The Association of American Physicians & Surgeons (AAPS) filed suit April 23, 2013, against the American Board of Medical Specialties (ABMS) over their maintenance of certification program. The suit, filed in a New Jersey federal court, alleges that the ABMS is restraining trade and causing a reduction in patient access due to burdensome recertification processes.
Jane Orient, MD, the AAPS' executive director, graciously agreed to discuss the issues with me.
Martin Merritt: I understand maintenance of certification (MOC) is one of the hottest topics in the field of medicine today?
Jane Orient: Yes. Many physicians are outraged, not only by the cost an expense which must be incurred to maintain certification, but also by the fear that MOC is being advanced as a requirement for hospital privileges, and perhaps even maintenance of licensure (MOL).
MM: The public might think the ABMS is a government entity?
JO: The ABMS is a not-for-profit corporation. According to the lawsuit filed by AAPS, the ABMS seems to exist to enrich its own executives, with little appreciable evidence that the MOC program has an effect on the quality of care.
MM: How does the ABMS MOC program actually work?
JO: I can mostly speak about what the lawsuit contains. ABMS and 24 separate corporations, which make up the 24 recognized board-certified specialties have agreed to impose on physicians a recertification program called the ABMS Maintenance of Certification. At one time, a physician could voluntarily choose to become board certified, and upon completion of the process, he or she was board certified for life. Now, the ABMS has decided to force board certified physicians to purchase its products every 10 years. If a physician cannot afford the time or the expense of recertification, he or she may be designated as "not meeting" the requirements of the ABMS, which tends to imply that a physician is less than qualified to care for patients.
MM: What is the AAPS seeking in the suit?
JO: AAPS’ lawsuit, seeks declaratory and injunctive relief to enjoin ABMS’s continuing violations of antitrust law and misrepresentations about the medical skills of physicians who decline to purchase and spend time on its program. AAPS also seeks a refund of fees paid by its members to ABMS and its 24 other corporations as a result of ABMS’ conduct.
Again, the lawsuit itself is the best source for information about the relief requested, but in a nutshell, what we are worried about is the fact that perfectly capable physicians are being black-balled, or locked out of the ability to treat patients, because they do not have the time, or inclination to purchase a product from a private corporation, which has nothing to do with the physician’s ability to treat patients.
MM. You cite an example in the lawsuit, I believe.
JO: In a case cited in this lawsuit, a first-rate physician in New Jersey was excluded from the medical staff at a hospital in his state simply because he had not paid for and spent time on recertification with one of these private corporations. He runs a charity clinic that has logged more than 30,000 visits, but now none of those patients can see him at the local hospital because of the money-making scheme of recertification.
MM: I would like to thank Dr. Orient for speaking with us. You can follow this lawsuit and other issues of concern at the AAPS website.