The American Board of Internal Medicine announced that it won’t implement its maintenance of certification program’s practice assessment, patient voice, and patient safety components until Jan. 1, 2019.

ABIM had previously delayed the three requirements until the end of 2016, but it extended the delay following recommendations from a task force formed to look at the overall maintenance of certification program.

The Assessment 2020 Task Force report suggested that ABIM should step back from assessing physicians’ quality of care and performance improvement. That portion has received pushback from the physician community, and that feedback contributed to the decision to delay.

“We decided to extend our decision not to require practice assessment while we work to expand the list of activities we recognize for MOC credit and seek partnerships to increase clinically relevant opportunities for doctors to engage in this important work,” said ABIM Chief Medical Officer Richard Battaglia. “Physicians can still earn MOC points for completing approved practice assessment activities, and one of the pathways for these points is through the American Board of Medical Specialties Multispecialty Portfolio Approval Program.”

ABIM will provide at least a full year’s notice when the requirements are reinstated, with updates on progress being communicated through the Transforming ABIM blog, Dr. Battaglia noted.The delay, however, does not lessen the importance of practice assessment, he cautioned.

“We hear from physicians that completing these activities allows them to look at data from their practice and implement quality improvements that lead to better care for their patients and improved processes in their practice,” Dr. Battaglia said. “But we also hear from physician feedback that the MOC program should do a better job recognizing meaningful activities they are already doing in practice.”

He also called on physicians to continue providing feedback to help ensure that MOC is a meaningful and relevant program.

“We want physicians to help us shape a MOC program that is meaningful and relevant, which is why we are looking to ensure that physicians receive credit for important quality improvement work they are already doing in practice,” Dr. Battaglia said. “Physicians have been telling us that there are many meaningful quality improvement programs that we could give credit for, so we are acting on their input to do a better job recognizing these activities physicians are already doing in practice.”

The American College of Physicians applauded ABIM’s decision to delay.

“The reaction from the physician community, the reaction from ACP, and certainly my own personal reaction is that we applaud that they are suspending the requirement longer,” ACP CEO Steven Weinberger said in an interview. “It will take more time to sort out what kind of role the board should have in those forms of assessment, and whether in fact they might just be able to use assessments provided by other organizations rather than doing the assessment themselves,”

He suggested that ABIM is looking at where it can incorporate assessments by other organizations, including public and private insurers, so it can remain focused on assessing knowledge and clinical skill.

“I think one of things they want to avoid is redundancy – a physician’s performance might be measured in the insurance environment, whether it be private or public, and then separately ABIM is doing that same sort of measurement,” Dr. Weinberger said.