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.
Go, go, go! I have sent my last dollar to the ABIM and am doing what I can in my local hospitals to change the rules. The only thing we need is cooperation.
YES!!! I too am fed up and am trying to organize a committee at my hospital to change the rules. Just last month a well qualified pediatrician in good standing was forced off the medical staff for not taking the Board exam again. The only way this practice will stop is if we stand together and all say NO!. I salute you for taking a stand and making it public. Lets get physicians back to treating patients and not supporting an ‘elite’ Board out of touch with the working physician and makes rules that do not adhere to.
I would like to hear what you are doing. We are making similar efforts in RI through RI Physicians for Quality Care, and I’ve love to share strategies. My email is lisa.frappier.ripqc@gmail.com. All are free to check out our Facebook page and contact me through that at https://www.facebook.com/RIPQC/
there is a petition everyone could sign so we could change the system: http://peds4mocreform.org/
Good for you, Meg! I am working on a committee in our hospital to end the MOC requirement. Initial board certification is OK, but after that, meaningful CME should suffice. We physicians have been extorted and abused long enough.
I was reading this post that a pediatrician friend of mine shared. I work in healthcare for PCP’s of geriatric practice. I saw your last name ECK. My maiden name was ECK. I live in Pennsylvania . The name is not very common and was wondering where you are from?
Bravo! ABMS has to stop running, oops, I mean ruining our lives. Some of the stuff they try to put us through is utterly ridiculous!
Thank you, Meg.
I am pessimistic about the whole matter, but I endorse those who are optimists, and believe that physician voices can change the system. I thoroughly believe that the myth of physician wealth in Washington will prevail over reality. Everyone in Washington knows, of course, that pediatricians are unwilling to surrender their spouse’s second Mercedes and their second vacation home in Aruba, to give up even 1¢ of their millions of dollars of income. The collapse of a society is directed by their unwillingness to face reality, and change. I doubt Washington can.
The myth is that physicians will tolerate any burden that is placed upon them. I am surprised to discover that Ayn Rand was indeed prophetic in her book Atlas Shrugged. I used to think that she was hard-boiled and cynical. Still do – but she might be right as well. The moochers and looters believe they can ride indefinitely on the backs of the producers. That’s us.
pediatricians making millions with vacation homes in aruba? NOT!
I think he was being sarcastic
Sarcasm!
Yes! Yes! Yes!
Congratulations! The best philosophy is always to “do the right thing” and you have done just that.
Thanks Bob! I have good mentors 🙂
Could not agree with you more!!
What is occurring with the Boards at the physician level is occurring to the citizen at the Federal and State level. Hopefully physicians who extract themselves from the stupidity of MOC will also think when it comes to election time who it was that brought up that which wasn’t to be discussed in contrast to those playing politics.
I admire you for speaking out. MOC is a bunch of wasted time. Let me know how I can help
Thank you for this well-written post, and for following what you believe. I didn’t pay the my MOC “enrollment” fee on time because I was unemployed, but despite doing the required CME, etc before that deadline, I have technically “lapsed” and must complete double the CME to “reactivate” my status, even though the only thing that was out of compliance was my check. If I did not need to find a new job in a new state, I would absolutely stand up against the extortion. Sadly, the extortion uses our careers as the threat.
Even more horrifying is that the ABP no longer recognizes the category “board eligible”. If more than 7 years lapse between residency and getting initial certification, you are no longer eligible to become board certified. The only way is to complete another year of residency! Imagine trying to find an open residency slot for one year, moving your family, and taking a $100K pay cut…just to get board certified so you can work. The lapse happens if doctors are “foolish” enough to go from residency into missionary work, or have a medical condition or other family issues that keep them from taking the boards.
I am one of these pediatricians who’s Board Eligibility has lapsed and I have no hope of ever being Board Eligible again. Unless, of course, I quit my job and find that one residency program that would accept me for one year while I continue to pay my mortgage and support my 2 boys as a single mom. I took the Boards twice after residency. I was a mom at that point and I went straight into practice. I failed both times and it was not until 6 years after residency, when I sought help for my test taking anxiety, that I was diagnosed with ADD. With one chance to pass the Boards, working full-time, and being a single mom to two young boys, the pressure was too much and I failed. I continue to work for now, fulfilling my passion of being a pediatrician. I practice up to date compassionate pediatrics in a Family Centered Medical Home. I take exceptional care of my patients. I have in access of 100 CME hrs despite my state requiring 60, I participate in AAP QI projects despite not being eligible to be a fellow or receive MOC credit, and I volunteer to teach parenting classes and work on State committees. I do this because I love what I do. I work with Board Certified doctors who practice out of date medicine and care only about getting home. Yet I live each day wondering if it will be my last day practicing pediatrics because I didn’t pass one test.
Your post brought tears to my eyes. I realize the main movement is for those protesting MOC but the few that are in my situation are no doubt praying for a change in this system.
Email me please silmamartinez@yahoo.com
Sylvia- I’m in same situation. Please email me drjennasue@gmail.com. Desperate not to have to look for another job.
I am curious if those like Dr. Edison, who have let their certification lapse, are having issues getting credentialed and reimbursed by insurance companies in private practice? Thank you
Its all true …MOC is a scam and a money maker for the people running it/the abim has the same scam and a 55million dollar slush fund that was hidden and finally caught on to by a very observant cardiologist who has started the other board committee NABPS….we need legal action!! petitions and blogs are good but the reality is our jobs are on the line with credentiling and insurance requirements…they hold us in very vicarious positions and they know it….lawyers, global boycotting and cutting off the hippocrits money supply will stop this…stop paying them!!!
Thank you, Dr. Edison
When I received the same letter from ABP I had the same reaction and sent them an angry email basically stating the obvious. I didn’t get any response. After a month I caved in and paid because my employer could penalize me if I lose my certification. On the ABP website I was not certified one day ( although I passed my recertification exam in 2013), but as soon as they received the payment – I was miraculously certified again. Really, really nauseating.
ABP has completely taken me off their website. That’s amazing.
Thank you for bringing this to the forefront for us. I agree that I gain nothing from the extra tasks that they require of us for MOC, and would be completing regular CME anyway because I want to be a good physician. Unfortunately, every job and every insurance payer wants to see this Certification, so what are we to do? Despite a perfect record, I have been unemployed for 6 months before, and desperately took a less ideal job to end the misery (an extra 3 months were spent trying to get a state license despite having 2 others already, and insurance credentialing hurdles). I cannot go through that again! Out of fear, I pay every fee and fill out every document and assignment I am given. Would another petition be of use? Can we be the voice of the Board which represents us?
Good for you Dr. Edison!! ACOG (your comrades in arms, Ob/Gyns) are under the same ridiculous requirements….after completing both a grueling written exam and an absolute nightmare of an oral exam 18-24 months later. To threaten any physician with loss of board certification over anything other than gross medical malpractice or ethics violations is egregious in my book. I will gladly help you in your fight with hospital & insurance credentialing issues! I signed Dr. Tierstein’s petition many, many months ago!! Every physician in clinical practice, should.
Great Letter to ABP, Meg. Thank you for your leadership on this issue in your field. As an OB I wish I could send you some patients… Here’s the letter that I sent to ABOG over two years ago:
With satyagraha,
Howie
November 29, 2013
Larry J. Copeland, M.D. and Frank W. Ling, M.D.
c/o The American Board of Obstetrics and Gynecology
2915 Vine Street
Dallas, Texas 75204
Re: ABOG ID 24150
Dear Drs. Copeland, Ling and Members of the American Board of Obstetrics and Gynecology,
I am a strong believer in the Oath of Maimonides. It reads:
“Grant me the strength, time and opportunity always to correct what I have acquired, always to extend its domain; for knowledge is immense and the spirit of man can extend indefinitely to enrich itself daily with new requirements. Today he can discover his errors of yesterday and tomorrow he can obtain a new light on what he thinks himself sure of today…”
I also embrace the parallel concept of satyagraha, loosely translated as “insistence on truth” (satya ‘truth’; agraha ‘insistence’) coined and developed by Mahatma Gandhi.1,2,3,4
Among others, I have previously published that MOC has never been proven to improve the quality of medical practice. To the contrary, it has been associated with the decreased collegiality of our profession as well as decreased involvement in local as well as national medical societies.5,6,7,8,9,10,11,12,13,14,15,16 Most practicing physicians find MOC to be clinically irrelevant 6,7,16 , and polling of physicians in clinical practice showed that only 1.6% wished to maintain the current system – whereas 4.7% supported reform and 93.7% voted to abolish requirements altogether.9
The American Board of Medical Specialties has published that the quality of research on MOC does not meet commonly accepted research standards17 and that certification does not “guarantee performance or positive outcomes”.18
As respected professionals, we as obstetrician/gynecologists believe in our own continued education and quality improvement. Accordingly, if MOC has not been empirically proven to improve our practices, or be clinically relevant for most of us, than why is it being forced down upon us?
Veritas vos liberabit – Shouldn’t we insist on truth? If MOC is inadvertently decreasing attendance at scholarly and collegial meetings, shouldn’t we consider that detrimental to the medical profession? With 50% of the counties in America lacking an obstetrician to deliver babies, won’t the early retirements MOC could provoke worsen the health access crisis?
The AMA House of Delegates study on the impact of MOC on physicians concluded, in a resounding consensus at their June 2013 meeting, that these programs were “burdensome, costly, and have little known positive impact on patient outcomes”11. You must also be aware that resolutions against MOC have recently been enacted by the American Medical Association and the state medical societies of New Jersey, Michigan, Ohio, Oklahoma, New York and North Carolina.
As you know, ABOG is currently tangentially involved in civil litigation with the Association of Physicians and Surgeons (US District Court No. 3:13-cv-2609-PGS-LHG) – as an apparent co-conspirator in “an unlawful conspiracy in restraint of trade in violation of Section 1 of the Sherman Act”. Furthermore, previous US Courts have favored antitrust provisions against other monopolistic professional certification processes19. On behalf of all Diplomates, I respectfully request a delay in continuing the current MOC process until the Court has ruled on this litigation.
I believe that my request is quite reasonable. In the words of Thomas Paine,
“He that in defense of reason rebels against tyranny has a better title to Defender of the Faith.”
With respect and satyagraha,
Howard C. Mandel M.D., FACOG
1) McKay, John P.; Hill, Bennett D.; Buckler, John; Ebrey, Patricia Buckley; Beck, Roger B.; Crowston, Clare Haru; Wiesner-Hanks, Merry E. A History of World Societies: From 1775 to Present . Eighth edition. Volume C – From 1775 to the Present. (2009). Bedford/St. Martin’s: Boston/New York. ISBN 978-0-312-68298-9. ISBN 0-312-68298-0. Page 859
2) Uma Majmudar (2005). Gandhi’s pilgrimage of faith: from darkness to light. SUNY Press. p. 138. ISBN 9780791464052.
3) M.K. Gandhi, Satyagraha in South Africa, Navajivan, Ahmedabad, 1111, pp. 109–10.
4) Mohandas K. Gandhi, letter to P. Kodanda Rao, 10 September 1935; in Collected Works of Mahatma Gandhi, electronic edition, vol. 67, p. 400. http://www.Ghandiserve.org
5) Not Until Proven to Improve Health Care Practice, Mandel HC. N Engl J Med 2013:368 1261-1263
6) Dubravic M. Board certification/recertification/maintenance of certification—a malignant growth. J Am Phys Surg 2011;16:52-53
7) Orient JM. AAPS survey: physicians skeptical of recertification. Evaluating the quality of care provided by graduates of international medical schools.
J Am Phys Surg 2009;14:17-18
8) Norcini JJ, Boulet JR, Dauphinee WD, et al. Evaluating the quality of care provided by graduates of international medical schools. Health Affairs 2010;29(8):1461-1468
9) Change Board Recertification. Website poll. Available at http://www.changeboardrecert.com/vote.html. Accessed December 30, 2012
10) MOC doesn’t create better physicians, Mandel HC. Med Econ Sep 25, 2013
11) AMA House Disses Recertification Programs, Pittman D http://www.medpagetoday.com/meeting coverage/AMA/39949 June 18, 2013
12) Recertification and Maintenance of Certification. Mandel HC; J Am Phys Surg:16;3,65 Fall 2011
13) Why don’t lawyers have to be recertified? Mandel HC, Med Econ Feb 10, 2012
14) Recertification and Maintenance of Certification. Sharon, GE; J Am Phys Surg:16:3,66 Fall 2011
15) Recertification and Maintenance of Certification. Mackel JV; J Am Phys Surg:16:3,66 Fall 2011
16) Kempen PM: Maintenance of Certificiation—important and to whom? Journal of Community Hospital Internal Medicine Perspectives,Issue 1, 2013 Pages 1-4
17) Sharp LK, Bashook PG et al. Acad. Med. 2002;77:534–542
18) http://www.abms.org/maintenance_of_certification/pdfs/ABMS-_MOCMythsFacts_3-20-13.pdf
19) Havighurst CC, King NM. Private credentialing of health care personnel: an antirust perspective. Part Two. Amer J Law Medicine 1983; 9:263-334
Currently, I have spent $225 (not to mention stress and time) to meet the QI requirement. I still haven’t met it. Nothing is good enough.
Thank you for being brave! I have given the ABP $9000 at this point for attempts At the neonatal-perinatal boards and now am in danger of losing my job if I don’t pass by Dec 2016. It is insane that this organization has the power to take away everything I have worked so hard to achieve, along with my money.
I can not agree with you more. Recently I was diagnosed with leukemia. Just before a 3 week hospitalization I wrote the ABP for a 1 month extension on my MOC part 4. I read the ABP reply from my hospital bed that was so callous and insensitive that I could not believe these people were actually deliverers of health care. The letter stated that they regret that there is no exceptions to the deadline of 12/17 and if I do not meet that deadline I will lose my certification. But they reassured me that they will be there to get my recertification when my health improved. They have some gall.
Ralph Schrager, MD
Interesting. I have an unrestricted certificate but voluntarily chose to enroll in MOC as I thought it was the right thing to do to demonstrate current competence. Then, a year ago I got sick and have been on medical leave/disability. Since I’m not seeing patients, I can’t participate in Part 4 activities and will lose my certification at the end of the ABP’s arbitrary 5 year cycle. I have jumped through all their hoops and paid all their fees for decades, but now my knowledge, skills and abilities will be forfeited because I can’t do a clinical quality improvement module.
Due to my health, I will probably relinquish my medical staff privileges and license while I am still in good standing, but it’s an awful way to end a 30+ year career in clinical and academic medicine.
A truly brilliant very learned friend of mine who is an M.D. PhD once told me a story of his childhood. At about age 10 he came home from school with his report card. As he stood before his parents tears filled his eyes. His small trembling hand relinquished the piece of paper to his mom. He had never gotten less than an “A” in his entire life. There in the first column the third box down was the letter “C”. He could see the red in her face as her rage built. He shuddered as the words came to her lips. “What is wrong with that TEACHER?”
I have worked with Dr. Ralph Schrager M.D. for more than 20 years. Without a doubt he is one of the finest physicians I have had the pleasure to know. He is one of the most respected neonatologists in our community. He is hard-working and compassionate. He has remain dedicated to lifelong learning and to educating others in our field. His work has made all the difference to so many babies and families. If at any point visibility is not recognized by the American Board of pediatrics, there’s nothing we can say except “WHAT IS WRONG WITH THE ABP???”
Yes Dr. Margiotti, you should write more about this, here on Rebel.MD. I practice up the street from you, if you need my help, please let me know.
Wow. That deserves a post. You should write about this.
I think there needs to be a process that encourages physicians to stay updated and current. Can we turn back this clock to appropriate CME hours annually? Maybe but then we need to do the appropriate oversight and competency of our colleagues with substantive corrective actions when it does not occur. If we had done this when the power was in our hands we would not be facing these outlandish mandates today. The state boards are comprised of physicians who did not exercise those powers – we are caught in these situations due to our refusal to REALLY be the head of the health-care team. It will take more than individual actions to make this change – it will have to come from the young, the old guard grandfathered out. The young will have to get on state boards, do actions that get the attention of our professional societies to speak for us, get on the ABP (by the way they do take and pass the MOC exams but none of them HAVE TO). Agitate, Organize, Plan, and Act.
I am part of the old guard – but I maintain MOC because I am in an academic setting and want young physicians to realize that we must be committed to being life long learners. Some how we need to find the important middle ground that does not COST so much money.
Dr. Young –
I too teach our young physicians and believe in continuing education, but I would argue that allowing any non-accountable, unelected non-practicing group of physicians the keys to their colleagues’ bank accounts while those same unelected physicians wallow in the spoils of luxury condominiums, stock options, health club memberships, spousal travel fees, and cash payments from highly conflicted, co-conspiring non-profits is a recipe for disaster. The social engineering of physicians using thuggery and intimidation cannot be tolerated and is so corrupt and despicable that every physician should stand up just as Dr. Edison has done. The entire MOC program is abusive and has NO PLACE in the practice of medicine. Unless and until the MOC program goes COMPLETELY away, there is simply NO ROOM for compromise other than recognizing MOC for what it is: extortion.
I commend Dr. Edison for her action here and while I recognize the impossible position our subspecialty boards have slowly placed practicing physicians over the years (who now work as employees of large hospital systems), actions like hers will kill the MOC beast in favor of a more balanced, accountable, and non-conflicted alternative.
I teach young physicians as well, and I teach them that continuing education is not only a joy, it is part of our oath. It’s not something we do because the boards tell us to do. Continuing education is CERTAINLY not the monopoly of the ABMS, even though they make it sound like they invented and patented the idea of continuing education.
I don’t know about your state board, but we are held to the highest standards of continuing education. We must complete 150 hours every 3 years. You know how many hours lawyers need to do? Zero. I have no apology for our commitment to education.
The funny thing about these specialty boards is that they claim to be holding doctors accountable, yet they have no jurisdiction within states to stop incompetent doctors! As long as the incompetent doc is board certified, ABMS has done their job apparently.
This last bit about lawyers is actually untrue, lawyers are regulated by their respective State’s bar, all of which have their own regulations for continuing legal education. In my own home state it’s 30 hours over the course of three years, no matter how long you have practiced. It is much less than physicians I admit, but then again the practice of law requires constant “continuing education” (at least in my sub specialty) if you ever have a chance of winning an argument!
Continuing education hours are the purview of the states, as they should be. MIchigan requires 150 hours every 3 years for doctors, but none for lawyers. http://www.attorneycredits.com/michigan-cle-faq
10 hours a year CLE, never retaking the Bar. Man, we really do a bad job protecting ourselves…
If you think complying with this obvious scam is an effective way to teach young doctors, they probably would do better without your input. I’m sorry to be so harsh but have you been reading what’s been said in these comments? No objective person could support MOC.
Well said! We have the same issues in ABIM, which is another tentacle of the same monster. Good for you! Conquer your fear and stand up against the abuse! Congratulations !
Thanks Meg,
Being Double boarded I’m double extorted !
End the MOC
I totally agree. The current MOC system for the ABP is simply a money making effort that requires physicians to do pay to do “busy work” that is meaningless in the day to day care of our patients. I am currently board certified and must keep that certification active as I work in a hospital setting and will lose my privileges if I don’t. I recently met the December 17th deadline – but I found the MOC part 4 to be completely useless as far as “improving my current practices” is concerned. One of the previous iterations of the recertification process actually met the specified goal of being a learning experience – in that iteration, we were required to complete a 3 section series; section one was general knowledge, section 2 was on diagnosis, and section 3 asked physicians to order tests in order to confirm our diagnosis while keeping a running tap on how much those tests cost and whether they actually gave useful information. It was a truly educational experience -so of course the system was changed! One of the best parts was that it was done on you home computer at your own pace, which made it much more “user friendly”. I agree that the system needs to change – I wouldn’t mind seeing it change back to that version – at least it met the requirement of making sure that physicians remained current, rather than wasting our time discussing how we wash our hands!
I agree 100%. This busy work is insane with zero proof that it improves anything in practice. I recently had similar issues when they would not accept my medical home certification, because it was Colorado not national. I showed them all of the paperwork, etc to prove that Colorado Medicaid follows national guidelines.
I’m convinced that the only way to win is a class action lawsuit.
A respectful organized boycott will be effective. Here’s a piece I wrote in JAMA Pediatrics:
Comment & Response | March 2015
The American Board of Pediatrics Should Close Up Shop
Abraham B. Bergman, MD1
1Department of Pediatrics, Harborview Medical Center, Seattle, Washington
JAMA Pediatr. 2015;169(3):287-288. doi:10.1001/jamapediatrics.2014.3108.
To the Editor The Nichols1 Viewpoint recently published in JAMA Pediatrics on the American Board of Pediatrics (ABP) begs the question of whether the ABP should have a future. I think not. When the ABP was formed in 1933, it was important for the public to have a means to identify physicians with special competence in the care of children. Now, numerous bodies (public and private) perform background checks. Patients are even able to discover what their physician eats for breakfast.
Assessing physician competency interests all medical educators, especially those involved in board certification. The hitch has always been centering the search on items that can be measured, such as factual knowledge, rather than qualities that help make physicians special, like empathy and integrity. Today’s wired world diminishes the value of memorized facts. With the help of a telephone, a clinician can instantly enter a constellation of symptoms and generate a differential diagnosis. The real measure of value added by an accrediting body has to be measured by comparing it with what is widely available.
Nichols envisions data captured by electronic medical records as useful to monitor quality improvement and patient outcomes. Because health supervision and treatment of viral illnesses constitute a large part of primary care practice, it is hard to contemplate what outcomes would be assessed: when a seborrheic dermatitis rash clears? The proportion of parents of infants with colic who retain their sanity? He also advocates greater emphasis on mental health content in the ABP examination. What kind of content? Probably not the skills I look for, such as providing end-of-life care, understanding the social determinants of health, empowering immigrant parents to get involved in their kids’ schools, or most importantly, being good listeners. Nichols even sees the ABP becoming involved with assessing professionalism, a quality that used to be called integrity. Other than lie detectors, finding assessment tools remains a work in progress.
Long ago, while involved in studies on the relevance of residency training to pediatric practice, Steven Dassel, Ralph Wedgwood, and I came up with highly subjective measures for identifying good pediatricians. Our participants had to be respected by their peers, hold clinical appointments in pediatric departments, and care for an appreciable number of children of physicians in their practices.2 Of course, the ABP’s measures for identifying good pediatricians are much more extensive and expensive. Residents currently pay $2265 to take a computerized examination administered by a commercial company, Prometric. In accredited pediatric residency programs, trainees have 3 years to learn, during which their competencies are assessed. There is no longer a need for an outside body to get involved. The ABP should close up shop.
ARTICLE INFORMATION
Corresponding Author: Abraham B. Bergman, MD, Department of Pediatrics, Harborview Medical Center, 325 Ninth Ave, Box 359774, Seattle, WA 98104 (oscarb@uw.edu).
Conflict of Interest Disclosures: None reported.
REFERENCES
1
Nichols DG. The future of board certification: learning is competency. JAMA Pediatr. 2014;168(9):789-790.
PubMed | Link to Article
2
Bergman AB, Dassel SW, Wedgwood RJ. Time-motion study of practicing pediatricians. Pediatrics. 1966;38(2):254-263.
PubMed
Copyright ©2015 American Medical Association
Excellent. This is really good. Thank you Abe. So many “grandfathered” docs are just happy to be in the clear and few will fight for the next generation of doctors. Please work to get your hospital policies and practice policies changed so doctors don’t have to do MOC. Initial board certification should be enough. Quite honestly, it’s only the grandfathered docs who can make these changes, as it isn’t viewed as a conflict of interest.
i am an EM physicain (40 years). i have felt this way about ABEM for years; i’ve written a few letters and whatever but this letter should motivate us old-timers with little to lose to shut down ABEM and reconfigure it entirely; same for any specialty, like pediatrics
Looking at their books, these boards are not going to change. Why would they? I think it’s more important to start locally and protect your local docs. Get your hospital bylaws changed so only initial board certification is needed. Change your practice bylaws as well. Hassle any insurance company that is forcing BC to participate. Get you state medical society on board to pursue state legislation. If the doctors in your area are protected, that’s what matters.
I thought I was alone on Dec. 17, 2015, a date that will live in infamy. Not only could I not afford the $1300., I felt it was unfair to have to pay $25. to obscure journals to pass the quiz.
No more $$$ for the ABFM…..As a solo doc, I make next to nothing. I don’t even see any medical patients anymore, so how is any of it relevant. I keep up on journals, am an excited learner. But when it is all about the money, and I have none–nope. Get your priorities in line.
Kudos to the MD’s who’ve jumped off the train to Medicine Pharmageddon. -Seth Gross, DC
Time for all doctors to unionize.
My colleague and I in private practice intend on becoming the third column and are exploring the National Board of Physicians and Surgeons, if they do actively accept and work with pediatricians.
They do, the board member representing pediatrics is Dr. David Driscoll from Mayo.
This is beyond maintenance of certificate. Health care in this country is all about profit and not the true well being of our patients. We are the agents of those organizations and everyone is capitalizing. Until we have a thoughtful one payer system we will have to pay exorbitant amounts for medical school, recredentialling, malpractice insurance etc. Thanks for making such a bold statement and not staying frozen and blind!
Our patients and the general public believe that being “board certified” indicates that you are clinically competent in your area of speciality. But the current MOC guidelines have very little to do with clinical competency.
I have a medical directorship appointment with my hospital and we do continuous QI work as a part of that position. But because it does not meet the QI template of the ABP with 9 months of data in a run sheet, none of the work of the last 9 years in this position counts. Ridiculous.
But the bigger point is that Quality Improvement does not in any way reflect the clinical competency of pediatricians. So why is the ABP in that business at all?
This kind of intrusion into true medical practice affects us all. Thank you for speaking out with such courage and determination…we wish you the best and hope that this will be the catalyst for change that the entire health system in the US needs.
Amen. If I did not work for a partnership that requires (and to be fair, rewards) board certification, I would have given it up long ago.
I’m thankful to be retired! I was Board Certified after I had been in practice for 11 years — but always enjoyed keeping up with CMEs annually. Practice should be a joy not a drudgery. At the time I took the exams, I had some free time and read Nelson from cover to cover which also was fun — I had taken a year off to return to school and get an MPH.
MOC should only require a certain amount of CME. Jeanne Griffith
My cousin Henry Ehrlich, the author of our book on allergies and children and of our website asthmaallergieschildren.com sent me Meg’s letter. I was reminded of a somewhat identical situation with our board in allergy and how they pushed MOC down our throats and all the rest. We have resisted our board and the board recanted. But a pediatric board acting the same as an allergy board. For shame !!! What a disgrace. I have just removed my ABP certificate from my wall.
Great letter Meg!!
I am grandfathered, but voluntarily took the neonatal recertification exam, had more than enough CME and then found that two of the myriad QI projects we do qualified. On Dec 17 I got a) word that I had met the certification requirements, and b) that unless I sent them $1300, they would not list me as certified. I declined. Extortion is not tolerable.
I agree with Dr Edison completely. I was forced into a pathetic scramble to meet the MOC requirements by Dec 17th, 2015. My father was assaulted, robbed and beaten in May and June of this year. I took responsibility for him during this time along with a serious immediate family tragedy. Then my father drowned in the 1000 yr flood on October 4th 2015. I had more important things on my plate than Prep Self Assessment, hand washing protocols and the minutia of detail the MOC requires in spite of my stellar boards exam results and my record as a pediatrician. I called the AAP requesting a compassionate delay in my MOC process. I was told we don’t do that! We would have to hire too many people to assess everyone’s unique situation. Bologna! I assess unique people’s problems daily times 35! The cost of our exam and MOC fees etc are more than enough. No compassion. No individual concern. No class. I am grateful for much of what the AAP does but for several years the price gouging and cumbersome rules and requirements that make me less efficient and effective for my patients has led me to stop my AAP memberships. The MOC pushes me over the edge. My hospital requires Board Certification so I jump thru your expensive hoops. Reform is coming. Reform is necessary. New blood is needed. There I have spoken my piece. If there is any truth to Dr Edison’s statement regarding ABP salaries and travel habits I am even further out raged.
In California an HCA-owned hospital medical staff recently voted that MOC would not be required for medical staff membership. At the annual meeting of the California Neurology Society, November, 2015, I distributed about 100 copies of this successful resolution. I expect to post it soon on http://www.politicsofhealthcare.com — alternatively, you can send me SSAE and I’ll mail you copy by snail mail. The hospital is Regional Medical Center, Fremont/San Jose area.—- Robert L. Weinmann, MD, Editor, The Weinmann Report, http://www.politicsofhealthcare.com and currently Chair, Legislative Committee, CA Neurology Society.
Good for you. This is insane.
I applaud Dr Edison for fighting for the rights for all pediatricians. The group of pediatricians that have not become board certified within 7 years after residency now have to complete an additional year of residency in order to become board eligible again. We have to find a residency that will take us and not get paid while we are working 40-80hr a week. So far only 1 residency program agreed to take 1 person. All other residency programs have said no to taking other noncertified pediatricians. The ABP has come up with this rule but there is no way to execute the remediation so great pediatrician have lost there jobs and livelihood because of this craziness. A class action suit has been attempted but lawyers want take the case. I don’t understand why this board has so much power. We are the people who completed medical school and residency as well as pass 3 step exams before we can get any state license. Many of the doctors have documented medical conditions/learning disorders that the ABP refused to give testing accommodations which would have helped them pass the boards. The ABP is insensitive and out of touch with our needs and only cares about the dollar.
Almost 44 years on, I still enjoy leisurely reading of medical journals.
Then, most states required evidence of CME for maintaining a medical license, reading and keeping an open set of eyes and ears was not sufficient. Coincidentally, the number of CME courses (and costs) increased. Additionally, Board Certification changed from lifetime to 5-10 years, depending on speciality.
Since that did not seem to satisfy the financial needs of the various Boards, they created Maintenance of Certification requirements.
It is quite impressive to me the creativity and imagination of the Boards, utilizing a moving target for physicians to keep their Board certification (especially in an era of Dr. Google, nurse practitioners, etc.).
If only I could invent something everyone required on an ongoing basis, and charge ever increasing amounts of money, I and my children would be financially set for life. It almost seems they are using the model of the “protection racket” perfected by the “Mafia,” — but with better lawyers to make it legal.
Just had to give a BIG “THANK YOU” to Dr. Edison for so elegantly stating what so many of us have been feeling for the last few years. I myself came to the same realization and that final decision to ELECTIVELY drop my ABP Certification was truly bittersweet. Over the past year, I kept hearing the Peter Finch line from the Movie Network, “I’m mad as Hell and not going to take it anymore” every time I received any notice from the ABP. I jumped at the opportunity to join Dr. Tierstein and the NBPAS. Reading Dr. Edison’s Open Letter, gives me the solace that I am not in the minority. Most anti-MOC campaigns have been aimed at the ABIM and it was rare to see anything specifically from Pediatricians. I now wait to see how the American Academy of Pediatrics responds to all of the Fellows who will no longer be Members since ABP certification is a requirement.
Meg,
Good luck taking on this 800 lb gorilla. Just had to take my board recert for ophthalmology. Our moc is much like yours. Just awful, seemingly created by people better suited for work at the irs or the dmv. The final insult was the nature of the questions on the exam. Some were unbelievably arcane trivia (how to manage a disease which has been reported less than 200 times – what, your not going to go look that up?) and some were total judgement calls, with not enough info given. Overall a stressful, expensive waste of time. I’m glad it’s behind me but wholly support any effort to scrap the whole thing!
Brian Willard md, Easton PA
Love this! Absolutely nailed it, Dr. Edison. ABMS/ABP so out of touch with reality.
Congratulations Dr. Edison and thank you very much!
Thanks for your thoughtful letter. I just spent the last two years catching up on all the busy work of modules and exam prep to pass my primary (family medicine) and sub-specialty (geriatic medicine) boards. While I’m good for another 10 years, I am appalled by all the time and money I spent in the process. After completing my residency and fellowship 15 years ago I served as a member of faculty at the residency and continue on the school of medicine’s adjunct faculty. I reguarly attend medical conferences both as a speaker and as an attendee. My focus is fully on geriatrics at this time. I lead a large group of providers that care for frail, elderly patients across many clinical settings (from hospital to home). I need no motivation to keep up with the latest evidence and standards in my field — I am a professional.
The thing that frustrates me the most is that I must maintain my family medicine certification (and all the modules and exam) in order to keep my geriatric certification (which is important in my role and for my credentials). It seems silly that though I’ve voluntarily limited my practice to geriatrics, I need to study the pediatric immunization schedules, medication impacts on pregnant women, and preventive care measures for a 50 year old male (to name a few examples). These are a needless waste of my time; I don’t need to tell anyone on this blog how my day is already filled with the many regulatory, operational, and professional requirements of maintaining a practice in medicine.
I fully support your call for change. I would add a call to end the absurdity of requiring maintanence of primary boards in the context of a practice that focuses on a sub-specialty.
Thank you for your great letter. We must put an end to this now. I am due to take my test again this year after years and years of practice I have to take a test on things that I don’t even do everyday. If I’m going to pay the kind of monies they want they should be providing free education to keep me current. Where is it?
Sadly, MOC has already ended the careers of too many gifted physicians in the prime of their careers. I personally know 2 pediatricians, 2 cardiologists, and an very well-known orthopedic surgeon who have left clinical practice rather than MOC. Now my personal internist of 20+ years (only mid 50’s in age!) tells me he is hanging it up rather than put up with another MOC.
As a patient I am being affected by this MOC mess. It MUST STOP!!!!!!
Because I am “grand-fathered in” or should I say “grand-mothered in” I am not at risk for losing my certification if not completing MOC. In an effort to remain current, I have always completed MOC over the years since its inception. Part 4 did me in in 2015, however. I was not able to devote the time, energy and effort necessary to meet this requirement. I am now non-compliant with MOC but luckily this does not effect me because of my year of certification. Fortunately, insurance company and hospital credentialing has not been affected so far. This system developed by the ABP is unrealistic, costly and is only encouraging competent physicians to sever ties with the ABP.
Rather than encouraging competence, this system is working against those committed most to the welfare of children.
After finishing a 3-year residency in Family Medicine, I passed the board test, re-certified in 7 years and re-certified again in 7-years. That meant that I was “certified” for the first 20 years of my practice. I have been in practice for 34 years now and my patients don’t give 2 cents if I am certified or not. I think I am a better physician now than I was 15-20 years ago when I was traveling to take expensive tests. I am a solo physician and I feel for those of you who have to do MOC to stay employed. We need to change the feeling in the community and with insurance companies about this. As more brave physicians opt out of this money-making racket, I hope attitudes will change. God bless you Dr. Edison!
Thank you Dr. Edison. I let my ABA cert expire in December. I am now certified with NBPAS. Everyone support the legal arm of the AAPS, the AHLF. Andrew Schlafly is spearheading the lawsuit against MOC and its abusive restriction of its trade restrictive, extortion tactics. Take the money you were going to send to ABMS and send half to AHLF. Then spend the other half on a nice vacation for your and your family.
I too am tired of the extortion. Will totally look into NBPAS certification. I agree with ophthalmology comment: If it is a topic you want to make sure you cover everything, then you are going to look it up or discuss with a colleague. The current ABP does not represent reality. We all have to look up something at some point. Love to do CMEs and read journal and online articles.
I think pediatricians will continue to be taken advantage of until there is a union that can stand up for our collective interests. When are pediatricians supposed to stand up for themselves when they are doing all the busywork of moc and seeing more patients due to poor insurance reimbursement? Plus the field is traditionally more family friendly so what limited spare time the majority of pediatricians do have is dedicated to family not reform. A lawyer talking to the ABP could be a lot more effective than 100 pediatricians….
Like you described, in order to keep my job I have to play this game for the hospitals, insurance companies, and the medical school faculty appointments. I applaud you! Please see/review what I have been posting about my experiences with MOC and ABIM:
So I am the kind of person that does not like things hanging over me. My last ABIM cycle ended in 2012. So with passing the re-certification test, in January of 2013 I did 100 plus MOC credits (100 every ten years was the standard at the time). Whew, I thought I had this behind me until I have to take the test again around 2020. ABIM announces in April of 2013, that starting in 2014 you need 100 MOC credits every five years and oh by the way anything you have done prior to January of 2014 will be erased! UGH!
So in early 2014 I got 100 credits again, knowing that I will have to satisfy their parochial nonsense of getting 20 every two years. But more importantly, just to get it off my back, I did a patient voice, practice improvement, and patient safety activity to once again, get this busy work behind me.
As I am doing this the outcry mounts and ABIM capitulates saying they have suspended the patient safety, practice improvement and patient voice requirements through 2017, now with this it is 2018. You have got to be totally kidding me! I played their silly games and this is what I get. I am still pissed off. I have personally written Dr. Barons. No one from ABIM has written back. If these functions are so goddamn important to patient care and outcomes, how can they just arbitrarily and now repeatedly suspend them. The whole thing is looking more and more like a money making sham off the backs of American Physicians. Hospitals and insurance companies need to quit relying on ABMS certification as a measure of quality – especially through their own actions, ABIM has proven that this is all arbitrary and capacious and they are making it up as they go along. No evidence to back it up.
Quality medical care needs to be measured through the lens of a trusting physician patient relationship. Not, MOC, PQRS, HEDIS, EHRs and meaningful use. These are all cheap and lazy surrogates for what really matters, a quality trusting physician patient relationship. When physicians and patient really know one another, patients will buy into what their physician tells them and won’t necessarily rely on expensive tests; compliance will improve. More importantly quality (true quality) will go up and over all costs will go down. Up front, this will cost some investment, insurance companies and policy makers do not have the foresight, the gumption, or the willingness to invest in this to make real health care reform work. Instead we have a broken system that got even more broken with all of this nonsense busy work. When is someone really going to see the light of what real medical practice is all about?
I was decredentialed as a nocturnist last month after providing night coverage to a rural hospital in Ohio. They coiuld care less that I have 29 yeras more experience than the doctor just out of residency, in fact they now use nurse practitioners to do many of the admits and cover the hospital as finding doctors to work at night is not easy. I simply refuse to be part of this racket anymore. It is pure evil and it must be challenged to go away or it will ruin all of our lives we worked so hard for. It is a cancer on our profession. We simply just all need to stop providing coverage simultaneoulsy to these hospitals and walk out NOW. They will beg for us to come back back on their knees in 24 hours, if it even takes that long but we must ALL do it together. The boards would then be a dinosaur of the past. They are truly useless and suck money from us like leeches. It is despicable and makes me ashamed of my peers who support this practice.
I wish to add that the secret to happiness is freedom of choice, and freedom of choice does not come without courage. Doctors must stand together NOW to stop and put an end to this racketeering organization known as the ABMS. They are subjecting us to extortion and it must be fought. If we do not stop this, than we are all truly simply cowards and deserve our fate. These boards have absolutely nothing to do with being a doctor today and caring for our patients. It is a travesty it has come to this but we doctors brought it to our doorstep by being complacent and silent and fearful of this and fearful of that. We must go on a work strike NOW. It would not take long to put the ABMS out of business. A couple days of not showing up work anywhere in the USA will end this forever!
Everyone should join NBPAS, https://www.facebook.com/RIPQC/ and doctors should demand there be a choice in board certification
Dr Edison, I was unable to verify your contention that “It’s about the president earning $1.3 million”. Neither Nichols or Stockman make that amount on the most recently available linked tax return. In the interest of avoiding disinformation, where did you get the information to make that claim. Also, although you may be correct, is it true or your opinion that Dr Nichols doesn’t do MOC?
Oh good, I was hoping we’d have an MOC apologist comment! It’s always fun, because there are always clear conflicts of interest…like having created a MOC project or simulation, or somehow benefiting from inflicting this upon your colleagues. You can read the tax returns, in 2013 Stockman was paid $1.3 million. Here I’ll do the work for you http://rebel.md/wp-content/uploads/2016/01/Stockman.jpg And you can verify anyone’s certification at the ABP website. Except for me, because I don’t exist on the page anymore. Nichols is obviously not practicing, but isn’t dong MOC in gen peds. But here, I’ll do the work for you. http://rebel.md/wp-content/uploads/2016/01/Nichols.jpg Have a great day!
Anyone who doesn’t think ABP has been paying the CEO too much should definitely see http://www.guidestar.org/FinDocuments/2010/231/417/2010-231417504-06d9e2d3-9O.pdf and look at part VII and see $1.193,191 plus $48,397 listed on the 990 as paid to Dr Stockman for his services only to the ABP.
I am sure he is NOT a MOC compliant person but a granddaddy of all gold diggers who admits he really wanted to be a used car dealer with his particular skill set!
there is a petition going around that you all can sign: http://peds4mocreform.org/
Spot on article. I am a forensic pathologist who will not participate in MOC once my first 10yr cycle expires. Doctors need to take back their autonomy. Join NBPAS and say NO to the ABMS.
That is exactly I wanted to let ABP know that it is for money so they can enjoy our money which is we make the hard way
I want to ask ABP how come the pediatricians who are grandfather in and exempt from recertification Are they not practicing pediatric or dealing with diseases of children?
Why there is different requirement
for taking care of patients?
OR this the only way for ABP to make us work hard enjoy our money and live like Royal
I took board after residency in 1989
And two recertification the 4th time on 12/12/15 I didn’t by few but attended many CME for it
Isn’t passing board exam that many times enough?
I work for FQHC it is mandatory to have the certificate so either I have to pay >$1300 and pass or retire
All I will say shame on ABP
Thank you Meg for your time and exploring ABP
RB
You should get bonus pay for your letter to the ABP. I retired 11/2 years ago because of )Carcinoid Tumor/Syndrome and the overbearing, ridiculous waste of time and money it was taking to support a group of Organizations that are strickly designed to make money for themselves and offer almost no benefit to pediatricians. It would make much more sense for them to pull a sample of records or ask local and Regional peers whether this Doctor is competent. I was AOA and chosen as one of the “Top Docs” in the Midwest by peere who were honored in their field of Pediatrics at Vanderbilt Childrens Hospital and LeBonheur childrens hospital. Bottom line is I agree with all you had to say in your letter and my hat is off to you. Bruce Maley M.D
Dear Dr Meg:I admire your sheepdog behaviour and I adore your style. I was board certified in 1989 and recertification 3 times since that time. In every recertification exam there was at least 2-4 question that are very wrong. In my first recertification in 1998 I have objected to 2 questions that were very wrong and I received an apology from the president of the APB … It was an open book exam and they had to respond but in the next 2 recertification in 2003 and recently in November 2015. I made my notes about 2 more questions but no response was sent ….
I had done 3 years of fellowship in Neonatology in Henry Ford one year and in Chidren hospital of Michigan for 2 years ( 2001-2004). For family reasons and logistic reasons that had to do with visa I was not able to come back and take the neonatology certification board . But I was working as a consultant Neonatologist head of 2 mist busiest Nicu units and had established 2 state of art Nicu units in Saudi Arabia and was teaching Pediatricians Neonatology and many of them became board certified neonatologist and are practicing in USA .
I have kept uptodate with Neonatology and I have been practicing Neonatilogy and Pediattics since 2004 as well as I was already practicing Pediattics since 1989 . I am now 58 years old I have applied to take the Neonatology certification exam this year and I was sent a very insulting letter accusing me of using the title ” Neonatology board eligible ” because the fellowship programs that I was in are not Recognised by ABP …. ???? Not Recognised ???? Although everybody is aware of those programs and the Chief of neonatology fellowship program who I was trained under at Wayne state university was Prof Dr Shankaran :the well known authority in whole body hypothermia treatment for HIE … Even if the programs were ok I still have to do 6 months of supervised training to be able to slt for the neonatology board certification …??!!! I did 36 months of clinical and I have 2 research papers …
Who is going to supervisor me … one of my students that I trained ??? I am 58 years old .. is it possible for me to be able to find a fellowship program to take me for 6 months ????? My fellowship is not approved ???? Where they are getting their information from??? This is the ABP now … I am also fellow of the Royal college of Phycsicians and Sirgeons of Csnada and certified by the RCPS(c) as a Pediatrician and Neonatologist. I strongly again support you very much and I think that the APB is becoming a monster rather than a teaching institution. They should be ashamed of their dictatorship actions and decisions. Let them look to their neiboughs Canada and see what they are doing and learn from them.
I fully support your sheepdog attidute and courage ” I called your stand as a sheepdog stand because it seems to me that the Pediatrician are the sheeps being hunted by ABP wolf. People like you are what we need to keep the wolf of ABP from braying on those poor sheeps Pediatricians and Nrinatologists like me. there must be a way to stop the wolf of ABP… You have started it please keep going and Keep up the excellent work .
Mfed Mostly FAAP., FRCPS(C)
drmosely@gmail.com
Love the message. DO NOT STOP. This has become ridiculous. I am due for my fourth recertification. The only one I found meaningful so far was the home computer exam, open book. Step 4 is ridiculous, and I found myself laughing at the ridiculousness of the modules as I read them. Cut the cost. Cut the waste of time of NUMEROUS people, including all the clerks that now much check this yearly because the ABP will no longer issue a “time limited certificate.”
I am now working Locum Tenens. TRUST me….. people are constantly evaluating my clinical skills.
The credentialing process as I change locations takes me OVER a WEEK to complete the correct forms etc. It is BEYOND burdensome and costly.
Susan
I refused to renew my board certification many years ago, once they added mindless busywork to the process. I haven’t regretted it once. I have saved thousands of dollars, hundreds of hours and endless aggravation. I honestly can’t imagine going back to it, even if they went back to the old and helpful open book format where you could read up about things you didn’t know, as I no longer see the need to spend so much money.
Thank you! The ABIM is nothing but coercion or extortion. It’s particularly shameful what the ABP TAX returns revealed though I suspect the ABIM TAX returns would probably exceed their egregious use of funds. Keep it up!