Medicine

Like many of my fellow pediatricians, today I read the three page letter written by American Board of Pediatrics CEO David Nichols.  It was a full day seeing patients and it took me nearly three hours to finish it. The letter was so upsetting I couldn’t handle reading it straight through. I’d start reading and my stomach would turn, I’d start to despair about the future of medicine, and I’d put the letter aside. Thankfully, it was a busy day and I was always rescued from this sadness with a patient. It’s summer, so that means sports physicals.  Today I saw lots of 14 year old girls, the same age as my oldest daughter, and it was fun. But between patients, I’d try to slog through more of the letter and the sadness would return…only to be rescued by a patient.

The emotional swing of my day is just one illustration of the stunning disconnect between the joy we find in being doctors and the soul-crushing work done to us by those in power. After carefully reading the letter, I had planned on writing a witty article making fun of the imaginary bell shaped curve and debunking Nichols’ whole straw man set-up. Now I realize it’s not worth it. Nichols’ letter is just one man’s desperate attempt to justify his million dollar salary. My sadness today was not with Nichols and the ABP, indeed I’m not even board certified through the ABP anymore, so what they say does not really impact me.

The real issue here is leaving medicine better than we found it. I can safely say the generations before me dropped the ball.  I’ve talked to many retired doctors and after chuckling “man I’m glad I got out”, there is a soft sadness and recognition of failure when they see the look on my face at those words.  They failed us.

Those in power now, like Nichols, are continuing to fail us.  At a certain point, even the $1.3 million dollar salary fades away late at night, and Nichols knows he’s made medicine worse for his fellow pediatricians. He’s taken our money, he’s driven good doctors into early retirement, he’s cost us jobs, promotions and pay.  He’s torn nursing physician mothers from their newborn babies, he’s forced physicians from the bedside of their own sick children and parents, he’s made physician cancer victims choose between taking a test to keep their job or taking care of their own health.  This is what the ABP Maintenance of Certification program and never-ending hoops are doing to us.

Nichols and the ABP are the perfect case study in how to ruin medicine and your fellow physicians.  From Nichols’ letter, it’s clear the ABP is not listening. Instead, the letter attempts to divert our attention and divide us.  Those of us who believe MOC is discriminatory, unjust, and an intrusion into the professional joy of the doctor-patient relationship are not just a “faction”, we are the majority.

The beauty of the MOC  fight is that it is also a perfect case study in how to make medicine better.  We are the majority, and we need to act that way.  We need to reject the whole premises and imaginary power of these boards.  We have to stop participating and let the program die away. This new generation of pediatricians graduating should be taking their boards for the first and last time. MOC stops with us.

As it stands, nine out of ten doctors do not recommend medical careers to their children. Those that do, do not recommend primary care.  This is a tragedy.  This world needs good doctors, and who better than the children of healers to carry on this calling?  There are so many things we do for our children to prepare their future, from teaching them to read to saving for college.  We need to take a hard look at the problems in medicine with them in mind. What can we do to make medicine a better career for them, how can we ease their way?

I can think of many toxic aspects of medicine, MOC is just one. I fight it because it’s an easy win. The tough ones on reimbursement and regulation are yet to come, but already we are seeing strong wins for those brave enough to challenge the whole system.  There are some bright spots, some really exciting bright spots in medicine.

Direct primary care, be still my heart!  The disruptors and innovators out there are almost too many to mention, Lee Gross of Epiphany Health, Josh Umbehr of Atlas MD, Ryan Neuhofel of Neucare,  I could go on and on. These docs are doing the impossible: after generations of rapidly deteriorating satisfaction in medicine as a career, they’ve actually created models that are better than the “golden age” of medicine. By meshing old school primary care with technology, they’re providing better quality care, better patient satisfaction, better physician satisfaction and decreased cost. It’s stunning. And it’s happening now.

When I see what these amazing docs are doing, how they are making medicine better for physicians and patients, when I step away and just spend time with my patients, all the babbling by Nichols and the ABP just looks pathetic, archaic, and irrelevant. Tonight, as I was thinking through all these issues and how I can improve my little corner of medicine, Zubin Damania posted this video, and I’m crying. This is exactly what I’m talking about. There is no question. I know where the real revolution in medicine is taking place and where our future lies. Let’s get to work building it.

Photo by Alex E. Proimos

Shhh. I think this is supposed to be a secret, but this Wednesday at the super-elite AMA House of Delegates meeting in Chicago, where only the mostly highly connected and AMA devoted doctors get to attend, they actually stood up for us.  It is now AMA policy that the AMA opposes mandatory ABMS recertification exams.

Crazy, right?  News of this random act of fortitude trickled out to us on Twitter by the small handful of delegates who very helpfully tweet updates for those of us on the outside.  But other than those little tweets, no word from the AMA on this incredibly good news.  This is HUGE folks! The AMA opposes ABMS recertification exams! It’s time for celebration, and press releases, and emails asking us to rejoin the AMA.  And yet, no word from the AMA.

It’s not listed in the Top 10 Stories from the AMA 2016 Meeting.  It’s not mentioned in the coverage of the MOC resolutions that passed. By looking at the AMA website and news coverage, the only MOC resolutions that passed were the typical mushy kind.  Here’s how the AMA reported their “newsworthy” MOC resolutions.  Hold on to your knickers, these are some groundbreaking resolutions.

“Delegates adopted policy to further these efforts, including:

• Examining the activities that medical specialty organizations have underway to review alternative pathways for board recertification
• Determining whether there is a need to establish criteria and construct a tool to evaluate whether alternative methods for board recertification are equivalent to established pathways
• Asking the American Board of Medical Specialties to encourage its member boards to review their MOC policies regarding the requirements for maintaining underlying primary or initial specialty board certification in addition to subspecialty board certification to allow physicians the option to focus on MOC activities most relevant to their practice.”

Whoa Nelly. And the AMA wonders why they’re bleeding membership. Nearly every doctor in the real world is saying “STOP MOC”. And the AMA flitters about asking for more studies and playing footsie with the ABMS. In defense of the authors, these resolutions probably started out strong. But once the board-member packed committees hacked them to impotent pieces, there’s no meat left.

So what about that resolution opposing ABMS testing?  Well, if you go to the AMA website and create a secure login and scroll through the hundreds of pages of amended resolutions from the nine reference committees, you’ll find…. Resolution 309 presented by Florida, California, Georgia, Pennsylvania, Washington, New York, & Virginia hidden in Reference Committee C.  The language is strong:

RESOLVED, That our American Medical Association call for the immediate end of any mandatory, recertifying examination by the American Board of Medical Specialties (ABMS) or other certifying organizations as part of the recertification process (Directive to Take Action);
and be it further
RESOLVED, That our AMA support a recertification process based on high quality, appropriate CME material directed by the AMA recognized specialty societies covering the physician’s practice area, in cooperation with other willing stakeholders, that would be completed on a regular basis as determined by the individual medical specialty, to ensure lifelong learning
(Directive to Take Action); and be it further
RESOLVED, That our AMA reaffirm Policies H-275.924 and D-275.954 (Reaffirm HOD Policy);
and be it further
RESOLVED, That the AMA voice this policy directly to the ABMS and other certifying organizations (Directive to Take Action); and be it further
RESOLVED, That there be a report back to the AMA HOD by the 2017 Annual Meeting. (Directive to Take Action)

Awesome, right? Well, as soon as the committee got ahold of it, they butchered into

RESOLVED, That our American Medical Association call for the immediate end of any mandatory, recertifying examination by continue to work with the American Board of Medical Specialties (ABMS) to encourage the development by and the sharing between specialty boards of alternative ways to assess medical knowledge other than by a secure exam or other certifying organizations as part of the recertification process (Directive to Take Action);
and be it further
RESOLVED, That our AMA support a recertification process based on high quality, appropriate CME material directed by the AMA recognized specialty societies covering the physician’s practice area, in cooperation with other willing stakeholders, that would be completed on a regular basis as determined by the individual medical specialty, to ensure lifelong learning
(Directive to Take Action); and be it further
RESOLVED, That our AMA reaffirm Policies H-275.924 and D-275.954 (Reaffirm HOD Policy);
and be it further
RESOLVED, That the AMA voice this policy directly to the ABMS and other certifying organizations (Directive to Take Action); and be it further
RESOLVED, That there be a report back to the AMA HOD by the 2017 Annual Meeting. (Directive to Take Action)

Funny how that works.  The resolution was dead. Gutted.

But between testimony in Reference Committee C on Sunday, and final voting on Wednesday, the Pennsylvania Medical Society melted the meeting down with a blistering two hour exposé on the abuses of the ABIM and the boards in general.  It was standing room only, with Dr. Wesby Fisher and Charles Kroll presenting their financial data, Dr. Bonnie Weiner discussing NBPAS, and Dr. Scott Shapiro announcing the PA Medical Society’s vote of “no confidence” in the ABIM and plans to pursue legal action against the boards.  Full report on the meeting and PowerPoint presentations can be found here.

With a much needed boost in morale and the data to support strong action, the full house convened on Wednesday and the delegates soundly rejected the Committee’s butchering of the resolution, extracted it to a full vote on the house floor, and restored the strong language of the first resolved.  It passed easily.

RESOLVED,That our American Medical Association call for the immediate end of any mandatory, secured recertifying examination by the American Board of Medical Specialties (ABMS) or other certifying organizations as part of the recertification process for all those specialties that still require a secure, high-stakes recertification examination.

Boom. This is amazing!  So why isn’t the AMA announcing this from the rooftops? Why is this hiding in hundreds of pages of resolution verbiage, only accessible via secure login?

Because they’re hoping you don’t know. If you don’t know, then they can ignore this policy exists and they won’t have to fight their friends at the ABMS on your behalf.  But now you do know. You know that your colleagues from Florida, California, Georgia, Pennsylvania, Washington, New York, & Virginia wrote a strong resolution and fought it to the end. Now their resolution is policy. Bravo to Texas and Michigan standing strong as well.

Obviously, I’m not good at keeping secrets, and I hope the rest of my physician colleagues spread this secret policy far and wide. While I’m not yet ready to jump on the AMA bandwagon, I am warming to the realization that the AMA is made up of individual doctors. If we fill the AMA with the right physician delegates who will fight for us, we might actually win a few battles.

UPDATE: 6/17/16 ABMS Responds to AMA MOC Resolution. Still no mention of the MOC resolution from the AMA.

Full annotated report of Ref Com C, along with members of the committee here.
Link to the AMA HOD Reports here, AMA membership not required, just create a login.
Photo by (cup)cake_eater

The American Board of Medical Specialties says “board certification is a voluntary process, and one that is very different from medical licensure.” This is echoed by my board, the American Board of Pediatrics, who says “Board certification is a voluntary process that goes above and beyond state licensing requirements for practicing medicine.”

Over the past few years, the definition of “board certified” has changed from a one-time test to an ongoing series of tests, hoops, and fees to maintain certification through the MOC program. Not participating in any portion of the convoluted and expensive MOC program results in loss of board certification, but so what? Board certification, either as initial certification or 20 years into maintaining certification is voluntary, so what’s the big deal?

Well, it turns out, not complying with MOC is a big deal. Not only has the definition of “board certified” changed, apparently so has the definition of “voluntary”.

On December 17, with the blessing of my partners, I decided to test how “voluntary” board certification is.  Over the past 13 years, I’ve passed my board examination twice, completed multiple proprietary online tests, and completed three ABP research projects on my patients. But when the American Board of Pediatrics threatened to revoke my certification and nullify 13 years of testing and research projects if I didn’t pay $1300 to “maintain certification”, I had enough. I didn’t pay, and voluntarily gave up my board certification.

I wrote a letter explaining why, so there wouldn’t be any confusion. To date, that letter has been read 100,000 times. Clearly, I hit a nerve among my colleagues. But what would happen to me professionally? What happens to doctors who stop doing MOC?

First off, after many threatening emails, the American Board of Pediatrics erases the name of any doctor who fails to complete any of the four parts of MOC from their website. Erases.

December 17, there I am.

And now, I don’t exist.

Grandfathered doctors, like ABP president David Nichols,  are listed as “Board certified, not participating in MOC”, but those of us who have passed multiple board exams and a decade of MOC? Erased.

Obviously, they have the technical ability to list us as “Board certified, not participating in MOC”, but they don’t. They erase our names, as if we’d never passed our boards to begin with. The only way to find out that I’ve passed two board exams is to write the ABP and pay $40 for a release of information. Why would they do such a thing, why make this so difficult for us? Because their website has the power to destroy our careers, that’s why.

Four weeks after my Open Letter to the American Board of Pediatrics was published, my name was erased from the ABP website and the threats began. On an insanely busy Friday afternoon in February, I was called by Blue Cross Blue Shield of Michigan/Blue Care Network, and informed that I had to immediately cease from seeing any of my BCBS/BCN patients. Immediately. They checked the ABP website, my name was no longer listed and I was therefore no longer allowed to see my patients.

I asked if I could have a colleague co-sign my notes, and that was not allowed. I asked it I could see my patients and not be paid. They said I was forbidden from seeing my patients. I submitted my board certification through the National Board of Physicians and Surgeons, and was told only ABMS boards were allowed. I asked if I asked if I could see the credentialing policy I was being held to, and was told “it was proprietary”. All this stress and harassment in Michigan,  because I didn’t pay $1300 to the American Board of Pediatrics, a multi-million certification corporation out of North Carolina. Unbelievable.

I pushed back and asked for a departicipation notice in writing, and they backed off. I now have until December 31, 2016 to comply and pay the American Board of Pediatrics $1500 (with the added $200 late fee, of course), or I will be banned from seeing my patients at that point.

Next up were the hospitals. My hospital privileges were due for renewal this month, and imagine my surprise when I had to sign a contract confirming that I would enroll in ABP MOC! This was nowhere to be found in my med staff requirements, which only requires me to have initial board certification. When I asked the hospital credentialers, they assured me this was a glitch. No one knew how this language made its way on to the computer-generated contract or how to change it.  After much anxiety, I signed the contract as there was no alternate way to get my privileges renewed. Time will tell if I lose my hospital privileges over a computer “glitch”.

So far, six months after dropping my board certification, I’m still standing, but not without a ridiculous amount of harassment and bullying. My scenario repeats itself thousands and thousands of times across the country. Usually, most doctors back down and pay the money, they stop doing CME of their own choosing and complete the education modules decreed by the boards, they stop doing their own novel medical research and instead complete the  busywork research for the boards, they give up family time to travel to review courses, they shut down their offices to take secure examinations.  Doctors do this out of fear. The ABMS has long banked on fear and intimidation as a business model.

That model is coming into question as more and more doctors fight back. Rather than fear, I’m banking on the strength of my fellow physicians to return board certification to its rightful place as a voluntary process: one that is not tied to licensure, hospital privileges, insurance participation. Oklahoma has shown us this is possible.

This morning,  Michigan will take the first step towards freeing our doctors from overreach of the ABMS, as House Bills 5090 and 5091 finally go to testimony before the House Health Policy Committee.  I will be there testifying, alongside an incredibly diverse group of physicians finding common ground on this issue.  The powerful insurance and hospital lobbies will oppose us, as anticipated. Maybe the ABMS will send someone to plead their case.

I remain optimistic that Michigan lawmakers will see MOC for the money-making sham it is, and act on behalf of Michigan doctors and our right to care for our patients without interference by these unaccountable outside board certifying corporations. My hope is that this will be the beginning for other states to follow in our footsteps and return board certification and MOC to a voluntary process, free of fear and intimidation.

Wow. For those who think MOC isn’t a big deal, my Open Letter to the American Board of Pediatrics just hit 70,000 views.  That’s stunning.

For those commending my bravery,  realize efforts like this are not done in isolation. I am not alone. I have the most amazing partners. I can’t even express how blessed I am to work with the ten doctors in our private practice. Not only do we share a common faith, we share a fierce independence.  They know that in the end, I may lose my MOC battle even on the way to winning the war. Blue Cross Blue Shield of Michigan may force me to be certified through the ABP, and rather than lose access to care for my patients, I will pay $1300 plus a $200 late fee to the ABP to regain my certification. But I certainly won’t lose quietly.

I have the support of my state medical society.  Michigan State Medical Society has the strongest state policy on MOC in the country: MOC should not be tied to licensure, hospital privileges or insurance participation and it should not be the monopoly of one organization. It helps knowing there’s a 15,000 member society on my side. And they’re doing the impossible. But more on that in another post.

I have the support of thousands of Sermo doctors, over 5,000 signatures on our pediatric MOC petition and now 70,000 views on the letter without one single doctor opposing my stand.  I am not alone. Numbers are clearly on our side.

Since writing my original letter, my inbox has been flooded with hundreds of heartbreaking stories. Physicians with cancer, on chemotherapy and immunosuppressed, are denied waivers to delay testing in the public facilities, losing their certification and their jobs. Parents of children with cancer are denied waivers while their children are undergoing treatment, losing their certification and threatened with job loss. Physicians are retiring early to avoid another costly and demeaning cycle of MOC. Physicians are feeling isolated and embarrassed after failing their re-certification and are falling into depression and suicide.

My eyes are wide open now, and I realize this is more than mere annoyance or financial inconvenience.  MOC is a toxic stress that is literally killing doctors. The worst part is the boards have heard our voices, yet they keep pressing forward. Their unflagging defense of MOC in the face of what they know it’s doing to our colleagues is not a simple error of knowledge, this is a breach of morality. This is something we cannot participate in.

It appears we’ve come to the divide in the road.  If you’ve had enough and are ready for a revolution in MOC, there are some very simple things you can do. This applies to all ABMS specialties, but I speak directly to my pediatric colleagues here.

1.) If you really don’t need MOC to practice medicine, please stop participating.  Continuing to financially support the ABP harms your colleagues, and it harms children as experienced doctors retire early.  Paying fees to the ABP harms more than just pediatricians,  as the ABP turns around and gives $837,000/yr to the American Board of Medical Specialties Foundation which develops MOC programs to inflict upon your colleagues in other specialties. When you give up your certification, send a letter to the ABP explaining exactly why.

The ABP has threatened to sue any doctor who calls themselves “board certified” in print or on the web if they don’t do MOC, so getting certified through the National Board of Physicians and Surgeons is probably a wise move if you still want to call yourself “board certified.” Note that you can still keep the “FAAP” in your title, even if you don’t do MOC, as the AAP only requires initial board certification to be a fellow.

2.) If you think you need MOC to practice, please make sure. Check your insurance contracts. Check your hospital privileges. We had a local pediatrician harassed by the children’s hospital when he didn’t participate in MOC.  Turns out, our staff bylaws only require initial board certification. The harassment was completely unfounded.

3.) If MOC is required for your job, insurance contracts, or hospital privileges…this is where the fun starts and is going to require more information than I can give in this post. It’s going to require politics, organized medicine, and some hard work.  I will post soon on exactly how this is done, but for now, if you’re really forced into MOC just start by asking questions. Call up your state medical society to see if they have written policy opposing MOC and resources to help. Find a few colleagues, and ask if hospital policy or office policy can be changed to either only require initial board certification or NBPAS as an alternative.  You might be surprised by how much support comes out of the woodwork.

And finally a word to those who are “grandfathered” and exempt from MOC. I harbor no bitterness toward my grandfathered colleagues. Indeed, the requirements enjoyed by grandfathered pediatricians should be the standard for all.  But to those grandfathered doctors who now know what is happening to your younger colleagues, yet turn your backs on us or even worse, enforce MOC requirements for our employment but not yours, I do hold you accountable.

There is a reason the “grandfathered” class exists. Established in your careers, and trained in an era that encouraged oppositional defiance, MOC wouldn’t have lasted 2 months if you were included. You would have fought and shamed the ABP into immediate apology and retraction.  Instead they targeted younger doctors facing significant education loans, newly employed with young families, just trying to make partner and not interested in making waves.

We all want to leave medicine better than we found it and this is the chance for our grandfathered doctors to step up in your circle of influence. It is likely you or your contemporaries are in hospital administration and on medical society boards.  You or your contemporaries are the ones making employment guidelines for your university department or private practice. Rather than breathe a sigh of relief that you’re exempt or nearing retirement, fight for us. Don’t show solidarity with us by voluntarily participating in MOC, show leadership by fighting for our right to self-education without coercion. Use your hard-earned status and influence to end MOC employment requirements for all pediatricians.

It’s no wonder the ABP has been successful at pushing us so far, yet listening so little. Pediatricians are a tolerant lot.  We have nearly unending patience. We can tune out incredible distractions to get our job done. We are literally pooped on every day, yet we show up day after day, with white coat pockets full of Star Wars stickers and love our jobs.

It’s because we’re viewed as such tolerant happy doctors that I started to worry what my patients would think if they read my letter as it was spreading quickly on social media.  A friend forwarded a comment one of my patients made on the article, something I wasn’t intended to see.  The mom said, “A doctor that fights this hard, will fight for us if we need her to.”

See, that’s what the American Board of Pediatrics forgot.  Pediatricians have devoted our lives to fighting tirelessly for the little guy. And this time, we’re the little guy.  If we can give even a fraction of that passion, tenacity, and love fighting for our fellow pediatricians, the ABP better hold on. They’re in for one bumpy ride.

Photo by anjan58

Dear American Board of Pediatrics:

On December 17 2015, at 3:01 in the middle of my busy day seeing patients, I voluntarily gave up my American Board of Pediatrics certification. I thought I should write this letter, hopefully preempting any more threatening emails warning me that I must pay up or lose my certification. This was not mere oversight on my part. This was purposeful.

The reason I am no longer ABP certified has nothing to do with my education or skill. Indeed, I’ve easily passed my board examination twice. Like a compliant pediatrician, I enrolled in MOC in 2010, paid my $1000 and completed all my educational requirements.  I participated and completed all my MOC requirements again in 2013 and 2015.

I have disrupted my office flow to ask patients to rate me on my hand washing and I’ve sent that data to the ABP.  Twice.  I have disrupted my office flow to ask patients to rate me on my ability to give them flu shots and I’ve sent that data to the ABP.  I have dutifully completed your proprietary CME modules. I have submitted to and passed two secure examinations where I was treated as a near-criminal. Up until December 17 at 3:00, I did everything you asked.

But when I was threatened with loss of certification if I didn’t give another $1300, I finally had enough. The fact that the ABP can completely strip qualified and competent pediatricians of board certification for not paying more money is further evidence that MOC is all about the money.

A quick glance at your tax records makes it abundantly clear that this IS all about the money.  It’s about the president earning $1.3 million, but not doing MOC himself. It’s about first class airfare for board members and their spouses and $1.2 million spent on board meetings and conferences. It’s about $102 million in total assets in 2013, skyrocketing up from $65 million just 4 years earlier. It’s about an elite group living lavishly while front-line pediatricians slave away complying with never-ending hoops and ever-increasing fees.

And that’s why I didn’t pay.  I can’t continue to fund this type of coercion.  Those funds are used to change MOC rules on a whim and to threaten pediatricians into compliance.  While the ABP board was enjoying holiday preparations with their families, thousands of pediatricians were scrambling desperately to complete their MOC by Dec. 17.  Social media groups and message boards were full of physician moms and grandmothers looking for support as ABM MOC was pulling them away from family events to take tests, run reports on patient charts, and then cough up $1300 out of fear. This breaks my heart. The ABP should be ashamed of themselves and what they’re doing to our colleagues. The ABP board should be ashamed of what they’ve done to the reputation of the ABP.

On one hand, I am sad about giving up my ABP certification. I remember the elation I felt when I passed my boards after residency. I really felt like I had accomplished something and that my certificate represented my professional  educational commitment to pediatric medicine. Now, after seeing the monster that board certification has ballooned into, I’m very happy to be off the MOC hamster wheel and no longer supporting a corrupt system that punishes very good doctors and pushes our most experienced pediatricians into early retirement.

As it stands, something with American Board of Pediatrics MOC must change. As pediatricians, we’ve joined the rest of our physician colleagues across all specialties pleading for MOC to end. It must return to a one time examination after residency, maintained by holding an unrestricted state medical license and completing CME hours of our choosing. Ongoing secure examinations must end, limitation to ABP and AAP proprietary CME must end, the outrageous fees must end, and the time-consuming busywork of “Part 4 Practice Improvement Modules” must end. MOC must be egalitarian for all pediatricians, without exemptions or lowered fees for favored groups.

These are not just my isolated musings, this is what 4000 of my pediatric colleagues have requested in petition at peds4mocreform.org . This is what 23,000 physicians have signed under Dr. Paul Tierstein’s petition.

If past behavior of the ABP is any indication, I’m sure there will be more board meetings, work-groups, and pilot programs to tinker with MOC, to make it more “integrated” with our practices. Dr. David Nichols will write another blog post letting us know you are listening and have tinkered some more.

It’s all this flailing around and tinkering that makes me realize you don’t get it. We aren’t asking you to tinker and integrate MOC, we’re asking you to stop. The ABP keeps arbitrarily changing rules, and will continue to control us with these never-ending changes.

I really don’t think the ABP will be able to end MOC until we are allowed to stop participating. In order for us to stop participating, we have to conquer the one thing that keeps us in compliance: fear.

So in 2016, while the ABP meets and tinkers, I will focus on ending the fear. I will focus on freeing pediatricians from MOC requirements for hospital privileges and insurance credentialing, so MOC is truly voluntary. I will focus on educating my colleagues about alternative board certification options that treat us fairly and professionally like the National Board of Physicians and Surgeons, so there is choice.

In the end, I truly hope the ABP regains some measure of credibility and respect among practicing pediatricians. That will only come by respecting us as the professionals and colleagues we are, and not siding with the many other forces that are piling never-ending requirements, regulations, fees, and abuses upon us in the pursuit of power and financial gain.

Sincerely,

Megan M. Edison MD

Photo by lukas.b0

Sign the Petition to End Pediatric MOC Here.

Contact the ABP here.