The American Medical Association’s updated policy on maintenance of certification is raising concerns, particularly as it relates to maintenance of certification’s role in licensure and credentialing.
According to the new policy, recently approved by delegates during the 2014 AMA Interim Meeting in Dallas, “the MOC program should not be a mandated requirement for licensure, credentialing, payment, network participation, or employment.”
This point in particular raised a red flag with the American Gastroenterological Association .
“I think the AMA expressed an odd, in my mind, an odd position that the MOC program should not be a mandated requirement for licensure, credentialing, etc.,” Dr. Arthur J. DeCross, chair of the AGA Institute’s MOC Subcommittee and associate professor of medicine at the University of Rochester (N.Y.) Medical Center, said in an interview. “I would argue that, ‘exactly why not?’ Maintenance of certification is really about life-long continuing medical education. It is really a way of saying it is not enough to pass a test, a board exam, when you graduate medical training and be grandfathered into several decades of clinical practice without ever having your certification updated or without demonstrating to the public that you are current and competent in medical practice.”
AMA said in a statement to Frontline Medical News that the recent change in policy was “introduced in relation to an increase in the frequency of requirements for one or more [American Board of Medical Specialties member boards’] programs and concerns about the relevance of selected MOC activities to physician clinical practice.”
However, to promote a policy that does not mandate MOC as a requirement for licensure and credentialing “undermines the public trust, and I think it undermines the core values of maintenance of certification,” Dr. DeCross said. “It’s not to say the MOC process is perfect, but it’s for that reason that the AGA will continue to work productively with the American Board of Internal Medicine to overcome those obstacles in the process of implementing the maintenance of certification process for our membership.”
Other MOC policy updates call for a process that is based on evidence and designed to identify performance gaps and unmet needs, providing direction and guidance for improvement in physician performance and delivery of care; that is examined periodically to evaluate physician satisfaction, knowledge uptake, and intent to maintain or change practice; and that is a tool for continued improvement.
AMA also is calling for practicing physicians to be well represented on specialty boards developing maintenance of certification programs, and those programs should include activities and measurements that are relevant to clinical practice and not be cost-prohibitive or present barriers to patient care.
Delegates also voted to encourage specialty boards to investigate alternative approaches to MOC and directed the organization to report annually on the MOC process.
A point that specialty boards, “which develop MOC standards, may approve curriculum, but should be independent from entities designing and delivering that curriculum, and should have no financial interest in the process,” was referred, according to an AMA document on the resolutions from the meeting.
