With her 10-year maintenance of certification (MOC) clock ticking closer to zero, Kim Monday, MD faced a harsh reality.
Either pass the required MOC test or lose her right to practice medicine. It was — and for many physicians, is — that simple. Monday, a Pasadena, Texas-based on-staff neurologist in the Memorial Hermann health system, lays out the truth for many doctors when it comes to MOC, especially those in large metropolitan areas.
"If you're in a big metro area, and [this also applies to] smaller metro areas, you have to have hospital privileges in order to be on insurance panels. If you're not on insurance panels and you're not [doing] concierge medicine…you're out of business," says Monday. "That seemed wrong on many levels and that's why I initially got involved."
Monday's "involvement" in this case was working with the Texas Medical Association to pass a bill essentially removing MOC from being a mandatory requirement to be on staff at hospitals. It took her all the way to the Texas Legislature, where she testified against MOC on behalf of the medical association.
Monday's involvement represents a new trend in medicine, as physicians affected by board recertification have taken their fight against the required program to their state-level governments. They're trying to remove MOC credential requirements in hospitals, on state licensing boards, and on insurance panels within their states. Medical Economics reports 19 states,, have either proposed or passed some kind of MOC-related legislation in effort to curb the requirements. Most have popped up in the last year or two.
"The problem with MOC is we're forced to participate, so there is no incentive for these boards to change. Why would they? We're forced to participate to work and they can charge whatever they want. That's why we're focusing on state legislation, because if you take away the 'force' part of that equation…we might actually have a chance of getting the boards to listen and modify MOC [requirements]," says Meg Edison, MD, a private practice pediatrician in Grand Rapid, Mich.
Many like Edison are not against the idea of continuing medical education, but do not like that MOC is required in order for them to work. Monday echoes a familiar sentiment among physicians when she calls MOC a form of extortion. Westby G. Fisher, MD, an internist, cardiologist, and cardiac electrophysiologist at NorthShore University health system in Evanston, Ill., puts it more bluntly.
"[This issue] crosses the political divide in America. It doesn't matter if you are right leaning, left leaning, extreme right, or extreme left politically. Corruption is corruption. Extortion of physicians will unite…like nothing else," he says.