MOC Archives - Medical Association of the State of Alabama

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MOC UPDATE: A Progress Report

Posted by admin on March 22, 2019

March 22, 2019: The Medical Association is continuing to work with various stakeholders to make improvements in the MOC process, and we would like to offer a progress report from the American Board of Medical Specialties and its Continuing Board Certification: Vision for the Future Commission. The final report is out, and member boards are beginning to implement Commission recommendations.

Perspectives on the Vision Commission Process

Sometimes You Just Don’t Know by Donald Palmisano describes his experience as a member of the Commission and thoughts on the Commission’s final report.

ABMS Member Board innovative assessments gain momentum in 2019

ABMS Member Boards’ Innovative Assessments Gain Momentum in 2019 describes progress by several ABMS Member Boards towards transitioning from traditional exams to longitudinal assessment programs.

Specific ABMS Member Boards mentioned include those representing anesthesiology, family medicine, ophthalmology, orthopaedic surgery, ob/gyn, pediatrics, psychiatry and neurology, radiology, and the seven boards participating in ABMS’ CertLink program – colon and rectal surgery, dermatology, medical genetics and genomics, nuclear medicine, otolaryngology-head and neck surgery, pathology, and physical medicine and rehabilitation.

For those of you wondering, “what’s longitudinal assessment?” – Longitudinal assessment approaches involve shorter assessments of specific content repeatedly over a period of time and often online, combining principles of adult learning with modern technology to promote learning, retention, and transfer of information. (For example, the ABA MOCA Minute includes 30 questions per calendar quarter, delivered through email, portal, or app.) Through this process, concepts and information are reinforced so that knowledge is retained and accumulated gradually. Overall, these programs allow physicians to assess their knowledge, fill knowledge gaps, and demonstrate their proficiency. They may offer both time and cost savings to board-certified physicians by reducing or eliminating the need for study courses, travel to exam centers, and time away from practice.

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MOC Update: ABMS Plans Implementation of Board Certification Recommendations

Posted by admin on March 14, 2019

March 12, 2019 CHICAGO – The American Board of Medical Specialties (ABMS) Board of Directors plans to address the recommendations shared in the Continuing Board Certification: Vision for the Future Commission’s final report. Presented to the ABMS Board in mid-February, the Commission’s final report is the culmination of research, testimony and public feedback from stakeholders throughout the Boards and greater health care communities. The Commission took all of this input into consideration, developing a set of recommendations to help continuing certification evolve into a meaningful and relevant program bringing value to a physician’s practice and meeting the highest standard of quality patient care.

The ABMS Board reviewed the Commission’s final report in detail during its February meeting, assessing how best to address the recommendations outlined. The Board agreed to the following as necessary first steps in implementing the Commission’s findings:

Establishment of the “Achieving the Vision for Continuing Board Certification” Oversight Committee charged with directing the implementation strategy. This committee will seek guidance from the ABMS’ new Stakeholder Council and various stakeholders in the continuing certification process throughout the implementation.
Creation of the following four Collaborative Task Forces that will include representatives from professional and state societies and other external stakeholders, focusing on the following areas identified in the Commission’s report:

o Remediation pathways
o Professionalism
o Advancing Practice
o Information and Data Sharing

Agreement of all 24 ABMS Member Boards to commit to longitudinal or other formative assessment strategies and offer alternatives to the highly-secure, point-in-time examinations of knowledge.
Commitment by ABMS to develop new, integrated standards for continuing certification programs by 2020. The standards will address the Commission recommendations for flexibility in knowledge assessment and advancing practice, feedback to diplomates and consistency.
Establishment of a meeting of the ABMS/Council of Medical Specialty Societies joint Board Leadership to ensure full specialty society engagement in building the road map defined by the Commission report especially with regard to the role of continuing certification in advancing clinical practice.

The Commission’s report affirmed that it is the role of the Boards to make summative decisions about continuing the certification of a physician based on a portfolio of information. However, the Commission called for the Boards to create formative processes that offer opportunities for learning and improvement as well as remediation when necessary before summative decisions are made. And, while the report itself didn’t comment directly on the work the Boards have already undertaken to enhance their programs, many of the Commission’s recommendations affirmed those actions, most notably those referencing alternative formative assessment strategies and improving communications with key stakeholders and diplomates.

The Medical Association has been active on the MOC issue, through both its MOC Study Committee and advocacy at the national and state levels. Below is the official statement on the “Vision Initiative” from MOC Study Committee Chairman Dr. Greg Ayers:

“The Medical Association of the State of Alabama’s MOC Study Committee supports a voluntary process for board certification in medical specialties and a departure from the sometimes punitive approach toward certification taken by some American Board of Medical Specialties’ specialty boards. This process must maintain high standards for professionalism and encourage lifelong learning that is clinically relevant to patient care within physicians’ individual practices. The MOC Study Committee believes the ABMS various specialty boards should continue efforts to improve upon and ensure inexpensive, accessible options for increasing the breadth and scope of physicians’ skills and knowledge so they may best serve their patients; however, those efforts should never, of themselves, hinder, obstruct nor supersede the actual provision of care. The ABMS Boards should collaborate to pursue implementation of reciprocal, longitudinal pathways for multi-specialty diplomates. The continuing physician specialty certification process of the future should not include the current high-stakes examination and burdensome, duplicative components of Maintenance of Certification. Given physicians’ support for self-regulation, the MOC Study Committee calls upon the ABMS Boards to fulfill its duty to administer specialty board certification in a manner that assists physicians in continuing to improve the quality of care patients receive.”

Greg Ayers, M.D., Chairman, MOC Study Committee

Tags: ABMS, ayers, certification, diplomates, MOC

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MOC Study Committee’s Official Statement on “Vision Initiative” Draft Report

Posted by admin on January 17, 2019

In response to the Medical Association and other state and national medical and physician specialty societies’ grievances with ABMS, its member Boards, and specifically the MOC program, ABMS sought input from a broad range of stakeholders in an effort to envision and craft a board certification system that is responsive and meaningful to physicians. This effort has included professional medical organizations, national specialty and state medical societies, hospitals and health systems and others. The group released its vision for the future of board certification – dubbed the “Vision Initiative.”

The Medical Association has been active on the MOC issue, through both its MOC Study Committee and advocacy at the national and even state levels. Below is the official statement on the “Vision Initiative” from MOC Study Committee Chairman Dr. Greg Ayers:

“The Medical Association of the State of Alabama’s MOC Study Committee supports a voluntary process for board certification in medical specialties and a departure from the sometimes punitive approach toward certification taken by some American Board of Medical Specialties’ specialty boards. This process must maintain high standards for professionalism and encourage lifelong learning that is clinically relevant to patient care within physicians’ individual practices. The MOC Study Committee believes the ABMS various specialty boards should continue efforts to improve upon and ensure inexpensive, accessible options for increasing the breadth and scope of physicians’ skills and knowledge so they may best serve their patients; however, those efforts should never, of themselves, hinder, obstruct nor supersede the actual provision of care. The ABMS Boards should collaborate to pursue implementation of reciprocal, longitudinal pathways for multi-specialty diplomates. The continuing physician specialty certification process of the future should not include the current high-stakes examination and burdensome, duplicative components of Maintenance of Certification. Given physicians’ support for self-regulation, the MOC Study Committee calls upon the ABMS Boards to fulfill its duty to administer specialty board certification in a manner that assists physicians in continuing to improve the quality of care patients receive.”

Greg Ayers, M.D., Chairman, MOC Study Committee

For more information, see also:

MOC UPDATE: Working to Solve Problems with Certification

Tags: ABMS, board, MOC, specialty

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MOC Update: Two Certification Programs Transition from Pilot to Permanent

Posted by admin on May 23, 2018

Last year, the Medical Association worked to bring together physicians, medical organizations, state medical societies, hospitals, health systems, patients and the American Board of Medical Specialties to investigate the future of board certification. The first in-person meeting in March produced testimony on continuing certification from stakeholders who provided their perspectives and experiences with continuing certification, the challenges they currently face, and their thoughts about opportunities about the future. Now, the pilot certification programs for two medical specialty organizations has become permanent.

In May, the American Board of Obstetrics and Gynecology and the American Board of Anesthesiology each received notification from the ABMS that their respective Maintenance of Certification pilot programs have been made permanent options for specific members of their groups who reach specific standards.

American Board of Obstetrics and Gynecology

The MOC pilot program is now a permanent option for ABOG Diplomates. If Diplomates meet the high-performance threshold determined by ABOG on the Part II: Lifelong Learning and Self-Assessment component in Years 1-6 of the MOC cycle, they can receive credit for meeting the MOC external assessment requirement. Diplomates must also continue to meet other MOC standards, including the annual MOC Professionalism and Professional Standing requirements. Upon entering Year 6, Diplomates will receive notification they qualify for the new pathway on their personal page in the ABOG physician portal if they have met all requirements. Diplomates that do not meet the eligibility requirements will continue to meet the external assessment standard by passing the MOC examination.

ABOG members can read the full statement here.

American Board of Anesthesiology, Inc.

The American Board of Anesthesiology’s MOCA Minute pilot is now a permanent component of the Maintenance of Certification in Anesthesiology™ (MOCA®) program. MOCA Minute launched in 2014 as a web-based tool that was expanded in 2016 to include most Diplomates. In 2017 those maintaining subspecialty certificates began participating as well. Diplomates answer 30 multiple-choice questions online each calendar quarter (120 per year) at their convenience. Their questions are customized based on which certificate(s) physicians are maintaining and their practice profile, which they fill out indicating the focus of the clinical practice. Upon answering questions, they learn immediately if their answers are correct and see the rationale, a critique and links to learning resources related to the questions.

ABA members can read the full statement here.

Tags: ABMS, anesthesia, anesthesiology, GYN, MOC, OB

Posted in: Education

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MOC UPDATE: Working to Solve Problems with Certifications

Posted by admin on March 28, 2018

UPDATE DEC. 12, 2018: The Continuing Board Certification: Vision for the Future Commission has released its draft report for public comment. The report, which includes the Commission’s key findings and recommendations, will be posted on the Vision Initiative website for comment through Tuesday, Jan. 15, 2019 at 11:00 p.m. CST.

The Medical Association remains committed to working with the American Board of Medical Specialties and its 24 Member Boards to improve the continuing certification process so that it becomes a system that demonstrates the profession’s commitment to professional self-regulation, offers a consistent and clear understanding of what continuing certification means, and establishes a meaningful, relevant and valuable program that meets the highest standard of quality patient care. The Boards will seriously consider the Commission’s findings and recommendations once finalized, as they continue implementation of improvements and pilots currently underway.

UPDATE JULY 20, 2018: The Continuing Board Certification: Vision for the Future or “Vision Initiative” is a collaborative effort that brings together multiple stakeholders to envision a system that is responsive to the needs of those who rely on it and that is relevant, meaningful and of value to physicians. The Vision Initiative includes physicians, professional medical organizations, national specialty and state medical societies, hospitals and health systems, the general public and patients, and the 24 Member Boards of the American Board of Medical Specialties.

The Vision Initiative held in-person meetings in March and May to solicit testimony from ABMS member boards, national specialty and state medical societies, key stakeholders, and the public regarding their perspectives on the continuous certification system as well as innovations and possible changes.

Here is a summary of the March and May meetings for your information.

Upcoming meetings, to be held August 29-30 and October 15-16 will discuss solutions in relation to MOC. (See timeline.) A draft report for public comment is anticipated in November 2018, with a final report from the Commission to ABMS due February 2019.

Interested medical societies can sign up for monthly updates to follow the Commission’s progress and be notified about opportunities for feedback and input at this link.

UPDATE APRIL 20, 2018: The Continuing Board Certification: Vision for the Future Commission is continuing its quest to bring together physicians, medical organization, state medical societies, hospitals, health systems, patients and the ABMS to investigate the future of board certification and recently hosted its first in-person meeting in March in Washington, D.C. Commission members heard testimony on continuing certification from stakeholders who provided their perspectives and experiences with continuing certification, the challenges they currently face, and their thoughts about opportunities about the future. The presentation components of the meeting were open to the public and video streamed for all to view live.

HOW CAN YOU PARTICIPATE? The Commission launched a stakeholder survey in February, which will remain open until May 11. Complete the survey, share the link with your colleagues, and urge them to participate as well. TAKE THE SURVEY

The next Commission meeting will be held May 30 – June 1. The meeting will feature sections open to the public and will be live video streamed. Details regarding the agenda and live streaming will be featured in next month’s update and posted on visioninitiative.org. Please make sure to bookmark the site for access to Commission meeting information, progress updates, and opportunities for your feedback and input, and remember to share this update with your colleagues and encourage them to become involved in the process as well.

The Medical Association continues to work with the American Board of Medical Specialties concerning physician frustrations with the current Maintenance of Certification process. Late last year, Association Executive Director Mark Jackson and Council on Medical Service member Jeff Rickert, M.D., joined representatives from other state medical societies and individual specialty boards for a meeting with the ABMS in Chicago, which included discussions about innovations the medical boards are working on to address continuous learning for physicians, many of which include input from various outside stakeholders and focus on greater consistency amongst the medical boards.

Following the Association’s Annual Governmental Affairs Meeting in Washington in February where Richard Hawkins, President and Chief Executive Officer of ABMS, was a guest speaker, the organization issued a statement as an update on the progress of issues of concern to physicians about Maintenance of Certification.

As a result of these meetings, and other meetings initiated by State Medical Societies, the Continuing Board Certification: Vision for the Future was formed as a collaborative effort bringing together physicians, medical organization, state medical societies, hospitals, health systems, patients and the ABMS to investigate the future of board certification.

The Commission invites input from all stakeholders. To participate in the discussion, you may provide comments to inform the future of board certification, learn how you can engage in the process, and sign up for monthly email updates from the Commission. LEARN MORE

Tags: ABMS, board, certification, maintenance, MOC

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ABMS Issues Statement about MOC Update

Posted by admin on February 2, 2018

Following the Medical Association’s Annual Governmental Affairs Meeting in Washington earlier this week where Richard Hawkins, President and Chief Executive Officer of the American Board of Medical Specialties, was a guest speaker, ABMS issued a statement as an update on the progress of issues of concern to physicians about Maintenance of Certification.

Late last year, frustrations with the current Maintenance of Certification process brought the Medical Association and representatives from other state medical societies and individual specialty boards to Chicago for a series of meetings with the American Board of Medical Specialties to discuss physician frustration with the MOC process. Leadership within ABMS and the specialty boards engaged in meaningful dialogue during the meeting with promises to address criticisms of the current MOC process.

As part of the ABMS statement, the organization vowed to continue to work closely with physician organizations to improve the certification process. The release included the following action statements:

To make testing more relevant to practice, Boards have modularized the exam in specific practice areas and given their diplomates more flexibility over the scope and frequency of assessment;
To eliminate the indirect costs of participation, Boards have modernized the assessment through convenient on-line testing or remote proctoring, eliminating the need for preparation courses, travel to exam centers, and time away from practices;
To simulate real-life application of knowledge and decision making, some Boards now permit the use of reference materials during the exam;
To assure that knowledge assessments help participating physicians to identify gaps in knowledge and guide their learning, assessments are accompanied by timely, actionable feedback;
To increase alignment between MOC and other quality and safety programs, a much wider variety of practice-based learning and improvement activities are now recognized, including those offered through hospitals, specialty societies, and state medical societies.
To assure opportunities for remediation of knowledge gaps, all Boards provide multiple opportunities for physicians to retake the exam.

Meanwhile, the entire Boards Community has:

Initiated a major redesign of ABMS governance to increase Board accountability and provide an ongoing opportunity for participating physicians to directly impact ABMS programs and policy;
Initiated the development of organizational standards to increase operational consistency, transparency and effectiveness across the Boards; and
Launched the Continuing Board Certification – Vision for the Future initiative to gather broad input about continuing certification from a wide range of stakeholders (especially physicians who spend most of their time in practice), consider alternatives, and make recommendations for the future.

Read the full statement here.

Read how the Medical Association has been working to ease MOC frustrations for our members.

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Medical Association Works to Ease MOC Frustrations

Posted by admin on December 14, 2017

Frustrations with the current Maintenance of Certification process brought together Medical Association Executive Director Mark Jackson and Council on Medical Service member Jeff Rickert, M.D., and representatives from other state medical societies and individual specialty boards for a series of meetings with the American Board of Medical Specialties.

The daylong meeting in Chicago was called at the request of state medical societies, including the Medical Association, who have expressed increasing frustration with the MOC process and have demanded changes be made. Leadership within ABMS and the specialty boards engaged in meaningful dialogue during the meeting with promises to address criticisms of the current MOC process.

Discussions included 170 innovations the medical boards are working on to address continuous learning for physicians, many of which include input from various outside stakeholders and focus on greater consistency amongst the medical boards. Innovations also include alternatives to the high-stakes exams with a focus on longitudinal learning for physicians in their relevant practice areas. Many medical boards outlined current (or moving to) learning modules that would be seamless for physicians and provide a gap analysis. Most medical boards seemed to be moving away from the high-stakes examination that has been the challenge of the physicians. There was also discussion by some of the medical boards on reducing the fees collected from physicians for the tests and the need to be more customer friendly.

The Medical Association’s Board of Censors created MOC study committee to fully examine the MOC issue and provide feedback to the Board. Dr. Rickert is a member of this committee and will provide input in the coming weeks as the committee discusses recommendations to the Board of Censors.

Tags: ABMS, certification, MOC, specialty

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Medical Association’s 2018 State and Federal Agendas

Posted by admin on December 13, 2017

The Medical Association Board of Censors has met and approved the Association’s 2018 State and Federal Agendas. These agendas were developed with guidance from the House of Delegates and input from individual physicians. As the Alabama Legislature and U.S. Congress begin their work for 2018, additional items affecting physicians, medical practices and patients may be added to this list.

Download the Medical Association’s 2018 State and Federal Agendas (PDF)

2018 STATE AGENDA

The Medical Association supports:

Ensuring legislation “first do[es] no harm”
Extending the Medicaid payment bump for primary care to all specialties of medicine
Eliminating the health insurance-coverage gap for the working poor
Ensuring fair payment for patient care and reducing administrative burdens on physicians and medical practices
Strengthening existing tort reforms and ensuring liability system stability
Empowering patients and their doctors in making medical decisions
Continued physician compounding, dispensing of drugs
The same standards and reimbursements for telehealth and face-to-face visits
Training, education and licensing transparency of all individuals involved in patient care
Continued self-regulation of medicine over all areas of patient care
Increased state funding to upgrade the Prescription Drug Monitoring Program to a useful tool for physician monitoring patients at risk for drug interactions and overdose potential
Using data analytics to combat the drug abuse epidemic by strengthening research capabilities of pre-approved, de-identified prescription information
Maintaining the Alabama Department of Public Health as the repository for PDMP information to ensure continuity for prescribers and dispensers and security for patients
Standard opioid education in medical school so the physicians of tomorrow are prepared to face the realities and responsibilities of opioid prescribing

The Medical Association opposes:

The radical Patient Compensation System legislation
Legislation/initiatives increasing lawsuits against physicians
Non-physicians setting standards for medical care delivery
Tax increases disproportionately affecting physicians
Expanding access to the Prescription Drug Monitoring Program (PDMP) for law enforcement
Statutory requirements for mandatory PDMP checks
Further expansion of Maintenance of Certification (MOC) requirements
Changes to workers’ compensation laws negatively affecting treatment of injured workers and medical practices
Any scope of practice expansions that endanger patients or reduces quality of care
Biologic substitution legislation that allows lower standards in Alabama than those set by the FDA that doesn’t provide immediate notifications to patients and their physicians when a biologic is substituted, and that increases administrative burdens on physicians and medical practices

2018 FEDERAL AGENDA

The Medical Association supports:

Meaningful tort reforms that maintain existing state protections
Reducing administrative and regulatory burdens on physicians and medical practices
Repeal of the Affordable Care Act and replacement with a system that:
- Includes meaningful tort reforms that maintain existing state protections
- Preserves employer-based health insurance
- Protects coverage for patients with pre-existing conditions
- Protects coverage for dependents under age 26
- With proper oversight, allows the sale of health insurance across state lines
- Allows for deducting individual health insurance expenses on tax returns
- Increases allowed contributions to health savings accounts
- Ensures access for vulnerable populations
- Ensures universal, catastrophic coverage
- Does not increase uncompensated care
- Does not require adherence with insurance requirements until insurance reimbursement begins
- Reduces administrative and regulatory burdens
Overhauling federal fraud and abuse programs
Reforming the RAC program
Prescription drug abuse education, prevention and treatment initiatives
Allowing patient private contracting in Medicare
Expanding veterans’ access to non-VA physicians
Reducing escalating prescription drug costs
A patient-centered MACRA framework, including non-punitive and flexible implementation of new MIPS, PQRS and MU requirements
Congressional reauthorization of CHIP (Children’s Health Insurance Program) at the current enhanced funding level
Better interstate PDMP connectivity
Eliminating “pain” as the fifth vital sign
Repealing the “language interpreters” rule
Requiring all VA facilities, methadone clinics and suboxone clinics to input prescription data into state PDMPs where they are located

The Medical Association opposes:

Non-physicians setting standards for medical care delivery
Publication of Medicare physician payment data
National medical licensure that supersedes state licensure
Legislation/initiatives increasing lawsuits against physicians

Tags: adph, agenda, bump, burden, certification, CHIP, compensation, drug, educate, federal, legislative, liability, license, licensure, MACRA, maintenance, Medicaid, MIPS, MOC, monitor, MU, opioid, PDMP, PQRS, prescription, reimburse, specialty, state, telehealth, train

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Association Voices Concern with MOC in Letter to ABMS

Posted by admin on August 18, 2017

Earlier this year, the Association’s House of Delegates passed a resolution formally opposing additional Maintenance of Certification requirements as dictated by the American Board of Medical Specialties and the American Osteopathic Association. While it was agreed that the need for continuing medical education to improve the quality of care, the expense and clinically irrelevant process of MOC often proved overly burdensome. Now, the Association has joined with other state associations to send a message to ABMS expressing concerns about MOC and have requested a meeting later this year to discuss the issues.

As discussions concerning MOC mounted during the June AMA meeting, a small group of national medical specialty society and state medical society CEOs furthered the discussion with a high-level summit that recently took place to discuss these problems, and a meeting this December with the American Board of Medical Specialties, the Council of Medical Specialty Societies, and state medical societies to directly share our views and seek agreement on how to reshape the MOC process to the betterment of our physicians and the patients in their care.

In the letter to ABMS, the groups were quick to explain that the intention is not to diminish patient care or physician training. However, the letter addressed that not only had many state legislatures addressed the issue of maintenance of certification either successfully passing new laws or laws that were pending but that this trend of legislative interference was another threat to a physician’s right to professional self-regulation. Along with the exorbitant costs of the MOC process and the lack of transparent communication from certifying boards have damaged the integrity of the MOC brand, all of which presents an opportunity to realign the process.

The Medical Association has begun to address this situation, and with the formation of this new joint initiative, will continue to be active in discussions to create a long-term solution for MOC. The joint meeting is currently scheduled for early December.

Read the letter to ABMS

Tags: ABMS, certification, maintain, MOC

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House of Delegates Pass Policy Opposing Further Imposition of MOC

Posted by admin on June 2, 2017

During Annual Session, the Medical Association’s House of Delegates passed a resolution formally opposing additional Maintenance of Certification requirements as dictated by the American Board of Medical Specialties and the American Osteopathic Association. While it was agreed that the need for continuing medical education to improve the quality of care, the expense and clinically irrelevant process of MOC often proved overly burdensome.

MOC is designed to show that once a physician’s formal training is over, they are continuing to practice lifelong learning by continuing to challenge themselves to keep up with the latest developments in their chosen field. However, while physicians do support efforts to improve the quality of care of their patients, physicians have argued for years that MOC is overly expensive and often clinically irrelevant to everyday practice.

For example, the American Board of Internal Medicine has long required internists to pass Maintenance of Certification exams every 10 years to keep their board-certified status. However, this policy has recently come under scrutiny due to its high burden to doctors and the lack of sound evidence that recertification processes improve doctors’ quality of care. The ABIM announced it would offer a new assessment option starting in January 2018, allowing doctors to be recertified through shorter, but more frequent, assessments. But it’s not clear that this will make much difference.

To alleviate some burden on our physicians, the Medical Association’s Counsel on Medical Services studied the need for MOC and presented a formal resolution to the House of Delegates during Annual Session in April. The resolution, which passed, created a formal policy to oppose adding any further requirements for MOC as a condition of licensure, reimbursement, employment or admitting privileges at a hospital.

Tags: advocacy, education, MOC

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