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Letter: MOC is a ‘Big Burden’

doi: 10.1097/01.EEM.0000480774.31889.35
Letter

Editor:

I read with interest Ruth SoRelle's piece on maintenance of certification (MOC), but I was disappointed at the general tone of happy acceptance of the MOC burden, and especially disappointed that there was no challenge to Dr. Barry Heller's self-serving comments. (“EPs Invest Long Hours in MOC, Costing about $2600 a Year,” EMN 2015;37[11]:1; http://emn.online/Nov15MOC.)

Twenty-six hundred dollars is still a substantial amount of money; for any other purchase of that size I would expect some objective demonstration of value, not just a subjective survey. And the cost estimates do not include the hard or soft costs of the patient satisfaction activity.

Dr. Heller is quoted as saying that “...ABEM diplomates spend about 15 hours per year participating in MOC. This equals just 17 minutes per week keeping up on changes in the specialty.” I have never met a single EP who only devotes 17 minutes a week to trying to stay current in EM, but I do agree that only 17 minutes (perhaps a short article or a handful of questions) would be entirely manageable. But the good doctor neglects all the administrative burdens of the program, including the need to re-verify my license every time I touch the ABEM website, the time spent retrieving the materials, the need to buy the tests and the CME for the tests separately, and so on. That, of course, doesn't count as time “participating” in MOC.

Finally, we are told that “100 percent report that the (Part IV) activity is relevant.” I recently attested, and I can say that the question about relevancy is not called out in any way as a survey or an optional question. It appears in every respect to be an actual part of the attestation. What candidate for recertification would dare to attest that they had performed a nonrelevant activity when they might be punished with nonacceptance of their activity or even subjected to an audit?

MOC is a big industry, a big burden on our profession, and it should receive the same scientific scrutiny of its efficacy that other aspects of medicine receive.

David K. English, MD

Oakland, CA

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