you rather be policed by your peers or a pencil pushing clip board toting monkey in a suit or someone who could no longer hack it as a nurse. Bureaucracy is not your friend. Everyone say it with me as this bears repeating:
Bureaucracy is not your friend.

The rising cost of healthcare closely parallels the increase in medical administration.

Is the ABA not considered a bureaucracy? A bureaucracy is a non-elected, policy-making, administrative group.

 

[TJRock]

Lifetime certification is a dumb idea. I see docs out there that got certified in the 1970s and still practice like it and I would not want one of my family members being treated by them.

So, how has MOCA made that situation better? Are they exempt from MOCA?

 

[TheLoneWolf]

They

Is the ABA not considered a bureaucracy? A bureaucracy is a non-elected, policy-making, administrative group.

They are. There is no physician that is not under the thumb of both their college and the state medical board. Which do you think is better? Our benefit is you are judged by your anesthesiology peers, not a crumb bum who thinks we are nurses supervised by the surgeons.

 

[Hamhock]

As I said, I've seen docs certified in the 1970s that haven't advanced since then but they are still board certified.

But doesn't that just prove the point of all the other posters? Doesn't it just prove that MOC isn't doing what you are suggesting is the intent?

HH

(unless MOC is only for the anesthesiologists who have been recently board-certified...I am not an anesthesiologist, so I don't really know)

 

[Aether2000]

As one of the ancient anesthesiologist board certified by the ABA in the early 1990s and grandfathered for life, MOCA is indeed required only for those who are not grandfathered. I participate in MOCA anyway but will never have to take their exam since I will retire before that point. Nonetheless, I have participated in CME, teaching (University, Hospital, Medical Society, and Anesthesiology Societies) for 30 years, and attend national conferences. Learning never stops and has nothing to do with being grandfathered or not. My latest educational passion is becoming proficient at TTE that I now use frequently preop, intraop, and postop.

 

[Guillemot]

I think the only problem with MOCA is that they just need to double the fees. Then it will be perfect.

 

[Southpaw]

But doesn't that just prove the point of all the other posters? Doesn't it just prove that MOC isn't doing what you are suggesting is the intent?

HH

(unless MOC is only for the anesthesiologists who have been recently board-certified...I am not an anesthesiologist, so I don't really know)

You are correct - MOC is only required by recently BC anesthesiologists. Interestingly, the guys making the rules at the ABA don't have to live by them. And yes I've definitely seem some weird-ass practice by guys who don't participate in MOC and often seem proud to not keep current with evidence with anesthesiology or fields that tangentially touch it. MOC should be required. It needn't be exorbitantly expensive. It also should be useful. I find that the ASA puts out excellent CME each year.

 

[Mman]

Do you advocate also making maintenance of education for college diplomas? how about high school? Medical school?

It's the same thing.

The difference between board certification and a HS or college diploma is that a diploma is evidence you met some academic requirements for a degree. Board certification is a statement by a professional society that your knowledge/practice meets applicable current standards of care.

Lifetime certification is a dumb idea from the past. We are better than that. I am not arguing that MOC is well done, merely that it is ABSOLUTELY necessary for physicians. The list of professions that are allowed to regulate themselves with essentially no outside oversight is miniscule. Let's not screw it up and invite everybody else to tell us how to do our job.

 

[Mman]

You are correct - MOC is only required by recently BC anesthesiologists. Interestingly, the guys making the rules at the ABA don't have to live by them.

I am far too lazy to look it up, but what percentage of officers at the ABA are not participating in MOCA? I mean I assume it's 0 but I'm willing to be surprised.

 

[Mman]

My ex-wife is a PH.d in mathematics. Seriously. She got it perhaps 11 years ago. She currently runs our flower shop and has for the past 10 years. The only math she does is calculate how much i owe her every month. Does that make her Doctor of Philosophy degree null and void? Does she have to take a math test every few years to maintain it. NOPE..

nobody is arguing that we should revoke MD or DO degrees from physicians that do not participate in specialty certification

 

[soorg]

I hope they rip their f$%kin' nuts off...

 

[pgg]

nobody is arguing that we should revoke MD or DO degrees from physicians that do not participate in specialty certification

If you can't bill or work or be employable without board certification/eligibility and the MOC game, they might as well revoke the degree.

I think board certification has value, but I'm not sure lifetime cert is really a bad thing. If you want to work, you have to maintain a license and hospital credentials, which require ongoing CME and peer review, respectively.

We can point at bad doctors who have lost their licenses or credentials.

Can we point to any bad doctors who've been weeded out of practice by MOC? No? Then what good is it?

 

[VA Hopeful Dr]

If you can't bill or work or be employable without board certification/eligibility and the MOC game, they might as well revoke the degree.

I think board certification has value, but I'm not sure lifetime cert is really a bad thing. If you want to work, you have to maintain a license and hospital credentials, which require ongoing CME and peer review, respectively.

We can point at bad doctors who have lost their licenses or credentials.

Can we point to any bad doctors who've been weeded out of practice by MOC? No? Then what good is it?

Part of the problem I see from a general standpoint is how easy it is to get CME these days.

Uses to be you could only get it by actually going to meetings. Now I can get my state-required 40 hours in under an hour with online stuff where I may or may not actually learn anything.

I think MOC is a good concept, it just needs tweaking.

 

[pgg]

Part of the problem I see from a general standpoint is how easy it is to get CME these days.

Uses to be you could only get it by actually going to meetings. Now I can get my state-required 40 hours in under an hour with online stuff where I may or may not actually learn anything.

I think MOC is a good concept, it just needs tweaking.

If the execution of something is consistently poor (the way all MOC is in all specialties), it's a stretch to think a little tweaking will fix it.

I agree CME is too easy to get. But isn't that what MOC is? CME with an extra markup and better profit margins?

Anyway, the real strength of our ongoing "competence certification" is credentialing and peer review, and to a lesser extent insurability. That can be weak at some hospitals, and it can be gamed, to an extent and for a while, but it's the ideal process. And MOC has nothing to do with it.

Why doesn't MOC have a peer review component? The obvious answer is because they can't charge us for it.

 

[T-burglar]

Good doctors will be good doctors without this horse ****. Lazy “doctors” won’t be made into good doctors by any MOC requirement.

Therefore stop torturing us with this crap

 

[Hamhock]

You are correct - MOC is only required by recently BC anesthesiologists. Interestingly, the guys making the rules at the ABA don't have to live by them. And yes I've definitely seem some weird-ass practice by guys who don't participate in MOC and often seem proud to not keep current with evidence with anesthesiology or fields that tangentially touch it. MOC should be required. It needn't be exorbitantly expensive. It also should be useful. I find that the ASA puts out excellent CME each year.

Wow. Interesting.
With this new (to me) knowledge, it seems to me that MOC is further undercut...or at least the ASA cronies who developed the policy.
If MOC was needed to keep anesthesiologists current, would not the ancient anesthesiologists need it most -- or even more MOC credits than the younger ones?
HH

 

[VA Hopeful Dr]

If the execution of something is consistently poor (the way all MOC is in all specialties), it's a stretch to think a little tweaking will fix it.

I agree CME is too easy to get. But isn't that what MOC is? CME with an extra markup and better profit margins?

Anyway, the real strength of our ongoing "competence certification" is credentialing and peer review, and to a lesser extent insurability. That can be weak at some hospitals, and it can be gamed, to an extent and for a while, but it's the ideal process. And MOC has nothing to do with it.

Why doesn't MOC have a peer review component? The obvious answer is because they can't charge us for it.

See I personally do find benefit in the FM MOC. I have yet to do any MOC-specific stuff where I didn't learn something.

And the cost/hour of CME I get on top of the MOC points themselves is about 40-50% less than for meetings. Its not super cheap, but its not that expensive - at least for us FPs.

 

[Mr.S]

nobody is arguing that we should revoke MD or DO degrees from physicians that do not participate in specialty certification

it is a similar argument. The value of going through the board certification process serves you your whole career as does a degree in a particular subject. Even if you never do anything to further the degree as in the case of my ex-wife The suggestion that it should be time limited cheapens the entire process and metric.

 

[kidthor]

MOC is a scam. No amount of bureaucrat dictated hoop-jumping is going to make me a better anesthesiologist. My drive to do the best for patients is what makes me better. MOC merely drains my bank account and burns away my time on this earth.

I'm in for our class action suit. Sign me up.

 

[Mr.S]

See I personally do find benefit in the FM MOC. .

There are lots of things i find benefit in that arent required to practice. I think the most insulting and unsavory thing about MOC, aside from the money grab scam that it is which is unsavory in and of itself, is the fact that it is punitive. The big bad MAN is going to take away your livelihood if you dont do what we say.. and give us money....

Im glad I donated 300 dollars to Wes for that lawsuit. In retrospect, Im sorry I didnt donate 600.

 

[skypilot]

While I do not believe the process of MOC is very well done, I 100% support the idea of it. Being a physician is a privilege and it is a privilege that society allows us to regulate ourselves. Unless you want to argue that the day you get board certified you should never have to open another book or read another journal or take another test and should be good for life, that means we either regulate ourselves or ask non physicians to do it for us.

Lifetime certification is a dumb idea. I see docs out there that got certified in the 1970s and still practice like it and I would not want one of my family members being treated by them.

Yes please do four years of med school, four years of residency and a one year fellowship only to be cut out at the knees by a CRNA with one tenth the training, or run around like a chicken with your head cut off supervising 5:1, and then be humiliated by the scam that is MOCA. Give me a break. We already have CME, use it the way it is supposed to be used.

These regulators are anti doctor. They are out to destroy the profession.

 

[Aether2000]

The lifetime certification docs are few in number compared to those requiring recert, and within a few more years we will all be gone. MOC on the other hand, is a many year process as envisioned in its current iteration by the ABA, therefore would not capture grandfathered docs who will retire soon.

 

[vector2]

The lifetime certification docs are few in number compared to those requiring recert, and within a few more years we will all be gone. MOC on the other hand, is a many year process as envisioned in its current iteration by the ABA, therefore would not capture grandfathered docs who will retire soon.

So a ton of the grandfathered docs were still practicing from ~2000-2010 and then started to retire post recession. Can anyone say or does anyone have any data that patient safety or outcomes improved dramatically this decade, and if so, can causation be attributed to MOC? If you look at the ABIM's propaganda paper, they clearly are trying to conflate the issue by claiming MOC is effective and then citing board certified vs non boarded studies

https://dlpgnf31z4a6s.cloudfront.net/media/40428/abim-certification-moc-what-the-research-shows.pdf


Seriously, one of the bullet points in that paper is:

• Implantations by a nonelectrophysiologist were associated with a higher risk of procedural complications and lower likelihood of receiving a CRT-D device when indicated compared with patients whose ICD was implanted by an electrophysiologist.3

Yea no fcking sht ABIM, that's very helpful.

 

[Southpaw]

I am far too lazy to look it up, but what percentage of officers at the ABA are not participating in MOCA? I mean I assume it's 0 but I'm willing to be surprised.

Also far too lazy to look up. I did go so far to look up the board of directors at the ABA. Almost all looked > 50. I don't know how lifetime cert is/was granted or when it was phased out, but most docs I know > 50 are not required to do MOC.

I cannot fathom a single reason why guys like @algosdoc or @BLADEMDA do MOC. Out of the goodness of your heart? Caring nothing about $$$? Certainly you shouldn't feel obligated. I find it a complete and total waste of time, resources, and $$$. The ABA could easily require we do anesthesiology-specific CME, of which the ASA has great resources, for MOC. I do feel we should do something, but the current setup feels like a scam and treats us like children.

 

[caligas]

Two fundamental problems with MOC

-the process is focused more on extracting money from participants than protecting patients

-the default should be certification, not expiration

 

[Mr.S]

Two fundamental problems with MOC

-the process is focused more on extracting money from participants than protecting patients

-the default should be certification, not expiration

The capitalists have created a new multi billion dollarscam in less then ten years.
That is impressive stuff. It is extortion.
And we are the absolute suckers who go along with it.
I cannot believe any one would even think this is anything other.

Sort of how they just created another step to the USMLE.
and everyone sort of when along with it without questioning it.
complete and utter horse####

 

[dannyboy1]

The capitalists have created a new multi billion dollarscam in less then ten years.
That is impressive stuff. It is extortion.
And we are the absolute suckers who go along with it.
I cannot believe any one would even think this is anything other.

Sort of how they just created another step to the USMLE.
and everyone sort of when along with it without questioning it.
complete and utter horse####

You can actually blame this one on the lawyers. In the good old days when you could be credentialed ( and stay credentialed) by the hospital and insurance companies with only board eligibility, the ABA had to play nice otherwise everyone would just not get certified. Once hospitals and insurance companies, probably out of fear of lawsuits decided that everyone needed certification the certifying boards had us by the short hairs and quickly did away with lifetime certification... and the rest quickly followed.

 

[Mman]

Also far too lazy to look up. I did go so far to look up the board of directors at the ABA. Almost all looked > 50. I don't know how lifetime cert is/was granted or when it was phased out, but most docs I know > 50 are not required to do MOC.

I cannot fathom a single reason why guys like @algosdoc or @BLADEMDA do MOC. Out of the goodness of your heart? Caring nothing about $$$? Certainly you shouldn't feel obligated. I find it a complete and total waste of time, resources, and $$$. The ABA could easily require we do anesthesiology-specific CME, of which the ASA has great resources, for MOC. I do feel we should do something, but the current setup feels like a scam and treats us like children.

every doc in my group is participating in MOC and 2/3 of them are over 50

 

[Mr.S]

You can actually blame this one on the lawyers. In the good old days when you could be credentialed ( and stay credentialed) by the hospital and insurance companies with only board eligibility, the ABA had to play nice otherwise everyone would just not get certified. Once hospitals and insurance companies, probably out of fear of lawsuits decided that everyone needed certification the certifying boards had us by the short hairs and quickly did away with lifetime certification... and the rest quickly followed.

You are absolutely correct!!!

Once they got the hospitals and the insurance companies on board, they couldn't resist the money making opportunity and they started charging an ongoing entrance fee (in the name of patient saftety) of course.

And we're falling for this hook line and sinker. At least some of us aren't.

What they don't realize, well maybe they do is that this whole scheme cheapens the whole process. It means nothing if everyone achieves it. Sort of like putting on your CV diplomate of the NBME Part 1,2 ,3.

 

[dannyboy1]

You are absolutely correct!!!

Once they got the hospitals and the insurance companies on board, they couldn't resist the money making opportunity and they started charging an ongoing entrance fee (in the name of patient saftety) of course.

And we're falling for this hook line and sinker. At least some of us aren't.

What they don't realize, well maybe they do is that this whole scheme cheapens the whole process. It means nothing if everyone achieves it. Sort of like putting on your CV diplomate of the NBME Part 1,2 ,3.

What is really needed are interventions by courts and/or state law. We already pay significant amounts of money to the state for medical liscences. Why should someone liscened by the state to practice medicine have to jump through any more hoops? Not being able to get credentialed is a de facto limitation on your ability to practice.